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Biomedical subjects

T Edén

Publications and source records attributed to T Edén.

18 recordsLinked to original sources
PubMed1992

Cancer pain relief by continuous administration of epidural morphine in a hospital setting and at home.

Fifteen patients with severe pain due to malignancy were treated by continuous epidural morphine infusions. A disposable external pump was used. Patients were treated in a hospital setting or at home for a total of 906 days. Pain intensity was estimated by VAS. The pumps functioned well. Bacterial growth was found in 0.6% of the balloon reservoirs used, while the epidural filters were free from growth. There were no clinical infections. It appears that this delivery system is safe, practical and suitable for use in the home environment.

Aged↗
PubMed1985

Penetration of cefaclor to adenoid tissue and middle ear effusion in chronic OME.

Cefaclor given per os 20 mg/kg body weight was readily absorbed and distributed to adenoid tissue and to middle ear effusion in children with chronic OME. The levels obtained were above the MIC values of most strains of respiratory pathogens. The penetration characteristics were the same after the first and the 20th dose in a b.i.d. regimen. Elimination was completed within about 12 h. The double dose, 40 mg/kg body weight, did not give higher levels but a longer duration.

Adenoids↗
PubMed1985

Long-standing otitis media with effusion--a convenient model for the study of antibiotic penetration to respiratory tract secretions.

In long-standing otitis media with effusion, myringotomy with aspiration of the middle ear exsudate is an established therapeutical procedure, which can be performed under carefully planned conditions. This common disease thus offers convenient advantages for the study of antibiotic concentrations in the middle ear. This is exemplified by a review of studies with erythromycin, doxycycline and cefaclor. A delayed penetration into the middle ear was demonstrated for all these antibiotics, especially for erythromycin. The elimination from the middle ear was slower than from serum, at least with erythromycin and doxycycline. With these two antibiotics, the middle ear concentrations were close to the peak serum levels, with only small fluctuations between doses during a course of treatment. With cefaclor, peak middle ear concentrations were less than 40% of peak serum levels. By using this model, data from a natural disease in humans are obtained. Since the mucosa anywhere in the respiratory tract reacts in a uniform manner to an inflammatory stimulus, results from studies on long-standing otitis media with effusion can disclose some aspects on antibiotic pharmacokinetics in respiratory tract secretions in general.

Anti-Bacterial Agents↗
PubMed1983

Penetration of cefaclor to adenoid tissue and middle ear fluid in secretory otitis media.

Seventy-nine patients that had persistent or recurrent secretory otitis media for over 3 months and were scheduled for myringotomy and/or adenoidectomy received a single dose of cefaclor (20 or 40 mg/kg) orally 0.5-4 hours before surgery. Cefaclor concentrations were determined in serum, middle ear fluid and/or blood-free adenoid tissue homogenate using microbiological methods. Concentrations in adenoid homogenate ran parallel to those in serum, indicating a rapid penetration to adenoid tissue. Penetration to middle ear fluid was delayed in comparison. In the 51 patients receiving 20 mg/kg, peak levels occurred after 0.5 hour in serum as well as in adenoid homogenate and middle ear fluid with mean values of 29, 7.5 and 5.1 mg/l, respectively. Concentrations in the middle ear fluid were greater than 2.0 mg/l from 0.5 to 3 hours after this dose. In the 28 patients receiving 40 mg/kg, concentrations levelled after 0.5 hour in serum and in adenoid homogenate, with mean values of 21-33 mg/l and 6.3-12 mg/l, respectively. Concentrations in the middle ear fluid reached 7.8 mg/l 2 hours after this dose. A dose of 20 mg/kg appears to be suitable for treatment of respiratory tract infections on a b.i.d. basis.

Adenoids↗
PubMed1982

The penetration of erythromycin into the middle ear.

