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Biomedical subjects

K Andrassy

Publications and source records attributed to K Andrassy.

228 records · Page 13Linked to original sources
PubMedDate not supplied

Alteration of hemostasis associated with cefoperazone treatment.

21 Patients with normal and impaired renal function were given cefoperazone in a recommended dose of 4 g/day, irrespective of renal function. Platelet function and plasmatic coagulation were analyzed before and on day 7 of therapy. In patients with normal renal function on their usual diets, there was neither impairment of platelet function nor plasmatic coagulation. High serum antibiotic trough levels, prolongation of bleeding time and decreased vitamin K-dependent coagulation factors, as verified by the prolongation of prothrombin time and the appearance of descarboxyprothrombin, could be observed in those patients with impaired renal function whose insufficiency was far advanced and accompanied by a complex clinical picture. In this situation vitamin K deficiency may be due to poor oral intake, along with interference of hepatic vitamin K metabolism, showing an effect similar to that seen after coumarin therapy. Dosage reduction of the antibiotic in advanced renal failure and repeated control of prothrombin time is advised.

Adenosine Diphosphate↗
PubMedDate not supplied

Life-threatening infection with multiresistant Staphylococcus epidermidis in a patient with end-stage renal disease: cure with chloramphenicol and quinupristin/dalfopristin (RP 59500).

A 45-year-old man with end-stage renal disease underwent a cadaveric kidney transplantation. The allograft had to he removed 10 days after transplantation because of an acute vascular rejection. After explantation, the patient suffered from a life-threatening infection with Staphylococcus epidermidis involving lungs, eyes and liver for 11 months. Despite adequate therapy including vancomycin followed by teicoplanin, he developed spondylodiscitis requiring repeated surgical interventions. The definitive cure was achieved by a sequential therapy with chloramphenicol and quinupristin/dalfopristin.

Anti-Bacterial Agents↗
PubMedDate not supplied

CRP levels in autoimmune disease can be specified by measurement of procalcitonin.

Autoimmune diseases (AID) are prone to infection particularly under immunosuppression. The differentiation of infection from active AID is often difficult. In order to specify the diagnostic value of measurement of procalcitonin (PCT) in AID 81 patients with anti-neutrophil cytoplasmic antibody (ANCA)-positive vasculitis were analyzed, 27 with rheumatoid arthritis and 25 patients with systemic lupus erythematosus at various stages of the disease. Although PCT levels (95th percentile) were below 0.5 ng/ml in patients with active systemic lupus erythematosus and rheumatoid arthritis, the cutoff for normal values (95th percentile) in patients with active ANCA-positive vasculitis was 0.89. Therefore PCT levels of < 1 ng/ml are recommended as cutoff for invasive infections in patients with ANCA-positive vasculitis. In view of the increased mortality under immunosuppression in patients with AID and additional bacterial infection the measurement of PCT is helpful when an infectious origin is suspected.

Antibodies, Antineutrophil Cytoplasmic↗
PubMedDate not supplied

Pharmacokinetics of cefotaxime in dialysis patients.

A literature review was carried out to assess the effect of hemodialysis, hemofiltration, and continuous ambulatory peritoneal dialysis on the pharmacokinetics of cefotaxime, particularly in patients with severe renal impairment. It was concluded that the dosage of cefotaxime, adjusted for renal function, would require no further adjustment during peritoneal dialysis or hemofiltration.

Adult↗
PubMedDate not supplied

Elimination of Staphylococcus aureus in hemodialysis patients.

Staphylococcus aureus infection and its complications are of great concern in the care of hemodialysis patients. Nasal contamination with S. aureus seems to be the main source of cutaneous contamination. The decontamination and recontamination of the skin of hemodialysis patients after using mupirocin nasal ointment was followed in a placebo control study. After 10 days of therapy with mupirocin nasal ointment, 25 of 33 (73%) patients were free of nasal S. aureus contamination in the nares (control subjects 2 of 21, 10%). At the same time, the prevalence of positive skin cultures for S. aureus decreased from 30 of 33 (90%) to 11 of 33 (33%) patients. However, during the ensuing 130 days, 14 of 25 (58%) patients with negative nasal cultures became recontaminated, while the skin became recontaminated in 11 of 22 (50%) patients. In 10 of 14 S. aureus recontaminated patients the original S. aureus lysotype was documented by specific phage reaction. Four of fourteen patients had a new S. aureus lysotype. Mupirocin nasal ointment eradicated S. aureus transiently in 75% of the patients but continuously in only 11 of 33 (30%) patients.

Administration, Intranasal↗