PubMed HealthSearch

Biomedical subjects

T Simon

Publications and source records attributed to T Simon.

At least 37 records · Page 2Linked to original sources

Double-blind trial of omeprazole and amoxicillin to cure Helicobacter pylori infection in patients with duodenal ulcers.

BACKGROUND/AIMS: Anti-Helicobacter pylori treatment with combinations of omeprazole and amoxicillin is a promising treatment option. The aim of this study was to investigate whether a daily omeprazole dose of 120 mg combined with amoxicillin would cure H. pylori infection at a rate comparable with that achieved with "triple therapy." METHODS: In a double-blind, randomized, controlled, and multicenter trial in Germany, 270 patients with an H. pylori-associated duodenal ulcer were treated with 40 mg omeprazole three times a day and 750 mg amoxicillin three times a day for the first 14 days (n = 139) followed by 20 mg omeprazole once daily until day 42 or with omeprazole plus 750 mg amoxicillin placebo three times a day for the same time period (n = 131). RESULTS: Cure rates of H. pylori infection were 91% in the omeprazole plus amoxicillin group, 0% in the omeprazole plus placebo group, and 89% and 0%, respectively, performing an intention-to-treat analysis. Cure of H. pylori infection in patients pretreated with omeprazole was only 58% compared with 95% in patients who were not. The cumulative 12-month relapse rates were 11.3% and 44% in the treatment groups and 1.6% in H. pylori-negative and 49% in H. pylori-positive patients. CONCLUSIONS: The combination of 120 mg omeprazole daily and 2.25 g amoxicillin daily with its H. pylori cure rate of around 90% is one of the best tolerated and most effective treatment regimens.

Adolescent

High doses of gonadotropins have no detrimental effect on in vitro fertilization outcome in normal responders.

OBJECTIVE: To examine the effect of high doses of gonadotropins on IVF outcome in normal (intermediate) responders. DESIGN: Retrospective analysis of patients undergoing IVF therapy from 1990 to 1994 at our institution. SETTING: Academic tertiary center. PATIENTS: A homogeneous group of women that consisted of intermediate responders examined in their initial attempt and who received differing amounts of gonadotropins were examined. INTERVENTIONS: All patients were stimulated using a combination of a GnRH-agonist and FSH and hMG and were allocated into two groups, based on the amount of gonadotropin administered initially (four or six ampules). MAIN OUTCOME MEASURES: Implantation and pregnancy (clinical and ongoing) rates were compared. RESULTS: There were no significant differences between patients receiving high doses versus those patients receiving lower doses of gonadotropins with regard to implantation and pregnancy rates. CONCLUSIONS: We conclude that high doses of gonadotropins have no detrimental effect on IVF outcome in normal (intermediate) responders.

Adult

Reduction in obstructive breathing events during body rocking: a controlled polygraphic study in preterm and full-term infants.

OBJECTIVE: To investigate the effect of body rocking on infant respiratory behavior during sleep. METHODS: Eighteen infants with documented obstructive sleep apneas were studied. There were eight premature infants with persistent bradycardias and 10 infants born full-term, admitted after an idiopathic apparent life-threatening event. No cause for the obstructive apneas was found. The infants were recorded with polygraphic techniques during two successive nights. They were randomly assigned to a rocking or a nonrocking mattress. The conditions were reversed the following night, in a crossover design. RESULTS: In both groups of infants, no significant difference was seen between the two consecutive nights for most of the variables studied: total sleep time, the proportion of non-rapid-eye-movement and rapid-eye-movement sleep, the number of arousals, the number and maximal duration of central apneas, the frequency of periodic breathing, the level of oxygen saturation, and heart rate. During the nonrocking nights, all infants had repeated obstructive breathing events. In seven of the eight preterm infants and in nine of the 10 full-term subjects, body rocking was associated with a significant decrease in the frequency of obstructive events. During rocking, in the preterm infants the obstructions fell from a median of 2.5 to 1.8 episodes per hour (P = .034). In the full-term infants, rocking reduced the obstructive events from a median of 1.5 obstructions per hour to 0.7 (P = .005). No difference was seen for the duration of the obstructive episodes. CONCLUSION: In preterm and full-term infants prone to obstructive sleep apneas, gentle side-to-side body rocking is associated with a significant decrease in the frequency of upper-airway obstructions.

Beds

[Knowledge about and attitude to HIV/AIDS among dentists and dental assistants in Budapest, November 1992].

