Search PubMed⌕ Search

Biomedical subjects

G Pfaff

Publications and source records attributed to G Pfaff.

At least 19 recordsLinked to original sources
PubMed1995

Single-dose pharmacokinetics of fluconazole in patients with liver cirrhosis.

The pharmacokinetics of a single 100 mg i.v. dose of fluconazole were studied in parallel groups of ten normal subjects and nine patients with liver cirrhosis, a condition with a high risk of life-threatening fungal infection. The following mean pharmacokinetic parameters were found for the patient group: terminal elimination constant 0.0101/h (normal 0.0214/h); mean residence time 134 h (normal 46.7h); area under the curve 200 h.mg/L(normal 69.4 h.mg/L); plasma clearance 0.96 L/h.kg(normal 2.16 L/h.kg). All these differences were statistically significant (P < 0.05). The majority of the patients were being concomitantly treated with duretics (frusemide and spironolactone). It is suggested that the known slight interaction between such drugs and fluconazole was intensified by the disease state. These results emphasize the need for caution in the treatment with fluconazole of patients with severe liver disease. Nevertheless, in view of the wide range of values found in the patients, and low toxicity of fluconazole, a dosage reduction in cirrhosis does not seem to be justified in the present state of knowledge.

Adult↗
PubMed1992

[The nutrition situation of the population in the former East Germany: results of household budget surveys in 1989].

The last representative nutritional surveys in households of the former GDR date back to 1989. Trends towards excessive energy intake have continued, resulting, above all, from high fat consumption. A considerable proportion of employed persons have their meals outside the home. The proportion of food used as animal feed was high in households of members of agricultural cooperatives.

Adult↗
PubMed1992

Relative bio-availability of sultamicillin in healthy volunteers following administration of two tablet formulations.

The pharmacokinetics of both ampicillin and sulbactam obtained from a balanced, open two-way crossover study in 20 normal adult volunteers receiving a single 375 mg oral tablet of sultamicillin administered as two different formulations--the original product (Duocid) and a generic formulation that is commercially available in Turkey--were compared. Pharmacokinetic parameters for the two formulations and for both ampicillin and sulbactam were tested for bio-equivalence by the two one-sided Student's t-test (80-120% range; P < 0.1). Area under concentration--time curves and maximum concentrations for both components were found to be non-equivalent for the two formulations, the generic formulation having consistently lower mean values. The results were consistent with studies of the in vitro release of sultamicillin from the two tablets. It is concluded that the generic formulation is pharmacokinetically inferior to the original product.

Adult↗
PubMed1991

[Design of and involvement in an interventional study on health education in basic schools: the Pforzheim Study].

We report the design and the determinants of participation in a controlled, randomized trial evaluating the efficiency of a school-based health education and promotion program. The health education program "Gesund leben macht Spass" ("Healthy living is fun") was developed by the AOK Pforzheim, a statutory health insurance organization in South West Germany. In this 7 week program, the body structure is presented systematically, and the children themselves are asked to correlate structure with function. During the fall of 1988, 490 pupils in 22 third grade level classes at 11 primary schools in Pforzheim and vicinity were invited to participate in a health survey (378 consenting parents = 77.1%). Ten schools with 19 classes and 413 students were admitted to the study (333 participating students = 80.6%). One year later, 290 children (70.2%) were available for follow up. Both examinations covered body weight and height, blood pressure level, total cholesterol, and the assessment of health related knowledge, attitudes and behavior by a repeat questionnaire. Parental consent rates in participating schools varied between 66.7% and 100%. Initial student participation was distinctly higher in schools in a rural (85.2%) as compared to an urban environment (73.2%), and among children of German nationals (83.2%) as compared to children of other nationalities (70.9%). After one year, participation rates in these groups approached each other. Schools in the intervention and control groups were similar in sociodemographic characteristics.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1989

Energy production, intracellular amino acid pools, and protein synthesis in chronic renal disease.

Intracellular glycolytic regulating enzyme activities, pyruvate kinase (PK) and phosphofructokinase (PFK), adenylate kinase (AK), energy charge (Ech), free amino acids (ICAA), and protein synthesis (PS) were measured in polymorphonuclear leukocytes--used as a cell model--in 62 adults and 12 children with chronic renal failure, and 66 normal adults and 21 children as comparison controls. In normal subjects, children had significantly lower enzyme activities and cell amino acid levels but similar Ech and higher PS than adults. ICAA concentrations were significantly higher than plasma amino acid concentrations (PAA) in both groups, and the PAA were not correlated with, nor indicative of, the ICAA concentrations. The variance (R2) in PS could be largely accounted for by a combination ("set") of six ICAA, as determined by multivariate analysis. The sets differed in children vs adults, suggesting that different proteins were being synthesized. In the uremic patients, reduced PF, PFK, Ech, most ICAAs and PS were indicative of cellular malnutrition. For the uremic adults, the abnormalities in cell metabolism were modified by therapy--nondialyzed uremics being worst, CAPD patients best and approximately normal, and hemodialyzed intermediate. The uremic CAPD children had reduced, PK, PFK, AK, most ICAA, and PS. Ech was increased. Cellular malnutrition in children with chronic renal failure may contribute to their poor growth.

