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Biomedical subjects

A Pfau

Publications and source records attributed to A Pfau.

At least 19 recordsLinked to original sources
PubMed1992

[Prostatic specific antigen for detection and monitoring of prostatic cancer].

Prostatic specific antigen (PSA) can be detected in normal and benign hypertrophic prostates, as well as in prostatic cancer and its metastases. Since it appears in the serum, this glycoprotein has become an established marker for the detection and monitoring of prostate cancer. Using a radioimmunoassay (CIS--Biointernational, France), we found serum PSA levels higher than 4 ng/ml in 55 of 58 patients with prostatic cancer. The concentrations were proportional to tumor stage: significantly higher in stages C and D than in stages A and B (p less than 0.002). In all 6 cases with occult prostatic carcinoma (stage A), levels were higher than 15 ng/ml. PSA was found to be a good indicator of response to therapy, as well as a marker of tumor progression during follow-up. After radical prostatectomy serum PSA levels decreased to below 1 ng/ml. Following radiotherapy levels returned to normal within 1-6 months in 8 of 11 patients. In 21 of 23 with metastases serum PSA decreased during hormonal treatment. In 3 who responded initially to hormonal therapy, levels increased before clinical manifestation of tumor progression. We conclude that PSA is a sensitive serum marker for the diagnosis of prostatic cancer in cases of metastatic disease of unknown origin, as well as for monitoring the response to treatment of prostatic carcinoma. The use of PSA serum levels for screening for prostatic cancer is still controversial.

Antigens, Neoplasm↗
PubMed1992

Effective prophylaxis for recurrent urinary tract infections during pregnancy.

Effective prevention of recurrent urinary tract infections (UTIs) and possible acute pyelonephritis is of major importance during pregnancy. During 39 pregnancies, 33 women with a history of recurrent UTIs (and, in some instances, pyelonephritis) received postcoital prophylaxis consisting of a single oral dose of either cephalexin (250 mg) or nitrofurantoin macrocrystals (50 mg). While 130 UTIs occurred during a mean observation period of 7 months before prophylaxis, only a single UTI occurred during pregnancy after prophylaxis; this difference was highly significant. Thus the use of one of these effective regimens is strongly recommended for any pregnant woman with a history of recurrent UTIs. The treatment's effectiveness can be explained by two features of the two antibacterial agents involved: both reach high bactericidal concentrations in the urinary tract and induce no (or minimal) resistance in the introital gram-negative bacterial flora.

Acute Disease↗
PubMed1991

[Extracorporeal shock wave lithotripsy for cystine urolithiasis].

We present 31 patients with cystine urolithiasis referred to our extracorporeal shock wave lithotripsy (ESWL) center since 1985. This group differed statistically from the other 3000 patients treated by us for urolithiasis with regard to age, stone burden, number of previous operations, and known duration of urolithiasis. The average known duration in those with cystine stones was 15 years. Of 26 patients with such a history, 22 had an average of 2 operations each. At referral, 14 had bilateral stones and among the others there were 5 nonfunctioning kidneys. Of 26 referred with a diagnosis of cystine nephrolithiasis, only 11 were being treated medically. At presentation, 31 had no stones and 1 was being treated medically. In the other 29 patients, 44 renal-ureteral units had urolithiasis. During follow-up 2 ureteral stones were discharged spontaneously and the other units were treated by ESWL, surgery and/or ureteroscopy, and percutaneous irrigation. 36/42 units were free of significant stone residue, but in 4 there were large gravel remains; 1 kidney was removed primarily and 1 kidney lost its function following prolonged obstruction after ESWL. During follow-up, of 11 patients unable to tolerate D-penicillamine and treated by urinary alkalinization alone, 3 have already formed new stones.

Cystine↗
PubMed1991

The treatment of chronic bacterial prostatitis.

Chronic bacterial prostatitis, the most common cause of recurrent urinary tract infections in the male patient, is a clinical entity accurately defined by two essential features: (1) recurrent urinary tract infections and (2) persistence of gram-negative bacteria in the prostatic secretion. Chronic bacterial prostatitis is mainly a bacteriologic diagnosis and, therefore, sequential bacteriologic localization cultures are the only way to correct diagnosis. Thirty-five of 39 patients (90%) with chronic bacterial prostatitis were cured of their disease either by a short-term (14-day) intramuscular kanamycin treatment or a long-term (average of five months) oral co-trimoxazole, pure trimethoprim or ciprofloxacin treatment; selected patients suffering from chronic bacterial prostatitis with an associated pathology such as benign enlargement of the prostate, associated occasionally with infected prostatic calculi, who did not respond to medical therapy alone, were cured by a combined adequate antibacterial and surgical (a modified retropubic prostatectomy) treatment. All the patients were followed up for at least one year and most patients several years following treatment.

Anti-Bacterial Agents↗
PubMed1990

Measurements of 129I in human and bovine thyroids in Europe--transfer of 129I into the food chain.

