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Biomedical subjects

D Adam

Publications and source records attributed to D Adam.

At least 199 records · Page 11Linked to original sources
PubMed1984

[Experiences with perioperative short-term prevention in thoracic wall and colorectal surgery in children].

This is a report on prophylaxis with antibiotics in chest wall deformities and colorectal surgery in childhood. The analysis shows a significant reduction of wound infections and general infections after administration of Cefamandol (150 mg/kg in 4 doses) or Cefotaxim (100 mg/kg in 3 doses) and Metronidazol (25 mg/kg in 3 doses) for one day only, starting one hour before operation. The positive effect of prophylaxis with antibiotics in these operations is compared with results in the literature.

Anti-Bacterial Agents↗
PubMed1984

Concentrations of ceftriaxone in prostate adenoma tissue.

A total of 46 patients aged 59-84 who underwent transurethral resection of the prostate gland received 2 g of ceftriaxone intravenously at different points in time, ranging from 30 min to 74 h before the operation. The antibiotic concentration was determined in the serum as well as in the prostate adenoma tissue using microbiological methods after treating the tissue in a stomacher. 30 min after application, tissue concentrations were between 12.9 and 73.7 micrograms/g, and after 4 h still between 1.0 and 50.0 micrograms/g. Even after 48 h levels between 0.6 and 5.6 micrograms/g were found. Therefore ceftriaxone proved not only to have a long serum half-life as compared to other comparable cephalosporins, but also prolonged tissue concentrations, which justifies a single preoperative dose before transurethral resection of the prostate gland, as established by the clinical results described.

Aged↗
PubMed1983

[Determination of cefoxitin serum and tissue levels. Perioperative antibiotic prevention in hand surgery in interventions in a bloodless field].

In 63 patients, who underwent handsurgery under tourniquet ischemia, 2 g of Cefoxitin were given i.v. The antibiotic levels in tissue and serum at different times were obtained using biological assay. The results area compared with cefoxitin-concentrations of samples from abdominal surgery. By means of regression-analysis the tissue-serumquotient is defined as the relation of function to the time. The model-character of the conditions unter tourniquet ischemia is described.

Adipose Tissue↗
PubMed1983

[Tissue concentrations of mezlocillin in prostate adenomas following intravenous bolus injections and continuous infusions].

In a total of 23 patients undergoing transurethral resection or suprapubic operation of benign hypertrophy of prostate perioperative antibiotic prophylaxis was started with 5 g of mezlocillin in each patient. In 5 patients (group I) the antibiotic was slowly (3 min) injected i.v. In 5 patients (group II) mezlocillin was administered as i.v. bolus injection of 1 g followed by i.v. infusion of 4 g during one hour. In 7 patients (group III) and in 6 patients (group IV) mezlocillin was administered as i.v. bolus injection of 1 g followed by i.v. infusion of 4 g during 4 hours. In the patients of group I-III a transurethral resection and in the patients of group IV a suprapubic prostatectomy was performed. Serum concentrations of mezlocillin were determined in intervals up to 4 hours after start of administration. The prostatic tissue concentrations were determined in both prostatic lobes in group I and group II 60 and 90 min and in group III and IV 4 hours after start of administration. In group V several tissue samples of the prostatic adenoma were obtained. The serum concentrations showed considerable interindividual variations, because the dose of antibiotic was the same in each patient and not adapted to the body weight. In group I the mean prostatic tissue concentrations at 60 min and 90 min after start of administration were 76 micrograms/g and 31 micrograms/g, respectively, in group II the mean prostatic tissue concentrations at 60 min and 90 min were 78 micrograms/g and 24 micrograms/g, respectively. In group III the mean tissue concentration at the end of the 4-hours infusion was 29 micrograms/g. In 2 patients of this group the concentrations of the 2 prostatic lobes differed considerably. In group IV measurable tissue concentrations of mezlocillin were found in 2 patients only. Considerable variations were found within the prostatic adenoma ranging from "non detectable" to approximately half of the serum concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

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PubMed1983

[Penetration of mezlocillin and oxacillin into the glandular and adipose tissue of the breast after simultaneous intravenous infusion. A pharmacokinetic study].

