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Biomedical subjects

C Piper

Publications and source records attributed to C Piper.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Acute interstitial nephritis following piperacillin].

A 75-year-old woman developed fever, exanthema and nonoliguric renal failure 16 days after the beginning of Piperacillin treatment. Renal biopsy revealed lympho-plasma-cellular acute interstitial nephritis (AIN). A lymphocyte-transformation-test showed significant stimulation of patient's lymphocytes by Piperacillin. Corticosteroid-therapy correlated to clinical and renal improvement. Nevertheless the patient died of foudroyant septicemia caused by E. coli. Our report describes the first immunologically documented case of AIN following Piperacillin treatment.

Aged↗
PubMed1989

[Oral contraceptives: undesirable effects in internal medicine].

Eight instructive clinical case reports on younger women demonstrate the actual problem of severe adverse reactions (ADR) associated with oral contraceptives. Complications consisted of cerebral arterial thrombosis, peripheral arterial thrombosis, cerebral embolism, pelvic vein thrombosis, pulmonary embolism, thrombosis of the sinus sagittalis, recurrent pancreatitis and focal nodular hyperplasia of the liver. Contraindications of hormonal contraception (i.e. heavy smoking) were not always taken seriously by the prescribing physician. The data bank of the Medicines Commission of the German Medical Association contributed 648 cases to draw an ADR frequency profile, according to age, doses, duration of prescription and deaths. 25 deaths in close connection to oral contraception intake were reported, mostly caused by arterial or venous thromboembolism. Deaths predominantly were reported in women less than or equal to 30 years old, mostly following exposition to low-dose-preparations and after relatively short duration of intake (less than or equal to 3 years). These non-representative observations call for strict consideration of contraindications and use of low-dose-preparations, even in younger women.

Adult↗
PubMed1989

Pharmacokinetics of the thromboxane A2 receptor antagonist sulotroban (BM 13.177) in renal failure.

1. Ten healthy volunteers and 26 hospital in-patients with endogenous creatinine clearances of 98 to 4 ml min-1 received an oral dose of 800 mg sulotroban (BM 13.177). The plasma and urine concentrations of sulotroban were measured by gas-chromatography over 72 h and the pharmacokinetic parameters were calculated. 2. The AUC rose from 28.5 mg l-1 h in healthy volunteers to 631.4 mg l-1 h in preterminal renal failure (medians). The CLR decreased from 317.0 ml min-1 to 6.5 ml min-1 at the lowest renal capacity. 3. According to the AUC values, reduction of the dose is not necessary at CLCr greater than 50 ml min-1, a dose of 20-40% of normal is appropriate at CLCr of 20-50 ml min-1 At CLCr less than or equal to 20 ml min-1 the normal dose should be reduced to less than 20% of normal. 4. Vaginal spotting was noted in three female patients and a gastro-intestinal haemorrhage that did not require transfusion in one male patient. These may be associated with the action of sulotroban.

Adult↗
PubMed1988

[A rare cause of infection in chronic dialysis patients: Malta fever (febris undulans melitensis)].

A 45-years-old Greek patient developed septicaemia in his 10th year of hemodialysis treatment. Clinical investigation was directed first on bacterial infection of the arteriovenous shunt, on urosepsis or bronchopulmonary infection. Then, serologically (Widal's reaction and ELISA-test) and in different blood-cultures Brucella melitensis was detected as causative agent for Malta fever (Febris undulans). The focus of infection is suspected in unpasteurized sheep-milk cheese of mediterranean origine, wherein Brucella species can survive for months. The patient was treated effectively by a combination of amoxycilline and clavulanic acid.

Amoxicillin↗
PubMed1987

[Gallbladder tuberculosis. Review and case report of a patient with advanced renal failure].

Tuberculosis of the gallbladder is a rare disease, which mostly is diagnosed by histological examination after cholecystectomy. Less than 60 cases are published. Four different manifestations are described by Weitz: The gallbladder infection by miliary tuberculosis in children or in adults, the disseminated abdominal tuberculosis including the biliary tract or the isolated infection of the gallbladder. Our case report outlines the progress of an isolated tuberculosis of the gallbladder wall in a patient with chronic renal failure. The uremic immunological anergy may have favoured the infection.

Adult↗
PubMed1985

Tolerance in patients with terminal renal insufficiency of high doses of cefotaxime.

Eleven patients with terminal renal insufficiency requiring dialysis were treated with 3 X 2 g cefotaxime in an open study lasting five days when the clinical findings strongly indicated a serious bacterial infection. The effect of the administration of the high-dose antibiotic on the coagulation system (Quick test, partial thromboplastin time, thrombin time, antithrombin III and platelets) and on brain function (EEG) was investigated. The serum levels showed that the serum concentrations were not abnormally high in cases of terminal renal insufficiency requiring dialysis. In contrast to previous investigations in other beta-lactam antibiotics, no changes in the coagulation system or EEG occurred. On the basis of these findings, no reduction in the dose appears necessary for cefotaxime, if therapy does not exceed five days.