118 Dentists and 115 Dental Nurses opinion was evaluated about their knowledges and attitudes to HIV/AIDS problem in Budapest (Hungary) 1992 November. The frequency of false knowledges about the transmission was 5-10%. More than 70% of the asked persons changed their habits in working place and 62% of dentists and 78% of nurses uses rubber gloves. 2.5% of the dentists and 7.8% of nurses thinks they will refuse the treatment of a HIV/AIDS patient. Most informations collected the doctors from professional literature and the nurses from mass medias, the mention of postgraduate trainings was low. Above data are valid for those persons who are working in the state health care system. Data of the private practice will be collected and analysed in the future.

Acquired Immunodeficiency Syndrome

[Experience with rocephin in orthopedic practice].

Authors report on the results of Rocephin prophylaxis in 30 total prostheses. The dose of the preparation was 2g/day. It was given 3 times in intravenous drop infusion 1-1.5 hours before the operation and on the second and third day. The drains were then removed. During 1 year observation no wound infection was observed. As a postoperative complication exacerbation of chronic bronchitis, existing already since years, was found. This however healed after 5 and 6 days of Rocephin and expectorant treatment. As side effect of the medicament, in single cases, vomiting, stomatitis, thrombocytopenia and allergic dermatitis were observed. It is stated, based on own experience, that the broad spectrum Rocephin, belonging to the third generation cephalosporins, securing a 24 hours bactericide activity, is suitable in a single 2g dose/day in hip endoprosthesis to prevent postoperative infections.

Aged

Splenic infarction associated with anticardiolipin antibodies in a patient with acquired immunodeficiency syndrome.

Although patients with AIDS frequently develop high titers of anticardiolipin antibodies, the clinical significance of this laboratory abnormality in AIDS patients is unknown. A 33-year-old female with AIDS, a prior small cerebrovascular accident, thrombocytopenia, and a coagulopathy suddenly developed left upper quadrant pain and tenderness due to splenic infarction associated with a high titer of anticardiolipin antibodies. Possible clinical manifestations of anticardiolipin antibodies in this patient include recurrent thromboembolism, coagulopathy, and thrombocytopenia. This case report suggests that anticardiolipin antibodies are associated with splenic infarction and that anticardiolipin antibodies associated with AIDS may sometimes be clinically significant.

Acquired Immunodeficiency Syndrome

Radiographic analysis of femoral interference screw placement during ACL reconstruction: endoscopic versus open technique.

Fifty patients with anterior cruciate ligament reconstruction using a bone-patellar tendon-bone autograft performed by two techniques were evaluated roentgenographically to compare the position of the femoral interference screws. Group I consisted of 25 patients in whom the screw was placed using a distal lateral femoral incision (the two-incision technique). Group II patients underwent arthroscopically assisted intraarticular placement of the screw. These patients were then evaluated with anterior-posterior (AP) and lateral roentgenograms. We observed that the AP and lateral screw angles were significantly different with the two techniques. In addition, the endoscopic placement of the femoral screw had an associated divergence of the screw relative to the bone plug in nine of 25 patients compared with zero of 25 in the open group. In conclusion, radiographic differences do exist between femoral interference screws placed for fixation of an ACL graft using the open approach and those placed endoscopically. Although the clinical significance of these differences is not known, we raise the question of greater divergence in femoral interference screw placement with the newer intraarticular femoral interference screw placement techniques.

Anterior Cruciate Ligament

Complex issues for sexual assault peer education programs.

Peer education programs dealing with sexual assault are important for starting dialogue and improving students' awareness. If a peer education effort is to be effective, the college or university must have written policies condemning sexual assault, investigative and reporting procedures, and comprehensive sexual education and information programs. Experience at Brown University revealed the necessity of providing peer educators with opportunities during initial training for open and honest dialogue on the politics of campus rape, facing issues of power and dominance, women's dress as a factor in rape, and the distinction between victim and survivor. These discussions can be strained and frustrating, but they are a necessary step in resolving conflict among the peer educators and helping them provide a consistent message.

Female

Ruptured ovarian artery aneurysm complicating a term vaginal delivery.

Ruptured ovarian artery aneurysm is rare. Of the eight cases previously reported, seven were diagnosed postpartum. Our case of a ruptured right ovarian artery aneurysm was associated with massive retroperitoneal bleeding. The probable time of rupture could be traced to the second stage of labor. This case indicates the need for early evaluation of atypical flank pain during labor.

Adult

Active AIDS surveillance: hospital-based case finding in a metropolitan California county.

