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Biomedical subjects

R Lüthy

Publications and source records attributed to R Lüthy.

At least 217 records · Page 12Linked to original sources
PubMed1979

[Use of antibiotics in a surgical clinic. A prospective study of the Waid Community Hospital, Zurich].

A study was performed to analyse antibiotic usage in a surgical department, with the object of providing a basis for improving antibiotic policies. Patients admitted to the Department of Surgery (134 beds) of the Waid Community Hospital in Zürich (400 beds) after 1st Jan. 1979, and who received antibiotics during the period between 22 Jan. and 31 March were included in the study (n = 154). Daily chartreview provided all necessary information on clinical, diagnostic and therapeutic data of the patients included. 154 patients had 178 treatment courses which were reviewed according to guidelines proposed by the "audits of Antimicrobial Usage" (1977) and categorized as follows: I. agree with indication, appropriate choice and use of antibiotics; II. same, inappropriate choice and/or use of antibiotics; III. administration not justified. 83 of 178 treatment courses were prophylactic and 95 therapeutic. 58% of the prophylactic treatment courses were not justified (cat. III), and the remaining 42% were inappropriate in choice and/or use of antibiotics (cat. II). 41% of therapeutic treatment courses were adequate (cat. I), 43% were indicated, but these patients would have benefited from a more appropriate choice and/or use of antibiotics (cat. II), and in 16% the use of an antibiotic was not justified (cat. III). These results are compared with similar studies. On the basis of our findings, appropriate propositions for improvement of antibiotic policies are discussed.

Anti-Bacterial Agents↗
PubMed1979

[Transcobalamine-II-polymorphism: biochemical and clinical aspects of rare variants].

Transcobalamin II(TC II) is an essential transport protein for vitamin B12 in blood. TC II can be split up into isoproteins by polyacrylamide gel electrophoresis. Family studies are compatible with a genetic polymorphism of TC II and a five allele system. Screening of TC II isoprotein patterns in about 1000 individuals yielded two unusual TC II variants: The first case was a black female with severe megaloblastic anemia since infancy. Her TC II was elevated and bound B12, but displayed markedly diminished functional capacity to transfer radioactive cyanocobalamin in cellular systems. Comparison of this patient's TC II isoprotein pattern with known variants showed a distinct difference in electrophoretic mobility, indicating the presence of a sixth allele. The second patient, also presenting with pernicious anemia-like symptoms, was found to possess an unusual TC II variant with reduced TC II serum levels. Corresponding variants were also observed in the patient's asymptomatic children. Thus, abnormal TC II variants probably causing megaloblastic anemias both correlated with unusual isoprotein patterns.

Anemia, Megaloblastic↗
PubMed1979

Human pharmacology of cefotaxime (HR 756), a new cephalosporin.

Cefotaxime (HR 756) is a new semisynthetic parenteral cephalosporin with exceptional activity against gram-negative organisms and considerable stability against their beta-lactamases. To study its pharmacokinetic properties, 0.5-, 1-, and 2-g doses were administered to each of six volunteers intravenously over 15 min, followed by a sustaining infusions of 0.5, 1, and 2 g/h, respectively, for 3 consecutive hours. The loading doses produced mean peak levels of 41, 93, and 160 mug/ml, and mean steady-state serum concentrations were 27, 64, and 138 mug/ml, respectively. The mean terminal half-life was 75 +/- 7 min. The total volume of distribution averaged 0.22 +/- 0.03 liters/kg of body weight. Total body and renal clearances were 232 +/- 30 and 145 +/- 24 ml/min per 1.73 m(2), respectively; 63 +/- 9% of the administered dose was excreted through the kidneys in 24 h. To determine the effect of cefotaxime on the renal tubules, urinary alanine aminopeptidase excretion was measured before, during, and after the infusions. It remained within the normal range in all instances; however, 48 +/- 14% of the total daily alanine aminopeptidase output was recovered during the infusion period. Side effects were dose related and included fatigue, loose stools, and night sweats. No significant changes in hematology, serum chemistry, or urinalysis were recorded.

