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Biomedical subjects

P Bauer

Publications and source records attributed to P Bauer.

At least 19 recordsLinked to original sources

Determination of zopiclone in plasma using column liquid chromatography with ultraviolet detection.

A reversed-phase liquid chromatographic method with ultraviolet detection for the determination of zopiclone in plasma is described. It is rapid, sensitive, reproducible and linear over a wide range. The method was used to study plasma zopiclone concentrations in a case of acute intoxication after oral ingestion of 300 mg of the drug. The plasma level was 1600 ng/ml 4.5 h after the dose and the elimination half-life was 3.5 h.

Adult

Transient non-cardiogenic pulmonary edema following massive ingestion of ethylene glycol butyl ether.

A case of acute poisoning with ethylene glycol butyl ether (EGBE) is reported in a chronic alcohol abuser. On admission the 53-year-old patient was comatose with metabolic acidosis, shock, and noncardiogenic pulmonary edema confirmed by haemodynamic study. Following supportive treatment and haemodialysis the outcome was favorable. The relationship between respiratory failure and EGBE is examined.

Alcoholism

Gastrointestinal malignant lymphomas of the mucosa-associated lymphoid tissue: factors relevant to prognosis.

Three hundred seven cases (244 gastric, 63 intestinal) of primary gastrointestinal non-Hodgkin's lymphoma (NHL) in stages EI and EII, according to a modified Ann Arbor system, were examined retrospectively. The histological classification for mucosa-associated lymphoid tissue-derived lymphomas was applied. Gastric NHLs (male-female ratio, 0.97; mean age, 64.5 years) were stage EI in 51% and stage EII in 49% of cases. Histological grade of malignancy was low in 41% and high in 59% of cases; all NHLs were B-cell type. Tumors were radically resected in 87%, and overall 2-, 5-, and 10-year survival rates were 61%, 55%, and 46%, respectively. Early lymphomas (substage EI1) had best prognosis (5- and 10-year survival rates, 90% and 70%, respectively). Intestinal NHLs (male-female ratio, 1.1; mean age, 54.4 years) were stage EI in 30% and stage EII in 70% of cases. Histology was low grade in 21% and high grade in 79%, and all but 11 cases were B-cell type. In 58% of cases, radical tumor resection resulted in overall 2- and 5-year survival rates of 44% and 24%, respectively. Major prognosticators for survival in gastric location were low-grade histology, low depth of infiltration, and low stage and radical resectability of lymphoma; all factors were strictly intercorrelated. In intestinal site, radical tumor resectability was highly significant for survival. Cumulative proportion of relapses after 5 years was higher in intestinal than in gastric sites (44% vs. 22%). In conclusion, primary gastrointestinal tract NHLs may represent an entity with respect to characteristic histological features, focal tumor growth, and potential cure by radical resection. Because of late relapses, clinical follow-up is needed.

Adolescent

Hearing loss from industrial noise, head injury and ear disease. A multivariate analysis on audiometric examinations of 110,647 workers.

From compulsory screening examinations of 260,917 noise-exposed workers standardized audiograms as well as medical and occupational histories of 110,647 workers were selected because of full-time exposure to well-defined noise greater than 85 dB (A) and analyzed by loglinear and multiple linear regression. The most important factors for prediction of pure-tone hearing loss at 4 kHz were found to be age, sex and noise immission level. For predicting speech impairment and handicap the history of ear disease, head injury and tinnitus were more important than noise immission level. Dose-response relationships are given to improve prevention and compensation of hearing loss from combined factors.

Adolescent

[Current treatment of poisoning by ingestion of caustic substances].

Lesions by ingestion of corrosive substances had so far been treated at the time of sequelae. In the seventies several events modified deeply the epidemiology and the early care of these poisonings. At that time household products like highly concentrated basic and acid substances and oxidizing agents were distributed and led to an increase of the number and the severity of these intoxications. In the same time, fiberoptic endoscopy of the digestive tract played a leading part to evaluate the diagnosis and the prognosis of these poisonings at an early stage, and thus, with accurate intensive care and digestive surgery contributed to generate appropriate guidelines, according to the severity. The first step of the treatment is fasting, fluid replacement and analgesic if required. A full examination must be performed, especially in the throat even if there is no strong correlation between early clinical signs and the severity of the lesions; blood samples must be obtained to look for metabolic acidosis, hyperleukocytosis hemolysis and consumption coagulopathy which could be better indicators of the severity. Fiberoptic endoscopy of the upper digestive tract should be performed as soon as the physical and psychological patient's condition is stable; if possible before the twelfth hour and no more late than the twenty-fourth hour. It should determine the lesions: type, range and grade according to Quincy's classification modified by Mongon and Di Constanzo. Survival and healing of "extremely severe" grade intoxication can only be obtained through a surgical intervention within the first hours; a laparotomy will indicate the depth of the lesions, which is not determined by endoscopy, and will consist of Celerier's stripping method and if necessary a gastrectomy, more seldom a cephalic duodeno-pancreatectomy. Only the surgical excision of necrotic tissues can prevent the occurrence of lethal complications like oesophageal or gastric perforations and septic shocks. The analysis of the literature from 1975 up to now gives us information on the methods and the results of these different therapeutic approaches.

