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Biomedical subjects

U Thurnheer

Publications and source records attributed to U Thurnheer.

17 recordsLinked to original sources
PubMed1995

[Cat scratch (?) disease].

The case of a 24 year old female student who developed typical cat scratch disease following an insect sting invited to review the literature. Over the last two years, Rocalimaea henselae could be identified and is now considered to be responsible for the majority of infected cases. It is related to Rochalimaea quintana that provokes trench fever and to Bartonella bacilliformis, known as the inciting agent of the verruca peruana and of Oroya fever. Recently, it has been proposed to integrate Rochalimaea and Bartonella into the family of Bartonellaceae. The diverse and fascinating array of clinical syndromes caused by R. henselae as well as their treatment are described. Capability to affect organs other than skin and lymph nodes is primarily but not exclusively associated with immunodeficiencies. In countries like Switzerland little information on these clinical pictures is available. However, it is important to recognize the typical symptoms and signs in order to initiate the appropriate and necessary examinations.

Adult↗
PubMed1995

Nephrotoxicity, high frequency ototoxicity, efficacy and serum kinetics of once versus thrice daily dosing of netilmicin in patients with serious infections.

The effect of dosing regimen on nephrotoxicity, high frequency ototoxicity, efficacy and serum kinetics was studied in a prospective, randomised clinical study. Therapy was started with total daily doses of 6 mg/kg given once (od) or thrice (tid) daily to 56 and 57 patients, respectively. Subsequent doses were adjusted according to serum levels. No major differences in toxicity or efficacy were noticed between od and tid regimens: clinical failures occurred in two and two patients, four and five patients suffered from a decrease of > or = 20 dB at least unilaterally at one frequency between 8 and 18 kHz, six and seven patients had a > 25 mumol/L or > 25% increase in serum creatinine, respectively. Serum creatinine or creatinine clearance did not change significantly during either therapy. Major differences between the two study groups were limited to pharmacokinetic parameters. Od dosing resulted in higher peak (mean of 21.6 vs 7.2 mg/L) and lower trough levels (0.5 vs 1.4 mg/L). Half-lives of netilmicin determined between 1 and 8 h increased significantly during therapy with tid (from a mean of 2.75 to a mean of 3.33 h, P < 0.01) but not significantly with od (rise from 2.8 to 3.03 h). Much longer half-lives were determined between 8 and 24 h in the od group (mean of 5.7 h, P < 0.01). In conclusion, only minimal differences in toxicity and efficacy were observed. Their clinical relevance appears to be minimal.

Adolescent↗
PubMed1994

Monitoring serum concentrations for once-daily netilmicin dosing regimens.

A once-daily dosing regimen for aminoglycosides is less expensive, at least as effective and possibly less toxic than multiple-daily dosing regimens. Once-daily dosing might also allow the frequency of measuring the serum concentrations of these antibiotics to be reduced since two of the major objectives of monitoring, high peak and low trough concentrations, are more likely to be achieved with this regimen. A novel strategy for monitoring serum concentrations which relies on a single sample obtained 8 h after a dose, as opposed to both trough and peak samples, is evaluated here. Serum kinetics of netilmicin were studied prospectively in 51 adult patients with initial serum creatinine concentrations of < 130 mumol/L who were treated with a median daily dosage of 400 mg. Concentrations measured 8 h after administration were within the target range of 1.5-6 mg/L in 113 of 134 dosing intervals studied. Concentrations above and below this range correlated significantly with higher and lower 24-h trough concentrations and areas under the curve respectively. There was also a significant correlation between 8-h netilmicin concentrations and nephrotoxicity (P < 0.05); a relative increase of > or = 25% in the serum creatinine concentration or an absolute increase of > 25 mumol/L was detected in 0 of 7 patients with an 8-h concentration of < 1.5 mg/L, in 3 of 33 patients (9.1%) with an 8-h concentration of 1.5-6 mg/L and in 4 of 11 patients (36%) with an 8-h concentration of > 6 mg/L.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Spontaneous pubic osteomyelitis caused by Pseudomonas aeruginosa].

A 53-year-old woman was admitted because of a two weeks' history of progressive perineal pain, low-grade fever, a high erythrocyte sedimentation rate, and tenderness over the inferior rami of the pubic bone. Osteomyelitis was suspected. However, bone scanning, computed tomography, and magnetic resonance imaging of the pelvis showed no evidence of intraosseous disease, but revealed signs of inflammation in the surrounding soft tissue. Conventional antimicrobial therapy was unsuccessful. Biopsy of the bone demonstrated active osteomyelitis and the cultures grew Pseudomonas aeruginosa. Osteomyelitis of the pubic bone and symphysis is most often a sequel to pelvic surgery but has also been observed in i.v. drug abusers. In both circumstances Pseudomonas aeruginosa has frequently been identified as the causative agent. Pelvic osteomyelitis is extremely rare in patients without predisposing factors. Osteomyelitis can only be differentiated from osteitis pubis, a non-infectious inflammatory disease, by bone biopsy. The treatment of choice for osteomyelitis is a beta-lactam antibiotic effective against pseudomonas in combination with an aminoglycoside for 4-6 weeks. Recent studies have demonstrated that new generation quinolones are also effective.

