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Biomedical subjects

H Grimm

Publications and source records attributed to H Grimm.

At least 217 records · Page 12Linked to original sources
PubMedDate not supplied

Interpretive criteria of antimicrobial disk susceptibility tests with cefpodoxime.

The interpretation of disk susceptibility testing with 30 micrograms cefpodoxime disks was evaluated on the basis of regression line analyses and preliminary MIC breakpoints of 2 and 4 mg/l. Using the DIN-58940 method, zone diameters up to 23 mm are resistant, 24 to 26 mm moderately susceptible, and 27 mm or more susceptible. The respective data for the NCCLS method are: up to 21 mm, 22 to 23 mm, and 24 mm or more.

Bacteria↗
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A new plasmidic cefotaximase in a clinical isolate of Escherichia coli.

Escherichia coli GRI was isolated from an ear exudate of a newborn. The strain was highly resistant to cefotaxime (MIC 128 mg/l). Resistance to cefotaxime and the majority of beta-lactam antibiotics was readily transferred to an Escherichia coli recipient strain. Both the wild type and the transconjugant strains are different in their resistance phenotype from TEM-3 beta-cefotaximase producers by higher MICs to the majority of beta-lactams and lower MICs to ceftazidime. The isoelectric point of the cefotaximase of E. coli GRI was 8.9 in comparison with 6.3 for TEM-3. Thus, the enzyme produced by E. coli GRI represents a new plasmidic (plasmid pMVP-3) broad spectrum beta-lactamase (CTX-M) which may not be closely related to either the TEM- oder SHV-family of extended broad spectrum beta-lactamases.

Cefotaxime↗
PubMedDate not supplied

Malignant jaundice: results of diagnostic and therapeutic endoscopy.

Direct cholangiography plays an important role in the diagnosis of malignant obstructive jaundice. Endoscopic retrograde cholangiopancreatography is gradually gaining ground over percutaneous transhepatic cholangiography. Endoscopy can determine the exact location and extent of the obstruction. Typical changes of the ducts are often helpful in interpreting the causes of obstructive jaundice. Representation of the bile and pancreatic duct systems is successful in 95% of cases in the hands of an expert. Acute pancreatitis is a complication occurring in about 1% of cases. Immediate drainage can usually prevent septic complications. Endoscopic drainage is a palliative measure for inoperable patients. Compared to biliodigestive anastomoses, catheters are subject to clogging in the less-risky, nonsurgical method. Blockage causes late cholangitis which can only be recognized and remedied by regular after-care of the patient. Endoscopic placement of the prosthesis has an 85% rate of success. The rate of complications related to the procedure is 2%. The mortality rate is 1%.

Adolescent↗
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Endoscopic therapy for biliary obstruction.

Endoscopic management of biliary obstruction is feasible in most patients and has emerged as standard treatment. Aside from the removal of bile duct stones, placement of a biliary stent is the most commonly employed modality of management. In experienced hands, this is successful in over 90% of patients. Lower procedure-related complications and the relative non-invasive nature of endoscopic treatment has relegated surgical management to a subsidiary role. Hospitalization time rarely exceeds 1-2 days. In most patients with advanced malignant disease and short life expectancy, stenting affords effective palliation. For the majority of patients endoscopic management is preferable to the percutaneous transhepatic approach due to lower overall mortality and morbidity. Stent occlusion necessitating replacement remains a problem, but improvements in this area can be expected. New plastic stent designs are undergoing investigation. Expandable metallic stents are promising but controlled comparative trials with conventional plastic prostheses are needed. Use of expandable stents should be judicious since these cannot be removed. In the future we can look forward to advances in peroral cholangioscopic technology which may permit targeted treatment of intraductal biliary malignancies.

Biliary Tract Neoplasms↗
PubMedDate not supplied

Clinical relevance of CagA-specific antibodies related to CagA status of Helicobacter pylori isolates using immunofluorescence test and PCR.

BACKGROUND: The cagA (cytotoxin-associated gene A) protein is found in about 50% of Helicobacter pylori strains; its clinical relevance in gastroduodenal disease is uncertain. PATIENTS AND METHODS: The frequency of IgG antibodies to cagA was studied by using a commercial Western blot assay in sera of 189 patients with endoscopically and histologically confirmed gastroduodenal disease. In addition, 38 H. pylori strains isolated from biopsies were analyzed by immunofluorescence test (IFT) and PCR for detection of cagA protein and cagA gene sequences, respectively. RESULTS: 54.3-60.0% of all patients with gastrointestinal diseases (chronic gastritis, gastric or duodenal ulcer and chronic duodenitis) and 28.6% with a normal mucosa were found to be positive for anti-cagA IgG antibodies. There was no significant difference in anti-cagA IgG seroprevalence between the different clinical entities. CagA-positive (cagA+) H. pylori strains were detected in 44.7% and 50% of the 38 isolates by PCR and IFT, respectively. 22 of 23 patients infected with cagA+ strains had anti-cagA antibodies. Using PCR as a gold standard, the sensitivity and specificity of the cagA IgG Western blot were 100.0% and 35.0%, respectively; the sensitivity and specificity of the cagA IFT were 76.5% and 71.4%, respectively. The incidence of the cagA+ H. pylori strains detected either by PCR or IFT was significantly higher (p < 0.05 and p < 0.01, respectiveLy) in patients with chronic duodenitis, gastric or duodenal ulcer compared to patients with chronic gastritis (66.7%, 80% and 30.4%, respectiveLy). CONCLUSION: In this study the cagA-specific serological status in H. pylori infections as diagnosed by IgG Western blot was of no predictive value for severity of disease. In contrast, the cagA status of H. pylori isolates, diagnosed by IFT or PCR, was a predictive marker for severe disease and, therefore, also of clinical relevance in the assessment of the virulence of the infecting strain.

Adolescent↗