The penetration of erythromycin was studied in 108 cases of secretory otitis media. Erythromycin ethylsuccinate was given orally in a dosage of 30-60 mg/kg/day and samples of middle ear effusion were obtained at different intervals. The concentration of erythromycin in the middle ear effusions reached the plasma level (1.1-1.2 mg/l) after 26 hours. The plateau levels were maintained during the steady state. Elimination was slow; 14 hours after the last dose of a ten-day treatment, the concentration of erythromycin in the middle ear effusions was still as high as 0.9 mg/l, compared to 0.2 mg/l in plasma. The concentration of erythromycin in the middle ear effusions surpassed the MICs of most respiratory pathogens. Erythromycin can thus be regarded as a suitable drug in the treatment of otitis media. Furthermore, since the respiratory mucosa reacts in a uniform manner to an inflammatory stimulus, the result of this penetration study is valid for inflammatory diseases in any area lined with respiratory epithelium.

Adolescent↗
PubMed1982

The penetration of erythromycin into Waldeyer's ring--tonsil and adenoid tissue.

Erythromycin ethylsuccinate was given orally (30-60 mg/kg/day) to 72 otherwise healthy children for different intervals before adenoidectomy. The concentration of erythromycin was assessed in homogenized tissue, in whole blood and in plasma, making it possible to calculate blood-free tissue levels. The tissue levels (1.5-2.0 mg/l) were the same as the plasma levels. Six patients with chronic tonsillitis were given 1000 mg erythromycin ethylsuccinate via a gastric tube, and tonsillectomy à froid was performed three to five hours later. This unusual mode of administration was chosen to avoid tonsil surface contamination, which might cause artificially high values. The concentration of erythromycin was assessed as described above. The levels of erythromycin in the tonsil tissue were the same as the concomitant plasma levels. Erythromycin has been shown to penetrate into adenoid and tonsil tissue and to attain levels similar to the simultaneous plasma levels. It may be inferred from this study that erythromycin penetrates into other lymphatic localities to the same degree.

Adenoidectomy↗
PubMed1981

High-dose tobramycin combined with clindamycin or lincomycin in the treatment of septic peritonitis and intraabdominal sepsis.

Tobramycin in combination with clindamycin or lincomycin were used as systemic antibiotics in the treatment of 20 consecutive patients with septic peritonitis or intraabdominal sepsis, 10 of which were in septic shock. Doses were: tobramycin 1.5 mg/kg body weight every 8 hours, with prolonged dosage interval in patients with reduced renal function, clindamycin 0.9 g every 8 hours and lincomycin 1.2 g every 8 hours. Therapy was monitored by means of tobramycin serum concentration determinations and renal function tests. Eventual cure of the infection was obtained in 19 patients. In 2 of these, the effects of the antibiotics were doubtful. Side effects were observed on 8 occasions: One patient had a slight and temporary subjective hearing loss, coinciding with raised trough levels of tobramycin. Diarrhoea occurred in 3 cases and skin reactions in 3 cases. Superinfection with Candida albicans fungemia occurred in one patient. From the overall results it is concluded that the antibiotic regimen is of value in serious life-threatening infections. Although the tobramycin dose was higher than customarily used in Scandinavia at the time, 0 hour and 1 hour serum concentrations remained stable during therapy in patients whose renal function was normal at onset of therapy. Serum creatinine (S-Cr) levels in these patients were also essentially unchanged. Temporary reductions in osmolality (Osm) ratio Osm-urine/Osm-serum occurred in 11 patients despite normal S-Cr, but it was hard to attribute these impairments of renal function to tobramycin specifically. It was also doubtful whether tobramycin further aggravated renal function in those patients where it was impaired at onset of therapy. Thus, no conclusive evidence of clinically important tobramycin-induced nephrotoxicity were found. We suggest that the dosage schedule of tobramycin used in this study is applied when treating serious intraabdominal infections.

Adolescent↗
PubMed1979

Penetration of erythromycin through respiratory mucosa. A study using secretory otitis media as a model.

