PubMed Health⌕ Search

Biomedical subjects

W Bommer

Publications and source records attributed to W Bommer.

At least 19 recordsLinked to original sources
PubMed2003

Miltefosine (Impavido): the first oral treatment against leishmaniasis.

Miltefosine is a novel antileishmanial drug that has significant selectivity in both in vitro and in vivo models. Clinical efficacy was demonstrated for the treatment of visceral leishmaniasis with the advantage of oral administration over the currently recommended antileishmanial drugs that require parenteral administration. Miltefosine produces high cure rates also in patients resistant to the standard antimonial therapy.

Administration, Oral↗
PubMed2001

M-mode echocardiographic predictors of six- to seven-year incidence of coronary heart disease, stroke, congestive heart failure, and mortality in an elderly cohort (the Cardiovascular Health Study).

Previous studies have identified a number of echocardiographic variables that predict cardiovascular disease (CVD) events and mortality, but have not focused on a large elderly cohort. The purpose of this study was to determine whether M-mode echocardiographic variables predicted all-cause mortality, incident coronary heart disease (CHD), congestive heart failure (CHF), and stroke in a large prospective, multicenter, population-based study. In the Cardiovascular Health Study, a biracial cohort of 5,888 men and women (mean age 73 years) underwent 2-dimensional M-mode echocardiographic measurements of left ventricular (LV) internal dimensions, wall thickness, mass and geometry, as well as measurement of left atrial dimension and assessment for mitral annular calcium. Participants were followed for 6 to 7 years for incident events; analyses excluded subjects with prevalent disease. One or more echocardiographic measurements were independent predictors of all-cause mortality and incident CHD, CHF, and stroke. After adjustment for anthropometric and traditional CVD risk factors, LV mass was significantly related to incident CHD, CHF, and stroke. The highest quartile of LV mass conferred a hazards ratio of 3.36, compared with the lowest quartile, for incident CHF. Furthermore, incident CHF-free survival was significantly lower for participants with LV mass in the highest versus the 2 lowest quartiles (86% vs 97%, respectively, at 2,500 days). Eccentric and concentric LV hypertrophy, respectively, conferred adjusted hazards ratios, compared with normal LV geometry, of 2.05 and 1.61 for incident CHD, and 2.95 and 3.32 for incident CHF. Thus, in an elderly biracial population, selected 2-dimensional M-mode echocardiographic measurements were important markers of subclinical disease and conferred independent prognostic information for incident CVD events, especially CHF and CHD.

Aged↗
PubMed1999

Value of negative dobutamine stress echocardiography in predicting long-term cardiac events.

UNLABELLED: To determine the value of negative dobutamine stress echocardiography (DSE) results in predicting subsequent long-term cardiac event rates, we retrospectively reviewed all dobutamine stress echocardiograms performed at our institution over a 3-year period (1992-1994). Follow-up was accomplished through the completion of a detailed questionnaire compiled from data obtained through chart review and direct telephone contact. Information regarding death also was determined by referencing patient data with mortality data available on the World Wide Web. Event rates were determined for hard (myocardial infarction [MI] or cardiac death) and soft (hospitalization for angina and/or congestive heart failure, coronary angioplasty, or coronary bypass surgery) cardiac events occurring after the negative DSE results for up to 7 years after the test. Negative test results were defined as those showing no new or worsening wall motion abnormalities after either a normal resting echocardiogram (normal-negative [NN]) or an abnormal segmental resting echocardiogram (fixed-negative [FN]). RESULTS: Of the 346 interpretable tests, 224 were negative for inducible wall motion abnormalities, with 171 NN and 53 FN. In the NN group, the MI rate was 1.5% per patient/year, and the mortality rate was 0.13% per patient/year. In the FN group, the MI rate was 0.7% per patient/year, and the mortality rate was 0% per patient/year. CONCLUSIONS: DSE results in both NN and FN groups predict a very low subsequent hard event rate and mortality for up to 5 years after the test.

Adrenergic beta-Agonists↗
PubMed1995

Amlodipine in chronic stable angina: results of a multicenter double-blind crossover trial.