The concentrations of mezlocillin and oxacillin were measured after simultaneous intravenous infusion of 4 and 2 g respectively in serum, fat and mammary gland tissue of 35 patients. The maximum mean concentrations of mezlocillin were measured in serum with 281 micrograms/ml and in fat with 38 micrograms/g after the end of the infusion and in the mammary gland with 52.3 micrograms/g after 90 minutes. Mezlocillin concentrations of less than or equal to 2.0 micrograms/ml and g respectively were found after 6-8 hours after the end of the infusion. The maximum mean concentrations of oxacillin were measured in the serum with 107.8 micrograms/ml also after the end of the infusion, declining to levels less than or equal to 2.0 micrograms/ml within 6 hours. Measurable oxacillin-concentrations could not be found in the fat and in the tissue of mammary gland with the chosen dose. The clinical relevance of the results is discussed.

Adipose Tissue↗
PubMed1983

Marital enrichment: the contribution of sixteen process variables to the effectiveness of a program.

A marital enrichment program, based on Sager's contractual model of couple functioning, was analyzed to see which of its components were linked to good and/or improved marital adjustment, communication and problem-solving skills. Nineteen couples underwent the eight-week program, and were pre- and posttested on the Dyadic Adjustment Scale, the Marital Communication Inventory, and the Marital Interaction Coding System. A factor analysis of 16 process variables within the program confirmed the relationship between components of the program and the therapeutic goals based on Sager's model. When the factors thus derived and the variables themselves were used as predictors of the outcome variables within stepwise multiple regression equations, a positive awareness of one's expectations and of the marital relationship seemed to be particularly important to couple functioning. The role of communication skills and of negotiation training were not as clear. One trend that emerged was that negotiation skills seemed more useful for seriously dysfunctional couples.

Communication↗
PubMed1983

Pharmacokinetics of azlocillin after discontinuous intravenous administration of high dose.

Azlocillin, an acylureido-penicillin, is often used in severe, and sometimes in life-threatening infections because of its good therapeutic effect, even against bacteria resistant to many other agents. In these patients sometimes doses of 10 g may be administered in order to improve therapeutic efficacy. In this study the serum concentrations and urinary excretion of azlocillin were investigated in 2 volunteers and 11 patients after the intravenous injection (5 min) of 2 g followed by intravenous infusion of 8 g over 4 h. The serum concentrations increased during infusion in volunteers and patients from a median value of 180 mg/l up to 317 mg/l. After the end of infusion the median concentrations fell through 94 mg/l at 2 h, and 43 mg/l at 4 h to 11 mg/l at 6 h. The median cumulative urinary excretions in patients were 2.50 g up to 4 h, 4.51 g up to 8 h, 4.89 g up to 12 h, and 5.43 g up to 24 h after the end of infusion. The median plasma half-life calculated from the last five serum concentrations (6-10 h after start of administration) was 100 min (range 60-180 min). The study showed that using this dose and mode of administration high serum concentrations can be maintained over many hours, which would be sufficient to treat life-threatening or difficult infections. The dose interval would have to be 12 h. The local and systemic tolerability was good, as shown by the laboratory parameters measured.

Adult↗
PubMed1983

Tissue concentrations of mezlocillin in benign hypertrophy of the prostate following intravenous bolus injection versus infusion.

