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Biomedical subjects

W Behrens-Baumann

Publications and source records attributed to W Behrens-Baumann.

At least 73 records · Page 4Linked to original sources
PubMed1997

[Tectonic epikeratoplasty as an alternative to keratoplasty à chaud?].

PURPOSE: To compare the outcome of epikeratoplasty vs. penetrating keratoplasty in patients with corneal ulcer. PATIENTS AND METHODS: 24 patients had been treated by an epikeratoplasty and 20 patients by a penetrating keratoplasty within 5 years. The indication to operate was progression of a corneal ulcer, perforated ulcer or a descemetocele. In epikeratoplasty a complete cornea with adjacent scleral rim was fixed upon the recipient eye by scleral sutures. This transplant was removed after some weeks. In both groups the patients were reexamined and the anatomical and functional outcome was registered. RESULTS: In both groups all but one globe could be saved. The integrity of corneal surface was restored in 85% (n = 17) of the keratoplasty group and in 75% (n = 18) in epikeratoplasty. The vascularization of the cornea after removing the transplant in epikeratoplasty patients was increased by 70% (n = 17) and their corneas revealed more opacification than before. In the penetrating keratoplasty patient group the vascularization increased in 40% (n = 8) and in 20% (n = 4) of the patients the transplant became cloudy. The visual acuity improved in 13 cases in penetrating keratoplasty but only in two cases after epikeratoplasty. CONCLUSION: A corneal ulcer (with or without perforation) treated by a penetrating keratoplasty with removing the ulcerated tissue has a better outcome than an ulcer covered by an epikeratoplasty. In patients only able to tolerate a short time of surgery with minimal operative risk or if there is no possibility of microsurgical treatment epikeratoplasty may be an alternative to penetrating keratoplasty in saving the globe. However, in most patients penetrating keratoplasty has better functional results.

Adolescent↗
PubMed1997

Povidone-iodine liposomes--an overview.

In recent years, liposomes have been increasingly explored as novel drug delivery systems, and several liposome-based drug products have been approved in Europe, the USA and Japan. Depending on size, composition and surface characteristics, liposomes interact specifically with biological structures. Liposomal drug products provide a topical activity at the desired locus of action and are deemed more effective and less toxic than conventional drug formulations. The combination of povidone-iodine (PVP-I) and liposomes unites the exceptional microbicidal activity of the antiseptic substance with the excellent tolerability and lack of immunogenicity of liposomes; in addition, liposomes provide a moist molecular film for the wound environment. The multilamellar vesicles act as microreservoirs hence prolonging the release of the active ingredient. Although no commercial product for repeated application on the eye is currently available, PVP-I has been used in ophthalmology not only for pre- and postoperative antisepsis, but also for the treatment of bacterial and viral conjunctivitis and for prophylaxis against ophthalmia neonatorum. For these indications, liposomal formulations with 2.5 and 5.0% PVP-I were developed. These eye drops are isotonic with tear fluid at pH 6. First in vitro tests demonstrated an excellent antimicrobial efficacy, and a placebo-controlled clinical study on volunteers showed a very good local tolerability. A study on rabbits demonstrated positive results of the PVP-I liposome eye drops compared to placebo and the broadspectrum antibiotic Polyspectran in a standardized model of Staphylococcus aureus deep eye infection. The other aim is a well-tolerated liposomal PVP-I hydrogel for improved antiseptic wound treatment with moisturizer. It has been reported that liposomes are enriched at the wound bottom for direct action against infection and support of wound healing. An animal study on the efficacy and tolerability of different formulations of a hydrogel with PVP-I liposomes in deep dermal burn wounds has indicated an outstanding quality of wound healing with smooth granulation tissue, less inflammation, less wound contraction and no hyperkeratotic reactivity, especially with the 3% PVP-I liposome formulation.

Administration, Cutaneous↗
PubMed1997

Topical antimycotics in ophthalmology.

This article surveys the current treatment of fungal eye diseases with topical antimycotics. Their various pharmacokinetic characteristics and antimycotic activities are presented and, in addition, the clinical symptoms of fungal eye diseases which can be topically treated are described, so that a correct diagnosis can be achieved rapidly to avoid delaying proper therapy. Finally, guidelines for treatment of keratomycosis are recommended.

Administration, Topical↗
PubMed1997

Prophylactic use of topical anti-infectives in ophthalmology.

