Search PubMed⌕ Search

Biomedical subjects

A Neiss

Publications and source records attributed to A Neiss.

At least 37 records · Page 2Linked to original sources
PubMed1993

Pharmacokinetics and protein binding of 3-ketodesogestrel and gestodene in the serum of women during 6 cycles of treatment with two low dose oral contraceptives.

The serum concentrations of 3-ketodesogestrel (KDG) and gestodene have been measured in 30 and 31 women respectively who took low dose oral contraceptives containing 30 micrograms ethinylestradiol together with either 150 micrograms desogestrel or 75 micrograms gestodene for 6 months. On days 1, 10 and 21 of the first third and sixth treatment cycles blood samples were drawn at 0, 0.5, 1, 1.5, 2, 3, 4 and 24 h. KDG and gestodene levels were measured by radioimmunoassays and were evaluated for Cmax (peak serum concentration), tmax (time to Cmax), and AUC (area under the curve) to 4 and 24 h. The overall total gestodene concentrations were higher and the accumulation of the steroid throughout a cycle greater than that of KDG. For example, the AUC0-4 of gestodene increased in cycle 1 by a factor of 2.8 (day 10 vs. day 1) and 3.6 (day 21 vs. day 1) compared to 2.3 and 2.6 for KDG. The higher concentration of gestodene reflects a lower volume of distribution than KDG, and is consistent with gestodene binding to sex hormone binding globulin (SHBG) with a higher affinity than KDG. Concentrations of KDG and gestodene were higher on day 1 of cycles 3 and 6 than on day 1 of cycle 1. The serum concentrations of KDG and gestodene during multiple dosing cannot be predicted on the basis of single dose pharmacokinetics.

Adolescent↗
PubMed1993

Influence of gestodene and desogestrel as components of low-dose oral contraceptives on the pharmacokinetics of ethinyl estradiol (EE2), on serum CBG and on urinary cortisol and 6 beta-hydroxycortisol.

A randomized controlled clinical trial was undertaken over a 6-month treatment period with two low-dose combined oral contraceptives (OC) to investigate whether the metabolism and elimination of ethinyl estradiol (EE2) is differently influenced by the two progestational components gestodene (G) and desogestrel (D), an issue which has been very controversial recently. The two formulations contained 30 micrograms EE2 each, together with either 75 micrograms G or 150 micrograms D. Of the 40 young women recruited for each formulation, 31 of each group were available for statistical evaluation. The pharmacokinetics of serum EE2 were studied on day 1, 10 and 21 of cycle 1, 3 and 6. There were no significant differences between the two groups in any cycle with respect to parameters measured. This was true for the distinct intracyclical rise in the mean EE2 serum levels from day 1 to day 10 and the smaller further increase between day 10 and day 21, with no change in this respect between the cycles studied. Respective changes were seen with regard to the area under the EE2 serum concentration curve up to 4 and 24 hours (AUC0-4 and AUC0-24), cmax and tmax of serum EE2. The estrogen-dependent corticoid-binding globulin (CBG) increased similarly in the two groups intracyclically and slightly also intercyclically at all times tested. Except for the first treatment cycle, urinary excretion of cortisol and 6 beta-hydroxycortisol displayed a tendency to lower values intracyclically as well as intercyclically, again with no differences between the two groups. Also, the 6 beta-hydroxycortisol-to-cortisol ratio was not different between the groups, showing a slight tendency to rise from about 4 at the beginning of the medication to around 5.5 at the end of the 6th treatment cycle in both groups. It is concluded that G and D as components of low-dose OCs exert comparable effects on the metabolism and elimination of EE2.

Adult↗
PubMed1991

Chemotherapy compared with bone marrow transplantation for adults with acute lymphoblastic leukemia in first remission.

OBJECTIVE: To compare efficacy of intensive postremission chemotherapy with allogeneic bone marrow transplantation in adults with acute lymphoblastic leukemia (ALL) in first remission. DESIGN: Retrospective comparison of two cohorts of patients. SETTING: Chemotherapy recipients were treated in 44 hospitals in West Germany in two cooperative group trials; transplants were done in 98 hospitals worldwide. PATIENTS: Patients (484) receiving intensive postremission chemotherapy and 251 recipients of HLA-identical sibling bone marrow transplants for ALL in first remission. Patients ranged from 15 to 45 years of age and were treated between 1980 and 1987. MAIN RESULTS: Similar prognostic factors predicted treatment failure (non-T-cell phenotype, high leukocyte count at diagnosis, and 8 or more weeks to achieve first remission) of both therapies. After statistical adjustments were made for differences in disease characteristics and time-to-treatment, survival was similar in the chemotherapy and transplant cohorts: Five-year leukemia-free survival probability was 38% (95% CI, 33% to 43%) with chemotherapy and 44% (CI, 37% to 52%) with transplant. No specific prognostic group had a significantly better outcome with one treatment compared with the other (6% for the difference; CI, -3% to 15%). Causes of treatment failure differed: With chemotherapy, 268 (96%) failures were from relapse and 11 (4%) were treatment-related; with transplants, 43 (32%) failures were from relapse and 92 (68%) were treatment-related. CONCLUSIONS: These results suggest that bone marrow transplants currently offer no special advantage over chemotherapy for adults with acute lymphoblastic leukemia in first remission.

