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Biomedical subjects

M Kurz

Publications and source records attributed to M Kurz.

At least 73 records · Page 4Linked to original sources
PubMed1995

Platelet disorders in uraemia before and after haemodialysis under the influence of low dose aspirin.

Thrombocyte dysfunction and increased bleeding time (BT) are well documented in uraemic patients. However, these patients are frequently medicated with low dose aspirin (ASA) in order to maintain shunt patency and prevent cardiovascular events. Recently, life- threatening gastrointestinal haemorrhage in an uraemic subject taking low dose aspirin has been reported. In this work ASA related bleeding risk in uraemic patients and the effect of haemodialysis on their bleeding tendency was studied by measuring in vitro bleeding time (BT) using the Thrombostat 4000 in 34 uraemic patients on chronic haemodialysis compared to 50 healthy subjects. Our results indicate that low dose aspirin does not influence uraemic thrombopathia 8 to 10h after ingestion but seems to increase bleeding risk shortly after ingestion. Moreover, haemodialysis alters uraemic in vitro BT with regard to the time after ingestion of ASA.

Adult↗
PubMed1995

Extrapyramidal side effects of clozapine and haloperidol.

Neuroleptic-induced extrapyramidal side effects (EPS) were evaluated in 92 patients treated with clozapine for the first time and 59 patients treated with haloperidol followed in a drug monitoring program. Side effects were measured by the Columbia University Rating Scale, the Simpson Dyskinesia Scale and the Hillside Akathisia Scale. The cumulative incidence rate for tremor was found to be 24.4% in the clozapine group and 39.3% in the haloperidol group. This did not amount to a statistically significant group difference. Bradykinesia was observed in 21.8% of the patients treated with clozapine and in 47.7% of the patients of haloperidol (P = 0.011). In the clozapine group the akathisia incidence rate was 5.6%, whereas haloperidol patients showed a higher rate of 31.7% (P = 0.005). Our results show higher incidence rates of tremor and bradykinesia during clozapine treatment than previous studies. We conclude that clozapine is not entirely free of EPS, but they are usually less severe and of a different quality than side effects induced by typical antipsychotics.

Adult↗
PubMed1995

Weight gain induced by clozapine.

Patients were investigated to gain more insight into the incidence and time course of clozapine induced weight gain (n = 81) and to compare weight gain in patients treated with clozapine (n = 31) with that of patients treated with standard antipsychotics (haloperidol, n = 11). 35.7% of the patients treated with clozapine gained weight according to our definition. If patients gained weight on clozapine this side effect was apparent within the first 12 weeks of treatment. Deviation from normal body weight at the beginning of treatment showed a significant influence on weight gain. Sex, severity of illness, comedication, mean clozapine dose and degree of improvement did not show an influence on this side effect. Weight increase was significantly higher in patients treated with clozapine than in patients treated with haloperidol.

Adult↗
PubMed1995

New semisynthetic glycopeptides MDL 63,246 and MDL 63,042, and other amide derivatives of antibiotic A-40,926 active against highly glycopeptide-resistant VanA enterococci.

A series of amide derivatives of natural glycopeptide A-40,926 (A), its 6B-methyl ester (MA) and 6B-decarboxy-6B-hydroxymethyl derivative (RA) were prepared with the aim of obtaining activity against glycopeptide-resistant enterococci. These compounds are structurally related to a class of amides of 34-de(acetylglucosaminyl)-34-deoxy teicoplanin which showed interesting activity against strains of Enterococcus faecalis and E. faecium highly resistant to both vancomycin and teicoplanin. Among them, RA-amides MDL 63,246 and MDL 63,042 were the most active derivatives against several Gram-positive bacteria, including VanB and VanC enterococci, and were moderately active (MIC range 0.5 approximately 64 micrograms/ml) against strains of Enterococcus for which vancomycin and teicoplanin MICs were > or = 128 micrograms/ml. The chemical rationale and the synthesis of these new series of glycopeptide derivatives are described. Preliminary in vitro data are reported and structure-activity relationships are discussed.

Anti-Bacterial Agents↗
PubMed1995

A comparison of European and American dosing regimens of schizophrenic patients on clozapine: efficacy and side effects.

We present a comparison of the results from two studies of patients on clozapine. The American study (n = 84; Hillside Hospital, Glen Oaks, NY) and the European study (n = 63; Innsbruck University Clinics, Innsbruck, Austria) both examine efficacy and side effects in schizophrenic patients on this atypical neuroleptic. There is a very substantial difference in the dosing regimen used on both continents and this is reflected in the studies reported. A question with major clinical implications is whether the higher doses commonly used in the United States lead to a better outcome or a different profile of side effects. Outcome as a function of serum concentration will be examined. Results confirm a lower dose, lower clozapine blood level, and a lesser degree of side effects in the Austrian cohort when compared to the American sample. Surprisingly, the clinical efficacy of the lower dosing regimen was superior to the higher dose. Reasons for this anomaly are explored.

Adult↗
PubMed1995

[Satisfaction of paid thrombocyte donors with instrumental thrombocytapheresis].

