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Biomedical subjects

S Merkel

Publications and source records attributed to S Merkel.

36 records · Page 2Linked to original sources
PubMed1995

[Toxoplasmosis and pregnancy--findings from umbilical cord blood screening in 30,000 newborn infants].

Cord blood screening for congenital toxoplasmosis was performed prospectively on 30,000 samples collected between 1986 and 1994 in the region of Basel, Switzerland, covering up to 95% of all births. Congenital infection was suspected in cases of serum with specific antitoxoplasma IgM or IgA or with a level of specific IgG above 300 IU/ml as measured by EIA from Sanofi-Pasteur. The percentage of cases to be screened declined from 2.5 to 1.2% and the cases of confirmed congenital toxoplasmosis from 0.073 to 0.033% during the observation period. This observation may be due to several reasons, such as improved primary prevention or more frequent diagnosis and treatment during pregnancy. In 178 cases of cord blood serology suspicious for acute toxoplasmosis, an enquiry with the gynecologist in charge of the pregnant woman was carried out. 126 mothers (71%) presented with a confirmed immunity against Toxoplasma gondii early in pregnancy and screening of the child was not needed. From 37 pregnancies (21%) no information was available. 15 out of 24 confirmed cases of toxoplasmosis of the mother during pregnancy were detected by cord blood analysis. In 17 of 24 cases of maternal toxoplasmosis treatment with spiramycin, pyrimethamine/sulfadoxine or both was performed. 10 of 17 newborns from mothers treated during pregnancy had elevated toxoplasma IgG titres at birth, but only one child was infected. 7 newborns had an inconspicuous toxoplasma serology at birth and were not infected. 7 cases of toxoplasmosis during pregnancy were detected by the check back and remained untreated; 4 out of 7 newborns had congenital toxoplasmosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Protozoan↗
PubMed1995

Synthesis and separation of protected tripeptide epimers by RP-HPLC.

Twenty three epimeric pairs of protected tripeptides of the type Z-Ala-Xaa-Val-OMe have been synthesized by conventional coupling procedures in solution. Optimal conditions for baseline separation of LLL/LDL epimers were found by high-performance liquid chromatography on a RP-18 column with aqueous methanol as mobile phase. The hydrophobic parameters (log kw) were determined for all tripeptides.

Amino Acid Sequence↗
PubMed1991

[Studies about the therapy of tuberculosis in East Germany (former GDR)].

On the basis of a questionnaire the therapy of 2285 patients with tuberculosis was evaluated for the years 1987-1989. The data of the GDR National Tuberculosis Register (9827 patients) were used for statistical comparison. 85% of the patients had a pulmonary tuberculosis, 947 patients (41% of all) excreted tubercle bacilli in the sputum. The average duration of treatment was 31.8 weeks, 94.7% of the patients were hospitalised for treatment for an average time of 12.4 weeks, the following outpatient treatment was 19.4 weeks in average. The initial phase (daily-treatment) in all cases of tuberculosis was 8.6 weeks, the follow-up phase was 23.2 weeks (all data are averages). The intermittent outpatient drug administration was made in 95% of cases under nurse control in outpatient departments. The initial treatment was started in 92.1% with 3 or 4 drugs (H/R/Z/S or E). Isoniacid and rifampicin were prescribed in 89.7% and pyrazinamide was used as a 4th drug. In the follow-up phase the combination isoniacid and rifampicin was employed intermittent in 75.7%. The delaytime for the evaluated cases was 38.8 days in average. The result of study shows, in most cases the patients were treated according to the recommendation of therapy. The clinical stay of patients is too long.

Adolescent↗
PubMed1990

[BCG osteomyelitis and arthritis].

Since 1980 an increase of the frequency of osteomyelitis after BCG vaccination has been described by some european countries. In the GDR osseous impairments as BCG complication are rarely. The authors report on an 18 months old boy with lesions of the distal tibia and the ankle-joint. He was vaccinated with BCG in the neonatal period. In contrast to the local findings general symptoms were unimportant. The surgical treatment was completed by antituberculotic chemotherapy. This treatment was successful.

Ankle Joint↗
PubMed1989

[Tuberculin sensitivity and tolerance of "direct" BCG vaccination of youths leaving school].

In 3,296 school-leavers (girls and boys aged 16 years with preceding BCG-vaccination as newborns and without boosting by tuberculin-testing or revaccination during the meantime) simultaneously with compulsory BCG-revaccination tuberculin testing with 2 TU PPD Dessau + Tween 80 was performed in 3 regions of the GDR (Cottbus, Erfurt, Neubrandenburg) in the 2nd half of 1985 and in the 1st quarter of 1986. Sensitivity to tuberculin was found in 7.3% considering reactions with greater than or equal to 6 mm induration as positive, and in 2.9% considering reactions with greater than or equal to 10 mm only. Positive reactions greater than or equal to 6 mm include remaining allergy caused by BCG and non-specific tuberculin sensitivity while a reaction limit greater than or equal to 10 mm is suitable to define tuberculosis infection prevalence. In contrast to studies performed 1973 and 1979 in the same territories a significant decrease in tuberculin sensitivity was evident (43.8% positive reactions (greater than or equal to 6 mm) in 1973 and 11.7% in 1979). The acceptability of "direct" BCG-revaccination has been estimated by evaluation of local reactions 4 weeks after vaccination in 2,123 school-leavers. The ulceration rate in tuberculin positive adolescents was significantly higher than in tuberculin negative. It showed highly significant decrease in comparison with 1979.

Adolescent↗
PubMed1989

[Recommendations for the therapy of atypical immunization courses and complications of BCG vaccination (Position: April, 1988)].