Adult

[Current status of poisoning by ingestion of caustics: apropos of a series of 49 cases].

The authors report the history of 49 patients, admitted to an intensive care unit after a caustic or corrosive ingestion. This series follows a similar one, related in 1979. An update is made for early evaluation and management, based on patients classification in three groups: severe cases, moderate cases, mild cases. Clinical and biological data, treatment and outcome for the three groups are related. The frequency and gravity of these poisonings appear to be the same as in the first series, with poor prognosis for extreme emergencies and high risk of oesophageal or gastric stricture for important forms. In this population, 20% of extreme emergencies have favorable outcome with early major surgical procedure.

Adolescent

[Impact noise and hearing. A study from audiometry screening in noisy occupational environments].

The hearing loss of 46,776 subjects exposed to hazardous impact or continuous noise was measured: 11% were exposed to impact noise (10.3% in men, 12.7% in women). Impact noise causes less hearing loss than continuous noise up to a noise emission level (NIL) of 115 dB(A). This result is still compatible with the concept of equivalent continuous A-weighted sound pressure level (LA,eq) and seems to be caused by the protective effect of the stapedius muscle. However, at emission levels higher than 115 dB(A), not covered by ISO 1999 prognosis, impact noise becomes more detrimental. This could be the effect of mechanical damage to the organ of Corti, as observed in animal experiments at sound pressure levels exceeding 114 dB(A). A diminishing protective function of the stapedius muscle could explain the more serious hearing impairment after long exposure to impact noise compared with shorter exposures to an equal dose. Since the hearing loss caused by impact or continuous noise is clearly different in the highest NIL ranges, safety criteria for impact noise should be revised. The NIL defined by Burns and Robinson underestimates the effect of the exposure time for impact noise.

Adolescent

Comparison of enteral nutrition and drug treatment in active Crohn's disease. Results of the European Cooperative Crohn's Disease Study. IV.

This study compared the effect of enteral nutrition as the sole therapy of active Crohn's disease with drug treatment. Patients with active Crohn's disease (Crohn's Disease Activity Index greater than 200) were randomized to receive either enteral nutrition with a liquid oligopeptide diet (n = 55) or a combination of 6-methylprednisolone, 48 mg daily, subsequently tapered, and sulfasalazine, 3 g daily (n = 52). The two groups were not different with respect to age, sex, body weight, location of disease, or treatment before the study. The severity of disease was similar at the beginning of the study in both groups [Crohn's Disease Activity Index (mean +/- SEM), 323 +/- 12 vs. 316 +/- 11]. Remission was defined as a decrease of the initial Crohn's Disease Activity Index by 40% or at least 100 points. Twenty-nine patients in the diet group and 41 patients in the drug group reached remission within 6 weeks of therapy (chi 2 test, P less than 0.01). The median elapsed time to remission was 30.7 days in the diet group compared with 8.2 days in the drug group (Mantel Cox, P less than 0.01). To determine whether one of these treatments was more beneficial for a subgroup of patients, the effectiveness of both treatments was analyzed separately in patients with very severe disease (initial Crohn's Disease Activity Index greater than 300) and less severe disease (initial Crohn's Disease Activity Index less than 300), and in patients with different disease location. However, no influence of initial disease activity or disease location on the effect of either treatment could be shown. These data show that enteral nutrition is less effective than a combination of 6-methylprednisolone and sulfasalazine in treating active Crohn's disease.

Adult

Effect of trospium chloride on urodynamic parameters in patients with detrusor hyperreflexia due to spinal cord injuries. A multicentre placebo-controlled double-blind trial.

In a multicentre placebo-controlled double-blind study 61 patients with spinal cord injuries and detrusor hyperreflexia were treated: 20 mg trospium chloride was given twice daily over a period of 3 weeks. Pre- and posttreatment urodynamic measurements demonstrated large improvements in maximum cystometric capacity (mean = 138.1 ml), decreased maximum detrusor pressure (mean = -37.8 cm H2O) and an increase in compliance (mean = 12.1 ml/cm H2O) in the treatment group. Urodynamic parameters in the placebo group remained substantially unchanged. Comparisons between the two groups revealed highly significant differences for these parameters (all, p less than 0.001). No effect on maximum flow rate and residual urine was detected in either group. The incidence of spontaneously reported side-effects was extremely low and comparable for both groups.