This study is based upon the concept that the respiratory mucosa reacts in a uniform manner to an inflammatory stimulus. Secretory Otitis Media (SOM) may be used as a model to disclose some aspects of antibiotic penetration. Erythromycin was given for different periods of time to 108 cases of SOM where myringotomy was indicated. The middle ear effusion was aspirated and blood samples were obtained simultaneously. The concentration of erythromycin was determined by microbiological procedures. Erythromycin penetrated into the middle ear effusion. After the fourth dose the concentration was at the same level as the plasma peak level. The elimination of the drug from the middle ear secretion was considerably prolonged compared with the rapid elimination from plasma. This implies that erythromycin attains a steady state in the middle ear effusion with concentrations equal to the plasma peak level.

Adolescent↗
PubMed1976

Enterovirus infections in acute pancreatitis - a possible etiological connection.

All patients admitted with a preliminary diagnosis of acute pancreatitis during a one-year period were subjected to virus investigations. 142 patients were included in the study and of these 91 were found to have acute pancreatitis. Evidence of enteroviral infection was found in 18 of the 91 patients (19.8 per cent). From 17 of the 18 patients enterovirus was isolated from feces or urine, and in one a significant titer rise (CF-test) against Coxsackie virus B5 was found. A significant titer rise of antibodies against the virus type isolated could be demonstrated in 7 of the 17 patients. Thus in 8 cases there was obvious evidence of an acute enteroviral infection during the episode of acute pancreatitis. The etiological agents in these cases were Coxsackie viruses B2, B3, and B5, and ECHO-viruses 6, 11, 22, and 30.

Acute Disease↗
PubMed1967

[Tinnitus].

Explore the source record for details and available documents.

Cardiovascular Diseases↗
PubMedDate not supplied

Penetration of doxycycline in respiratory mucosa.

In order to study the penetration of doxycycline (Idocyklin) in respiratory mucosa 100 mg tablets were given in standard dosage to 58 patients with longstanding secretory otitis media, the "secretion-in-cavity" model, and to 37 patients with nasal polyposis, the tissue model. Myringotomy with aspiration of the middle ear secretion or polypectomy was performed at different intervals during the course of medication. Blood samples were drawn simultaneously. The concentration in secretion, tissue and serum was assessed by means of a microbiological agar well method. The mean concentration of doxycycline in respiratory mucosa and secretion was found to exceed the MICs of the common respiratory pathogens as soon as 3 hours after the first dose, and remained on a therapeutical level until 24 hours after the last dose. The results are in full agreement with those obtained from penetration studies in other parts of the respiratory tract, thereby lending support to the validity of the models used.

Adolescent↗
PubMedDate not supplied

The effect of erythromycin on the nasopharyngeal pathogens in children with secretory otitis media.

Seventy-five children not older than 11 years, with secretory otitis media of more than 3 months' duration were randomly divided into two groups prior to myringotomy. One group remained untreated, whereas the other received erythromycin ethylsuccinate (Abboticin) in standard dosage for the last 10 days before surgery. Nasopharyngeal cultures were taken under general anaesthesia, which ensured an uniform mode of sampling. In the erythromycin-treated group the occurrence of Streptococcus pneumoniae (3%) and Branhamella catarrhalis (0%) was significantly lower than in the control group (35% and 32%, respectively); and the frequency of cultures with no pathogen was significantly higher in the treated group. The occurrence of Haemophilus influenzae remained essentially unchanged.

Bacteria↗
PubMedDate not supplied

Penetration of enoxacin into middle ear effusion.

An oral dose of 400 mg enoxacin was given to each of 19 patients with long-standing secretory otitis media (SOM). A total of 27 samples of middle ear effusion (MEE) and blood were collected at different intervals during a 6-h period after administration of the drug. The concentration of enoxacin in MEE and serum was determined by a microbiological agar-well diffusion method. Enoxacin was found to penetrate rapidly into MEE but was eliminated slowly. The concentration in MEE was about the same at one hour as at 6 h (median value 0.6 mg/l) with a slight peak at 4 h (median value 0.9 mg/l). The peak in blood occurred after one hour (median value 1.8 mg/l), followed by a slow decrease in the concentration during the 6 h studied. The concentration of enoxacin in MEE exceeded the MICs of some (but not all) pathogens usually responsible for infections in chronic otitis media.

Administration, Oral↗