After introduction of the "direct" BCG-vaccination of the 16 years old youngsters in 1981 a small increase of atypical reactions and complications of the vaccination was probable. References and experiences about different therapy methods of these atypical reactions and complications gave rise to recommend uniform guide-lines for definition, diagnostic and therapy.

Adolescent↗
PubMed1988

[Specific and nonspecific tuberculin sensitivity in school children in East Germany. East German draft report of a multinational epidemiologic study of the prevalence of specific and nonspecific tuberculin sensitivity in Europe].

By means of dual-testing with tuberculin (2 TU PPD RT 23 and 2 TE PPD Dessau) and sensitin Scrophulaceum (5 TU PPD scroph.) evidence and degree of specific and non-specific tuberculin sensitivity in schoolchildren aged 7-14 years was examined under the conditions of preceding BCG-vaccination as newborns in the counties of Cottbus, Erfurt and Neubrandenburg. In a cohort of 2,792 children sensitivity to tuberculin was found in 5.98% considering positive reactions with greater than or equal to 6 mm induration and in 1.50% considering reactions with greater than or equal to 10 mm only. Reactions with induration of 6 mm and more comprehend remaining allergy caused by BCG while the limit greater than or equal to 10 mm seems to be suitable to define tuberculosis infection prevalence. Tuberculin sensitivity shows frequencies corresponding with the epidemiology of tuberculosis. Sensitivity to PPD scroph. increases from north to south with significant difference between the counties of Neubrandenburg and Erfurt. Nonspecific tuberculin sensitivity is partly prevalent in the counties of Cottbus and Erfurt.

Child↗
PubMed1986

[Daily ultrashort chemotherapy and intermittent short-term chemotherapy with 4 drugs of communicable pulmonary tuberculosis treated for the first time. Results of a cooperative multicenter study].

Three short-course regimens, all comprising isoniazide (H), rifampicine (R), streptomycine (S) and pyrazinamide (Z), are compared in a randomized prospective cooperative clinical trial. The drugs are given daily in a 3-month regimen (3-HRSZ), twice a week in a 6-month regimen (6-HRSZ2), and in a further two-phase 6-month regimen the 4 drugs are administered 3 times a week for the first 3 months followed by the administration of HSZ twice a week (without R) for further 3 months (3-HRSZ3/3-HSZ2). The number of patients admitted to study is 80, 144 and 139 respectively. The 3-month regimen has been stopped because of a high rate of relapses. 17 p.c. of the patients admitted have to be excluded from analysis for various reasons, out of these 5.8 p.c. because of adverse reactions. Two thirds of the patients had heavily positive sputum cultures at the start. 300 patients completed therapy. At the end of therapy cultures were negative in 94 p.c., 100 p.c. and 99 p.c. respectively. The rate of bacteriological relapses is 19 p.c. in 3-HRSZ, 9 p.c. in 3-HRSZ3/3-HSZ2 and 3 p.c. in 6-HRSZ2, during a follow-up period of 3-4 years after completing therapy. The acceptability was good in all treatment groups. Adverse reactions like "flu" were rarely observed. Increased blood urea was common but in general without clinical symptoms. Elevation of ALAT and ASAT was relatively frequent but mostly transient and without clinical importance. The results served as basis for the new "Recommendation for Treatment of Tuberculosis" and are interpreted with regard to practical consequences and possibilities for further rationalisation of treatment.

Adolescent↗
PubMed1984

[Cooperative study on the recurrence of lung tuberculosis in East Germany].

144 patients with bacteriologically positive results were analysed out of 258 relapses of pulmonary tuberculosis within one year (1979/80) to find the causes which are favouring relapses. It has been found that in 28% an inadequate chemotherapy, in 16% uncontrolled use of drugs, and in 13% of cases uncooperative attitude of patients were supposed causes of relapse. Causes of relapse could not be established in 23% of patients. Silicosis and chronic alcoholism were observed in 22% of patients with relapse.

Adolescent↗
PubMedDate not supplied

A comparison of continuous epidural infusion and intermittent intravenous bolus doses of morphine in children undergoing selective dorsal rhizotomy.

BACKGROUND AND OBJECTIVES: Selective dorsal rhizotomy (SDR) is associated with moderale to severe postoperative pain. Although the efficacy of epidural analgesia in this population has been demonstrated, it has not been compared with conventional intravenous (i.v.) analgesia. This prospective study compared the effects of epidural and i.v. morphine regarding postoperative analgesia, side effects, and outcomes in children following SDR. METHODS: Twenty-seven children were randomized to receive either epidural or i.v. analgesia. Children in the epidural group had a catheter placed by the neurosurgeon and received preservative-free morphine (Duramorph) 30 microg/kg, followed by an infusion of 3 microg/kg/h for 3 days. Children in the i.v. group received morphine 0.05-0.1 mg/kg intraoperatively, followed by 0.02 mg/kg doses postoperatively administered by nurses via a patient-controlled analgesia device. RESULTS: The epidural group experienced lower pain scores (P = .04) and fewer muscle spasms (P < or = .04), and tolerated activity better (P < or = .02) during the early postoperative period than the i.v. group. Side effects were similar between groups, with no respiratory depression in either group. Parents of children in both groups perceived an adequate level of comfort and were very satisfied with the analgesic technique. Additionally, parents believed that their child's postoperative pain was less than anticipated (P < or = .01). CONCLUSIONS: Both techniques provided effective postoperative analgesia with a similar incidence of side effects; however, our findings suggest that continuous infusions of epidural morphine improved overall comfort with lower pain scores, fewer muscle spasms, and improved tolerance of activity during the initial postoperative period.

Analgesia, Epidural↗