Adult

Efficacy of alfuzosine (an alpha 1-adrenoreceptor blocking drug) in benign hyperplasia of the prostate.

Thirty-three patients with symptoms of outflow obstruction due to BPH were randomized into a double-blind study for 8 weeks treatment with alfuzosine 2.5 mg x 3 or placebo. Alfuzosine blood concentrations were analysed. The residual volume was significantly reduced in the alfuzosine group, from 98 to 43 cc (p less than 0.02) and the average urinary flow as measured by timed micturition was significantly improved (p = 0.023). Subjective symptoms were reduced in both groups. However, no statistically significant differences between the groups were recorded. Side-effects were limited and without clinical importance.

Adrenergic alpha-Antagonists

Effects of tolmetin, paracetamol, and of two combinations of tolmetin and paracetamol as compared to placebo on experimentally induced pain. A double blind study.

Previous studies in animals suggested that a coadministration of the anti-rheumatic/anti-inflammatory agent tolmetin (Tolectin) and of paracetamol potentiates the effects of these two drugs. The present study was carried out to assess whether or not the dosis of tolmetin necessary to obtain an analgesic effect can be reduced when paracetamol is coadministered in a model with experimentally induced pain in healthy human subjects. The effects of tolmetin 200 mg (T 200), paracetamol 400 mg (P 400), tolmetin 150 mg plus paracetamol 300 mg (T 150 + P 300), and of tolmetin 100 mg plus paracetamol 400 mg (T 100 + P 400) on pain threshold to electrical and thermal stimuli and on pain tolerance to electrical stimuli were compared to the effects of placebo under double blind conditions. Each of 20 healthy volunteers received all of the 5 treatments randomised according to four 5 X 5 Latin squares. The results showed that the combination T 100 + P 400 had better analgesic effects than the double dose of tolmetin, T 200, alone, while the effects of P 400 could not be discrminated from placebo. In a sequential t-test the effects of T 100 + P 400 could be discriminated from placebo already after 14 Ss. The effects of T 200, T 150 + P 300, and T 100 + P 400 respectively could not be differentiated, indicating that the dose of tolmetin can be reduced markedly by simultaneous administration of paracetamol without a loss in analgesic potency. Coadministration of tolmetin and paracetamol permits a marked reduction of the dose of tolmetin without any loss of analgesic potency as measured in a model with experimentally induced pain in healthy subjects.

Acetaminophen

The effect of intramuscular pirenzepine on esophageal contractile activity and lower esophageal sphincter pressure under fasting conditions and after a standard meal. A double blind study.

In two studies, each on 16 healthy volunteers, the effects of pirenzepine on esophageal and lower esophageal sphincter (LES) contractile activity were studied under double blind conditions. One study was carried out on subjects who had fasted, the other on subjects who had ingested a standard meal. Each subject underwent two experiments, one with i.m. injection of 0.2 mg/kg body weight pirenzepine, the other with an injection of solvent. Heart rate, respiratory rate, electroencephalogram, and reaction time to acoustical stimuli were recorded to control for cardiovascular, respiratory and central nervous effects respectively. Pirenzepine under both fasting and nonfasting conditions caused significant decreases in number, amplitude, and duration of swallow-contractions. LES pressures under both conditions were significantly lower after pirenzepine than after the solvent. Pirenzepine furthermore caused a significant heart rate deceleration and respiratory acceleration, as well as an increased power in the faster Beta- and decreased power in the Alpha-range of the EEG. In conclusion, pirenzepine inhibits esophageal and LES contractile activity and also affects the central nervous system by a direct or indirect mechanism. An application of pirenzepine in hypertensive states of the LES and the esophagus seems possible and deserves further investigation.

Adult

[Determining the average posteruptive age of teeth from the results of cross-sectional studies (author's transl)].

If results of cross-sectional studies must be used as a basis for setting up models of development of caries in permanent teeth, then the average rather than individual posteruptive age of teeth has to be resorted to. Data available for this purpose had been obtained from a total of 54,000 children living in two G.D.R. cities, namely, Plauen and Karl-Marx-Stadt, as well as from two surveys made in 1959 and 1971, respectively. Calculation of the average posteruptive age of teeth assumes good knowledge of the distribution of dates of eruption in a population. Of the three types of distribution considered, namely, normal, lognormal, and log-logistic distribution, the log-logistic model proved to be superior to others because of better adaptation to the data available. The method of calculating the posteruptive age of teeth is described and illustrated by use of a number of examples. Since one of the two surveys (namely that which was made in Karl-Marx-Stadt in 1971) was made after twelve years' drinking water fluoridation, it was possible to study the effect of fluoridation upon the eruptive behavior of permanent teeth. The results of this study confirmed those obtained during previous investigations.

Adolescent