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Biomedical subjects

W Handrick

Publications and source records attributed to W Handrick.

At least 73 records · Page 4Linked to original sources

[New developments in bedside diagnosis].

The time required to isolate microorganisms, identify them, interpret results, and provide guidance for therapy is inordinate for urgent decisions in primary care. The emphasis for a more rapid diagnosis bedside or in the office, respectively, is caused apart from medical reasons by economic restrictions necessitating earlier diagnosis, more immediate and appropriate treatment, shorter patient hospital stays, and allowing the patient to resume normal productivity earlier. After describing some general criteria with regard to the design of tests for bed-side diagnosis we discuss well known and novel procedures: microscopy of clinical specimens, microbial antigen detection, and nucleic acid hybridization. In concluding remarks we underline the necessity of careful clinical studies concerning sensitivity, specificity, and reliability as well as quality control measures for every novel assay before and during introduction in clinical and office practice.

Bacteria↗

[Microbiologic diagnosis of diseases of the lung, bronchi and pleura].

Microbiological examination of sputum specimens is of limited value and may give misleading results. On the other side, knowledge of aetiologic agents and corresponding antibiograms may be life-saving in nosocomial pneumonias, for instance. Bronchoalveolar lavages and invasive diagnostic procedures are necessary to obtain microbiological materials without contamination by oral germs. Blood cultures and pleural effusions are useful too. Further informations are given by CF, immunofluorescence (antibody or antigen), ELISA, CIE, latex-agglutination and other modern techniques. Bacterial bronchitis should be treated on the base of calculated chemotherapy. Microbiological procedures are indicated only in the case of repeated therapeutic failure. Invasive diagnostic measures should be avoided in the case of bronchitis. Calculated chemotherapy is sufficient in most cases of community-acquired pneumonias too. Nosocomial pneumonias have a high mortality which only can be reduced by rapid aetiologic diagnosis. All efforts in this direction are of considerable value. Special problems are connected with aspiration pneumonia, atypical and viral pneumonias and pleural empyema. Besides pleural exudate pleural biopsies are useful to demonstrate some special microbes.

Bacterial Infections↗

[Oxacillin-induced granulocytopenia].

A girl at the age of nearly 13 years with a haemodynamic insignificant defect of the ventricular septum fell ill with a staphylococcal endocarditis of the aortic valve. After a high dosage therapy with oxacillin for some weeks occurred a leucocytopenia which was reversible after discontinuation of this therapy. Because we could find only few reports about this problem in the german literature, we will report about our patient and give a short survey of literature.

Adolescent↗

[Pneumococcal infections in children: osteomyelitis and arthritis].

A pneumococci-osteoarthritis in 8 children is reported on. In almost all the cases an adequate therapy (antibiotics, immobilization, physical therapy) resulted in a healing process free of defects with a full maintenance of the articular function. Besides by staphylococci and haemophilus influenzae, pneumococci too use to play a role as pathogenic organisms for osteomyelitis and arthritis.

Arthritis, Infectious↗

[Principles of modern antibiotic therapy in the general practice and clinic. Discussion of the contribution by Walter Siegenthaler and Gertrude Siegenthaler-Zuber published in Z. gesamte inn. Med. 42 (1987) 614-618].

W. Siegenthaler's and G. Siegenthaler-Zuber's opinion, according to which in the majority of infections in practice an etiological (microbiological) diagnosis may be renounced and the guiding slogan "before therapy the gods have placed the diagnosis" should be relativized for the situation in the practice in contrast to the situation in the clinic, is opposed. Microbiological findings represent an unrenouncable basis for a rational antimicrobial chemotherapy in practice and clinic. In the individual case this does not exclude a calculated chemotherapy on account of a clinical and microbiological tentative diagnosis made by the physician in charge. But at the latest when the empiric therapy fails an efficient microbiologic diagnostics must be at our disposal.

Anti-Bacterial Agents↗

[Staphylococcal endocarditis in the mitral valve prolapse syndrome].

A girl, aged 13 8/12 years, in whom has been known a syndrome of the mitral valve prolapse since the 10th year of age, fell ill with an acute endocarditis by staphylococcus aureus. As the therapy with antibiotics remained without any effects and due to an early embolic dispersion including the brain an operative approach was no more possible death occurred. The pathologic-anatomical investigations resulted in a distinct ulceropolypous endocarditis of the mitral valve. At the instance of this case report the most important facts nowadays known about the relation between the syndrome of mitral valve prolapse and endocarditis are summed up.

Adolescent↗

Diagnostics of septicaemia in childhood by coagulation parameters.

The diagnostic importance of coagulation parameters was tested in 438 children with septicaemia by discriminant analysis. The values of 756 patients with other diseases had been analysed for comparison. After the selection of the parameters by multivariate analyses discriminant functions were calculated for different subgroups. The best discriminant functions were found for septic newborns up to the age of 3 days. Their use may be helpful for diagnostics in practice. A more weak discrimination power was evident in newborns beyond the 3rd day of life. A simultaneous comparison of 7 subgroups of newborns with different illnesses by 3 discriminant functions led to lower sensitivity rate and don't suit for practice. Beyond the postnatal period the diagnostic importance of coagulation parameters for septicemia is even lower. The low reparation capacity of thrombopoiesis in neonates may be a cause for the good discriminant functions for septicaemia. The reason for the better discrimination in the newborns up to the 3rd day could be the more profound defects in the coagulation system.

Blood Coagulation Tests↗

[Listeriosis of the central nervous system in children beyond the neonatal period].

Observations on three children with neurolisteriosis (one case of meningitis, two cases of meningoencephalitis, each Serovar 4 b), show that even after the neonatal period, listeriosis must not be ignored in the process of diagnosis and therapy. It is the bacteriological examination of the cerebrospinal fluid, together with the blood culture, and not clinical symptoms and serology that guarantee a timely diagnosis and therapy (ampicillin and gentamicin).

Anti-Bacterial Agents↗