The efficacy and safety of amlodipine, 10 mg, a new long-acting calcium antagonist, was compared with placebo in 103 patients with stable angina pectoris in a multicenter double-blind crossover study. The trial consisted of an initial 2-week single-blind placebo period followed by a first period of 4 weeks of double-blind therapy, which was followed by a 1 week washout period and then a second 4-week double-blind period after treatments were crossed over. Twenty-four-hour Holter electrocardiographic monitoring was carried out in 12 patients at three centers. In the first double-blind period amlodipine produced a significantly greater increase in symptom-limited exercise duration (amlodipine 478.5 to 520.6 vs placebo 484.6 to 485.2 seconds; change +8.8% vs +0.1%, respectively; p = 0.0004) and total work (amldipine 2426 to 2984 vs placebo 2505 to 2548 kilopondmeters; change +24% vs +1.7%, respectively; p = 0.0006) and a decrease in angina attack frequency (from 3 to 1 per week; p = 0.016) and nitroglycerin consumption (from 2 to 0.5 tablets/wk; p = 0.01) compared with placebo. Holter monitoring revealed significant reductions in numbers (amlodipine 4.65 to 2.22 vs placebo 1.84 to 1.54; change -52% vs +84%, respectively; p = 0.06), absolute total area (amlodipine 87.66 to 11.43 vs placebo 5.76 to 35.24; change -87% vs +513%, respectively; p = 0.02), and duration (amlodipine 12.29 to 2.95 vs 1.66 to 7.74 seconds; change -76% vs +367%, respectively; p = 0.008) of ST-segment depressions after treatment with amlodipine compared with placebo. After the treatments were crossed over changes continued to favor amlodipine.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Prolonged haemolytic anaemia in malaria and autoantibodies against triosephosphate isomerase.

Prolonged haemolysis may accompany infection with Plasmodium falciparum. We observed prolonged haemolysis in 4 of 10 patients with this type of malaria after parasitological cure. IgM antibodies specific for the glycolytic enzyme triosephosphate isomerase were detected in these patients' sera. Clinical recovery and a decrease in haemolysis coincided with a fall in these autoantibodies. In vitro, affinity purified autoantibodies isolated from the sera directed against triosephosphate isomerase induced lysis of erythrocytes and activation of complement as shown by the 51Cr release assay. We assume that autoantibodies against triosephosphate isomerase contribute to the development of prolonged haemolysis and anaemia in P falciparum malaria.

Adult↗
PubMed1992

[Diagnostic and therapeutic problems in Lamblia infections].

A 28-year-old woman complained of chronic diarrhoea of about one year's duration, made worse by taking food. As a lactose tolerance test showed evidence of severe intolerance she was given a lactose-free diet, but this brought no improvement. Duodenal biopsy showed villous atrophy, and in the duodenal juice there were numerous flagellated lamblia. After a single oral dose of 2 g tinidazole the diarrhoea stopped, the lamblia disappeared, and the lactose intolerance and villous atrophy cleared up. Lamblia were also detected in the duodenal juice of a 50-year-old woman, but her infection was much more difficult to treat. Tinidazole (single dose of 2 g), metronidazole (800 mg twice daily for 6 days), ornidazole orally 500 mg twice daily for 10 days and ornidazole intravenously 500 mg twice daily for four days all proved ineffective. However, after a 5-day course of epsilon-9-aminacridine (100 mg three times daily by mouth) the diarrhoea ceased and both vegetative forms and lamblia cysts disappeared. These cases emphasize that lambliasis should be considered as a possible cause of severe chronic diarrhoea even when there is no history of travel abroad and when the symptoms are atypical. Conventional chemotherapeutic agents may be ineffective.

Adult↗
PubMed1992

Magnetic resonance and other imaging techniques in valvular and cardiac disease.

A number of new magnetic resonance imaging techniques are offering excellent views of the cardiovascular system. These techniques can provide accurate information about chamber sizes, ventricular mass, and wall motion. Blood flow patterns can be analyzed to provide semiquantitative estimates of valvular regurgitation. Accurate measurements of the area and velocity of great vessel flow may provide the first truly quantitative magnetic resonance imaging estimates of shunt flow and regurgitant volumes. Future developments and improvements may lead to coronary artery imaging in clinical patients. In addition to these promising developments in magnetic resonance imaging, several other interesting imaging papers are discussed in this review of magnetic resonance and other imaging techniques.

Cineangiography↗
PubMed1992

Distribution and correlates of sonographically detected carotid artery disease in the Cardiovascular Health Study. The CHS Collaborative Research Group.