Adolescent↗
PubMed1989

Studies on the synergism of sulbactam and beta-lactam antibiotics under in vitro conditions and in healthy volunteers after intravenous administration. Antibacterial activity in vitro, compatibility and pharmacokinetics of the drugs in combination.

Sulbactam, a new beta-lactam inhibitor, increased the in vitro activity of cefotaxime, mezlocillin and piperacillin against 803 clinical bacterial isolates. The synergism of sulbactam and these antibiotics was particular marked against 467 beta-lactamase positive strains, both aerobic and anaerobic. In the presence of sulbactam the mean minimal inhibitory concentrations (MICs) of the antibiotics against beta-lactamase positive bacteria were greatly reduced: with cefotaxime by 58%, with mezlocillin by 64% and with piperacillin by 70%. Sulbactam alone at low concentrations inhibited the growth of only a few strains (Neisseria spp., Acinetobacter spp.). The inhibitor proved to be very stable in infusion media under a variety of conditions and was compatible in vitro with 14 different beta-lactam antibiotics. The pharmacokinetics profiles of sulbactam and the antibiotics cefotaxime, mezlocillin and piperacillin were similar after infusion to healthy volunteers. The relevant pharmacokinetic parameters of the single substances were essentially unchanged when administered in combination. The general similarity between the pharmacokinetics of sulbactam and of the beta-lactam antibiotics appears to be an essential precondition for the therapeutic success of such a synergistic combination. Thus the physicochemical and pharmacological properties of sulbactam apparently permit flexible dosage in combination with different penicillins or cephalosporins and sulbactam can be administered as non-fixed combination in the clinical treatment of bacterial infections.

Adult↗
PubMed1988

Antidepressant combination therapy of endogenous depressions with benzodiazepines or neuroleptics--a study comparing adjuvant treatment with oxazolam versus chlorprothixene.

Antidepressants are routinely administered in combination with benzodiazepine tranquilizers or low-potency neuroleptics. A controlled study was conducted involving 40 endogenous depressive inpatients who were treated with maprotiline in combination with the benzodiazepine oxazolam or the neuroleptic chlorprothixene. After a period of two weeks there was no significant difference in the clinical ratings (HRSD, Bf-S, BL, CGI) of the two groups studied. Only in the factor "anxiety" and the adjective mood scale scores was there a tendency toward quicker onset of action (third day) in the patient group treated with oxazolam, though it was not statistically significant. The clinical global evaluation (efficacy, tolerability) showed more favorable ratings for oxazolam than for chlorprothixene. Both substances were generally tolerated well; oxazolam hardly ever caused any side effects. However, a slight deterioration of some patients' conditions was observed after discontinuation of oxazolam.

Adult↗
PubMed1987

[Results of treatment following surgical management of complete acromioclavicular joint dislocation (Tossy III injury). Management using ligament sutures and direct transarticular and indirect extra-articular stabilization].

In the last 5 years 36 patients with complete akromioklavikular separation were treated in 21 cases by ligament suture and Balser-plate, in 15 cases by ligament suture and "Zuggurtung". Good and very good results were found in 85%. Patients in which the protection of the ligament suture was given by application of the Hook-plate had better results than those with "Zuggurtung". The use of the Balser-plate remarks a safe method in protecting the coracoid-clavicular ligament suture. The rate of complications is rare, compared with the patients in the other group. Functional results seem to be better in comparison to other methods of operative treatment.

Acromioclavicular Joint↗
PubMed1986

Is prenatal ultrasonography of any advantage?

With the percentage of prenatally diagnosed malformations rising, there is a growing need for the contribution of the pediatric surgeon regarding prognostic and therapeutic aspects for the unborn child. An important risk factor for the validity of any statement is the possible presence of undetected, associated malformations. In spite of all advantages prenatal diagnosis offers regarding carefully planned therapy, etc., doubt and uncertainty always remain.

Congenital Abnormalities↗
PubMed1986

Problems of staging colorectal cancer.

A total of 2994 cases of previously untreated colorectal carcinomas taken from the database of the International Cancer Patient Data Exchange System of the UICC were analyzed. The objective was to compare pretherapeutic and postsurgical data and to investigate the impact of missing information on the quality of tumor staging under routine conditions. In clinical staging, a higher percentage of items were marked "unknown" in the questionnaires than in histopathological staging. The clinical and postoperative assessment of TNM stages Ib, II, and III frequently diverged, indicating a low precision for clinical staging. Fistulae were rarely observed in either colon or rectum carcinoma.