Adolescent↗
PubMed1991

How can disease-free survival of adult ALL patients with or without transplants be compared?

525 patients with acute lymphoblastic leukemia (ALL) between the ages of 15 and 44 were treated according to the German study protocol. 41 patients received HLA-identical sibling bone marrow transplants in first remission. Disease-free survival was compared in patients with transplants and patients who were intended for further chemotherapy. After adjusting for potential biases, prognostic profiles of the two groups could be determined, the impact of time-to-transplant bias estimated and similar patients compared after appropriate adjustments. The initial patient characteristics of both groups were quite comparable as was the treatment outcome. The three year probability of disease-free survival was 34% (95% confidence interval: 16% to 52%) in both groups after statistical adjustment.

Adolescent↗
PubMed1989

Intraoperative cryoanalgesia for postthoracotomy pain relief.

In a randomized study, 63 patients were investigated for the benefits of cryoanalgesia after thoracotomy. Analgesia and its dependent effects such as enhancement of mobility, respiratory function, and reduced need of narcotics were evaluated. No significant differences in these variables were observed between the cryoanalgesia group and the control group. However, moderate to severe neuralgia was found in a number of patients in the cryoanalgesia group in the late postoperative period. Cryoanalgesia for pain relief after thoracotomy is not recommended.

Adult↗
PubMed1989

[Clinico-pharmacologic study of a new sustained-release oral salbutamol preparation in patients with obstructive airway disease].

A new sustained release preparation of oral salbutamol (8 mg) was compared to salbutamol (8 mg) and placebo in 15 patients suffering from chronic obstructive airways disease in a randomized double-blind cross-over trial. Changes in airways resistance and amplitude of finger tremor as well as subjective assessment of side effects (tremors, unrest, palpitations) revealed a longer lasting effect following the sustained release preparation of salbutamol.

Adult↗
PubMed1987

Survival and quality of life after continuous accelerated radiotherapy of glioblastomas.

One hundred and thirty three patients were given radiotherapy after subtotal resection of glioblastoma with different total doses and fractionation schedules including 38 patients receiving continuous accelerated fractionation with 3 fractions of 1.6 Gy per day up to 60 Gy in 2 weeks. Tolerance of the accelerated schedule was as good as of the conventional schedules but overall survival was not improved.

Adult↗
PubMed1987

[Advantages and problems of multicenter therapy studies exemplified by a study of the treatment of metastasizing renal cell carcinoma with recombinant interferon-alpha-2c].

The advantages of multicenter trials are numerous: quicker recruitment of the necessary number of patients, clearer results which are more convincing and whose acceptance is higher, as the patient sample of multicenter trials is supposed to be representative. However, multicenter trials require strong efforts for quality assurance concerning admission, treatment and follow-up, thus a highly developed coordinating center is needed. Data on recruitment and protocol compliance, i.e. deviations from the study protocol, are presented for the study of the treatment of metastatic renal cell carcinoma and discussed with respect to their impact on the results of the study. 102 patients were randomized either for IFN alpha-2C or IFN alpha-2C plus medroxyprogesteroneacetate. 16% of the patients violated inclusion criteria and essential data were missing in 16% of the patients. Overall treatment results (remission rate of 5.6%, median survival time of 7 months) and the data on adverse events have been biased by lack of protocol compliance. However, the results concerning the lack of differences between treatments remain valid.

Carcinoma, Renal Cell↗
PubMed1986

[Therapy and prevention of reflux esophagitis. Results of a multicenter study with cimetidine. I: Epidemiology and results of acute therapy].