Bovine thyroid glands from different countries in Europe and human thyroid glands from Lower Saxony (Federal Republic of Germany) show isotopic 129I/127I ratios of 2.1 X 10(-9) to 8.2 X 10(-8) for cattle and 2.1 X 10(-9) to 8 X 10(-8) in humans. These values give information about the concentration of fallout 129I in Europe since most of these glands were collected in areas without nuclear facilities. Some of the human thyroids were collected after the Chernobyl accident between May 1986 and February 1988. Results obtained from human thyroids taken in some locations of Lower Saxony show no significant increase of the 129I during this time. Higher concentrations of 129I were only found in cattle grazing in the vicinity of a reprocessing plant in Mol, Belgium. Samples of soil, vegetation, milk, and water from this area contained higher than normal concentrations of 129I. The long-term transfer of radioiodine from the soil to the plant and the translocation within the soil were studied using a soil monolith with a 129I-contaminated surface. During the 4 y of the experiment, the transfer factor plant/soil decreased from 0.3 to 2.2 X 10(-3). Soil samples taken in 5-cm steps to a depth of 30 cm then at 40 and 50 cm depths showed that the transport of radioiodine to lower layers proceeds very slowly. The top 5-cm layer contained about 80% of the total radioactivity 52 mo after contamination. In an in-vivo study with a dairy cow, the transfer of radioiodine from feed to milk to cow meat and to pig thyroid gland was followed for 53 d using 129I-labeled pasture grass contaminated via roots. A part of the milk obtained from the cow was fed to a pig as a substitute for humans. The mean value of the transfer factor milk/feed was 2.4 X 10(-3) d kg-1. The values of the transfer factor cow meat/feed obtained for different muscle cuts and organs (excluding thyroid) ranged between 3.0 X 10(-4) (kidney) and 5.4 X 10(-2) d kg-1 f.w. The transfer factors pig thyroid/milk (as pig feed) and pig thyroid/cow feed exhibited values of 1.2 and 8.7 X 10(-3) d kg-1 f.w., respectively.

Animal Feed↗
PubMed1989

Long-term transfer of I-129 into the food chain.

To investigate the transfer of Iodine-129 along the feed-animal-milk-pig thyroid pathway under conditions of short- and long-term contamination, two feeding experiments with dairy cows were carried out. Pasture grass radiolabelled with I-129 via root uptake was used as labelled feed in both experiments. During the first experiment the transfer of I-129 from feed to milk and the effective removal half-life of I-129 in the milk were determined after constant doses of I-129 in the labelled grass had been administered for a period of 8 days. In the second experiment the long term transfer of I-129 from feed-to-milk-to-cow-meat and to pig thyroid gland was followed for a period of 53 days. The pig was used because of the physiological similarity between pigs and humans. The effective half-life for removal of I-129 from milk was found to be 1.6 days. The values for the transfer factor from feed-to-milk (in units of day kg-1) resulting from the 1st assay ranged between 1.0.10(-3) and 1.7.10(-3). The long term feeding experiment exhibited a middle value for the transfer factor of 2.4.10(-3). The transfer factors pig thyroid/milk (as pig feed) and pig thyroid/cow feed exhibited values of 1.2 and 8.7.10(-3) respectively.

Animal Feed↗
PubMed1989

Effective prophylaxis of recurrent urinary tract infections in premenopausal women by postcoital administration of cephalexin.

A total of 31 sexually active premenopausal women, prone to have recurrent urinary tract infections but who otherwise were healthy, underwent postcoital prophylaxis consisting of a single oral dose of 250 mg. cephalexin. While 127 urinary tract infections occurred in these patients during a mean of 6 months before treatment, only 1 occurred during a mean of 12 months after postcoital cephalexin prophylaxis. This difference was statistically highly significant. Each of these patients ingested approximately 120 cephalexin tablets per year of postcoital prophylaxis. Postcoital oral cephalexin prophylaxis is highly effective in the prevention of recurrent urinary tract infection in the nonpregnant as well as pregnant premenopausal women because of easy compliance, the high urine concentration achieved and the minimal induction of resistance to cephalexin in the introital gram-negative bacterial flora. Postcoital cephalexin prophylaxis achieves identical results to daily cephalexin prophylaxis but uses only a third of the tablets required in the daily regimens. Finally, cephalexin represents an additional valuable antibacterial drug in postcoital prophylaxis along with cotrimoxazole, nitrofurantoin and cinoxacin.

Adult↗
PubMed1988

Can extracorporeal shock wave lithotripsy eradicate persistent urinary infection associated with infected stones?

Infected renal stones can be treated by extracorporeal shock wave lithotripsy but it still is not clear whether successful stone fragmentation and the disappearance of all macroscopic stone fragments guarantee eradication of the infection. Therefore, a prospective study was done in 135 patients with renal or upper ureteral stones associated with persistent urinary tract infection. The urinary infection was localized in each patient by bilateral ureteral catheterization. Upper tract infection in the kidney containing the stone was found in 75.6 per cent of the cases. A total of 94 patients completed treatment with extracorporeal shock wave lithotripsy and were followed for 3 to 16 months (mean followup 6.4 months). A marked correlation between the incidence of residual macroscopic stone fragments and the presence of persistent infection was noted. Of the 51 patients who became free of stones 48 (94 per cent) had sterile urine. Only 3 of the 51 patients had persistent infection in the treated kidney despite complete disappearance of the stones. In 45 of the 59 patients with stones smaller than 2 cm. (76 per cent) the infection was eradicated, whereas of the 35 with larger stones the urine became sterile in only 13 (37 per cent). We conclude that extracorporeal shock wave lithotripsy can be endorsed for treatment of small infected stones but it is inadequate for treatment of stones larger than 2 cm. unless combined with percutaneous nephrolithotripsy or chemical dissolution of the residual infected fragments.

