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Biomedical subjects

M Rotter

Publications and source records attributed to M Rotter.

At least 73 records · Page 4Linked to original sources
PubMed1986

Does transurethral resection of prostatic carcinoma promote tumor spread?

122 patients with prostatic carcinoma treated by radiation therapy were reviewed. An actuarial analysis was done on survival comparing patients treated by transurethral resection (TURP) prior to radiation to those diagnosed by needle biopsy. Survival rates were not significantly different between groups. TURP was also without effect on interval free of distant or local recurrence. Survival and time to distant or local recurrence were analyzed by tumor stage and grade. A multivariate analysis with the Cox model was made by which the effects of TURP and tumor grade and stage were examined simultaneously. TURP was without effect on survival rates and interval to distant or local recurrence after adjustments had been made for the effects of stage and grade.

Actuarial Analysis↗
PubMed1986

[Does radiosterilization of the vagina occur through therapeutic radiation dosages?].

The endogenous genital flora is a major source of infections of the female genital tract, especially in patients with cervical or endometrial cancer. Until recently the "radiosterilisation of the vagina", respectively a prophylactic and/or therapeutic effect of irradiation (external high voltage as well as intracavitary-radium) concerning infections was postulated in the literature. This theory was disproved in a prospective clinical and bacteriological study covering 48 patients with advanced cervical cancer undergoing primary intracavitary radium-irradiation and 38 patients with inoperable endometrical cancer, undergoing primary Iridium-192-afterloading. Following intracavitary radium for cervical cancer some typical nosocomial pathogens like Streptococcus faecalis, Enterobacter, Klebsiella, Proteus and Pseudomonas were isolated significantly more frequently than before treatment. Likewise, the mean number of aerobic bacterial species increased significantly after irradiation. Also primary Ir-192 (afterloading) irradiation did not alter the frequency of isolation of the resident flora in endometrial cancer patients. Therefore, "radiosterilisation" of the vagina as result of radiotherapy does not exist.

Adenocarcinoma↗
PubMed1986

[Susceptibility of the Bacteroides fragilis group to 10 antibiotics. Results of 4 laboratories in Austria].

The susceptibility of 197 strains of the Bacteroides fragilis group (109 B. fragilis, 27 B. thetaiotamicron, 23 B. vulgatus, 1 B. distasonis, 11 B. ovatus and others) to penicillin G, cefoxitin, latamoxef, piperacillin, mezlocillin, clindamycin, metronidazole, tetracycline, doxycycline and chloramphenicol was tested by an agar dilution method. 4 microbiological laboratories in Austria participated in this investigation. In all laboratories the same method was used and a joint quality control carried out. The most active substances were metronidazole and clindamycin (MIC50 1.0 and 0.5 respectively; MIC90 4 mg/l for both). Tetracycline showed only little activity, whereas doxycycline inhibited a major portion of the strains at therapeutically relevant concentrations (MIC50 16 and 2 mg/l, MIC90 32 and 16 mg/l, respectively). The MIC90 of chloramphenicol was 8 mg/l. Piperacillin and mezlocillin were about equally active (MIC50 both 16, MIC90 32 and 64 mg/l, respectively). For penicillin G, the MIC values were also favourable, the MIC90 being 32 mg/l. The possible causes for the discrepancy between the good in vitro activity and the clinical ineffectiveness of penicillin G are discussed. The cumulative MIC values (50, 90%) for cefoxitin were 8 and 32 mg/l, respectively. The MIC's of latamoxef showed a wide distribution resulting in a low MIC50 (4 mg/l) and a high MIC90 (128 mg/l). This distribution was due to the differing susceptibility of the individual species within the Bacteroides fragilis group. For B. thetaiotaomicron the highest MIC values were determined. This species as a whole was less susceptible to the beta-lactam antibiotics tested. The non beta-lactam antibiotics showed no substantial species related differences. No relevant differences between the individual laboratories were observed.

Anti-Bacterial Agents↗
PubMed1985

[Resistance of blood culture isolates in vitro to 4 aminoglycoside antibiotics in Austria--1982/83].

