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Biomedical subjects

B Eber

Publications and source records attributed to B Eber.

At least 109 records · Page 6Linked to original sources
PubMed1996

[Serum digoxin level in patients with dilated cardiomyopathy].

To investigate whether measuring levels of digoxin in patients with idiopathic dilated cardiomyopathy (IDC) is helpful in dose adjustment of digoxin we did the following study. In 77 patients (63 male, 14 female) with invasively verified IDC serum-digoxin levels were measured after a treatment period with beta-acetyldigoxin of at least 6 months. All patients received digoxin, 76 had ACE-inhibitors and 69 used diuretics. Mean serum-levels of digoxin were 0.96 ng/ml while using a mean daily dose of digoxin of 0.24 mg. Those who showed a serum level of digoxin within the recommended range took a slightly higher daily dose of digoxin when compared to those with low levels of digoxin (0.26 vs. 0.23 mg/day, p < 0.05). Therefore, we conclude that low serum-levels of digoxin are mainly caused by low intake of digoxin and it is justified to measure digoxin-levels in IDC-patients even if it increases costs.

Adult↗
PubMed1996

[Current aspects of ACE inhibitor therapy from the cardiologic viewpoint].

From a cardiologist's view there are several established indications for the use of ACE-inhibitors like hypertension, heart failure and acute myocardial infarction. In other forms of coronary artery disease like stable and unstable angina and prevention of arteriosclerotic complications. ACE-inhibitors are under discussion. As antihypertensives ACE-inhibitors are about equally effective as calcium blockers, betablockers and diuretics without the negative effects on lipid metabolism and insulin sensitivity. Vascular and cardial remodelling are prevented with ACE-inhibitors at least to a certain degree. In heart failure ACE-inhibitors reduce morbidity and mortality, if left ventricular ejection fraction is reduced. In acute myocardial infarction ACE-inhibitors are indicated in overt heart failure, depressed left ventricular function and high-risk-patients. In silent ischaemia and secondary prevention ACE-inhibitors are under discussion.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1996

[Smoking behavior and views on the smoking topic in the Styrian population--results of a survey at the Graz autumn convention].

Cigarette smoking has been identified as a major risk factor for cardiovascular diseases apart from hypercholesterolemia and arterial hypertension. Diseases of the respiratory system and several neoplasms as well as complications of pregnancy are considered to be "smoking-related", too. In order to survey the smoking habits and views on smoking in the Styrian population, a questionnaire was issued to 1034 visitors of the Graz Autumn Fair 1992. Pleasure proved to be the main motivation for smoking both in men and in women, habit, addiction, stress and boredom being further motivations. Not only non-smokers, but also smokers were assessed to be aware of smoking being a health hazard. Prohibition of tobacco advertising was accepted most widely as a mean of anti-smoking campaign. About half the non-smokers are exposed to environmental tobacco smoke, at place of work more frequently than at home. Percentage of smokers differs with age and job classes, however, no geographical variations were found. Further anti-smoking measures should be considered. Smoking restrictions at place of work and in public could prevent passive smoking. Ban on advertising seems to be the most effective anti-smoking campaign.

Adolescent↗
PubMed1995

[Thrombosis of a prosthetic mitral valve in the anticardiolipin syndrome].

A 40-year-old woman in whom the mitral valve had to be replaced with a prosthetic one (St. Jude's) had to be reoperated 8 months later because of endocarditis on the second prosthetic valve (Carbo-Medics). Four months later her general condition deteriorated progressively with cough and dyspnoea, requiring hospitalization. Auscultation revealed moist rales over both lung bases; heart sounds were distant but otherwise normal. The "international normalized ratio" was 2.5, while erythrocyte sedimentation rate, white cell count and C-reactive protein were normal. Transthoracic echocardiography demonstrated a hardly moving mitral valve prosthesis with an opening area of 0.8 cm. Subsequently this decreased further and measurement of the anticardiolipin antibody titre revealed an IgG fraction of 37.9 U/ml (normal up to 12 U/ml). Within 48 hours thrombolysis with streptokinase had increased the valve's opening area to 1.8 cm. The patient made an uneventful recovery under strict anticoagulation. This case illustrates that the anticardiolipin syndrome can be a cause of an otherwise unclear genesis.

