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Biomedical subjects

H Rosin

Publications and source records attributed to H Rosin.

At least 19 recordsLinked to original sources
PubMed1993

[Mitral valve endocarditis caused by Salmonella enteritidis].

The epidemiology of salmonellosis has undergone a change during the last 2 years. An increase in the number of cases of enteritis and sepsis caused by Salmonella enteritidis has been observed. We report on the case of a 65-year-old woman with mitral valve endocarditis due to Salmonella enteritidis. The infective endocarditis occurred without prior episodes of gastroenteritis. After having undergone prosthetic valve replacement and antibiotic therapy with ciprofloxacin, the patient recovered completely.

Aged↗
PubMed1991

Bacteremia during extracorporeal shock wave lithotripsy of renal calculi.

An increasing incidence of bacterial endocarditis has been observed since the beginning of the last decade. An explanation for this fact is the expansion of diagnostic and therapeutic procedures in diverse medical disciplines. In a clinical study performed on 49 consecutive patients undergoing extracorporeal shock wave lithotripsy a 14.3% rate of bacteremia was detected during treatment. The bacterial spectrum consisted of gram-positive cocci, gram-negative cocci, Bacteroides capillosus and Proteus mirabilis. In principle, these results do not call for an antibiotic prophylaxis. Nevertheless, according to the recommendations of the American Heart Association and the Deutsche Gesellschaft für Herz- und Kreislaufforschung, patients with a cardiac risk predisposing to bacterial endocarditis must receive perioperative antibiotic prophylaxis.

Adult↗
PubMed1990

[Bone banks in the FRG. Results of a survey].

In a nationwide survey, 1350 departments of general surgery, trauma surgery, and orthopedic surgery were approached in an attempt to determine how many surgeons use bone grafts and how they manage their bone banks; 961 responded to the postal enquiry. Bone banks are currently in use in 471 departments. The storage temperature varies between 0 degrees C and -30 degrees C in more than 50%. In 90% bone is stored for no longer than 12 months. In only 6 bone banks secondary sterilization of the bone is performed. In 1 year, 71,000 autogeneic and 25,000 allogeneic bone grafts are performed. A further 18,000 per year could be performed if bone grafts were available. We discuss the results of the survey and present an overview of the current problems concerning storage temperature and adjuvant local antibiotics, the role of HIV in bone banking, and the possibilities opened up by secondary sterilization.

Bone Transplantation↗
PubMed1987

Microbial spectrum of blood and body cultures in febrile episodes of children under chemotherapy for treatment of malignant diseases.

One hundred thirty-five febrile episodes in 111 children with malignancies were reviewed. In 50 of 125 episodes blood cultures were positive; gram-positive bacteremia was detected in 40 episodes and gram-negative bacteremia in 10 episodes. The predominant gram-positive bacteria were coagulase-negative staphylococci, the predominant gram-negative bacteria were Escherichia coli. The possible role of coagulase-negative staphylococci in causing septicemia in immunocompromised hosts is discussed with conclusions that influence designing a primary antibiotic regimen to treat febrile episodes in leukopenic children.

Adolescent↗
PubMed1986

Experimental studies with absorbable and nonabsorbable sutures in infected canine arterial anastomoses.

Vascular anastomoses are usually performed with nonabsorbable synthetic suture material. In an infected wound suture material may have a negative effect on the healing of vascular anastomoses, leading to leakage and formation of false aneurysms. In a canine model 40 neck wounds and 40 groin wounds were contaminated with a standard suspension of Staphylococcus aureus. Subsequently 80 end-to-end anastomoses were performed in both carotid and femoral arteries with the absorbable polydioxanone (PDS) or the nonabsorbable polypropylene (PPL) suture material in one of either side. After wound infection or hemorrhage occurred, or at least 7 days to 6 months after vascular surgery, the dogs were put to death and the contaminated vessels were removed to determine the extent of infection with light and scanning electron microscopy. Macroscopic (presence of pus, anastomotic rupture, or aneurysm) and microscopic findings (absorption, tissue reaction) were compared statistically with the McNemar test. There was no difference in the incidence of wound infection between the sutures examined. Bacteriologic cultures revealed no other microorganism than the inoculated staphylococcus strain or occasional skin contaminants. In the PPL group hemorrhages occurred more frequently (n = 6) than in the PDS group (n = 2; p = 0.125). Anastomotic aneurysms (n = 5) were found only in the PPL group (p = 0.375). These differences, although statistically not significant (because of the small number of the studied anastomoses), suggest the use of monofilament absorbable suture material for autogenous anastomoses in a contaminated area.

Animals↗
PubMed1984

[Therapy and prevention of infectious endocarditis].

