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Biomedical subjects

L Bernhard

Publications and source records attributed to L Bernhard.

8 recordsLinked to original sources
PubMed2002

The efficacy of prophylactic outpatient antibiotics for the prevention of neutropenic fever associated with high-dose etoposide (VP-16) for stem cell mobilization.

High-dose etoposide (2 g/m(2)) plus G-CSF is a very effective regimen for peripheral blood progenitor cell (PBPC) mobilization. Unfortunately, neutropenia is common. The infectious complications associated with high-dose etoposide have not been previously described. After noting a high incidence of hospitalizations for neutropenic fever, we began a vigorous prophylactic antibiotic regimen for patients receiving high-dose etoposide plus G-CSF, attempting to reduce infectious complications. Ninety-eight patients underwent etoposide mobilization between December 1997 and June 2000. Three chronological patient groups received: (1) no specific antibiotic prophylaxis (n = 44); (2) vancomycin i.v., cefepime i.v., clarithromycin p.o., and ciprofloxacin p.o. (n = 27); and (3) vancomycin i.v., clarithromycin p.o., and ciprofloxacin p.o. (n = 27). The patients not receiving antibiotic prophylaxis had a 68% incidence of hospitalization for neutropenic fever. In the patients receiving prophylaxis, the incidence was reduced to 26% and 15% respectively, for an overall incidence of 20% (P < 0.001 for comparison between prophylaxed and unprophylaxed groups). We conclude that etoposide mobilization is associated with a significant incidence of neutropenic fever, which can be substantially reduced by a vigorous antimicrobial prophylactic program.

Ambulatory Care↗
PubMed2002

A multivariable analysis of factors influencing mucositis after autologous progenitor cell transplantation.

Mucositis is a common and vexing complication of autologous progenitor cell transplantation (ABMT). A modified oral mucositis assessment scale (OMAS) has been found to be a reproducible and effective tool for monitoring mucositis after radiation therapy or chemotherapy. We utilized the modified OMAS scale to study clinical parameters associated with the development of mucositis in 79 patients undergoing ABMT. Median patient age was 52; 61% had non-Hodgkin's lymphoma (NHL), 23% multiple myeloma and 14% Hodgkin's disease. Patients were mobilized with G-CSF alone or the combination of etoposide plus G-CSF. Univariable correlates of worse mucositis were prior radiation therapy (P = 0.004), a diagnosis of NHL (P = 0.014), progenitor cell mobilizing regimen containing etoposide (P = 0.001), and ABMT preparative regimen containing etoposide (P = 0.006). Multivariable regression analysis revealed that NHL diagnosis (P = 0.007), prior radiation therapy (P = 0.001), and etoposide in the mobilizing regimen (P = 0.034) were associated with worse post-transplant mucositis. Worsening mucositis correlated with a longer inpatient length of stay. We conclude that several variables contribute to worsening mucositis during autologous transplantation, including etoposide in the progenitor cell mobilizing regimen.

Etoposide↗
PubMed2000

Continuous handrail support, oxygen uptake, and heart rate in women during submaximal step treadmill exercise.

Past research suggests that continuous handrail support during exercise attenuates physiologic responses to exercise and reduces aerobic benefits; however, this phenomenon has not been systematically studied in women exercising on the step treadmill. The effects of three levels of handrail support (continuous light, continuous very light, or no handrail support) on oxygen uptake and heart rate during step treadmill exercise were examined in 15 healthy women. Measures were obtained during 6 bouts of exercise, 3 bouts at 25 steps/min followed by 3 bouts at 33 steps/min. At both step rates, mean oxygen uptake was significantly reduced during continuous light and continuous very light handrail support as compared with no handrail support, and mean heart rate was significantly reduced during continuous light versus no handrail support. At 25 steps/min only, mean heart rate was significantly reduced during continuous very light versus no handrail support. Findings indicate that women who use even continuous light or continuous very light handrail support attenuate physiologic responses during step treadmill exercise, thereby reducing aerobic requirements and gaining suboptimal benefits from exercise.

Adult↗
PubMed1991

[Interlocking central medullary nailing of recent femoral and tibial fractures. Statistical study apropos of 835 cases].

Kuntscher's conventional closed intra-medullary nailing represents a good procedure in the treatment of diaphyseal fractures of the femur and the tibia but had a very restricted area (the midshaft) of indications. Thanks to the interlocking technic which consists in the fixation of the nail to the bone by means of transfixing screws either in a static or in a dynamic procedure, the method can be extended to fractures localised between both epiphysis of the long bones. After a first period between 1974 and 1983 of development of the method summarized in a first statistic, a second study was performed between 1984 and 1989 in the Center of Traumatology of Strasbourg with 837 cases of fresh fractures of the femur (385) and the tibia (397) treated by locked intra-medullary nailing. In two third of the cases the procedure was static and in one third it was dynamic. Full weight bearing was allowed in a mean period of 60 days. On the femur (371 closed and 65 open fractures), we had noted 8 infections out of which 2 deep infections (0.45%), 5 non unions, 25 moderate malunions in varus and 18 in valgus. On the tibia (267 closed and 132 open fractures) we had observed 15 deep infections (3.7%) out of which 9 (2.2%) after open fractures, 15 non unions (3.7%), 22 compartment syndroms, 6 mal unions in varus and 54 malunions in valgus greater than 5 degrees out of which 15 greater than 10 degrees.

Adult↗
PubMedDate not supplied

Health-promoting behaviors of African American women.

Limited information exists concerning health behaviors of African American women. The purposes of this study were to describe health-promoting lifestyle behaviors among a sample of 187 African American women and to compare findings to other published reports on the Health-Promoting Lifestyle Profile (HPLP) instrument. Subscales with the highest means in this study were interpersonal support and self-actualization. However, when compared to reports of HPLP scores for other groups, total HPLP and subscale scores of women in this study were generally lower. Readability and applicability of the HPLP instrument may affect its validity and reliability in a diverse sample.

Adolescent↗