OBJECTIVE: The increasing need for single-donor platelet concentrates makes it necessary to motivate platelet donors to donate regularly. The authors examined the contentment of existing donors in order to create a basis for improvements and to raise the attractiveness of donation. DESIGN: Open empirical data acquisition. SETTING: Institute for Transfusion Medicine at the General Hospital Vienna. PARTICIPANTS: 211 platelet donors. INTERVENTIONS: Interview with a self-developed questionnaire. RESULTS: Whereas donors rate the work of the staff as being very good, they are less content with the surroundings in the pheresis unit. Younger and higher-educated donors as well as persons who have been donating for less than 5 years show more negative ratings than comparable groups. The financial compensation is important to ensure a high donation frequency. CONCLUSIONS: The attractiveness of donation could be raised by improving certain aspects of donation. In order to ensure a high donation frequency donors should be granted a financial compensation, as otherwise particularly younger donors, who are more likely to be seronegative for antibodies to CMV, would not donate any more or at least not that often.

Adult↗
PubMed1995

[Tandem transplantation with peripheral autologous hematopoietic blood stem cells in treatment of oncologic and hematologic malignancies. Initial results of the Donauspital, Vienna].

10 patients were subjected to tandem transplantation for breast cancer (n = 3), ovarian cancer (n = 2) and multiple myeloma (n = 5), at the Second Department of Medicine, Donauspital, Vienna. The breast cancer patients were in stages 2 and 3, respectively, at diagnosis and entered complete remission thereafter. 2 of them developed lymph node metastasis and additional local recurrence, the 3rd patient presented with distant metastasis. The 2 patients with ovarian cancer were in stages Figo III and IV, respectively, at the time of diagnosis, and showed minimal residual disease at second-look-operation. 5 patients with multiple myeloma were in stage 3 pretransplant. Peripheral stem cells were obtained after either high-dose cyclophosphamide or FEC induction and application of cytokines. In 4 patients, tandem transplantation has been completed. 1 patient with multiple myeloma, who had received total body irradiation in combination with chemotherapy for the 2nd transplant, succumbed from idiopathic interstitial pneumonia. No severe clinical complications were observed in all other patients. All patients with solid tumors entered complete remission after the 1st transplantation. 3 of them completed tandem transplantation. Of these, 2 remain in continuous complete remission, the 3rd patient relapsed in lymph nodes day 485. In patients who received only 1 course of high dose chemotherapy with stem cell transplantation, relapses occurred on days 29 and 75, respectively. All patients with multiple myeloma entered only partial remission. We conclude that supralethal chemotherapy with peripheral blood stem cell support is a safe procedure that may at least induce prolonged remissions in solid tumors and hematologic malignancies.(ABSTRACT TRUNCATED AT 250 WORDS)

Austria↗
PubMed1994

Formation of multiple complexes between actinomycin D and a DNA hairpin: structural characterization by multinuclear NMR.

The solution conformations of a DNA oligomer and its complexes with the anticancer drug actinomycin D (ActD) were characterized using homo- and heteronuclear NMR techniques. Previous high-resolution NMR investigations of ActD-DNA complexes employed symmetric double-stranded DNA oligomers, yielding two identical symmetry-related complexes. In order to understand the important effects that neighboring base pairs and/or unusual nucleic acid structures may have on ActD binding specificity and orientation, we chose to study the oligonucleotide d(TCGCGTTTTCGCGA), which adopts a hairpin structure in solution. NOE cross-peak intensities were used to generate distance constraints for molecular dynamics simulations and structure determinations of the free oligonucleotide and for both complexes. A total of 86 intermolecular NOEs were identified for each complex, 27 of which involve exchangeable protons. These intermolecular NOEs along with changes in the phosphorus chemical shifts were used to determine the drug binding site on the DNA. As expected, ActD intercalated exclusively at the single d(GC) step in the DNA hairpin. Interestingly, although the two complexes, which differ by the orientation with which the asymmetric drug chromophore intercalates the DNA, were not formed in equal concentrations, their conformations are very similar. The RMS difference of the DNA hairpin in the two complexes is only 1.10 A. The structures of the minor groove binding pentapeptide rings are not affected by any of the changes in the normal double-helical structure imposed by the hairpin loop. The total pairwise RMS difference over all atoms for the four peptides (two per complex) in the calculated structures is 0.72 A. Conversely, the structure of the hairpin loop is not appreciably changed upon binding--the RMS difference between the free DNA loop region and the loop region in the two complexes is 1.68 A and only 0.43 A between the two complexes. Our data also support a possible conformation of the d(T)4 loop that does not possess a thymine-thymine "wobble" base pair.

Amino Acid Sequence↗
PubMed1994

PLT-30: an improvement for platelet collection on the Baxter CS-3000 Plus.