Only 40 years ago infectious endocarditis (IE) was lethal in most cases. Due to the development of numerous antibiotics and continuous improvements in heart valve surgery, a wide range of possibilities for therapy and prophylaxis of IE are available. The prognosis depends essentially on rapid and relevant diagnosis, which should be followed by immediate and adequate therapy consisting of general measures for treatment of septicaemic disease and specific antibiotic therapy. As multiple complications may develop during IE, careful follow-up by clinical, laboratory and mechanical examinations is necessary to decide whether surgical intervention is urgently indicated or not. In case of complications such as myocardial failure, septicaemic embolism or acute renal failure, as well as septicaemia persisting for more than 72 hours in spite of antibiotic treatment, immediate valve replacement is usually indispensable. Furthermore, large vegetations found by echocardiography, or infections caused by staphylococci, gramnegative bacteria or fungi are arguments for early surgery. For most of the IE pathogens the antibiotic treatment concept is nowadays widely acknowledged. Penicillin-sensitive streptococci are treated with a combination of penicillin S and an amino-glycoside (streptomycin). If the penicillin-MBK is very low, combined treatment can usually be abandoned. In patients allergic to penicillin, treatment with lincomycin has advantages over vancomycin or cephalosporins. In enterococcal IE, ampicillin plus aminoglycoside is the combination of choice. Streptomycin has preference over gentamicin here only if the enterococci are not streptomycin-resistant. If penicillin allergy is evident, the new beta-lactam antibiotic imipenem offers a way out of the present therapy dilemma. For penicillin-sensitive staphylococci a combination of penicillin-G with gentamicin given over 6 weeks is recommended. In case of penicillin allergy, cefazolin or vancomycin may provide a substitute for penicillin. In penicillin-resistant staphylococci the combination of oxacillin or flucloxacillin with gentamicin is established. Fungal endocarditis can be treated with a combination of amphotericin-B and flucytosin. Cure without surgery, however, is rare. For the large remaining number of pathogens which are less frequently responsible for IE, antibiotic management depends on sensitivity test in vitro, as the sensitivity of pathogens may vary widely. Though not only groups of patients with high infection rates are widely known, but also the events provoking the infections, the prophylaxis of IE continues to be inadequate.(ABSTRACT TRUNCATED AT 400 WORDS)

Anti-Bacterial Agents↗
PubMed1984

Cell-substrate interaction. A method for evaluating the possible correlation between metastatic phenotype and cell surface energy.

The interfacial energy of the non-attached to substrate cell surface was analysed in tumor cell variants of the K-1735 melanoma and UV-2237 fibrosarcoma series, which exhibit distinct metastatic phenotypes. The highly metastatic cell variants exhibited a two-fold increase in the ability to form rapid cell substrate interactions, as compared with their low-metastatic counterparts. These results further highlight the possible role of cell adhesiveness in the process of metastasis.

Animals↗
PubMed1984

Prosthetic valve endocarditis: clinical findings and management.

Prosthetic valve endocarditis (PVE) was shown in 46 patients out of a group of 2163 carrying prosthetic heart valves. The cumulative rate of early PVE was 1.4% and 1.5% for PVE occurring between the 60th day and 10 years after surgery. In 37% of all cases this was caused by staphylococci, 20% by streptococci, and 13% Gram negative species. Fungi were found in 9% and mixed infections in 21%. The incidence of staphylococci, Gram negative pathogens and fungi was significantly higher in early PVE. In 5 patients, valve involvement consisted in echocardiographically shown vegetations and/or obstructive thromboendocarditis. In 90% of 37 patients who developed paravalvular leakages, there was high intravascular haemolysis uncharacteristic of the type of prosthesis implanted. In 70% fluoroscopy revealed disproportionate tilting of the prosthetic annulus, and in 75% there was a distinct echocardiographic pattern in the closing movement of the valve poppet. The cumulative survival rate after six months was 31% for the conservatively treated, and 66% for the medically plus surgically treated patients. Survival rates at the end of a maximum follow-up of 20 years was 15% with conservative treatment and 51% after primary surgical therapy. The prognosis was worse (P less than 0.01) in patients who, during aortic PVE, developed heart failure refractant to therapy due to haemodynamically significant prosthetic valve dysfunction, to sepsis that persisted for more than 72 h despite antibiotic therapy, to major septic embolism or to acute renal failure. The retrospective prognosis was more favourable for patients with early aortic (P less than 0.02) or mitral (P less than 0.05) valve re-replacement than for patients who had been treated medically only.

Adult↗
PubMed1984

Bacteriological assistance for optimal antibiotic therapy of endocarditis.

The specific anatomical changes of the infected valvular tissue demand the best bactericidal antibiotic therapy of endocarditis. However, quantitative antibiotic sensitivity testing and determination of the bactericidal effectiveness is not sufficiently routinely practised. It is presented how appropriate bacteriological assistance to achieve the optimum antibiotic therapy for endocarditis leads to favourable clinical results. Establishment of reference laboratories for quantitative antibiotic sensitivity testing in every case of endocarditis is proposed. Active cooperation between these centres would provide excellent data for method and result comparison.

Anti-Bacterial Agents↗
PubMed1983

The benefits of drug monitoring in patients with bacterial meningitis, eg, chloramphenicol monitoring.

Regular drug monitoring during therapy with chloramphenicol sodium succinate is actually recommended by expert centers. In this report a case of meningitis due to Salmonella typhimurium is described, which underlines the necessity of examining both the chloramphenicol and the chloramphenicol succinate concentrations. It is suggested that medical microbiologists and clinicians should be encouraged to take advantage of new, quick, and sensitive methods for drug monitoring in order to achieve optimal therapy.

Chloramphenicol↗
PubMed1981

[Diagnosis and current antibiotic therapy of urinary tract infections (author's transl)].

The problems caused by urinary tract infections confront the urologist with multiple specific tasks and call for cooperation with other specialists. In addition to basic and urological diagnostic acts recommendations are made for succeeding in diagnosis by means of bacteriology and nephrology. Considering the clinical degrees of urinary tract infections and the associated spectrum of causative bacterial agents the principles of current antibiotic treatment are presented

Anti-Bacterial Agents↗