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Biomedical subjects

H Grimm

Publications and source records attributed to H Grimm.

At least 127 records · Page 7Linked to original sources
PubMed1986

[In vitro activity of new quinolones against nonfermenters and references to sensitivity tests].

Studies of cross resistance between norfloxacin, ofloxacin, enoxacin and ciprofloxacin using 599 strains of non-fermentative gram-negative rods (297 Pseudomonas spp. and 302 Acinetobacter spp.) resulted in nearly identical minimal inhibitory concentrations of norfloxacin and enoxacin Comparing MIC values, in most ofloxacin was one to four dilution steps superior to enoxacin, and ciprofloxacin was one to four dilution steps superior to ofloxacin. There was not much difference in MICs when species were studied in more detail. In some instances susceptibility testing with more than one new quinolone may be necessary, and evaluation criteria are given.

Acinetobacter↗
PubMed1986

Prophylactic sclerosing of esophageal varices--results of a prospective controlled study.

Of 60 patients suffering from various stages of esophageal varices with no previously recorded bleeding, 30 underwent combined peri- and intravascular fiberscopic sclerotherapy in a prospective controlled study. Each of the two groups consisted of 22 men and 8 women with an average age of 49 years. The cause of portal hypertension in 58 patients was a morphologically proven cirrhosis of the liver, due mainly to alcoholism. Portal vein thrombosis was present in two patients. The severity of the liver disease was first evaluated in accordance with the PUGH modification of the CHILD classification. 53% of the patients in the control, and 56% in the treatment, group belonged to the prognostically favourable CHILD A category. The period of observation was at least 26 months, with a mean of 36 months. Sclerotherapy lowered the risk of bleeding to 13.3%; in the control group it was 30%. The mortality rate during the overall observation period was lowered significantly (p less than 0.05) by sclerotherapy to 5.9% in the CHILD A group as compared with 25% in the control group. The mortality rate of CHILD B and C patients was over 40% in the control group and an unequally large 70% in the treatment group. The most frequent cause of death was bleeding from esophageal varices in the control group and liver failure in the treatment group. Complications were seen in 20% and paralleled the severity of the esophageal varices. All complications responded to conservative treatment and no fatality was seen.

Esophageal and Gastric Varices↗
PubMed1986

Endoscopic dilatation and papillotomy of the accessory papilla and internal drainage in pancreas divisum.

In the case of pancreas divisum the minute orifice of the minor papilla has offered a special challenge to endoscopic diagnosis and therapy. Here we describe a method for easy cannulation of the minor papilla and drainage of the pancreatic duct. By means of a flexible guide wire and a dilator, the tiny papilla can be simply dilated, enabling papillotomy to be successfully accomplished. This method has been used in six cases without any major complications, and should pave the way for diagnosis and therapy of pancreas divisum.

Adult↗
PubMed1986

[Effect of isoflurane on respiratory mechanics].

The effects of the inhalational anaesthetic, isoflurane, on two major parameters of respiratory mechanics--resistance and compliance--were studied in a total of 30 patients. With increasing inspiratory concentrations of isoflurane, resistance was measured in 5 spontaneously breathing patients using the oscillation method. In 16 mechanically ventilated patients resistance and compliance were calculated from airway pressure, gas flow, and tidal volume. In 9 patients with asthma or COPD the course of resistance and compliance was recorded intraoperatively. An increase in resistance of up to 117% of the initial volume occurred during spontaneous respiration, and was caused by a decrease in tidal volume. During mechanical ventilation with constant tidal volume, no definite changes in resistance or compliance were seen with increasing isoflurane concentrations. In the patients with elevated airway resistance there were only minor, statistically non-significant changes in resistance and compliance. The results show that the effects of isoflurane on respiratory mechanics do not differ from those of halothane or enflurane. Therefore, isoflurane may be considered appropriate for use in patients with impaired airway resistance.

Adult↗
PubMed1985

Injection of nonvariceal bleeding lesions of the upper gastrointestinal tract.

In a prospective series 102 non-variceal upper GI bleeders were studied. An indication for endoscopic injection therapy was seen in 63 patients. In accordance with bleeding intensity, 27 patients were grouped as Forrest Ia, 37 as Forrest Ib, 8 as Forrest II with a "visible vessel" and 13 as Forrest II without one. Definitive hemostasis was achieved in almost 100% of the cases. Within the Forrest Ia group mortality was lowered to 11% as compared with 20% within the emergency surgery group. More than 80% of patients had at least one severe coexistent illness. The aim of endoscopic injection is to avoid surgery in high-risk patients.

Adolescent↗
PubMed1985

[In vitro activity of seven gyrase inhibitors of a group of heterocyclic carbonic acids against nonfermenting gram negative rods (nonfermenters)].

MIC (minimal inhibitory concentration) determinations for nalidixic acid, cinoxacin, pipemidic acid, norfloxacin, enoxacin, and ciprofloxacin were done by agar dilution on isosensitest agar (oxoid). Bacterial strains investigated were 189 Pseudomonas aeruginosa, 164 Acinetobacter lwoffii, 4 Ps. maltophilia, 3 Ps. putrefaciens and 3 Ps. odorans. The results in summary are: Ciprofloxacin is the most active gyrase inhibitor against Ps. aeruginosa as well as against other nonfermentative gram-negative rods, versus Ps. aeruginosa norfloxacin is a little more active than ofloxacin, against nonfermentative gram-negative rods other than Ps. aeruginosa norfloxacin is markedly less active than ofloxacin. Problems concerning cross-resistance of new gyrase inhibitors are discussed.

