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Biomedical subjects

C Meier

Publications and source records attributed to C Meier.

At least 19 recordsLinked to original sources
PubMed1995

[Rhabdomyolysis in patients treated with simvastatin and cyclosporin: role of the hepatic cytochrome P450 enzyme system activity].

We describe two patients treated with a combination of cyclosporin and simvastatin who had to be hospitalized due to rhabdomyolysis. As suggested by reduced cyclosporin clearance, both patients had impaired activity of the hepatic cytochrome P450 enzyme system, which may have contributed to the development of rhabdomyolysis. After cessation of treatment with simvastatin and intensive hydration, both patients recovered within one week. While rhabdomyolysis has been described in several patients receiving the combination lovastatin/cyclosporin, so far only one case has been reported in patients treated with simvastatin/cyclosporin. Our cases therefore suggest that this complication may be more frequent than previously suspected. In patients treated with cyclosporin, HMG-CoA reductase inhibitors should be used cautiously, and concomitant administration of drugs inhibiting the hepatic cytochrome P450 enzyme system should be avoided.

Anticholesteremic Agents↗
PubMed1994

[Drug-induced (probably allopurinol) agranulocytosis. Case report and discussion].

Agranulocytosis is a rare but sometimes extremely dangerous adverse drug reaction which can be induced by almost any drug. We report the case of a 89-year-old man with a well-documented granulocyte chart, who received allopurinol in addition to preexisting therapy with cardiovascular drugs. Three weeks later agranulocytosis was found which bone-marrow biopsy indicated was drug-induced. After cessation of all drugs, isolation and antibiotic therapy, the leukocyte count returned to normal but the patient died four weeks later from progressive renal failure. A relation between allopurinol therapy and agranulocytosis was presumed. The drugs which might have caused this adverse reaction are discussed. The incidence, signs, symptoms and treatment are summarized and proposals are made concerning the action to be taken in the event of drug-induced agranulocytosis.

Acute Kidney Injury↗
PubMed1994

A chemiluminescence assay to detect antibodies to brain surface antigens in human sera.

A chemiluminescence assay was developed based on the interaction between antibodies binding to the surface of living brain cells in culture and macrophages. Such interaction leads to production of reactive oxygen radicals which can be measured by a chemiluminescence assay. This assay was used to detect anti brain antibodies in serum samples from humans with various neurological diseases. Such antibody activity was found in a high proportion of these patients. Subsequent experiments with purified IgG fractions and corresponding F(ab')2 fragments showed that the observed reactions were highly specific. It was concluded that the chemiluminescence assay is a sensitive and useful technique to detect autoantibodies in neurological diseases.

Animals↗
PubMed1993

[The drug information service in the hospital].

A Drug Information Service (MID) delivers competent information, free from influences of industry. Users are mainly physicians and pharmacists, who are not able to solve a particular pharmacologic problem by their own means. For many years such MIDs are operated in several countries by clinical pharmacists. In Switzerland, too, there is particular interest in drug-oriented information for years. In this article a short overview on basic informations and first experiences concerning this domain are presented.

Drug Information Services↗
PubMed1993

[Drug interactions as a cause of drug side effects].

Adverse drug interactions are a frequent clinical problem. Mechanistically, they can be classified as pharmaceutic, pharmacokinetic and pharmacodynamic interactions. Mostly, however, several different mechanisms are involved in the pathogenesis of adverse drug interactions, which makes their predictability as well as their prevention strongly dependent on the early and adequate recognition of high-risk patients. Such high-risk situations include drug-related (e.g. galenic form, stability, enantiomers), patient-related (e.g. pharmacokinetics, age, genetic disposition) and various exogenous (e.g. polypragmasy, alcohol abuse, food) factors. Especially the recent progress in the molecular characterization of hepatic biotransformation reactions has markedly increased our understanding of many potentially toxic drug interactions. In addition, several alternative compounds with distinct potentials for interactions with other drugs are now available in various therapeutic drug classes. In the future it will be important to further increase our pathophysiologic and pharmacogenetic knowledge, in order to further improve the predictability, prevention, early recognition and therapy of adverse drug interactions.

Dose-Response Relationship, Drug↗
PubMed1992

[Lyme borreliosis: significance of the serological diagnosis of an infection with Borrelia burgdorferi in neurological diseases with inflammatory cerebrospinal fluid syndrome].