In 23 patients undergoing transurethral resection or suprapubic operation of benign hypertrophy of the prostate, perioperative antibiotic prophylaxis was started with 5 g of mezlocillin in each patient. In five patients (group I) the antibiotic was given as an intravenous bolus. In five patients (group II) mezlocillin was administered as a bolus of 1 g followed by an intravenous infusion of 4 g over 1 h. In seven patients (group III) and in six patients (group IV) mezlocillin was administered as a bolus of 1 g followed by an intravenous infusion of 4 g over 4 h. In the patients of group I-III a transurethral resection and in the patients of group IV a suprapubic prostatectomy was performed. Serum concentrations of mezlocillin were determined for up to 4 h after the start of the administration. The prostatic tissue concentrations were determined from both prostatic lobes in groups I and II 60 and 90 min and in groups III and IV 4 h after start of administration. In group IV multiple tissue samples of the prostatic adenoma were obtained. The serum concentrations showed considerable interindividual variation, largely because the dose of antibiotic was the same in each patient and not adapted to the body weight. In group I the mean prostatic tissue concentrations at 60 min and 90 min after start of administration were 76 and 31 mg/kg, respectively. In group II the mean prostatic tissue concentrations at 60 min and 90 min were 78 and 24 mg/kg, respectively. In group III the mean tissue concentration at the end of the 4-h infusion was 29 mg/kg. In two patients of this group the concentrations of the two prostatic lobes differed considerably. In group IV measurable tissue concentrations of mezlocillin were found in two patients only. Considerable variations were found within the same prostatic adenoma ranging from undetectable to approximately half of the serum concentration. The diffusion of mezlocillin into the prostatic tissue obviously depends on the size of the prostate. The dependence of concentration within the same adenoma on different histological structures remains to be investigated.

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PubMed1983

Reproducibility study of the pharmacokinetics of amikacin, gentamicin and tobramycin; a three-way crossover study.

The hypothesis that the pharmacokinetics of amikacin are more predictable than those of gentamicin or tobramycin was studied. In a three-way crossover design 58 volunteers received 7.5 mg/kg amikacin by iv infusion and either 1.5 mg/kg or 1 mg/kg gentamicin and tobramycin. The mean half-life and mean serum concentration at 1 h for each drug was determined. No consistent significant difference was found between the pharmacokinetics of amikacin and the other two drugs.

Amikacin↗
PubMed1983

Penetration of ceftazidime into human tissue in patients undergoing cardiac surgery.

The penetration of ceftazidime into human heart muscle, skeletal muscle, skin, fat and bone was measured in 39 patients undergoing cardiac surgery. Mean serum levels of 70 mg/l were measured 1.5 h after dosing with mean levels of 27 mg/l after 4 h and 5.5 mg/l after 12 h. Tissue levels of ceftazidime were measured up to 280 min after dosing. These levels were high with mean corrected levels after 120 min of 20.0 mg/l in bone, 7.1 mg/l in skin (after 100 min), 9.2 mg/l in fat, 12.7 mg/l in heart muscle and 9.4 mg/l in skeletal muscle. Serum and tissue levels were sufficient to prevent infection by all likely pathogens, including Staphylococcus aureus, 98% of which have a ceftazidime minimum inhibitory concentration of 8 mg/l or less. There were no post-surgical infections.

Adipose Tissue↗
PubMed1983

[Tissue concentration of ceftizoxime in the lung].

2 g ceftizoxime were administered as a i.v. bolus injection to 34 patients, in whom a lung operation was performed for either therapeutic or diagnostic reasons. At different time intervals after the injection, a lung biopsy was taken together with a serum sample to measure the antibiotic concentrations. The serum concentrations of ceftizoxime in these patients differed only slightly from results obtained with healthy volunteers. 60 min after injection, ceftizoxime-concentrations in the lung tissue varied between 7 and 15 micrograms/g (mean 11, n = 4) and declined slowly thereafter. After 4 h in two patients values of 2 and 4 micrograms/g ceftizoxime, respectively, were obtained. Even after 7 h concentrations of more than 1 microgram/g tissue were found.

Adult↗
PubMed1983

[Antibiotic therapy in infectious endocarditis].