Anti-Bacterial Agents↗
PubMed1984

[Risk of chickenpox during pregnancy and the neonatal period].

A newborn fell ill from congenital chickenpox eight days after delivery, a chickenpox rash having been noted in the mother two days before delivery. Administration of zoster-hyperimmune serum to the mother at the onset of the rash and to the child immediately after birth had no demonstrable effect on the course of the disease. Autopsy, the baby having died on the eleventh day post-partum, revealed focal necrotizing pneumonia of all the lobes. Varicella-zoster virus was isolated from lung material. On the basis of present knowledge the risk of varicella infection in the fetus and neonate is 1-7 maternal cases per 10 000 pregnancies. Transplacental passage of the virus can occur at any time during pregnancy. A congenital varicella syndrome is very rare in the first two thirds of pregnancy, but bland infection of the fetus is also likely. Illness of the mother at the end of pregnancy leads to clinically manifest varicella in about a quarter of neonates. The death-rate of congenital varicella is up to 30% if the mother falls ill between the fourth day before and the second day after delivery. Neonatal varicella acquired post-partum takes a relatively mild course. The most important prophylactic measure, in addition to the administration of zoster-hyperimmune serum to the mother within three days of incubation, is to delay delivery past the critical period.

Adult↗
PubMed1984

Effect of selective ultraviolet phototherapy on DNA and antinuclear antibody titers in psoriatic patients.

The sera of 21 psoriatics treated by selective ultraviolet phototherapy (SUP) for 1-7 months were screened for IgG- and IgM-anti-DNA antibodies and antinuclear antibodies (ANAs) by standardized ELISA and the indirect immunofluorescence technique. No patients developed IgG-antibodies against native DNA under SUP, but two patients increased their IgM-antibody titers five- and tenfold, respectively. The IgG- and IgM-anti-single-stranded-(ss)DNA antibody titers remained unaltered in 38% and 57% of the patients. In 43% and 24%, respectively, they rose to a maximum of three times their original; and in 20% they decreased to a minimum of 40% of their pretherapeutic titers. After 1 month therapy no patient had produced ANAs, but all three patients showing ANAs before therapy had increased titers (one titer step). These remained on the elevated level or were even further increased by one-titer step during progressive therapy. Two patients out of 14 developed low titers of IgM-(1:20) or IgA-(1:40)ANAs against deoxyribonucleoprotein (DNP), initially after 3 months of irradiation; in one of them IgG-ANAs (titer 1:10) against DNP were additionally formed after 6 months of therapy. Our results suggest that lesions in DNA and DNP generated by SUP trigger an immune response to nuclear antigens.

Adolescent↗
PubMed1984

Interpretive criteria for the agar diffusion susceptibility test with enoxacin.

Regression analyses to determine the correlation of MIC and inhibition zone produced by enoxacin discs were carried out using 300 freshly isolated cultures of infective organisms (20 strains each from 15 species). For this purpose, commercially available discs containing 10 micrograms enoxacin and locally made discs containing 5 and 10 micrograms enoxacin were used. Studies were performed simultaneously with I.C.S. and Kirby-Bauer methods on Iso-Sensitest and Mueller-Hinton agars. It was found that correlation becomes poorer with increasing disc content and when the Kirby-Bauer method was used. Based on preliminary MIC breakpoints of 1 and 4 mg/l and the zone cut-off points calculated from regression equations, no major errors were found in zone interpretations. Minor errors were observed in 3.7% with our own 5 micrograms discs used in the I.C.S. method, and in 11.0% with 10 micrograms commercial discs and the Kirby-Bauer method. For 5 micrograms enoxacin discs and the Kirby-Bauer method the following zone interpretations are recommended: resistant up to 13 mm, intermediate 14-21 mm, susceptible 22 mm or more. The respective values for the I.C.S. method are: resistant up to 14 mm, intermediate 15-22 mm, susceptible 23 mm or more.

Agar↗
PubMed1984

Interpretation criteria for sensitivity testing of ceftriaxone in agar diffusion test according to the DIN 58940 method.

On the basis of a regression analysis of the correlation between minimal inhibitory concentration (MIC) and inhibitory zone diameter, interpretative criteria are established for the agar diffusion test with ceftriaxone disks (30 micrograms) in DST agar according to the DIN method. The correlation is good (r = -0.9242); the regression equation is x = -0.43 y + 20.53 (y = inhibitory zone diameter, x = log2MIC + 9). Following appropriate discussion, provisional MIC breakpoints of 8 and 32 mg/l are proposed for ceftriaxone. On the basis of these threshold values, the following criteria are established for interpreting the inhibition zone of ceftriaxone: resistance (corresponding to an MIC of 64 mg/l and more up to 15 mm; moderate sensitivity (corresponding to an MIC of 16-32 mg/l) 16-19 mm; sensitivity (corresponding to an MIC of up to 8 mg/l) 20 mm and more.

Agar↗