The prophylactic use of topical anti-infectives is indicated on the eye (1) prior to any surgery on the eye, by periorbital and conjunctival administration and, if required, intraoperatively as well; (2) in the form of the Credé prophylaxis against ophthalmia neonatorum; (3) with accidental pathogenic contamination of the eye; (4) to prevent conjunctivitis by intensive care surgical patients; (5) for the antiseptic irrigation of donor bulbi prior to keratoplasty, and (6) if required, to prevent ocular infection in a given epidemiological situation. The drug of first choice is polyvinylpyrrolidone-iodine at a concentration ranging from 1.5 to 5%. Another topical anti-infective is a 0.02 or 0.01% solution of polyhexanide, a promising medication, currently in the process of being approved.

Animals↗
PubMed1997

[Diagnosis and therapy of fungal keratitis--a review].

The diagnosis and current therapy of keratomycosis is presented in an overview. The following characteristics are helpful in clinical diagnosis: unsharp borders of the infiltrate, elevated infiltrate with initially epithelium, satellites and pyramidal hypopyon. The microbiological and microscopic confirmation is often possible only after repeated debridements. Lactophenol Blue is very suitable for staining the material obtained. Fluconazol is recommended for the local treatment of candida keratomycosis. Alternatively, amphotericin B is a potent antimycotic. However, a debridement is necessary to enhance bioavailability of this drug. If pharmacotherapy is not efficient enough, keratoplasty should be performed as soon as possible.

Antifungal Agents↗
PubMed1996

[Subjective contrast evaluation by visually handicapped patients].

Personal optical and electronic devices are helpful to people with binocular vision of less than 0.3 or a substantially impaired visual field. Striking brightness and color contrast may help patients to orient themselves outdoors. This is particularly true for patients with age-related macular degeneration who have diminished contrast sensitivity as evaluated by the Vistech test and the low-contrast sensitivity test. In this study, the desired level or color combination of contrasts was assessed subjectively by a scaled estimate. The patients were required to assess a sample of 79 black-and-white and color contrasts according to a five-point scale comprising the ratings "much too low", "low", "optimal", "high", "much too high". The visual fields (outfield, infield) were either colorless or contained the colors yellow, green, red, purple or blue. The study involved 59 patients with age-related macular degeneration. Ninety percent of the patients were over 65 years old. There were twice as many women as men. The control group population consisted of 43 emmetropic subjects. In black or white infields on a colorless background (light gray to dark gray), a slight preference for positive (infield lighter than the background) contrast situations was found. The optimal contrasts were in the range of [K[ > 0.91. When colored infields were presented on a colorless background, the light infield colors yellow and green were preferred. The optimal contrast level was found to be [K[ > 0.85. Similarly, when colorless and colored infields were presented, light infield colors (white, yellow, green) on a dark background (purple, blue) were preferred. In selecting contrasts, subjects with impaired vision because of age-related macular degeneration preferred positive contrasts, i.e., mainly white, yellow and green on a colored or colorless background. These results provide information that can be used in designing orientation aids, e.g., road striping and lines, edges of stairs, handrails, timetables, etc. Conflicts of interest with emmetropic subjects is not to be expected. Subjects in the control group, while preferring similar contrasts, were ready to accept a wider range than the partially sighted.

Aged↗
PubMed1995

[Contrast sensitivity of visually handicapped patients].

The contrast sensitivity of 41 patients with low visual acuity, as a result of age-related maculopathy, diabetic retinopathy or open-angle glaucoma, in most of them, was studied by means of the VISTECH test and the Buser LCS-test. The VISTECH test revealed reduced contrast sensitivity, especially at high frequencies. This reduction was marked in patients with diabetic retinopathy. Contrast on the color TV monitor was adjusted by the subjects. Yellow and green monitors were chosen equally often by the patients. A positive contrast (black text with light background) was preferred. The contrast required was noticeably higher than that required by subjects with normal eyes.

Adolescent↗
PubMed1994

A comparison of the ocular hypotensive efficacy and systemic safety of 0.5% levobunolol and 2% carteolol.

In a 3-month, double-masked, randomized clinical trial, the ocular hypotensive efficacy and systemic safety of 0.5% levobunolol and 2% carteolol were compared in 59 patients with open-angle glaucoma or ocular hypertension. The overall mean decrease in intraocular pressure was 7.3 mm Hg (27.4%) in the 0.5% levobunolol group and 4.1 mm Hg (14.8%) in the carteolol group. This difference was statistically significant (p = 0.0004). Changes in visual field and cup-disk ratios were few and similar between the groups. Effects on mean heart rate were noted in both treatment groups. The mean decrease in heart rate in the carteolol group was greater (-8.4 beats/min) than in the levobunolol group (-3.1 beats/min). This difference had marginal statistical significance (p = 0.059). We conclude that 0.5% levobunolol and 2% carteolol administered twice daily differ in lowering intraocular pressure as well as in their effects on heart rate.

