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Biomedical subjects

O Leiss

Publications and source records attributed to O Leiss.

At least 19 recordsLinked to original sources
PubMed1995

[Risk of infection in endoscopy].

Infection is one of the hazards of endoscopic procedures. This long known risk has received major concern because of potential HIV infection. In the individual patient, both, patient related factors (such as the compromised host) and procedure related factors (such as tissue damage) determine the risk of infection. The potential for transmission of microorganisms from patient to patient or from the endoscopic equipment to the patient is reviewed. Common sources of infection and relevant microorganisms are listed. For prevention of transfer of infective agents through the contaminated endoscope the importance of thorough mechanical cleaning of the endoscope and adequate disinfection is stressed.

Cross Infection↗
PubMed1995

[Pathogenesis of stomach carcinoma--significance of nitrates, N-nitroso compounds, nutritional factors and Helicobacter pylori-induced chronic active and chronic atrophic gastritis].

Epidemiological data on gastric cancer, time trends and histological classification are reviewed. Known models on gastric carcinogenesis including the pathogenetic importance of nitrates and N-nitroso compounds and protective effects of dietary components are discussed and recent evidence on Helicobacter pylori (Hp) induced chronic active gastritis, its progression to chronic atrophic gastritis and its role in gastric carcinogenesis is summarized. Epidemiological, clinical and pathological support for a causal relationship of Hp and gastric carcinoma is included in a new multistep model on aetiopathogenesis of gastric cancer. The follow-up of patients at risk as well as the question of cancer prevention by Hp eradication are mentioned.

Feeding Behavior↗
PubMed1995

[Preventing transmission of infection in endoscopy: hygienic maintainance of flexible endoscopes and measures for personal protection].

For prevention of transfer of infective agents by the contaminated endoscope the importance of thorough mechanical cleaning of the endoscope and adequate disinfection is stressed. Mode of action and side effects of liquid disinfectants as well as resistance of microorganisms (spores and some mycobacteria) to germicidal chemicals are mentioned. The different steps of disinfection procedures and potential causes of failure are discussed. Automatic disinfection systems are required for a higher degree of security of both patient and staff of the endoscopic unit. A regular control of the efficacy of the disinfection process is recommended and models for implementation are discussed. For prevention of occupationally acquired infection general precaution guidelines (use of gloves, prevention of needle-stick injuries) and vaccination programs are stressed.

Cross Infection↗
PubMed1993

[What is the onset of primary biliary liver cirrhosis?].

The medical records of 49 consecutive patients with primary biliary cirrhosis of the liver were screened for informations about medical examinations during the years before the diagnosis was established. In 15 cases previous medical reports could be found. Evidence of liver disease (slight elevation of transaminases and gamma-GT) was documented up to 18 years before the diagnosis was proven. In 6 patients liver biopsies had been performed: normal 1 x, fatty liver 1 x, fibrosis 1 x, non-specific hepatitis 1 x, chron. pers. Hep. 2 x. The characteristic increase of alkaline phosphatase often occurred within a few months. Antimitochondrial antibodies became positive independent of the beginning of cholestasis. It can be concluded that early stage primary biliary cirrhosis must be considered in patients with long standing slight elevation of liver enzymes even without cholestasis when other causes can be excluded.

Adult↗
PubMed1993

[Gastroenterologic-endoscopic studies in ambulatory practice. Spectrum of applications, trends, quality and economic aspects].

A review on spectrum, frequency and complication rate of gastroenterological endoscopy in ambulant practice is given based on data of the National Association of Public Health Insurance Physicians of Germany. The following important aspects are mentioned: 1. Endoscopy has surpassed radiology in diagnostic examinations for gastric and colonic diseases. 2. Gastroscopy is more commonly carried out by physicians, coloscopy by gastroenterologists or specialists. Hospital doctors don't contribute significantly to ambulant endoscopic examinations of stomach and colon. 3. Endoscopic examinations of the pancreas, biliary tree, laparoscopy and other techniques play an insignificant role in ambulant practice. 4. The complication rate of ambulant gastroenterological endoscopy is very low. There have been only a few malpractice cases due to complications of gastroenterological endoscopic examinations. 5. The quality of coloscopy is not yet satisfactory as measured by the relative proportions of partial and total coloscopy. 6. In the past only limited attention was given to aspects of quality assurance and quality control in endoscopy in ambulant practice. This should be changed in the future. 7. The fees for gastroscopy and coloscopy allowed by the public insurance companies don't cover the expenses and are inadequate. As a result, a negative impact on the quality of medical care can be expected.

Ambulatory Care↗
PubMed1991

[Prevention of recurrence after successful gallstone dissolution].

Gallstone recurrence is a major problem in the medical treatment of gallstones (treatment with UDCA/CDCA, ESWL, local MTBE lysis). The probability of gallstone recurrence is higher in subjects with multiple stones before dissolution treatment and in older subjects (greater than 50 years). The present knowledge on factors predictive of gallstone recurrence and the results of clinical trials for preventing recurrence are given. The different effects of diet and drugs on cholesterol saturation of bile, on nucleation of bile, on mucus production of gallbladder and on gallbladder contractility are discussed and recommendations for a rational approach for prevention of gallstone recurrence are given. Preventable risk factors for gallstone disease have to be eliminated. In general, continuous post-dissolution treatment seems not justified. Regular follow-up ultrasound examinations should be started to detect renewed of gallstones at an early stage.