Over the period September 1982 to February 1983 268 blood culture isolates were consecutively collected in 4 microbiological laboratories in Austria (Linz, Vienna, Graz, Feldkirch) and 251 of these strains (streptococci excluded) were tested for resistance to Gentamicin (G), Tobramycin (T), Netilmicin (N) and Amikacin (A) using a microtitre broth dilution method. This investigation was part of an international study. Of the bacterial strains examined 57% were staphylococci (34% Staphylococcus aureus) and 43% gram-negative rods (18% E. coli, 17% other enterobacteriaceae and 5% Pseudomonas aeruginosa etc.). 25% of all strains tested were resistant to Gentamicin (MIC greater than 4 mg/l), 27% to Tobramycin (MIC greater than 4 mg/l), 6% to Netilmicin (MIC greater than 4 mg/ml) and 5% to Amikacin (MIC greater than 8 mg/l). The resistance rate of staphylococci was markedly greater towards Gentamicin (35%) and Tobramycin (39%) than Netilmicin (4%) and Amikacin (6%). The respective percentages of resistant gram-negative rods were considerably smaller, except in the case of Netilmicin (G 13%, T 11%, N 8%, A 4%). Regional differences were observed between Linz and Vienna in the resistance of staphylococci to Gentamicin (24% versus 49%) and Tobramycin (33% versus 53%). On a weight basis Netilmicin was the most active substance in combating nearly all groups of bacteria. Also in strains sensitive to the other aminoglycosides the MIC values of Netilmicin were considerably lower than for the other substances. A noteworthy feature in comparison with the results of other countries participating in this international study was the distinctly higher incidence of staphylococci among the blood culture isolates and the considerably higher percentage of aminoglycoside-resistant strains in Austria. Analysis of the data suggests that the high resistance rates among staphylococci are a consequence of selection by frequently used antibiotics. Hence, it appears essential to observe the development of aminoglycoside resistance in Austria closely and to recommend that these substances, of extreme value in the treatment of severe infections, should be used solely for the most stringent indications.

Aminoglycosides↗
PubMed1984

Postoperative infections in colonic surgery after enteral bacitracin-neomycin-clindamycin or parenteral mezlocillin-oxacillin prophylaxis.

In a prospective randomized, blind trial, three groups of patients undergoing elective colonic surgery were compared for frequency of surgical wound infection, intra-operative wound contamination and other postoperative infections. All patients allotted to the three groups received whole gut irrigation (101 balanced salt solution) by gastric tube on the evening before surgery and were treated as follows. Group A: no antibiotics; Group B: neomycin (1 g/l) + bacitracin (50,000 IU/l) + clindamycin (900 mg/l), contained in the last 31 of irrigation fluid; Group C: mezlocillin (4 g) + oxacillin (2 g) intravenously (iv) at induction of anaesthesia, followed by two identical doses at 8 and 16 h. The rate of postoperative wound infection was highest in A (38 per cent) and much lower in B (3.3 per cent, P less than 0.002) and C (6.9 per cent, P less than 0.004). The difference between B and C was statistically not significant. In A a correlation was established between the degree of wound contamination and the occurrence of wound infection. Intra-operative wound contamination was lowest in B (30 per cent), equal in A (58.1 per cent) and B (55.2 per cent). Other infections were least frequent in group C (four of 29 patients), but were not significantly different to groups B (six of 30) and A (nine of 31). It is concluded that antibiotics together with an effective mechanical preparation considerably reduce the rate of wound infection in colonic surgery.

Adult↗
PubMed1984

Effects of aerobic exercise and weight loss on riboflavin requirements of moderately obese, marginally deficient young women.

In a previous study, exercise was shown to increase riboflavin requirements of active, normal weight young women. The present study examined the effect of exercise and weight loss on riboflavin status of moderately overweight women. The experiment was designed as a two-period cross-over with an initial base-line period and two 5-wk metabolic periods. The basic diet contained 1200 kcal with a riboflavin concentration of 0.8 mg/1000 kcal. Exercise consisted of a program of dance exercise. Riboflavin depletion, as measured by increased erythrocyte glutathione reductase activity coefficients and decreased urinary excretion of riboflavin, occurred during both nonexercise and exercise periods. Erythrocyte glutathione reductase activity coefficients increased from a base-line mean of 1.28 +/- 0.11 to 1.40 +/- 0.12 during nonexercise and to 1.49 +/- 0.16 during exercise. Urinary excretion of riboflavin fell from 48 +/- 12% of intake during base-line to 30 +/- 13% during nonexercise and to 19 +/- 6% during exercise. Riboflavin depletion was not related to the rate or composition of weight loss or to change in aerobic capacity.

