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Biomedical subjects

B Braendli

Publications and source records attributed to B Braendli.

9 recordsLinked to original sources
PubMed1991

[Continuous quinidine infusion and blood exchange transfusion in severe tropical malaria: a case report].

We report on a serious case of malaria due to Plasmodium falciparum. Although the 46-year-old Swiss female had strictly followed the recommended prophylaxis with proguanil and chloroquine she was infected during a stay in Namibia which had lasted several month. The patient had poor prognostic signs such as encephalopathy (cerebral malaria), a parasitemia of 34% but only moderate renal impairment. Instead of the classical treatment with quinine, the patient was treated with a constant infusion of quinidine over 3 days which was combined with an exchange transfusion of approximately 2 liters on the first day of treatment. All clinical signs of the infection improved within less than 2 days as did the parasitemia. The patient was discharged after a hospital stay of 11 days. Quinidine as opposed to quinine may be more readily available, less toxic and more efficacious. Treatment with quinidine must carefully be monitored. Exchange blood transfusions may be an important additional therapeutic modality in severe plasmodium falciparum malaria.

Animals↗
PubMed1991

[Clinical aspects and diagnosis of malaria].

Malaria must be included in the differential diagnosis of all febrile patients. Malaria is classified 'complicated' or 'uncomplicated', according to clinical findings (cerebral malaria, generalized convulsions, pulmonary edema, severe anemia, hyperthermia, renal failure, haemoglobinuria, shock, spontaneous bleeding) and laboratory results (parasitemia greater than 5%, haemoglobin less than 5 g%, creatinine greater than 265 mumol/l, glucose less than 2.2 mmol/l, DIC, pH less than 7.2, bilirubin greater than 50 mumol/l). Plasmodium (P.) vivax, P. ovale and P. malariae cause uncomplicated disease as a rule, whereas P. falciparum may result in either of both. Complicated falciparum malaria is always at risk for a lethal outcome. Only microscopic evidence of malaria parasites proofs the diagnosis. The thick smear is good for screening, thin films are necessary to determine the species. Serology and cultures are not helpful in diagnosing acute malaria. Tests for drug resistance await to be applicable for emergency situations.

Adult↗
PubMed1991

[Malaria study].

Compliance with malaria prophylaxis or reserve drugs was investigated in 477 individuals travelling to regions with endemic malaria. Correct intake of prophylactic medication was confirmed in 225 out of 285 (= 78%). Compliance was independent of type of drug (Mefloquine, Sulfadoxine-Pyrimethamine, Chloroquine). Two tourists missed to start prophylaxis one week before the onset of their travel. 14 travellers stopped prophylactic medication too early after their return, 31 tourists took too high doses of mefloquine. None of the tourists travelling to countries with a therapeutic reserve only became sick, whereas two travelling to Africa contracted malaria.

Antimalarials↗
PubMed1990

[East African sleeping sickness (Trypanosoma rhodesiense infection) in 2 Swiss travelers to the tropics].

We report on two Swiss travellers who acquired African sleeping sickness (Trypanosoma rhodesiense) the same day while visiting the Akagera park in Rwanda. The first patient developed clinical signs of sleeping sickness 8 days after being bitten by a tsetse fly. Trypanosomes were demonstrated in the blood and CSF. The other patient fell ill 13 days after the bite and trypanosomes were found only in blood samples. The first patient (cerebral trypanosomiasis), was treated with melarsoprol. He developed an allergic reaction under treatment but made a good recovery 4 months later. The second patient (hemo-lymphatic trypanosomiasis) was put on suramin, which was well tolerated. He recovered after 2 months.

Adult↗
PubMed1990

[Vaccinations for travel abroad].

Travel to the developing world by Swiss citizens has been increasing. Vaccine-preventable diseases challenges the physician to provide pre-travel advice. Each traveler's itinerary, duration of stay and medical history, including previous immunization, should be reviewed. Vaccinations are required or recommended according to the requirements and the epidemiology of countries being visited. This article summarizes updated recommendations to individual vaccines and immunoglobulins.

Child↗
PubMed1978

[Atenelol and bendrofluazide in the treatment of medium and severe hypertension (preliminary report)].

In 15 patients with moderate to severe hypertension (WHO II--III) atenolol was evaluated against a thiazide diuretic (bendrofluazide) in a single blind crossover study. Systolic blood pressure values were lowered more efficiently by the diuretic, while diastolic pressure values were significantly better controlled by atenolol. Atenolol and bendrofluazide, by mere addition of the pressure effects of the single components, clearly afforded the best pressure control. Side effects of atenolol were frequent but mild, never causing major concern with the patients or a dropout from the study. Although the pressure response to atenolol was significantly better in the normal and high renin group of patients, there was no statistically significant correlation between the reduction in plasma renin and blood pressure induced by atenolol. In turn, the pressure response to the diuretic was significantly better in low renin than in normal and high renin patients.

Atenolol↗