Aged↗
PubMed1986

[Delivery planning and interdisciplinary management of large coccygeal teratomas].

Prenatal sonographic screening and a growing experience of examiners with regard to possible congenital malformations such as large coccygeal teratomas have induced the request for an early interdisciplinary consultation between obstetrician, human geneticist, paediatric surgeon, neonatologist and psychologist. It should aim at a careful information and counselling of the parents with regard to the mode of delivery and possibilities of operative management. The prerequisites for far sighted planning and performance of delivery are demonstrated by the example of large coccygeal teratomas. The availability of equipment, facilities and manpower at the time of delivery guarantees a course of delivery at reduced risk and is, together with the psychological guidance of the parents, a basic element of optimal care for the newborn.

Coccyx↗
PubMed1986

Morphologically different biopsy specimens of the human gastric mucosa. II. Adenylate cyclase activity in response to prostaglandin E2 and histamine.

Adenylate cyclase (AC) in response to prostaglandin E2 (PGE2) and histamine was studied in morphologically different biopsy specimens from human gastric mucosa. The activities of the enzyme were log-normally distributed and did not differ between males and females. PGE2 activated AC in a concentration-dependent manner in normal gastric mucosa (n = 57), chronic superficial gastritis (GI, 18), chronic gastritis with beginning atrophy (GII, 10), chronic atrophic gastritis (GIII, 24), gastric ulcer (GU, 39), duodenal ulcer (DU, 32), and biopsies of patients operated according to Billroth II (BII, 20) and was most efficacious in GIII and BII. Histamine, which was studied in normal gastric mucosa (n = 27), DU (n = 20), GU (n = 13), and BII (n = 18), stimulated AC most efficaciously and potently in DU, was less effective in normal gastric mucosa and GU, and had no effect at all in BII. Cimetidine treatment of DU patients did not change the PGE2 action, while the degree of stimulation by histamine was reduced. The data indicate characteristic differences of the PGE2- and histamine-sensitive AC in the mucosal samples of these patients.

Adenylyl Cyclases↗
PubMed1986

Pharmacogenetics of dextromethorphan O-demethylation in man.

The metabolism of dextromethorphan has been investigated from the aspect of genetically determined intersubject differences of oxidative drug metabolism in man. For this purpose, the urinary elimination of dextromethorphan and dextrorphan, which is the major O-demethylated metabolite in urine, has been studied in selected drug hydroxylation phenotypes. Dextromethorphan O-demethylation co-segregates with polymorphic debrisoquine hydroxylation, whereas no such co-segregation exists with the independently controlled mephenytoin polymorphism in man. The urinary dextromethorphan over dextrorphan metabolic ratio was validated for linearity of O-demethylation vs dose administered, and for varying urine collection intervals at different urinary pH values. A 94% repeatability of the dextromethorphan metabolic ratio could be established in extensive and poor metabolizer phenotypes. In a preliminary study, different rates of N-, O- and N,O- demethylation of dextromethorphan to yield D-methoxymorphinane, dextrorphan and D-hydroxymorphinane, respectively, were found in extensive- (Sprague-Dawley) and poor-metabolizer (female dark Agouti) rat strains. The observed interphenotype differences in man and the interstrain variations in an experimental animal model indicate that dextromethorphan O-demethylation is catalysed by the debrisoquine-type cytochrome P-450 isozyme. Therefore, the common genetic control of debrisoquine and dextromethorphan metabolism indicates that dextromethorphan might be used as a safe and innocuous substitute for debrisoquine in future routine phenotyping in the field of human pharmacogenetics of oxidative drug metabolism.

Adult↗
PubMed1985

New ways in counselling on prenatally diagnosed congenital malformations. An experimental information project using Bildschirmtext/Videotex.

A bibliometric analysis of source items recently published in German-language gynaecology journals and one German-language journal covering a broader field of medicine yielded but one publication linked with prenatally diagnosed congenital malformations and their surgical treatment. Thus, journals usually assessed by the gynaecologist are in this respect at present not a useful source of information for the practitioner outside specialised centres. In order to explore the usefulness of Bildschirmtext (BTX, Videotex), a new electronic medium, as an alternative in counselling for congenital malformations and similar rare medical problems, an experimental database was constructed. Pages giving data on diagnostic pathways, incidence, prognosis, specialised treatment centres and suggested further reading on abdominal wall defects were compiled and are stored in a central computer of the German Federal Postal Services. Data are accessible via the regular telephone network and a specially equipped TV set. The method, although still experimental, is considered useful for offering medical intelligence to the medical professional outside specialised centres.

Abdominal Muscles↗