Adult↗
PubMed1995

Heart rate deflection related to lactate performance curve and plasma catecholamine response during incremental cycle ergometer exercise.

The correlation between the behaviour of the heart rate/work performance (fc/W) curve and blood lactate ([la]b) and plasma adrenaline/noradrenaline concentrations ([A]/[NA]) during incremental cycle ergometer exercise was investigated. A group of 21 male sports students was divided into two groups: group I, with a clear deflection of the fc/W curve; group II, without or with an inverse deflection of the fc/W curve. The aerobic threshold (Thaer) and the lactate turn point (LTP) were defined. Between Thaer and maximal work performance (Wmax) the behaviour of the fc/W curve as well as the behaviour of [la-]b and [A]. [NA] were described mathematically. The fc, systolic blood pressure (BPs), W, [la-]b, [A] and [NA] at rest, Thaer, LTP, Wmax, after 3 and 6 min of recovery (Re3/Re6) were calculated. A significant difference between the two groups could only be detected for fc at LTP, Re3 and Re6 (P < 0.05). No significant correlation could be found between individual fc/W-behaviour and individual time course of [la-]b, [A] and [NA]. However, a significant correlation was visible between [la-]b/W-behaviour and individual catecholamine response. These results and the fact that the different flattening at the top of the fc/W curve was related to diminished stress-dependent myocardial function led us to the conclusion that it is possible that sympathetic drive is not directly involved in mechanisms of regulation between load dependent fc and myocardial function. In addition, individual fc/W behaviour was independent of BPs and Wmax, or individual conditions of energy supply.

Adult↗
PubMed1995

Severe hypotension and coma secondary to unrecognized chronic anterior hypophysitis.

We report an endocrine emergency of a 52-year-old woman with chronic anterior-pituitary failure of autoimmune origin who developed hypopituitary crisis with coma and severe hypotension provoked by an intercurrent bronchopneumonia. At admission to the ICU hypopituitarism had not been diagnosed and only Hashimoto's thyroiditis with thyroid replacement therapy could be obtained from the patient's history. Although the patient presented with somatic signs suggestive of hypopituitarism, other causes of coma and hypotension had first to be excluded. In the absence of specific treatment the patient died 18 h later with refractory cardiac arrest. Diagnosis of acute decompensated chronic hypophyseal failure must be considered if hypothermia, refractory hypotension and signs of infection without fever are associated with a short stature and the loss of axillary and public hair. Waiting for laboratory confirmation of the diagnosis must not delay immediate life-saving specific glucocorticoid treatment.

Acute Disease↗
PubMed1995

Roxithromycin in the treatment of Lyme disease--update and perspectives.

Spirochaetal infections have been successfully treated with penicillin; more recently, erythromycin has been used in cases with known penicillin allergy. The discovery of the spirochaete Borrelia burgdorferi and the elaboration of a new generation of macrolides with properties that differ from older macrolides have led to new ways of treating spirochaetal disease with these compounds. This paper presents data on the in vitro and in vivo efficacy of a combination of roxithromycin and co-trimoxazole against B. burgdorferi. In vitro (checkerboard technique; B. burgdorferi strain B31; modified BSK II medium) it was found that while roxithromycin showed excellent efficacy against B. burgdorferi (MIC 0.031 mg/l), co-trimoxazole had no effect. However, the combination of both chemotherapeutics led to a minor synergistic effect, decreasing the MIC for roxithromycin by one dilution step at concentrations of co-trimoxazole from 256 to 8 mg/l. In addition, a clearly reduced growth of microorganisms was seen at concentrations of roxithromycin as low as 0.015 mg/l in combination with 256 to 4 mg/l co-trimoxazole, when compared to the positive controls. Most interestingly, however, the motility of B. burgdorferi was markedly reduced even when the two drugs were combined at very low concentrations. In an in vivo, non-randomised, open, prospective pilot study it was found that of 17 patients with confirmed late Lyme borreliosis (stage II/III), treated with combined roxithromycin (300 mg b.i.d.) and co-trimoxazole for 5 weeks, 13 (76%) recovered completely by the end of treatment, and four continued to have symptoms on follow-up at 6 and 12 months. This success rate is similar to that seen with i.v. penicillin and ceftriaxone. It appears that the reduced motility of B. burgdorferi makes the pathogen more accessible to the immune system.