OBJECTIVES: Health departments that use passive surveillance alone cannot be sure of the level of complete and accurate reporting of acquired immunodeficiency syndrome (AIDS) cases. We sought to develop a model of active AIDS case reporting using limited county resources. METHODS: A validation study of AIDS case reporting using discharge diagnosis codes was undertaken to assess underreporting. Hospital-specific protocols for active surveillance were developed. RESULTS: The validation study revealed that 24% of AIDS cases in all hospitals were not reported through passive surveillance in 1990. In the first 3 months of 1991, active surveillance identified nine unreported cases (69% of the total cases reported) in one hospital. These underreporting estimates far exceed the 15% national underreporting rate estimated by the Centers for Disease Control. CONCLUSIONS: A method of hospital-based case finding was developed and serves as the model for implementing an ongoing program of active surveillance needed to ensure complete, accurate, and timely reporting of diagnosed AIDS cases. Application of this model may be helpful in attempts to minimize underreporting.

Acquired Immunodeficiency Syndrome

Colonic toxicity of administered medications and chemicals.

Although medication-induced colonotoxicity is uncommon, it is important that it be recognized, because the initial therapy for this condition is medication discontinuation. This review categorizes the association between the listed medications and colonotoxicity as "well-established" or "probable," according to the following criteria: number of clinical studies by independent clinical investigators, total number of reported cases, plausibility of an association based on experimental and pharmacologic studies, and validity of an association in each reported case. Medications associated with colonic ischemia include cocaine, ergotamine, estrogen, amphetamines, digitalis, methysergide, and vasopressin. Medications associated with colonic pseudoobstruction include narcotics, phenothiazines, vincristine, atropine or other anticholinergics, ganglionic blocking agents, and tricyclic antidepressants. Medications promoting infectious or necrotizing enterocolitis include numerous antibiotics associated with pseudomembranous colitis, deferoxamine associated with Yersinia enterocolitis, chemotherapy associated with neutropenic colitis, and hyperosmolar medications or formulas in infants. Medications associated with an allergic, inflammatory, or cytotoxic colitis include gold compounds, nonsteroidal antiinflammatory drugs, alpha-methyldopa, flucytosine, methotrexate, salicylates, and sulfasalazine. Potassium chloride, administered in slow-release wax matrices, can cause intestinal ulcers. Chronic cathartic use leads to colonic hypomotility and abdominal distention. Methysergide can cause a colonic stricture due to retroperitoneal fibrosis. Intrarectally administered compounds that have produced a toxic colitis include powerful acids, bases, and other corrosives. Enemas using hypertonic radiographic contrast agents have been associated with colitis in patients with colonic obstruction.

Colonic Diseases

Fulminant acute colitis following a self-administered hydrofluoric acid enema.

A 33-yr-old white male presented with bloody diarrhea, leukocytosis, and left lower quadrant direct and rebound tenderness after a self-administered concentrated hydrofluoric acid enema while intoxicated from intranasal cocaine administration. Intraoperative flexible sigmoidoscopy and a gastrografin enema revealed severe mucosal ulceration and edema in the rectum and sigmoid colon. Laparotomy revealed an ulcerated, necrotic, and purulent sigmoid colon and intraperitoneal pus. The patient underwent a limited sigmoid resection and a Hartman procedure. Five months later, the patient presented with a rectal stricture which was resected. This case demonstrates that a hydrofluoric acid enema can cause fulminant acute colitis and chronic colonic strictures.

Acute Disease

Physiological growth of arteries in the rat heart parallels the growth of capillaries, but not of myocytes.

Maladaption to hemodynamic overload, especially to arterial hypertension, has important clinical implications, and it is necessary to obtain criteria in order to discriminate physiological and pathological growth processes. We investigated the physiological growth of intramyocardial arteries in the rat heart. A new stereological method was introduced to determine the length of intramyocardial arteries from counts on histological sections. Four groups of male Sprague-Dawley rats of different ages were investigated. The growth rate of arteries was characterized by the growth coefficient b according to the exponential function y = axb (allometric growth function). Analysis of left ventricular weights (LVW) and total lengths of left ventricular intramyocardial arteries (L) revealed Lv = constant.LVW0.71 (r = 0.77, P < 0.001). The growth coefficient b < 1 indicates that the arterial supply of the heart, i.e. the length density of arteries Lv (length per unit myocardial volume), decreases during normal growth. Empirically, we found L = constant.LVW-0.28 (r = 0.43, P < 0.01). Previously, we estimated growth rates of b = 0.33 for the total length of left ventricular myocytes and b = 0.71 for the total length of capillaries. Thus, growth of intramyocardial arteries considerably exceeds the length increase of myocytes, but is proportional to the length increase of capillaries. Growth analysis of total mitochondrial volume using historical data of our group revealed proportionality to arteries, as well (b = 0.76). This indicates that growth of arteries and capillaries may be determined by oxygen consumption.

Animals