Adult↗
PubMed1984

Effectiveness of cefamandole against methicillin-resistant strains of Staphylococcus aureus in vitro and in experimental infections.

An investigation was carried out into the effectiveness of cefamandole as compared to that of cephalothin against methicillin-sensitive and methicillin-resistant strains of Staphylococcus aureus both in vitro and in mice with the experimental peritonitis-induced septicaemia as a model for a generalized infection. In the agar-diffusion test 95% of 118 and in the broth-dilution test 80% of 30 methicillin-resistant strains were sensitive to cefamandole. In experimental infections the ED50 with methicillin-resistant strains was 20 times greater than that required for the methicillin-sensitive strain although the MIC was only twice that for the latter. Doses of cephalothin required for treatment of infections due to methicillin-resistant strains were also twenty times greater than for those due to the methicillin-sensitive strain. But these differences were consistent with those in MIC (by factors of 16-32). Thus, the results of in-vitro testing of cefamandole are not predictive for its therapeutic efficacy in staphylococcal infections with methicillin-resistant strains. Therefore, rather than relying on inhibition zone diameter and MIC, the information that a staphylococcal strain is methicillin-resistant should be used as an indication not to choose cefamandole for chemotherapy.

Animals↗
PubMed1984

[Control of infection in a primarily surgical intensive care unit].

All of one year's 251 patients of a predominantly surgical intensive care unit (i.c.u.) were continuously followed up for infections according to a standard protocol. These protocols were evaluated for 174 patients who stayed at least 48 h at the unit. More than one third (36.7%) were already infected on admission (external origin), 35% contracted infections at the unit, primarily or additionally (internal origin) and 40% remained without an infection. Fifty eight percent of patients already infected on admission were surgical and required intensive care for complications. Among the patients who contracted their infection solely at the unit 61.5% suffered from trauma. Patients having contracted their infections at the i.c.u. stayed significantly longer than those without (additional) infections (13 and 6 days respectively). Mortality was highest (45%) in patients who were already infected on admission and who acquired additional infections during their stay at the i.c.u. Of patients with infections of exclusively external or internal origin 23.5 and 17.9% respectively died whereas among those who remained uninfected this proportion was only 7%. The 75 infections acquired before admission to the i.c.u. included infections of the respiratory tract in 14.4% of all patients, peritonitis with 10.3%, urinary tract in 8.0% and septicemia in 5.2%. Artificial ventilation was employed more often in infected patients (73.8-100%) than in non-infected ones (56.3%). They also carried more intravasal catheters (2.76-3.05 per patient) than the latter group (1.79). Of the 82 infections acquired in the i.c.u. the respiratory tract was affected in 19.5% of all patients and the urinary tract in 13.8%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

[Evaluation of procedures for vaginal disinfection].

At the occasion of the usual preparations preceding gynecological operations the average vaginal bacterial release of 42 patients, already anaesthesized, was assessed by a rinsing technique to be 5,04 +/- 0,98 log10 c.f.u. per ml sampling fluid after aerobic and anaerobic culture. The reduction of this bacterial release caused by the measurement itself is relatively small, therefore the technique was found to be suitable for evaluation of the efficacy of germreducing measures like irrigation or disinfection. An irrigation with isotonic saline during 30 s was measured to reduce the vaginal bacterial release by 0,4 +/- 0,5 log-steps. A solution containing 0,08% chlorhexidine gluconate + 0,1% benzalkon gluconate applicated during 5 min caused a reduction of 1,04 +/- 0,76 and a watery solution of povidone-iodine one of 2,29 +/- 1,00 log-units when used for 3 min. When after disinfection the sustained antimicrobial action of the chlorhexidin-containing preparation was not neutralized already during the sampling process by Tween 80 + lecithine + histidine being contained in the sampling fluid, an erroneously optimistic log reduction of 2,35 +/- 0,48 was measured. From the results it was calculated that 17-23 volunteers are necessary in order to detect with sufficient statistical safety an observed mean log reduction to be 0,5 log-units smaller than a hypothetical minimal reduction of 2,00 log-steps as required provisionally on an arbitrary basis.

