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Biomedical subjects

W Rösch

Publications and source records attributed to W Rösch.

At least 55 records · Page 3Linked to original sources

[Fungi in feces, fungi in the intestines--therapeutic consequences?].

Yeast in stool specimen are due to transient or commensal growth in the GI tract. Only in immune deficient subjects candida albicans may grow invasively in squamous epithelium. In dermal or vaginal mycosis systemic therapy does not add benefit to local measures. Candida-induced diarrhea in hospitalized patients following chemotherapy stop after a few days of nystatin treatment. Candida hypersensitivity syndrome does not exist, antifungal diet does not eradicate yeast. Stool examination for candida is of no sense because a positive finding is seen in up to 80% of healthy persons.

AIDS-Related Opportunistic Infections↗

Evidence for intestinal secretion as an additional clearance pathway of talinolol enantiomers: concentration- and dose-dependent absorption in vitro and in vivo.

PURPOSE: To evaluate carrier-mediated intestinal secretion of talinolol enantiomers in vivo and in vitro. METHODS: In clinical studies with i.v. and p.o. dosage of rac-talinolol (30 mg and 100 mg, resp.) performed in a small number of cholecystectomized patients total and partial clearances were determined on the basis of plasma, bile and urine concentrations. The dose-dependence of AUC was investigated in 12 healthy volunteers (25, 50, 100, and 400 mg rac-talinolol as single p.o. doses). Concentration-dependence of the permeability across Caco-2 cell monolayers included concentrations from 0.1 to 2.0 mM, inhibition by verapamil was tested at 0.5 mM. RESULTS: The total clearance as well as the apparent oral clearance (CL/F) were slightly higher for S-(-)- than for R-(+)-talinolol. Calculation of the partial clearances showed that also the residual clearance was higher for the S- than for the R-enantiomer. In the healthy volunteers, CL/F increased with increasing doses, while the S/R ratio decreased approaching unity for the highest dose. Also the results from Caco-2 cell permeation studies yielded a clear concentration-dependence with decreasing stereoselectivity for the higher concentration range. Permeability of both enantiomers was considerably higher for b-->a than a-->b transport, however, this difference disappeared when verapamil was added. CONCLUSIONS: Although not very expressed, the detected stereoselectivities indicate a preferential absorption of R-(+)-talinolol in a lower concentration and dose range, which is most probably due to a moderate stereoselectivity at the carrier system involved in intestinal secretion.

Administration, Oral↗

[Follow-up of kidney function in children with former posterior urethral valves].

Severe forms of posterior urethral valves involve the risk of upper urinary tract damage and impaired renal function. For this reason, 26 boys formerly (between January 1980 and December 1989) treated for high-grade urethral obstruction were re-examined with reference to renal function. Results were compared with observations in a control group of 26 boys matched for age and height undergoing minimal urological surgery. While there were no significant differences in haemoglobin, height, blood pressure or kidney volume, in 14 of 20 patients with normal glomerular filtration rate pathologic findings were recorded, most of which related to urine concentrating capacity, tubular phosphate handling and hyperparathyroidism. These observations necessarily have implications for treatment of such children even if they are assumed to have unimpaired renal function. In future, monitoring of renal function in children with former posterior urethral valves should include different tests, and in particular tests of concentration capacity and measurement of parathyroid hormone.

Child↗

[Reflux disease and Barrett esophagus--monitoring and therapy].

Heartburn and epigastric pain are the leading symptoms of reflux disease. Next to other symptoms like pharyngeal burning, regurgitation and retrosternal pain, chronic hoarseness and coughing as well as angina pectoris symptoms may point towards a pathological reflux. In endoscopically verified reflux esophagitis proton pump inhibitors are the treatment of first choice. Aim of therapy is loss of symptoms, healing of epithelial defects and prevention of Barrett's esophagus. If a columnar epithelium-lined esophagus is seen, surveillance is recommended in one- or two-year intervals.

Adult↗

[Long-term results of bouginage of peptic esophageal strictures. A retrospective analysis of an 8 year time spain].

BASIC REMARKS: Peptide stricture is a late stage of reflux esophagitis which prompts the patient to see a doctor for worsening dysphagia. METHOD: A retrospective analysis over an 8-year period, during which 53 patients with peptic esophageal stricture underwent bougienage and received aftercare. Twenty-five of these patients were interviewed with the aid of a questionnaire. RESULTS: In more than 80% of the patients, dilatation, usually performed on an outpatient basis, led to satisfactory results, in particular in combination with long-term medical treatment. Although repeat bougienage sessions were necessary--after lengthy intervals--in about one-half of the patients, the intervals between sessions became longer (1.5 to 1 bougienage session per year). CONCLUSION: Currently, bougienage to a diameter of 2.0 cm, in combination with 20 to 40 mg omeprazole administered long-term, would appear to represent optimal treatment.

Adult↗