PubMed Health⌕ Search

Biomedical subjects

T Mindermann

Publications and source records attributed to T Mindermann.

26 records · Page 2Linked to original sources
PubMed1993

Randomized placebo-controlled trial of single-dose antibiotic prophylaxis with fusidic acid in neurosurgery.

In neurosurgery, the antibiotic prophylaxis of choice has not yet been determined. The ideal drug should have an appropriate antimicrobial spectrum and favourable pharmacokinetic properties. In addition it should be nontoxic and easy to apply. We therefore conducted in 90 patients a prospective, randomized, placebo-controlled, double-blind trial in clean neurosurgery at increased risk of wound infection using a single pre-operative dose of 500 mg fusidic acid. Fusidic acid is a steroid-like antibiotic with a serum half-life of about 10 hours and excellent activity against gram-positive bacteria, including methicillin-resistant staphylococci. The neurosurgical infection rates for craniotomies, posterior fossa surgery and implantation of foreign bodies were 2.4% in the treatment group and 9.1% in the placebo group, respectively. This difference is statistically significant at a 95% confidence level.

Adolescent↗
PubMed1993

Penetration of fusidic acid into human brain tissue and cerebrospinal fluid.

Penetration of fusidic acid into brain tissue in six patients and cerebrospinal fluid in seven patients was determined. Tissue samples, taken during surgery revealed drug levels at about 7% of simultaneous serum concentrations. In contrast, cerebrospinal fluid concentrations were below 1% of serum levels. Since serum- and tissue levels of fusidic acid were far above the minimal inhibitory concentration (MICs) of staphylococci and streptococci, and since it has a long serum half-life of about 10 hours, it is a promising candidate for prophylaxis in neurosurgery.

Adult↗
PubMed1993

Penetration of rifampicin into the brain tissue and cerebral extracellular space of rats.

Rifampicin is used to treat neurosurgical shunt infections because of its excellent in-vitro activity against staphylococci and its adequate penetration into the CSF. However, nothing is known about rifampicin concentrations in the cerebral extra-cellular space (CES). We measured the penetration of rifampicin into the CES of anaesthetized rats by microdialysis using low-flow and equilibrium methods. Depending on the method, rifampicin concentrations in the CES were 0.3-1% of the serum concentration or 3-8% of brain tissue concentration, respectively. These experimental data in animals suggest that the recommended dose of rifampicin in man might be inadequate for treatment of some brain infections.

Animals↗
PubMed1993

Thyrotropin-producing pituitary adenomas.

To evaluate the biology of thyrotropin (TSH)-producing pituitary adenomas, the authors reviewed the charts of 19 patients who underwent transsphenoidal surgery within a 15-year period at the University of California, San Francisco (UCSF). Between 1989 and 1991, the period during which immunostaining techniques were used consistently for diagnosis, 2.8% of the pituitary adenomas treated at UCSF were TSH-producing. The rate of reoperation for tumor recurrence was 10.5%. Before pituitary surgery, more than one-third of the 19 patients had undergone thyroid ablation. Two patients had a history of Hashimoto's thyroiditis. The female:male ratio was 1.7:1. Women tended to develop these tumors at a younger age and had a longer history of symptoms but their tumors were smaller and less often invasive than those seen in men. About 50% of the tumors were purely TSH-producing and 50% were plurihormonal, including five that produced both TSH and adrenocorticotroph hormone. All tumors were macroadenomas. Before surgery, 46% of the patients had abnormal electrocardiographic findings; 16% had a rapid onset of severe neurological conditions either before or after surgery. It is concluded that TSH-producing adenomas are more common in patients who undergo surgical treatment than was previously thought. In addition, they occur more frequently in women, have a different biology in women than in men, and tend to be associated with potentially life-threatening cardiovascular and neurological complications.

Adenoma↗
PubMed1992

Significant lateralisation of supratentorial ICP after blunt head trauma.

After blunt head trauma simultaneous left and right hemispheric intracranial pressure (ICP) monitoring revealed a pressure gradient of about 30 mmHg persisting until the 5th day after the accident equilibrating thereafter. ICP was elevated over the radiologically more compressed hemisphere. The supratentorial space seems to allow considerable interhemispheric pressure gradients. As a consequence epidural ICP monitoring should be performed over the hemisphere with signs of greater compression.

Brain Edema↗
PubMed1989

[Partial gastrectomy and Roux-en-Y anastomosis in recurrence of reflux following fundus plication].

Roux-en-Y reconstruction has been in use for several years as a reoperation for persistent esophagitis after fundoplication. The limited data in the literature appear to favour this approach. We have conducted a retrospective review of the records of 5 patients who have undergone this type of surgery for persistent reflux in the last four years. In 3 of these patients after fundoplication endoscopy showed grade IV esophagitis, grade III esophagitis in 1, and grade II esophagitis in 1. After Roux-en-Y reconstruction 1 endoscopy showed grade I esophagitis in 1 patient, and grade II esophagitis in 1. Three patients had no evidence of esophagitis and 1 patient was symptom-free and refused endoscopy. These results are in agreement with those in the literature. We conclude that Roux-en-Y diversion is a practicable reoperation after fundoplication and provides good results.

Adult↗
PubMed1984

[In which operations is antibiotic prevention carried out with only a a single dose? Results of a survey among chief physicians in general surgery in German-speaking Switzerland].

We have been asking 108 surgeons in chief of the German speaking part of Switzerland in what operations they are giving an antibiotic prophylaxis. We wanted to know how far the application of the single-dose concept has been entering every day's practice in Switzerland. Its value has been proven in several prospective, randomized, controlled studies. Out of 84 valid questionnaires we could see that single-dose prophylaxis has not yet come into common use, although it is not only more reasonable but also less expensive than a prolonged course. Fortunately, already 90% of the surgeons are giving an antibiotic prophylaxis in colorectal surgery and 53% in biliary tract surgery. A majority of surgeons do not yet provide antibiotic prophylaxis in gastric surgery nor in appendectomies, where the single-dose prophylaxis is effective as well.

Anti-Bacterial Agents↗