The CS-3000 is a well-established blood cell separator. To increase the efficiency of platelet collection, Baxter developed a new separation chamber, the TNX-6, for the follow-up model of the CS-3000, the CS-3000 Plus. To reduce the occurrence of platelet aggregates and to increase platelet yield and efficiency the collection chamber A-35 has been replaced by a new, volume-reduced chamber called PLT-30. We analyzed on the basis of 201 platelet separation procedures with the CS-3000 Plus fitted with both new chambers the efficiency of platelet collection. The platelet yield per unit (mean +/- SE) was 4.55 x 10(11) +/- 0.07 x 10(11) and the efficiency was 50.79 +/- 0.76%; only 3.98% of the platelet concentrates were below 3 x 10(11). To compare our data with results from the A-35 we enrolled 33 random donors (17 in Innsbruck, 16 in Vienna) in a controlled study. Using both chambers in a randomly selected sequence within a period of 1 month on each chamber, we evaluated platelet yield, efficiency, and the contamination with white blood cells (WBCs). We found a platelet yield per unit (mean +/- SE) of 3.74 x 10(11) +/- 0.11 x 10(11) using the A-35 and of 4.4 x 10(11) +/- 0.21 x 10(11) with the new PLT-30 (P = .0001). The efficiency of the collecting process (mean +/- SE) was higher with the PLT-30 (47.76 +/- 2.11%) than with the A-35 (40.68 +/- 1.29%). The difference is statistically significant (P = .0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Cell Separation↗
PubMed1994

Hydrosalpinx formation and its regeneration after microsurgical reconstruction--a functional and morphological study on rabbits.

The development of mechanically induced hydrosalpinx and the subsequent regeneration of the uterine tube following correction were investigated with reference to morphological and functional parameters in 33 rabbits. Mechanically induced hydrosalpinx leads to reduced fertility. The characteristic morphological alterations are flattening of the folds, deciliation, reduced secretory activity and general de-differentiation of the epithelial cells. The intensity of these changes peaked as little as 4 weeks after induction of the hydrosalpinx. The deciliation is generally patchy. The division into different fields, islet formation and celestial chart phenomena reflect different degrees of vascularization and/or oxygenation. These alterations were completely reversible within 8 weeks after reconstruction. In isolated cases only the formation of polypose stumps was seen, which were, however, covered with a normal epithelial surface. The discrepancy between the reduced tubal function following reconstruction for hydrosalpinx and the complete regeneration of the tubal mucosa suggests that other regulatory mechanisms more important for the function of the uterine tube are impaired.

Animals↗
PubMed1994

Antipsychotic maintenance treatment of schizophrenia patients: is there a consensus?

We obtained pharmaco-epidemiologic data regarding the antipsychotic maintenance treatment (AMT) of schizophrenia patients through a postal survey sent to all Austrian psychiatrists and neurologists. Drug therapy was considered the most important therapeutic approach in the long-term management of schizophrenia. However, the majority of the respondents clearly were not satisfied with the current status of scientific knowledge about dosage and duration of AMT. Single-drug treatment with antipsychotics was preferred by the respondents; oral and depot neuroleptics were used with equal frequency. Haloperidol was the oral drug most frequently mentioned as first choice (44% of the respondents), followed by clozapine (14.1%) and thioridazine (9.2%). The proposed mean daily doses showed striking variations among respondents. The proposed mean length of maintenance treatment in first-episode patients was 7.3 months; in multi-episode patients, it was 20.1 months. The results show considerable variation in physicians' attitudes toward AMT.

Administration, Oral↗
PubMed1994

[The value of sequential CD 34 measurement for carrying out stem cell pheresis].

The recent significant improvement in disease-free survival in patients with certain haematological malignancies is due to high-dose chemotherapy and subsequent autologous bone marrow and/or stem cell transplantation. The proliferation and egression of stem cells into the peripheral blood must first be stimulated by defined chemotherapy and/or by administration of cytokines. However, the increase of circulating stem cells in peripheral blood is limited to only a few days. By immunologically analysing white blood cells for the expression of the surface antigen CD 34 it is possible to calculate the numbers of haematopoietic progenitor cells. Thus, besides monitoring haematopoietic recovery, the estimation of CD34+ cells in the peripheral blood can be used to indicate the optimal time point for stem cell collection. Two to four stem cell pheresis (one per day) may then yield sufficient stem cells to enable the safe and rapid reconstitution of haematopoiesis following supralethal chemotherapy.

Antigens, CD↗
PubMed1994

Compliance with antipsychotic drug treatment: influence of side effects.

In addition to other factors such as type and duration of treatment, patient- and illness-related variables and other psychosocial features, side effects are known to exert a significant influence on the compliance with antipsychotic treatment. This has been demonstrated for extrapyramidal motor side effects and akathisia, sedation, weight gain and sexual dysfunctions. Other adverse events interfering with the patients' social roles also interfere with the patients' willingness to comply with treatment. It is important to acknowledge this not only in the acute treatment of schizophrenia but especially during maintenance and prophylactic treatment. Compliance can be considerably improved by a) adequately informing the patient about the risks and nature of side effects and b) by recognizing and treating side effects, since prevention of adverse events is not easily achieved. An underestimation of the influence of side effects on compliance will often lead to treatment failures that are erroneously attributed to treatment resistance.

Adult↗