The most common causes of infective endocarditis, accounting for 65 to 85% of all cases, are viridans streptococci and other nonhemolytic streptococci. Enterococci are the offending microorganisms in 5 to 15%, staphylococci in 5 to 15% and gram-negative bacteria from the intestinal tract in 2 to 6%. In rare cases, infective endocarditis may be caused by any of a number of other pathogenic and nonpathogenic bacteria. Men over 60 years of age and women under 40 have a higher likelihood of contracting enterococcal endocarditis subsequent to febrile infections of the urogenital tract or after abortion; intravenous drug users tend to infections with gram-negative bacteria; patients with intravascular catheters who are administered cortisone, broad-spectrum antibiotics or cytostatic drugs are at risk of endocarditis from Candida or Aspergillus. At least two, but in general, five blood cultures should be drawn in short intervals. With the use of proper techniques for detection of aerobic and anaerobic microorganisms as well as fungi, positive blood cultures can be obtained in 95% of the patients. Antibiotics may be discontinued temporarily in pretreated patients. Bactericidal antibiotics are indicated. The following rule is valid as a guideline for adequate antibacterial chemotherapy: at maximal concentration after antibiotic administration, a bactericidal effect should still be demonstrated after 1:8 dilution of the patient's serum. Prior to receipt of blood culture findings, in forms tending to be subacute, treatment should be directed at streptococci and enterococci. If the course is more acute, in the presence of an intracardiac foreign body or in intravenous drug users, the antibiotic employed should also be effective against staphylococci.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

[Pharmacokinetics after discontinuous intravenous administration of azlocillin].

In severe, sometimes life-threatening infections azlocillin (Securopen) is administered in single doses up to 10 g in order to increase therapeutic efficacy. Therefore the serum concentrations and urinary excretion of azlocillin were investigated in 2 healthy volunteers and in 11 patients after intravenous injection (5 min) of 2 g followed by intravenous infusion of 2 g/h over 4 h. The serum concentrations increased during infusion in patients up to a median concentration of 317 mg/l. The median serum concentrations decreased down to 94 mg/l at 2 h, 43 mg/l at 4 h and 11 mg/l at 6 h after the end of infusion. 24-h urinary excretion in patients was 54.3%. Serum half-life from the last five serum concentrations (6-10 hours after start of administration) calculated amounts to a median half life of 100 min (range 60-180 min). The study showed, that using this dose and kind of administration high serum concentrations can be maintained over many hours, sufficiently high also for life threatening and difficult-to-treat infections, if administered at intervals of 12 hours.

Adult↗
PubMed1982

[Cefotaxim for peri-operative short-term prophylaxis of infection in cardiac surgery. Concentrations in myocardial, pericardial, fat and skeletal muscle tissues].

Cefotaxim was administered intravenously in a dose of 50 mg/kg body-weight before and immediately after cardiac surgery. The drug's concentrations were measured in serum, myocardium, peri-operative fat, pericardium and skeletal muscle. The highest concentration was found 15 minutes after injection: 32 micrograms/g in pericardium, 22 micrograms/g in myocardium, 17.9 micrograms/g in fat and 12.3 micrograms/g in skeletal muscle. After 2 hours the average concentration in pericardium was 10.7, in myocardium 3.8, in fat 5.4 and in skeletal muscle 2.4 micrograms/g. The corresponding mean serum levels were 237.4 and 33.3 micrograms/ml, respectively. The tissue concentrations were thus high enough to be effective against infections caused by cefotaxim-sensitive organisms. There was primary wound healing in all 16 patients. No other infections, such as pneumonia or urinary infections, occurred.

Adipose Tissue↗
PubMed1982

[Mezlocillin and oxacillin concentrations in the bile of the choledochus].

The purpose of this study was to determine the antibiotic concentrations in serum and bile one and two hours after the completion of a simultaneous short-term infusion of 4 g mezlocillin and 2 g oxacillin. Seven patients were studied. Bile was withdrawn from the bile duct by means of a Teflon catheter. The mean serum concentrations of mezlocillin were 130.4 mg/l and 60.8 mg/l one and two hours after the end of the infusion, respectively. The mean serum concentrations of oxacillin determined at the same times were 57.9 mg/l and 18.9 mg/l, respectively. The mean biliary levels of mezlocillin were 3215.6 mg/l and 2483.1 mg/l one and two hours after the end of the infusion, respectively. The corresponding mean biliary values for oxacillin were 497.3 mg/l and 205.5 mg/l.

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