Ceftazidime↗
PubMed1991

[Unstable angina pectoris].

Unstable angina pectoris, a particular form of acute coronary heart disease is described in two exemplary cases. This article will illustrate problems with definition and further (sub-)classification of the disease. Furthermore etiology and pathophysiologic mechanisms as well as diagnostic tools, current management and prognostic aspects will be discussed.

Adult↗
PubMed1988

[The osmotic gap in the diagnosis of alcoholic intoxication].

Sodium, urea, glucose and osmolality were determined in 50 hospitalized patients. Osmolality was calculated according to two different methods and compared with measured osmolality. Both methods showed equally close correlations (r = 0.87), and for clinical use we recommend the following simple formula: osmolality = 2 x sodium + glucose + urea. The two formulas studied were then used to calculate the osmolal gap (difference between measured and calculated osmolality) in 30 patients with ethanol intoxication, in order to estimate the blood alcohol concentration. For the equation: blood ethanol concentration (g/L) = osmolal gap/27 we found a very good correlation between calculated and measured ethanol levels (r = 0.95). Our data confirm previous reports that blood ethanol can be quickly and fairly exactly estimated by using the osmolal gap.

Alcoholic Intoxication↗
PubMed1988

[Septic melioidosis following a visit to India].

A case is reported of lethal septicemic melioidosis due to Pseudomonas pseudomallei in a 40-year-old woman who had been in India. The epidemiology, clinical findings and management of this unusual disease are discussed. The diagnostic value of serological tests and in vitro sensitivity of Pseudomonas pseudomallei to various antibiotics are outlined. Melioidosis should be considered in the differential diagnosis of any febrile condition in a person returning from a tropical country.

Adult↗
PubMed1988

[Fructosamine determination as a screening test for diabetes mellitus in patients with acute coronary heart disease].

Plasma fructosamine was determined in 41 patients with acute coronary heart disease (acute myocardial infarction and instable angina) to assess its usefulness as a screening method for diabetes mellitus. The results (11/15 true positive and 23/26 true negative) were comparable to those for glycated hemoglobin (14/15, 22/26). Discriminant analysis was performed to extract additional information from further laboratory data (glucose and albumin).

Coronary Disease↗
PubMed1983

Venom immunotherapy in hymenoptera sting allergy. Comparison of rush and conventional hyposensitization and observations during long-term treatment.

42 patients with confirmed hypersensitivity to honey bee (HBV) and/or yellow jacket (YJV) were treated with the respective venoms (7 with HBV, 5 with VJV and 30 with both venoms). Treatment tolerance, skin tests (ST), specific IgE- and specific IgG-antibodies were monitored before, after 3, 6, 12, 24 and 36 months. 21 patients had a rush and 21 a conventional treatment schedule. Maintenance dose was 100 micrograms. Adverse effects occurred as large local (8 patients), slight systemic (12 patients) and moderate to severe systemic reactions (4 patients). Of 24 re-exposed patients 17 had no reaction at all, six a markedly decreased and one an unchanged reaction. After 3 years of treatment ST became negative in nine of 31 patients on HBV and in seven of 26 patients on YJV. RAST became negative in three of 30 patients on HBV and 17 of 29 patients on YJV treatment. Both ST and RAST became negative in five HBV- and 10 YJV-treated patients. Loss of venom hypersensitivity according to diagnostic tests may correspond to actual desensitization and enable discontinuation of immunotherapy.

Adolescent↗
PubMed1979

Immunotherapy in bee sting hypersensitivity. Bee venom versus wholebody extract.

Fifty-six patients with serologically confirmed bee sting hypersensitivity were treated for 1-3 years with either bee venom (BV) (31 patients) or wholebody extract (WBE) (25 per cent of re-exposed patients on BV-therapy showed a diminished reaction and 75% no reaction. Thirty-three per cent of re-exposed patients on WBE-therapy developed an unchanged or worse reaction, 42% a diminished reaction and 25% no reaction at all. An initial rise in BV-specific IgE was observed in BV-treated patients, whereas IgE levels after 1 year of treatment lay significantly below pretreatment values in both treatment groups. BV-specific IgG increased markedly in patients on BV-therapy and decreased slightly in those on WBE-therapy. The initial IgE increase induced by BV-therapy was insignificant in patients with high pretreatment levels of specific IgG-antibodies. Similarly, re-exposed patients with high BV-specific IgG showed no IgE increase, whereas a substantial rise in specific IgE was observed in those with low IgG. On the basis of clinical and serological results immunotherapy with BV is considered to be clearly superior to immunotherpy with WBE.

Adult↗
PubMed1978

Liver involvement in cystic fibrosis. A report of 9 cases.

9 out of 204 unselected cystic fibrosis (CF) patients seen at the Department of Pediatrics, University of Berne, Switzerland, over the last 20 years had clinically overt liver disease. In 7 patients liver cirrhosis was demonstrated (3.4%). Focal biliary cirrhosis was the pertinent finding in 3 cases, whereas another 3 showed unspecific nodular cirrhosis. One infant presented with prolonged obstructive jaundice due to partial extrahepatic atresia and delayed passing of meconium. Two other patients had steatosis. A review of the literature dealing with clinical and laboratory findings in CF patients with liver disease is given.

Adolescent↗