To look for a correlation between positive antibody-response against Borrelia burgdorferi (Bb) and an inflammatory CSF-syndrome, from May 1988 to May 1989 333 patients from the Neurological Department of the University of Bern underwent lumbar puncture with cell count, quantitative and qualitative protein analysis and antibody determination against Bb in serum and CSF. 6 patients with active syphilis were excluded. The results of the 333 remaining patients were analyzed using chi 2 or Fisher's exact test. The antibody determination was performed using an immunoperoxidase assay (IPA). Our results are calculated for three cut-off points: Bb-IgG 1:64, 1:128, 1:256 and/or Bb-IgM 1:16, 1:32, 1:64. We found 11.7% patients to be seropositive (Bb-IgG 1: greater than or equal to 256 and/or Bb-IgM 1: greater than or equal to 64). We demonstrated the following correlations: elevated cell count (greater than 10/mm3 cells CSF) versus elevated Bb-titer (1: greater than or equal to 256), elevated total protein of CSF (greater than 48 mg%) versus elevated Bb-titer, blood-brain-barrier dysfunction versus elevated Bb-titer. In diagnostic subgroups, the same correlations were only demonstrated for PNS disorders (n = 134), and especially PNS-disorders without compression. 8 cases showed the high risk constellation inflammatory CSF syndrome and highly positive titer (Bb-IgG 1: greater than or equal to 256). Only 2 had typical neuroborreliosis, while in 2 cases the possibility of neuroborreliosis was open. Patients with MS did not show a special risk for Bb-infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

[Epidemiological aspects of neurological complications of Lyme borreliosis in Switzerland. A case-control study].

To determine the individual relative risk to neurologically affected patients of infection with Borrelia burgdorferi, within the framework of a multicenter case control study encompassing the four neurological departments of the Universities of Basel, Bern, Zurich and Lausanne, 378 patients and 1134 healthy blood donors serving as controls underwent analysis for antibodies against Borrelia burgdorferi by ELISA. The seroprevalence were estimated for a cut-off point of 2 standard deviations from the mean, these values corresponding to cut-off points of 1:32 for IgM and 1:256 for IgG by immunofluorescence testing. For IgM, 4.8% of the neurological patients were positive versus 4.1% of controls; the corresponding values for IgG were 10.1% versus 10.7% respectively. Hence, neurologically affected patients were not at higher risk for infection with Borrelia burgdorferi than were controls. We found no elevated relative risk in any diagnostic subgroup. The results of a positive Lyme serology must therefore be interpreted with care and in relation to clinical and CSF findings. On the basis of our results, screening for Lyme borrelioses serves no purpose.

Adolescent↗
PubMed1992

Regression of coronary artery dimensions after successful aortic valve replacement.

BACKGROUND: The effect of regression of myocardial hypertrophy on coronary artery dimensions was evaluated in patients with aortic valve disease who underwent valve replacement. METHODS AND RESULTS: Cross-sectional area (CSA) of the three major coronary arteries (left anterior descending [LAD], left circumflex [LCx], and right coronary artery) was determined by quantitative coronary arteriography in 15 patients with aortic valve disease before and 38 months (range, 14-113 months) after successful aortic valve replacement. Twelve normal subjects served as controls. Left ventricular (LV) angiographic mass was calculated according to the method of Rackley. CSA of the left coronary artery was larger in aortic valve disease than in controls (LAD, 15 versus 8 mm2, p less than 0.001; LCx, 14 versus 6 mm2, p less than 0.001). After valve replacement, CSA of the left coronary artery decreased (LAD, 12 mm2, p less than 0.05 versus before surgery; LCx, 11 mm2, p less than 0.05 versus before surgery) but remained significantly larger than in controls. CSA of the right coronary artery in patients with aortic valve disease was not different from controls. LV muscle mass was significantly increased in aortic valve disease patients before (364 g) and after (250 g) valve replacement compared with controls (135 g). The appropriateness of coronary artery size with respect to muscle mass was evaluated by normalizing CSA of the left coronary artery (LAD + LCx) per 100 g of LV muscle mass (mm2/100 g). This index amounted to 11 mm2/100 g in controls, to 8 mm2/100 g in preoperative patients (p less than 0.05 versus controls), and to 10 mm2/100 g in postoperative patients with aortic valve disease (p = NS versus controls). CONCLUSIONS: In patients with aortic valve disease, CSA of the proximal LAD and LCx is increased, but this increase is not sufficient to keep CSA per 100 g of LV mass within normal limits. The postoperative decrease in muscle mass is associated with a decrease in the size of LAD and LCx, whereas the size of the right coronary artery remains unchanged. In contrast to the preoperative state, the residually hypertrophied LV myocardium after aortic valve replacement is supplied by an enlarged but adequately sized LAD and LCx.

Aortic Valve↗
PubMed1992

Neurological complications of Lyme borreliosis.