Aerobiosis↗
PubMed1983

Bacteraemia in surgical patients with intravenous devices: a European multicentre incidence study. The European Working Party on Control of Hospital Infections.

A survey of the incidence of bacteraemia and the use of intravenous (IV) devices among 10,616 surgical patients was performed in 42 hospitals in eight countries. It was found that 63 per cent of the patients surveyed had an IV device inserted at some time during their hospital stay, with national variations between 40 and 99 per cent. The incidence of device-related thrombophlebitis was 10.3 per cent, with national variations between 7.8 and 28.4. Among the surgical patients not given IV therapy, 1.5/1000 had a bacteraemia, 0.5/1000 of them hospital-acquired. The corresponding figures for patients with a peripheral but no central IV device were 6.9 and 3.7, and for patients with a central venous catheter (CVC) 59.0 and 44.8, respectively. Even though there was a strong correlation between the incidence of bacteraemia and certain diagnoses there was also an independent correlation between it and CVCs or peripheral IV lines. No correlation was demonstrated between the number of catheter days per site for patients with a peripheral IV device, and hospital-acquired bacteraemia. This may be due to the low mean number of catheter days per site that was observed. There was a large and not easily explained national variation in the incidence of bacteraemia in patients with CVCs of between 16 and 108/1000.

Catheterization↗
PubMed1983

[Comparison of the ELISA (lipopolysaccharide) and Widal reactions (O antigen) in the diagnosis of Salmonella infections].

At various times after the onset of disease 50 sera of patients with bacteriologically proven salmonella infections were investigated for O-antigen specific antibodies in ELISA and Widal-tests. 21 of these sera were derived from patients with typhoid fever, 10 from patients with gastroenteritis due to various species of salmonella group D and 19 from patients with group B salmonella-gastroenteritis. Additional 44 sera stemming from patients without such infection were included in the investigation as a control. With ELISA the sera were examined for antibodies of the IgM- and IgG-class separately. As antigens lipopolysaccharide W-preparations from S. typhi ("group D-antigen") and S. typhimurium ("group B-antigen") were used in the ELISA. High reciprocal titers (geometric means: 1404, 2560, and 1020) of IgM were demonstrable in sera drawn 11-30 days after onset of the disease with group D- and group B-antigen respectively (Fig. 1, Table 1 and Table 2). With increasing distance of time from the onset of the disease these titers decreased rapidly. The titers of agglutinating antibodies as measured in the Widal-test behaved similarly to those of IgM (Fig. 1, Table 1 and 2), and the correlation between both was high (r = +0.93, Fig. 2). In contrast, titers of IgG-antibodies reached their maximum later, namely 31-60 days after onset of the disease (Table 1), and the correlation to the agglutinin-titers (r = +0.33, Fig. 3) was much lower. In sera of patients with typhoid fever reciprocal titers of IgM against the homogeneous group antigen surmounted those of IgG at the average by about 5 log2-step (mean g: 1404 and 79 respectively) between the 11th and 30th day of disease. At this stage of the disease also sera from patients with gastroenteritis due to both salmonella D or B demonstrated clearly an IgM-dominated ratio. After a period of more than 2 month this ratio was about 1:1 in sera of patients with typhoid fever or with salmonella group D-gastroenteritis, but was clearly IgG-dominated in sera obtained from patients with group B-gastroenteritis. This might be due to the fact that most of the sera classified as "obtained greater than 2 months after onset" stemmed from excreters of salmonella B species.(ABSTRACT TRUNCATED AT 400 WORDS)

Antibodies, Bacterial↗
PubMed1982

Vaginal organisms in prepubertal children with and without vulvovaginitis. A vaginoscopic study.

