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Biomedical subjects

T Leitha

Publications and source records attributed to T Leitha.

61 records · Page 4Linked to original sources
PubMed1989

Activity of clavulanate-potentiated penicillins against methicillin-resistant Staphylococcus aureus.

It has been suggested that combinations of penicillins with clavulanate may be useful in treatment of infections by methicillin-resistant strains of Staphylococcus aureus (MRSA). To determine the potentiating effect of clavulanate on the antibacterial activity of penicillins, we studied MRSA in vitro by an agar-dilution method. A total of 124 clinical isolates of MRSA were tested for sensitivity to benzylpenicillin, amoxycillin, and ticarcillin alone and in combination with 1.25, 2.5, 5.0 and 10.0 mg/l of clavulanate. Most of the strains were not typable by the international reference set of bacteriophages of human staphylococci but showed typical properties of nosocomial strains. A reduction in the MIC90 of benzylpenicillin and amoxycillin to 25 mg/l was seen in the presence of 2.5 mg/l of clavulanate. The effect was less pronounced with ticarcillin. In spite of some increase in the susceptibility of MRSA to benzylpenicillin and amoxycillin produced by clavulanate, these combinations seem to be inappropriate in infections due to MRSA.

Clavulanic Acids↗
PubMed1989

Inadvertent catheter-induced right bundle branch block in a patient with preexistent left bundle branch block and recurrent macroreentrant ventricular tachycardia.

This article describes the inadvertent, catheter-induced induction of right bundle branch block resulting not only in transient complete infra-His heart block but also in temporary interruption of the macroreentry circuit of ventricular tachycardia. A patient with preexistent left bundle branch block and spontaneous ventricular tachycardia based upon the bundle branch reentry mechanism underwent electrophysiological testing for the evaluation of sotalol drug efficacy. In search of an optimal His-bundle recording, the manipulation of a 6 Fr quadripolar catheter caused a right bundle branch block, thus advancing the preexistent left bundle branch block to complete heart block. Retrograde ventriculoatrial conduction remained unaffected. The macroreentrant tachycardia with left bundle branch block configuration was no longer inducible. While the patient continued on unchanged sotalol medication (320 mg/d) he required temporary pacing for 16 hours until the block subsided. A subsequent induction attempt demonstrated initiation of the tachycardia. Finally, guided by invasive testing, the patient successfully received amiodarone therapy (300 mg/d). The patient completed an uneventful follow up of 27 months. No progression of conduction delay was observed. This case suggests that the inadvertent induction of right bundle branch block prevents the initiation of ventricular tachycardias relying on bundle branch reentry. Therefore, missed diagnosis or misinterpretation of antiarrhythmic drug efficacy might occur if there is no electrophysiological reevaluation after right bundle branch recovery.

Aged↗
PubMed1989

Platelet deposition at angioplasty sites and its relation to restenosis in human iliac and femoropopliteal arteries.

The amount and time course of platelet accumulation at angioplasty sites and influence of these platelets on restenosis after percutaneous transluminal angioplasty (PTA) in peripheral arteries were determined in 92 patients, who received either a high or low dose of aspirin. Platelet deposition was quantitated by means of dual-radiotracer scintigraphy and calculation of a platelet accumulation index (PAI). The PAI was higher (P less than .05) 4-6 hours after PTA compared with that on subsequent days. There was a trend toward greater platelet accumulation in vessels with extensive dissection. Platelet accumulation at the PTA site occurred with both doses of aspirin, with no differences between the two dosage groups. Twenty-one of 67 patients who underwent PTA in the femoropopliteal segment developed restenosis during a median follow-up of 14 months. The median PAI at 4-6 and 22-24 hours after PTA was significantly less in these 21 patients than in the 46 without restenosis. The data suggest that use of antiplatelet agents to prevent platelet deposition after PTA may not be useful for prevention of restenosis.

Angioplasty, Balloon↗
PubMed1988

[High dosage and intermediate dosage cytosine arabinoside in the treatment of secondary leukemias].

Patients with secondary acute myeloid leukaemia (AML) following treatment with alkylating agents and/or radiation show a poor response to standard induction therapy. Between 1983-1987 8 consecutive patients were treated with high-dose cytosine arabinoside (HD-ARA C; 3 g/sqm twice daily for 6 days) or intermediate-dose cytosine arabinoside (ID-ARA C; 0.5 g/sqm twice daily for 6 days). Complete remission was achieved in 3 patients (HD-ARA C: 2/3l; ID-ARA C: 1/5) and partial remission in 3 patients (ID-ARA C: 3/5). One patient (HD-ARA C) died during prolonged aplasia, one patient (ID-ARA C) proved refractory to treatment. The respective duration of remission in the 3 responsive patients was 3, 7 and 8 months. The probability of survival of the whole group was 50% after 12 months and 25% after 24 months. Our results confirm the efficacy of monotherapy with ARA C in the treatment of secondary AML. Consolidation therapy with ID-ARA C for 4 days seems to prolong remission.

Adult↗
PubMed1985

Methicillin- and gentamicin-resistant Staphylococcus aureus: susceptibility to fosfomycin, cefamandole, N-formimidoyl-thienamycin, clindamycin, fusidic acid and vancomycin.

The in vitro activity of fosfomycin against 90 strains of methicillin- and gentamicin-resistant Staphylococcus aureus was studied in an in vitro microtitre system using Mueller-Hinton broth supplemented with glucose-6-phosphate. In parallel the antistaphylococcal activity of cefamandole, N-formimidoyl-thienamycin, clindamycin, fusidic acid and vancomycin was determined with the same organisms. The following MIC50 (MIC95) values were obtained: fosfomycin 8 (128) mg/l, cefamandole 8 (greater than 64) mg/l, clindamycin 0.25 (16) mg/l, fusidic acid less than 0.25 (less than 0.25) mg/l, vancomycin 1 (2) mg/l and N-formimidoyl-thienamycin 4 (16) mg/l. A high MIC/MBC ratio was noted for cefamandole, in contrast to fosfomycin.

Cefamandole↗
PubMedDate not supplied

In vitro activity of fosfomycin against methicillin-susceptible and methicillin-resistant Staphylococcus aureus.

The in vitro antibacterial activity of fosfomycin was compared to that of oxacillin, cefazolin, ceftriaxone and vancomycin against isolates of Staphylococcus aureus from patients treated at the University of Vienna General Hospital. Of 211 strains, 104 were methicillin-susceptible and 107 were methicillin-resistant. Fosfomycin inhibited over 90% of the strains at concentrations of less than or equal to 64 mg/l, independent of methicillin susceptibility or resistance. The minimal bactericidal concentrations (MBC) were one dilution above the minimal inhibitory concentrations (MIC). Vancomycin showed activity similar to fosfomycin while other beta-lactam antibiotics such as oxacillin, cefazolin and ceftriaxone were inactive against methicillin-resistant S. aureus. Fosfomycin at a high dosage seems to be a potential drug for the treatment of infections due to methicillin-resistant S. aureus.

Anti-Bacterial Agents↗