Chenodeoxycholic Acid↗
PubMed1991

[Traveler's diarrhea. Incidence--pathogens--pathophysiology--clinical aspects--prevention and therapy].

About one-third of travellers will be affected by travellers' diarrhoea. Regions with low risk are Northern Europe, the United States, Australia and New Zealand. Intermediate risk is found in Southern Europe, most islands of the Caribbean, Japan, Israel and Southern Africa and high risk in developing countries. Among the most commonly isolated pathogens are enterotoxigenic E. coli, Salmonella, Shigella, Campylobacter, G. lamblia, E. histolytica and viruses. The individual risk depends on the age and constitution of the traveller, on styles of travel and on previous expositure in developing countries. Travellers' diarrhoea is usually a short self-limited disease for 2-5 days. Nutritional prophylaxis along the principle "boil it, cook it, peel it, or forget it" is useful. Prophylaxis with non-antibiotic drugs is only justified in special cases.

Bacteria↗
PubMed1990

[Hygienic measures in endoscopy].

Risks of infection associated with endoscopy, sources of infection, relevant microorganisms (P. aeruginosa, Serratia, HIV, HB, Cryptosporidiosis), disinfection procedures and the steps of disinfection procedures and reasons for failing of disinfection procedures are discussed. Channel systems and rinsing solutions are relevant but until today underestimated sources of infection. In detail the contamination of the channel system in endoscopes, problems of good disinfection and the significance of mechanical cleaning are described. In cases of Pseudomonas aeruginosa infections after endoscopy an immediate investigation of the contamination of the endoscope and of rinsing solutions is necessary. Automatic disinfection systems are requested, because with such systems a higher security for patient and personal is achievable. A regular control of the efficacy of the disinfection process by a competent Hygiene-Institute is recommended.

Cross Infection↗
PubMed1989

Biliary lipid composition in patients with cystic fibrosis.

Lipid composition of gallbladder bile was determined in 20 patients with cystic fibrosis (CF) (9 females and 11 males, ranging in age from 3 to 18 years). The results were compared with 47 normal subjects matched for age, sex, and pubertal stage. In patients with CF, bile was undersaturated with cholesterol before puberty in both sexes and no differences with normal controls could be observed. After puberty, a similar increase in cholesterol saturation was noted in females with CF (85 +/- 15% vs. 130 +/- 38%, p less than 0.01) and normal controls (82 +/- 11% vs. 138 +/- 31%, p less than 0.01). No change in cholesterol saturation could be observed in male patients and controls after puberty. Molar percentage of chenodeoxycholic acid (CDCA) was lower (p less than 0.05) in postpubertal females (31 +/- 9%) and males (36 +/- 7%) with CF compared to controls (42 +/- 8% and 40 +/- 5%, respectively), while cholic acid (CA) was higher in all patients with CF. In females with CF, lithocholic acid (LCA) increased after puberty (2.2 +/- 0.8% vs. 5.3 +/- 2.6%, p less than 0.05) and was higher compared to controls (2.2 +/- 0.8%, p less than 0.001). An increase was also noted for deoxycholic acid (DCA) in postpubertal females with CF (1.7 +/- 2.6% vs. 10.8 +/- 7%, p less than 0.05), but it was lower in both sexes after puberty than in respective controls. The present results suggest that cholesterol saturation of bile in patients with CF is not different from respective controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

Administration of a terpene mixture inhibits cholesterol nucleation in bile from patients with cholesterol gallstones.

Patients with cholesterol gallstones referred to elective cholecystectomy were randomly assigned prior to operation to no treatment (n = 14), treatment with one capsule t.d.s. (n = 12) or two capsules t.d.s. (n = 11) of a terpene mixture (Rowachol). Patients with pigment stones (n = 7) or no biliary tract disease (n = 5) were also studied. Lipid composition, presence of cholesterol monohydrate crystals, and nucleation time were determined in gallbladder bile aspirated during surgery. Cholesterol saturation was similar in the different groups. Crystals were present in all cholesterol gallstone patients without treatment and in none of the controls. In one of the patients treated with one capsule and four of the patients treated with two capsules crystals could not be detected. The terpenes prolonged nucleation time from 2.8 to 5.8 days (one capsule; P less than 0.05) and to 9.5 days (two capsules; P less than 0.001), respectively; but nucleation did not occur in seven controls. Although the mechanism by which the terpene mixture inhibits the formation of cholesterol crystals in bile was not determined, the findings suggest that the terpene mixture might be a useful agent for a clinical trial to test whether they will prevent recurrence of gallstones after medical dissolution.

Bile↗
PubMed1987

Increased prevalence of apolipoprotein E2 in patients with retinitis pigmentosa.

Apolipoprotein E isoforms were determined in 139 unrelated patients with retinitis pigmentosa (RP). When compared to prevalence rates for the general population in Germany, an increased prevalence was observed for phenotypes E2/E2: 10.1 vs. 1.0% (p less than 0.001), E2/E3: 19.4 vs. 12.0% (p less than 0.05), and E2/E4: 5.8 vs. 1.5% (n.s.), while the prevalence appeared to be reduced for phenotypes E3/E3: 48.9 vs. 59.8% (n.s.) E3/E4: 13.7 vs. 22.9% (p less than 0.05), and E4/E4: 2.2 vs. 2.8% (n.s.). These findings suggest that genetically determined abnormalities of plasma lipoprotein metabolism may be associated with some forms of RP.

Apolipoprotein E2↗