Adult↗
PubMed1984

Impaired natural killer cell function in hemophiliacs with or without continuous substitution.

In the present study, 28 hemophiliacs substituted continuously and 5 hemophiliacs who had received almost no blood products were investigated. Cells of OKT 3+, OKT 4+, and OKT 8+ subsets were counted. Percoll separated fractions of peripheral blood mononuclear cells were examined by morphological criteria and were tested for NK cell activity. We found that the NK cell activity of both groups of hemophiliacs was decreased on testing Ficoll separated cells or low density Percoll separated cells. Normal NK cell activity was found in medium density cells of hemophiliacs. Two possible explanations are discussed: first, the NK cell activity may be suppressed in hemophiliacs and secondly, there may be a block in maturation of NK cell activity. It is unlikely that chronic substitution by blood products counts for these alterations. The possible role of chronic infections is discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1983

[Lung edema after administration of hydrochlorothiazide. A rare and life-threatening side effect].

Recurrent pulmonary oedema occurred in a 62-year-old woman after repeated intake of hydrochlorothiazide-triamterene tablets. Eight similar reports in the medical literature suggested it to be a rare case of intolerance to hydrochlorothiazide. The lymphocyte transformation test proved an allergic genesis: there was significant stimulation of patient lymphocytes by active agent/metabolite serum of hydrochlorothiazide but not triamterene.

Drug Hypersensitivity↗
PubMed1983

Specific gene mutations in L5178Y cells in culture.

The predominant test system uses a near-diploid L5178Y mouse lymphoma cell line and is based on the quantitation of forward mutations occurring at the heterozygous thymidine kinase (TK) locus (TK+/- leads to TK-/-). (Other markers, such as ouabain- or methothrexate-resistance and alanine independence, in other L5178Y mouse lymphoma cells were also examined, but our criteria for the acceptability of data or the paucity of data considerably reduced the value of these mutagenesis test systems to this study.) The biochemical basis for the L5178Y/TK+/- assay depends on the ability of TK-competent cells to phosphorylate 5-bromo-2'-deoxyuridine or trifluorothymidine. The phosphorylated product or its metabolites kill these cells, thus, medium containing 5-bromo-2'-deoxyuridine or trifluorothymidine is capable of selecting for cells that are lacking the TK enzyme (TK-/-). TK-/- cells eventually give rise to a bimodal distribution of colony sizes. The relative proportion of small and large colonies appears to be characteristic of the mutagen, its dose, and the length of the expression period. A total of 108 references were reviewed and 48 chemical agents were evaluated. Of these, in vivo carcinogenicity data existed for 44 and covered a wide variety of chemical classes (43 compounds) and a complex mixture. In this system, 39 agents were positive, 1 was negative, and 4 yielded inconclusive results. The 44 test substances evaluated were insufficient to single out agents or agent classes for which the assay was particularly well suited; however, with the exception of thymidine analogs, the system seems to be versatile. The correlation of the TK locus assay results with the carcinogenicity data revealed that 2 agents were definite false positives (sodium azide and methotrexate) and 1 agent was a definite false negative (1,1-dimethylhydrazine). Further evaluation suggested that 4-acetylaminofluorene and diphenylnitrosamine were questionable false positives, while benzo[e]pyrene was a questionable false negative. (The term questionable was used to imply uncertainties concerning the mutagenicity and/or carcinogenicity data). Thus, the assay is of value in the battery approach to mutagenicity/carcinogenicity screening.

Animals↗
PubMed1983

[Pharmacodynamics and pharmacokinetics of bemetizid in comparison with hydrochlorothiazide. A controlled human pharmacologic study of acute effects].

Pharmacodynamics and Pharmacokinetics of Bemetizide Compared with Hydrochlorothiazide/Controlled clinical study of acute effects Bemetizide in doses of 1, 5, 10, 20, 50 mg versus 25 mg of hydrochlorothiazide were examined in a placebo-controlled randomized single-dose study under standardized conditions in normal male volunteers. The diuretic effects of bemetizide and hydrochlorothiazide were qualitatively equal, though after higher doses bemetizide showed greater maximal, statistically significant effects on the excretion of sodium, chloride and urine volume (relative efficacy). A trend to increased elimination of potassium was detectable. Diuresis of calcium and magnesium and pH of urine were unchanged. The effects of the reference dosis of hydrochlorothiazide were constantly lower than those of higher doses of bemetizide conferring to the 24-h aliquot and the fractioned samples. The action of both substances began within 1 to 2 h after oral application exceeding 24 h. Kinetics of effects and pharmacokinetics were closely correlated. The evidence of dose-dependent kinetics for bemetizide supports the assumption, that it is absorbed incompletely in higher doses. Because of the lack of a parenteral preparation it is not possible to provide reliable information on the maximal potency of bemetizide.

Adolescent↗