Administration, Oral↗
PubMed1995

Transient reduction of autoantibodies against oxidized LDL in patients with acute myocardial infarction.

Fifteen consecutive patients (mean age 66 +/- 14, range 31-82) with an acute myocardial infarction (MI) suitable for thrombolytic therapy were included in this study. Autoantibodies against oxidized low-density lipoprotein (LDL) were determined by enzyme-linked immunosorbent assay (ELISA). Patients (n = 10) with marked elevation of the MB isoenzyme of creatinine kinase (CK-MB)-mass had significant decreases of oLDL-Ab during the acute phase, with a minimum after 8 h following the onset of thrombolytic therapy (within-group significance: p < .001; between groups: p = .01). Patients (n = 5) with CK-MB-mass values less than 70 ng/ml did not show this phenomenon. Furthermore, significant correlations existed between CK-MB-mass and oLDL-Ab after 6 and 8 h (n = 15; r = .72; p = .003) and the time of the highest CK-MB-mass values (after 12 h) and the time of the maximal decrease of oLDL-Ab (after 8 h) (r = .74; p = .003). Our observations provide further evidence for the release of free radicals and for increased lipid peroxidation during reperfusion after prolonged ischemia. The decrease of oLDL-Ab appears to be a marker for the severity of MI.

Adult↗
PubMed1995

[Coronary aneurysm in a 69-year-old patient. Transthoracic echocardiography].

This case report is on a 69-year old male patient treated with cephalosporins because of suspected myocarditis due to borreliosis. Using transthoracic echocardiography a big aneurysm of the proximal part of the left coronary artery was detected. Coronary angiography revealed an aneurysm 1.2 cm in diameter at the origin of the left anterior descending branch and confirmed the initial diagnosis. In addition, coronary three-vessel disease with reduced left ventricular function was found. Coronaritis due to Lyme borreliosis could not be ruled out with certainty. The patient was relatively asymptomatic, and hence conservative therapy was recommended. The case described here serves as a basis for a discussion on the aetiology, clinical manifestation, diagnosis and therapeutic management of coronary aneurysms.

Aged↗
PubMed1995

Effects of treadmill exercise protocol with constant and ascending grade on levelling-off O2 uptake and VO2 max.

In order to investigate the effect of an exercise protocol on the levelling-off O2 uptake and VO2 max values, ten male subjects aged 28 +/- 5 yrs, height 1.8 +/- 0.05 m, body mass 76 +/- 6 kg performed two treadmill exercise protocols: 1) constant grade (CG) of 5%, with increasing running speed starting at 6 km.h-1 and increments of 2 km.h-1 every 3 minutes. 2) ascending grade (AG) starting at 0% and increments of 5% every 3 minutes, with constant running speed of 5 km.h-1. During each protocol oxygen uptake (VO2), pulmonary ventilation (VE), tidal volume (Vt), and breathing rate (BR) as well as blood lactate concentration (La) and heart rate (HR) were measured. In CG a levelling-off phenomenon of VO2 in all cases was observed. Aerobic capacity expressed as VO2 max in CG was 46.2 +/- 6.0 ml.min-1.kg-1. In contrast, VO2 max was 35% higher in AG (62.6 +/- 7.2 ml.min-1.kg-1). The behaviour of VO2 indicates a lower efficiency with increasing work load in AG as compared to CG. Regarding maximum performance it can be concluded that VO2 in CG seems to be limited by a mechanical or neuromuscular constraint on the depth of breathing, which is confirmed by a distinct flattening of Vt. The levelling-off of the VO2 in CG, something which is not observed in AG, can be explained plausibly this way.

Adult↗
PubMed1995

Cases of Lyme borreliosis resistant to conventional treatment: improved symptoms with cephalosporin plus specific beta-lactamase inhibition.