BACKGROUND AND PURPOSE: This article describes the prevalence of extracranial carotid atherosclerosis assessed by ultrasonography, its association with risk factors, and its relation to symptomatic coronary disease and stroke in men and women aged > or = 65 years. METHODS: Maximum percent stenosis, maximum common carotid artery wall thickness, and maximum internal carotid artery wall thickness were assessed using duplex ultrasound in 5,201 men and women aged > or = 65 years in the Cardiovascular Health Study, a study of the risk factors and natural history of cardiovascular disease in the elderly. Existing coronary disease and stroke were assessed by physical examination and participant history. RESULTS: Detectable carotid stenosis was present in 75% of men and 62% of women, although the prevalence of > or = 50% stenosis was low, 7% in men and 5% in women. Maximum stenosis and maximum wall thickness measurements increased with age and were uniformly greater at all ages in men than in women (p < 0.00001). Established risk factors for atherosclerosis (hypertension, smoking, diabetes) and indications of vascular disease (left ventricular hypertrophy, major electrocardiographic abnormality, bruits, and history of heart disease or stroke) related to all three carotid artery measures in the elderly. Of the three ultrasound measures, the best correlate for a history of coronary disease was maximum internal carotid artery wall thickness. For stroke the best correlate was common carotid artery wall thickness. Multiple logistic regression models of prevalent coronary heart disease and stroke that included the ultrasound findings indicated, after adjustment for age and sex, that maximum internal wall thickness and maximum common carotid wall thickness were significant correlates of both. Maximum stenosis did not add significantly to the correlation. CONCLUSIONS: In the elderly the incidence of carotid atherosclerosis was high, although the frequency of severe disease was low. The prevalence and severity of carotid atherosclerosis continued to increase with age even in the late decades of life, and more disease was found in men than in women at all ages. Known risk factors for atherosclerosis continued to relate to carotid abnormalities in the later decades of life, both in symptomatic and asymptomatic subjects.

Aged↗
PubMed1991

Use of sonography to evaluate carotid atherosclerosis in the elderly. The Cardiovascular Health Study. CHS Collaborative Research Group.

Carotid sonography is being performed on more than 5,000 participants in the Cardiovascular Health Study, a prospective, multicenter study of cardiovascular disease in men and women aged 65 years and older. The sonographic methods used to examine and measure the extracranial carotid arteries are described. Initial validation studies were performed on 61 subjects with a mean age of 68.6 years. Analysis of within- and between-sonographer differences and between-reader differences were performed for selected variables. In general, the mean absolute differences for within- and between-sonographer comparisons were small, with even less variability between readers. Variability was less for the common carotid artery than for the internal carotid artery. These data suggest that carotid sonography is a reliable and reproducible method for use in the study of carotid atherosclerosis in population studies.

Age Factors↗
PubMed1989

Studies on the pathogenesis of Acanthamoeba-associated meningoencephalitis.

100 indoor swimming pools were examined for the presence of free-living amoebae. Limax amoebae of the genus Acanthamoeba could be isolated from 34 samples. Naegleria spp. were not present. After axenic cultivation the pathogenicity in mice was tested. Histological as well as immunohistological procedures were compared in order to identify the amoebae in brain sections and to clarify the route of infection. The results indicate a direct invasion of the central nervous system by acanthamoebae via the nasal mucosa and the olfactory bulb.

Acanthamoeba↗
PubMed1984

In vivo correlation of thermodilution cardiac output and videodensitometric indicator-dilution curves obtained from contrast two-dimensional echocardiograms.

In previous studies, indicator-dilution curves obtained by videodensitometry of contrast two-dimensional echocardiograms have shown close correlation with measurements of blood flow in vitro. In this study the technique was extended and contrast indicator-dilution curves obtained in vivo were correlated with simultaneous cardiac output measurements determined by thermodilution in eight dogs. Two-dimensional echocardiograms of the left ventricle were performed with the transducer on the myocardium during left atrial-pulmonary vein injection of 10 cc of a 1 X 10(-4) concentration of 30 mu diameter microballoons. A total of 148 injections were performed at 37 levels of cardiac output (1.70 to 7.90 liters/min) induced by alterations of left ventricular preload, isoproterenol and propranolol. Indicator-dilution curves were obtained from recordings of the analog signal of a linear videodensitometer focused on the left ventricle. Linear regression analysis between total area of the indicator-dilution curves and cardiac output yielded correlation coefficients (r) of 0.77 to 0.96 (mean 0.90) for individual dogs, and 0.65 for all cardiac output determinations in all dogs. Analysis of indicator-dilution curve area by the forward triangle-exponential decay method yielded enhanced individual coefficients of 0.90 to 0.97 (mean 0.94) with cardiac output and 0.61 for the group of animals. It is concluded that echographic indicator-dilution curves obtained from uniform size microballoons and videodensitometry may be obtained in vivo and correlate with cardiac output measurements.

Animals↗