Administration, Topical↗
PubMed1993

[Comparison of complications after intra- and extracapsular cataract extraction with lens implantation. Results of a prospective, randomized, clinical study].

BACKGROUND: The postoperative complications of ICCE with ACL implantation are compared with those of ECCE and PCL. Our clinical experience with ICCE and ACL implantation can not confirm the widespread rejection of this method. PATIENTS AND METHOD: A prospective, randomized, clinical study with participation of medical statisticians was performed. A total of 190 patients with ICCE and ACL and 170 patients with ECCE and PCL were followed up for 2 years. The follow-up examinations were performed upon dismission from the hospital, after 6, 12 and 24 months. The data were compiled in a computer program designed for this study and evaluated by the statisticians. The surgical procedures and the surgeons were defined prior to the beginning of patient recruitment. RESULTS: ICCE with ACL shows much less postoperative complications as usually emphasized. There were only 2 (1.2%) of retinal detachment and no case of corneal decompensation. Cystoid macular edema 8 (4.7%), postoperative vitreous prolaps into the anterior chamber 4 (2.3%) and spontaneous complaints of pain 16 (9.4%) occurred in a low percentage after ICCE with ACL. These complications did not occur after ECCE with PCL. The patients with ECCE and PCL showed capsular fibrosis in 48 (28%) making it the most frequent complication of the whole study. 33% of these patients required YAG-laser capsulotomy. Since retinal detachment occurs in 2.5% after YAG-laser capsulotomy we can not regard capsular fibrosis as a totally harmless complication. It is noteworthy that visual acuity is almost identical 1 year after surgery in both methods. CONCLUSIONS: The results of this study show that the evaluation of ICCE with ACL is too negative. The elimination of postoperative complications in this method is more difficult. ECCE with PCL is burdened by frequent capsular fibrosis. Visual acuity is almost the same in both methods 1 years after the operation. ACL-implantation remains our method of choice for secondary implantation in patients with an intact iris diaphragm.

Aged↗
PubMed1993

[Reproducible model of a bacterial conjunctivitis].

To test the efficiency of antimicrobial substances on bacterial conjunctivitis under standardized conditions a reproducible model is needed. As there are no data in the literature concerning this topic we have developed a model of bacterial conjunctivitis in the rabbit eye. Instillation of a suspension of Haemophilus influenzae, Staphylococcus epidermidis or Staphylococcus aureus into the cul-de-sac did not result in any effect. Thus, standardized techniques of conjunctival incision were used additionally. A follow-up was done for a period of 2 weeks (degree of conjunctival hyperemia, microbiology). Radial incision of the conjunctiva with injection of an S. aureus suspension (50 microliters of ATCC 29213; 1.35 x 10(8) cells) was done mimicking a branch injury. This resulted in a purulent conjunctivitis over a period of 1 week and disappeared within 14 days. The swabs were negative on day 7. This is the first model establishing a reproducible purulent conjunctivitis in the rabbit. Using this model antimicrobial substances may be tested under standardized conditions.

Animals↗
PubMed1993

Antiseptics versus antibiotics in the treatment of the experimental conjunctivitis caused by Staphylococcus aureus.

To evaluate the effect of some antiseptics, which have fewer side effects than antibiotics, an experimental model of bacterial conjunctivitis in vivo was used. This model imitates traumatic Staphylococcus aureus conjunctivitis in the rabbit. At 48 h after infection, polyvinylpyrrolidine (PVP)-iodine, bibrocathol (Noviform, NF), ethacridine (Biseptol, BS) and bacitracin+polymyxin B+neomycin (Polyspectran, PS) were applied. NaCl served as the control. At days 2, 5, 8, 11 and 14 a photographic documentation was done, and a swab was taken every 2nd day. In achieving regression of hyperemia, the substance tested were ranked in the following order: PVP, NF, BS, PS, and NaCl. In the elimination of S. aureus, the ranking order was BS, PVP, PS, NaCl, and NF. The overall ranking was PVP, BS, PS, NF, and NaCl. However, the differences were not significant. In this standardized in vivo model of bacterial conjunctivitis, antiseptics are superior over an antibiotic in accomplishing regression of hyperemia and germ elimination.

Animals↗