Cephalosporins↗
PubMed1979

[On-line measurement of antibiotic concentrations (author's transl)].

A laboratory computer implementation of an inhibition zone antibiotic assay is described. It utilizes square plates with 49 or 64 wells containing standards and unknowns. Inhibition zone sizes are measured and, using parabolic regression, the unknown antibiotic concentrations are computed.

Anti-Bacterial Agents↗
PubMed1978

[New antibiotics in the treatment of urinary tract infections].

Based on the frequency of the isolated bacteria the antibiotics and chemotherapeutics commonly used in infections of the urinary tract are discussed. It turns out that ampicillin and sulphamethoxazole-trimethoprim are still the drugs of choice in the treatment of these bacterial diseases. A true advance is achieved by the introduction of carbenicillin and the new aminoglycoside amikacin. Carbenicillin can be used in Pseudomonas infections and is characterized by its low toxicity. Amikacin is the drug of choice against aminoglycoside-resistant gramnegative bacteria.

Amikacin↗
PubMed1977

[Assay of aminoglycosides in serum using the urease method (author's transl)].

The urease method developed by Noone et al. for rapid bioassay of aminoglycoside antibiotics in serum is described in detail. The accuracy of the method was improved by using a BM 1-09 electrode assembly (Metrohm, CH-9100 Herisau, Switzerland) in conjunction with a digital pH-Meter (Metrohm E 500). The mean difference between spiked serum samples and measured concentrations was +0.37 +/-0.78 microgram/ml. The coefficient of determination between the urease and agar diffusion method was 0.94. Disadvantages of the method are a low sensitivity at concentrations below 1.5 microgram/ml and a large serum sample (1.5 ml). Advantages are its simplicity and rapidity.

Aminoglycosides↗
PubMed1976

[Aminoglycoside antibiotics from a clinical viewpoint].

Indications, side effects, dosage and pharmacokinetic properties of gentamicin, tobramycin, sisomicin, kanamycin and amikacin are reviewed. Different aspects of aminoglycoside antibiotics in combination with beta-lactam antibiotics are briefly discussed. Finally, the indications for the assay of serum levels of aminoglycosides are listed. Gentamicin, tobramycin and sisomicin appear to be very similar with regard to in vitro performance, clinical efficacy and pharmacology. Ototoxic and nephrotoxic side effects are observed - in decreasing order of frequency - with sisomicin, gentamicin and tobramycin. The advantage of amikacin is its stability against enzymatic inactivation, which should make it an agent of first choice against aminoglycoside-resistant gram-negative bacteria.

Aminoglycosides↗
PubMed1975

[Proceedings: Chemotherapy of bacterial endocarditis].

The present concepts of antibiotic therapy in bacterial endocarditis are reviewed. Recommendations for the treatment of the most frequent pathogens -- streptococci of the viridans group, enterococci, staphylococci -- and for unknown organisms are presented. Antimicrobial therapy directed against gramnegative organisms, especially of the pseudomonas group, and against anaerobic bacteria is briefly discussed. The presence of renal impairment calls for adjustment of dosage; relevant nomograms are published in the literature. Probenecid may be added to the antibiotic therapy to increase serum levels of penicillins and some cephalosporins, though a major drawback is its side effects. Clinical experience teaches that every recrudescence of bacterial endocarditis adds permanent damage to an already impaired valve. Hence it is of utmost importance that the aim of antimicrobial therapy should be a 100% cure.

Cephalosporins↗
PubMed1975

[Aminoglycoside antibiotics from clinical viewpoint].

Indications, side effects, dosage and several pharmacokinetic properties of gentamicin, tobramycin, sisomicin, kanamycin, amikacin, and streptomycin are delt with in the first part. Hereafter, some aspects are briefly mentioned concerning combinations of antibiotics with aminoglycosides, as well as indications for the evaluation and analysis of the aminoglycoside concentration in the serum.

Amikacin↗