We present four cases of verified late Lyme borreliosis with persistent symptoms and positive serology despite repeated courses of high-dose intravenous penicillin G and/or cephalosporins (including cefoperazone). The patients were now treated with cefoperazone 2 g plus sulbactam 1 g bid iv for 14 days. At the end of treatment, patients were symptom free and have remained so for the following 12 months. By then, IgG against Borrelia burgdorferi had decreased. It is concluded that the addition of beta-lactamase inhibitors to intravenous treatment could be beneficial in Lyme disease refractory to conventional treatment.

Cefoperazone↗
PubMed1995

Changes in thyroid hormone parameters after acute myocardial infarction.

Abnormalities in circulating thyroid hormone levels are very common in systemic nonthyroidal illnesses, such as acute myocardial infarction. In this study, thyroid parameters were determined in a series of 16 consecutive infarction patients treated by thrombolysis. Blood samples were taken before therapy as well as 2, 4, 6, 8, 12 and 72 h following admission. Total and free serum thyroxin and triiodothyronine decreased and reverse T3 increased significantly showing no major variations up to 72 h, whereas thyroid-stimulating hormone values remained almost unchanged during the observation period. Subjects with CK-MB levels of more than 150 ng/ml (n = 10) revealed similar changes in thyroid parameters in comparison to those with lower values (n = 6; NS). Thus, although hormone modifications very often occur following acute infarction, thyroid status may not serve as a marker for the extent of left ventricular dysfunction in the early phase of myocardial infarction.

Aged↗
PubMed1995

Sulfoconjugated and free plasma catecholamine levels at rest and during exercise in patients with idiopathic dilated cardiomyopathy.

Plasma levels of sulfoconjugated (sc) catecholamines (CA) have been shown to be increased with activation of the sympathoadrenal system in a number of clinical settings. We evaluated the relation between scCA and clinical or hemodynamic parameters of patients with idiopathic dilated cardiomyopathy (IDC) at rest and during incremental exercise testing. Eleven healthy subjects, nine patients in New York Heart Association (NYHA) functional class I (IDC-A group) and 11 in NYHA functional class II and III (IDC-B group) performed a symptom-limited, graded bicycle exercise test. Resting, peak and various postexercise levels of plasma free and scCA were determined by high-pressure liquid chromatography. Resting CA levels obtained in the supine position were remarkable for elevations of free norepinephrine (NE) in IDC-B patients (355 +/- 157 ng/l) as compared to IDC-A patients (177 +/- 54, p = 0.006) or healthy controls (193 +/- 74, p = 0.007). Similarly, scNE was highest in IDC-B patients with 1856 +/- 1089 ng/l, followed by IDC-A (1028 +/- 187, p = 0.025) and control subjects (1109 +/- 440, p = 0.025). There was a highly significant correlation between free and scNE (r = 0.76, p < 0.0005). Whereas resting free dopamine (DA) levels were comparable in all three groups, scDA was found to be elevated clearly in IDC-B patients (8772 +/- 2097 ng/l) and significantly different to IDC-A (5786 +/- 2481, p = 0.01) or control subjects (4892 +/- 1575, p = 0.0005). The NYHA functional class and maximum exercise performance correlated best with resting scDA (r = 0.68, p = 0.001 and r = 0.56, p = 0.005, respectively). At peak exercise, IDC-B patients exhibited a significant decrease in scNE and sc epinephrine (E) (from 1856 +/- 1089 to 1495 +/- 932 ng/l, p < 0.005 and from 491 +/- 173 to 282 +/- 143 ng/l, p < 0.01) compared to controls (from 1109 +/- 444 to 1094 +/- 548 ng/l and from 379 +/- 200 to 329 +/- 134 ng/l). In IDC-B patients this decrease in scNE and scE at peak exercise was related inversely to the rise in free NE and E (r = -0.81, p < 0.005 and r = -0.68, p < 0.05). Resting hemodynamic indices generally were reflected better by some free CA rather than by conjugated forms or by parameters of clinical performance. These findings suggest that in addition to free or scNE levels, resting scDA is elevated in symptomatic patients with IDC.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