In a prospective clinical and microbiological study covering 67 prepubertal children the vaginal flora of 31 asymptomatic children was compared to 36 children suffering from abnormal vaginal discharge and/or vulvovaginitis. Vaginoscopy was employed to obtain bacteriological specimens without contamination. Swabs were inoculated into prereduced transportmedia (PORT A CUL, BBL) and cultured aerobically and anaerobically. The most prevalent aerobic organisms were Staphylococcus epidermidis. Enterococci and Escherichia coli; the predominant anaerobic bacteria were Peptococcus and Peptostreptococcus, Veillonella parvula, Eubacteria, Propionibacterium and Bacteroides species. A similar microbiological pattern was found in both groups, although anaerobes, like Peptococci and Peptostreptococci and Bacteroides species, as well as yeasts, like Candida albicans were significantly more frequent in the group with signs and symptoms. Lactobacilli were less common in this group.

Adolescent↗
PubMed1982

Endometrial bacteriology in patients with endometrial cancer before and after primary intracavitary irradiation using IR-192 and an afterloading technique.

In a prospective clinical and bacteriological study the endocervical and endometrial flora of 38 patients with biopsy proven cancer of the endometrium was studied before and after intrauterine irradiation with 10 Gy (Ir-192, afterloading device, Buchler, Braunschweig). Bacteriological swabs were taken transcervically. Anaerobic transport media were used and cultures were done aerobically and anaerobically. The mean number of aerobic organisms per patient increased from 2.13 to 2.49 (not significant (n.s.)), and of anerobic organisms from 1.42 to 2.00 (n.s). Neither the recovery rate of aerobic and anaerobic bacteria nor the composition of endometrial flora was altered significantly by intracavitary irradiation. Only aerobic sporeformers increased from 5.3% to 21% (2 p less than 0.05). The most prevalent aerobic species were S. epidermidis, streptococci and E. coli, the predominant anaerobic species Pepto- and Peptostreptococcus and Bacteroides. Our results clearly show that the intrauterine administration of 10 Gy by a Ir-192-afterloading device does not sterilize the endocervix or endometrium and infections may occur after intracavitary radiotherapy.

Aged↗
PubMed1982

Urinary-tract infection and bacteraemia in hospitalized medical patients--a European multicentre prevalence survey on nosocomial infection.

A co-ordinated survey of 3899 medical patients in 169 wards, performed simultaneously in eight countries, showed a point-prevalence of urinary-tract infection (UTI) and bacteraemia of 12.6 and 1.6 per cent, respectively. One-half of the infections were acquired after the patients' admission. The bacteriological patterns of hospital- vs community-acquired infections were different, but showed no unexpected features. Antibiotic treatment was recorded in 22.3 per cent of the patients in this study, urinary-tract disinfectants, sulphonamides or penicillins being used in 95 per cent of those treated for UTI. The overall prevalence of urinary-tract drainage was 11.0 per cent with no significant difference between the two sexes. At ward level the rate of catheterized patients varied from below 5 per cent to more than 25 per cent, indicating--besides variations in the ward populations--differences in policies. The association between nosocomial UTI and the presence of an indwelling catheter and/or female sex was confirmed, while high age appeared to be a secondary risk factor among catheterized patients. The prevalence of nosocomial bacteraemia in patients with UTI was five times higher than in those without urinary-tract involvement, and a significant part of the nosocomial cases of both UTI and bacteraemia was clearly device-related. Guidelines for the use of indwelling catheters should be restrictive and provide for prompt removal. When introduced and followed they will effectively reduce nosocomial UTI and bacteraemia.

Age Factors↗
PubMed1982

[Anaerobic microflora of praepubertal children (author's transl)].

Bacteriologic cultures of the vagina and the cervix of 38 praepubertal children, aged 3 months to 16 years (average age 9 years) from the outpatient department for infants and juveniles of the 1st Department of Obstetrics and Gynecology of the University of Vienna were obtained vaginascopically using anaerobic transportmedia (Port a Cul) and were examined for aerobic and anaerobic bacteria. An average of 5.3 species was also isolated per child (2.9 aerobic and 2.5 anaerobic species). The commonest anaerobes were Peptococcus, Peptostreptococcus, Bact. melaninogenicus, Proprionibacterium and Veillonella parvula, the prevalent aerobes, were Enterococci, E coli and Staphylococcus epidermidis. Our results suggest that anaerobic bacteria amount a significant component of the flora of the lower genital-tract of healthy children, as well as of infants with vaginal discharge.

Adolescent↗