Lyme disease, like syphilis, a spirochetal infection, can appear with exacerbations and remissions in different stages. The clinical picture is marked by dermatological, neurological, rheumatic and cardiological complications. PNS complications appear in the second and third stage. Tick bite meningoradiculoneuritis neuritis (Garin-Bujadoux-Bannwarth-Syndrome), characterized by painful asymmetrical sensory and motor dysfunctions and inflamed CSF, is a typical manifestation of the second stage. Mononeuritis multiplex appearing in conjunction with acrodermatitis chronica atrophicans is a typical PNS manifestation of the third stage. CNS involvement may also occur in early and late stages of Lyme-Borreliosis, presenting as myelitis or progressive encephalomyelitis. Lyme-Borreliosis is a treatable condition, which should not be missed in the differential diagnosis of PNS and CNS disorders.

Acrodermatitis↗
PubMed1991

The modification of guanine nucleosides and nucleotides by the borderline arylamine carcinogens 4-methyl- and 4-methoxyaniline: chemistry and structural characterization.

We report here on the conformational analysis of C8-arylamine nucleoside and nucleotide adducts of the borderline carcinogens 4-methylaniline and 4-methoxyaniline. The non-phosphorylated adducts show anti conformation of the glycosidic link, while the corresponding 5'-phosphorylated adducts have a syn conformation. All adducts exhibit a predominant C2'-endo conformation of the sugar ring and a gg conformation of the exocyclic bond.

Aniline Compounds↗
PubMed1991

[Fatigability and weakness from a neurological viewpoint].

Fatigue is a frequent but ill defined symptomatology in many disorders of the central and the peripheral nervous system. It is characterized as a fluctuating incapacity or weakness, often in the absence of overt paresis. Experimental or diagnostic evidence of fatigue is available only in disorders of the peripheral motor neuron, the neuromuscular junction and the muscle fibers, but not in CNS disorders. Fatigue, as a fluctuating symptomatology may be misdiagnosed as simulation or malingering not only by lay persons, but also by doctors.

Central Nervous System Diseases↗
PubMed1991

[Adverse side effects of amalgam? An interdisciplinary study].

In an interdisciplinary study starting 2.5 years ago patients with various symptoms, which they associate with amalgam fillings, were examined. According to the first results of this study with 50 patients, the Hg-concentration in urine does correlate with the amount of amalgam fillings before and after taking DMPS (2,3-Dimercapto-1-propane-sulfonic-acid), but with a maximum of 66.4 micrograms Hg (24 h urine) the amounts of mobilization measured were significantly below toxicologically critical limits. Only in 3 patients did the individual immunological values (CD4/8 ratio, antinuclear antibodies) by far exceed standard values. In one case an allergy to amalgam is suspected. 40% of the patients showed a pathological psychiatric status (neurosis, depression, etc.). Another quarter had psychological problems like alcoholism or drug abuse. There is no reason at the moment to reject amalgam as filling material either because of the measured Hg-concentrations or because of any immunological or allergological findings.

Adolescent↗
PubMed1990

[Computer-assisted drug information].

Experience with a university hospital based drug information service (DIS) is reported. A total of 501 drug related questions were analyzed during two prospective evaluation periods of 13 and 14 months' duration respectively. Information was requested by physicians and pharmacists chiefly on practical aspects of drug treatment in individual patients (77%), such as drug choice, dosage adaptation, side effects and interactions. Inquiries on drug safety in pregnancy and lactation (8.8%), and questions on pharmaceutical properties (14.2%), including pharmacokinetics, were also frequent. Our experience indicates that a problem-oriented, comprehensive DIS necessitates close cooperation between physicians trained in clinical pharmacology and pharmacists within the same team. The use of electronic media greatly facilitates the collection of drug related information, data retrieval and storage. Drug information services can contribute to improved quality and safety of drug therapy.

Computers↗
PubMed1990

[Peroneal muscle atrophy with talipes cavus. Pyramidal symptoms and sensory disorders in one family. On the problem of the nosological classification of hereditary spinal diseases and polyneuropathies].

We describe a family with peroneal muscular weakness and atrophy with associated pyramidal signs. Onset of obvious symptoms was usually after the age of 50 years, but history pointed to subtle symptoms at an earlier age. The disorder was of autosomal dominant inheritance. The muscle weakness involved only the legs. All affected persons remained independent as regards their ability to walk. Sensory disturbances were never significant for the affected individual. With regard to the neurographies, the disease could be classified as a form of hereditary motor and sensory neuropathy (HMSN). The clinical picture, however, allows the classification of the disease as a form of spinal muscular atrophy or spastic spinal paralysis. We discuss the diagnostic implications of such disorders, which involve both the peripheral and the central motor pathways.

Adult↗