In a sequential observational study efficacy and safety of two dosage regimens of cimetidine for the treatment of reflux-oesophagitis (RE) were examined. 22 office-based specialists took part in the trial. 187 patients received 1600 mg cimetidine (400 mg q.i.d.) daily and 136 patients received 800 mg cimetidine (400 mg b.i.d.) daily, over twelve weeks. The two dosages proved to be equally effective. In the group of patients with RE of stage I at the beginning of the trial, the healing rates were 82% under 1600 mg cimetidine/die and 86% under 800 mg cimetidine/die. In the group of those patients, who entered the study with RE of stage II, in both dosage groups the lesions of 87% of the patients were healed completely or had decreased to stage I. The severity of the mucosal lesions was judged endoscopically, based on a classification scheme modified according to Savary and Miller. The incidence of unwanted symptoms was not significantly different in both dosage groups (1600 mg: 5.3%, 800 mg: 3.4%); none of the symptoms which occurred was judged as definitely caused by cimetidine. The patient collective of the trial was characterized epidemiologically; out of the risk factors examined, only duration of RE history and number of previous RE episodes correlated with the severity of the disease, smoking and alcohol consumption showed no influence.

Adolescent↗
PubMed1985

[Determination of serum theophylline concentration in ambulatory practice].

Serum-theophylline concentration was measured in 486 ambulatory patients from 407 referring practitioners. They had been on maintenance treatment of 350 mg theophylline (Bronchoretard) twice daily. The concentration was within therapeutic range (8 to 20 mg/l) in 53% of patients, while it was below it in 43% and above in 4%. About half the patients receiving this dose would thus need individual adaptation of dosage, guided by clinical findings and serum concentration, in order to achieve optimal use of the drug's prophylactic and therapeutic potential. It is concluded that (1) theophylline dosage based entirely on standard dose will lead to an unacceptably high percentage of under-dosing; (2) schematic consideration of body-weight, sex, age, living habits, and accompanying diseases proved to be unreliable and insufficient for individual dose determination; (3) dose adaptation to individual clinical situations and serum concentration is necessary in theophylline treatment of ambulatory patients and, in the light of present technical facilities, is cost-effective.

Aged↗
PubMed1984

[Treatment results in brain metastases with primary irradiation and after surgery and postoperative irradiation].

61 patients with cerebral metastases were treated between 1977 and 1982, 32 out of them were operated and postoperatively irradiated, 29 only irradiated. The irradiations were given for curative purposes. Sixteen patients were alive at the date of December 31, 1982. The survival times calculated with the method of Kaplan-Mayer were 10 months after surgery and irradiation and 5 months after irradiations alone. In case of metastases of the mammary carcinoma, surgery with irradiation seems to be an especially effective method, as is suggested by the median survival time of 35 months and the total absence of local recurrences. In most of the other cases, too, the prolonged survival time was accompanied by a good quality of life which lasted for a considerable period of time. Younger patients had a longer survival time than older patients. The results of a high-dosed therapy with several daily fractions, namely 60 Gy within 17 days or 1825 ret NSD, respectively, were not (yet) better than those of conventional fractionation and dosage with 50 to 60 Gy in 5 to 6 weeks or 1572 to 1768 ret NSD, respectively. However, the value of this method was the same, its advantage lying in the shorter treatment time. Only in patients over 60 years, above all if they had received a total-brain irradiation with this method, we think to have seen a more frequent development of psychosyndromes. (The calculation of the survival times includes all cases, even patients who died during or shortly after radiotherapy).

Age Factors↗
PubMed1982

Studies on bacterial hypersensitivity in man. Interrelationship between skin reactions to bacterial peptidoglycan and serum peptidoglycan antibody titers.

The nature and extent of bacterially induced allergies are difficult to define. Since peptidoglycan, the main component of the cell wall of almost all bacteria, has been available in a highly purified, chemically and immunologically well-defined form, investigation of the allergological significance of this cell component is feasible. Intracutaneous tests were carried out on 181 test subjects with five different peptidoglycan (PG) preparations from Staphylococcus aureus, Staphylococcus epidermidis and Streptococcus Pyogenes. The results of the investigation were compared with the result of determination of serum PG antibodies and serum IgE concentrations. It was shown that test subjects with dual and later reactions to three different staphylococcal PGs displayed significantly higher PG antibody titers than test subjects with negative reactions. Such a relationship could not be found with the cutaneous reactions to streptococcal PG. The total serum IgE values were very much higher in test subjects with immediate reactions to staphylococcal PG than in test subjects with a negative reaction. Typical Arthus reaction or late granulomatous reactions were not observed. Humoral antibodies are involved at least in part in the elicitation of dual and late reactions. Thus, there are interesting parallels to allergy to fungal spores and organic dusts.

Adolescent↗