Adult↗
PubMed1988

Prevention of recurrent urinary tract infections in premenopausal women by post-coital administration of cinoxacin.

A total of 21 sexually active premenopausal women, prone to recurrent urinary tract infections but who otherwise were healthy, underwent post-coital prophylaxis consisting of bladder voiding and a single 250 mg. tablet of cinoxacin. While 94 urinary tract infections occurred during a mean of 7.5 months before treatment, only 8 occurred during a mean of 12.5 months after prophylaxis. This difference was statistically highly significant. A mean of 106 cinoxacin tablets per patient were administered during post-coital prophylaxis. Cinoxacin represents an additional valuable and effective antibacterial in post-coital prophylaxis of recurrent urinary tract infection in otherwise healthy premenopausal women, although it is slightly less effective than cotrimoxazole or nitrofurantoin. Effective post-coital prophylaxis requires the use of much smaller quantities of antibacterial agents than the daily use of a single tablet and in women with a high incidence of recurrent urinary tract infections it is superior to intermittent self-administered antibacterial therapy.

Adult↗
PubMed1987

Use of internal polyethylene ureteral stents in extracorporeal shock-wave lithotripsy of staghorn calculi.

Ureteral stenting during extracorporeal shock-wave lithotripsy (ESWL) of complete staghorn calculi, using an internal polyethylene pigtail catheter, was found to be an efficient prophylactic measure against the high rate of complications in these cases. In the presence of a ureteral stent the stone fragments passed more easily into the bladder, accumulation of obstructing stone streets was prevented, and internal drainage of the urine was guaranteed. The need for auxiliary measures such as percutaneous nephrostomy, ureteroscopy or ureteral meatotomy was prevented in most cases. This prophylactic measure may turn ESWL to become the primary treatment of large staghorn calculi.

Catheters, Indwelling↗
PubMed1987

Shock-wave treatment for stones in the kidney and ureter. The Jerusalem experience.

We report on our first 6 months' experience with the extracorporeal shock-wave lithotripter (ESWL). During this period, 410 treatments were given to 350 kidneys and ureters. Our series was characterized by a particularly high proportion (40%) of multiple and large calculi and included 25 complete staghorns. The latter required multiple treatments (up to five), but no adjunct percutaneous nephrolithotomies were used in this series. A percutaneous nephrostomy was inserted in 20 cases. Thirty-six ureteric calculi above the pelvic level were treated in situ, with 95% success. The presence of a ureteric catheter is useful in these cases. Posttreatment pain was graded, and 61% of the patients did not require any analgesia. High-frequency jet ventilation was used in 91% of the 172 patients receiving general anesthesia and was of great value in minimizing respiratory-stone movement. The principal complication encountered was ureteric obstruction due to impacted particles. Temperature greater than 38 C occurred in 8.5% of the cases. It is suggested that the availability of the ESWL should encourage the early treatment of both renal and ureteric calculi, as well as enable the treatment of certain patients rejected for conventional surgery.

Adolescent↗
PubMed1986

Congenital varicella causing neurogenic bladder and anal dysfunction.

An infant with congenital varicella syndrome due to maternal varicella zoster is presented. Unlike other reports in which such infection caused multiple congenital defects, our patient suffers from atonic bladder and anal dysfunction as the sole manifestation of congenital varicella syndrome. Attention is called for maternal varicella as a possible cause for limited neurologic damage in the fetus.

Anus Diseases↗
PubMed1986

Prostatitis. A continuing enigma.

After all is said and done, prostatitis is still a syndrome often difficult to interpret and with an unclear etiology and pathogenesis in many patients. However, if approached intelligently by an interested, knowledgeable, and honest physician, prostatitis in its different variations can be diagnosed correctly and the adequate treatment adjusted accordingly wherever possible. When no specific treatment is available, reassurance and general supportive measures will often alleviate the condition remarkably.

Anti-Bacterial Agents↗
PubMed1984

A randomized comparison of 1-day versus 10-day antibacterial treatment of documented lower urinary tract infection.

We randomized 58 women with lower urinary tract infection diagnosed on bilateral ureteral catheterization studies to a 1-day or 10-day treatment regimen. The study revealed that 1-day adequate antibacterial treatment was as effective as 10-day treatment for lower urinary tract infection. Sterile urine was obtained in all 27 women (100 per cent) given 1-day treatment and in 30 of 31 (97 per cent) given 10-day therapy. Three weeks after the 1-day treatment significantly more postmenopausal women had infected urine than premenopausal women. This difference was not seen in the 10-day group. We conclude that 1-day treatment is sufficient for the cure of lower urinary tract infection in women.

Adolescent↗