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Biomedical subjects

W Gaus

Publications and source records attributed to W Gaus.

88 records · Page 5Linked to original sources
PubMed1978

Protective isolation and antimicrobial decontamination in patients with high susceptibility to infection. A prospective cooperative study of gnotobiotic care in acute leukaemia patients. III: The quality of isolation and decontamination.

In a cooperative study, the quality of protective isolation and of antibiotic decontamination of the digestive tract was studied in patients with acute leukaemia by (bio)-typing of Enterobacteriaceae species, Pseudomonas aeruginosa and Staphylococcus aureus isolated from oral washings and faecal samples. These samples were collected before and during treatment of 82 patients who were either isolated and decontaminated for which latter purposes a combination of neomycin, polymyxin, bacitracin and nystatin was used (group A); isolated without decontamination (Group B) or treated on the ward without decontamination (Group C). The results indicated that protective isolation had only been completely successful during the entire (remission induction) treatment period in one of the 32 patients in Group B. In Group A patients, who underwent antibiotic decontamination in addition, successful isolation was achieved in 57% of 28 patients. Successful antibiotic decontamination of the digestive tract for the entire treatment period as far as all potentially pathogenic species are concerned, was realized in 4 (14%) of the 28 patients of Group A. Bacteriologically confirmed infections occurred in 50% of Group A patients, in 59% Group B patients and in 64% of Group C patients. It is concluded that the quality of isolation had in general been insufficient but that it was improved by oral nonabsorbable antibiotics and, furthermore, that the antibiotic decontamination procedure also requires improvement.

Adolescent↗
PubMed1978

Comparative trial on the therapeutic effectiveness of the new anthelmintic drug: ciclobendazole.

In a double-blind study in Cameroon the vermicidal effect of Ciclobendazole, a new Benzimidazole derivative, was evaluated and compared to Mebendazole. Ciclobendazole and Mebendazole were equally effective in the treatment of Ascaris and Hookworm infestations. An increase in the dosis of Ciclobendazole from 600 mg to 1200 mg did not lead to an improvement in the effectiveness. When treating trichuriasis significantly better results were achieved with Mebendazole (p = 0.01). Both drugs were tolerated equally well. Side effects, such as vomiting and diarrhoea, only occurred in a small percentage of cases.

Adult↗
PubMed1977

Protective isolation and antimicrobial decontamination in patients with high susceptibility to infection. A prospective cooperative study of gnotobiotic care in acute leukemia patients. II. Organizational and statistical concept.

The organizational and statistical concept of the cooperative randomized controlled clinical trial on gnotobiotic care and its effect in acute leukamia patients is described. The purpose is the clarification of the concept of the study and the comparison with other studies on the same subject. It is concluded that the value of the results and of the decisions based on them depend mainly on the statistical design, the protocol, and the performance of a study. The performance of a controlled study depends on its organizational details, its monitoring, documentation, and appropriate biometric evaluation. In this particular study it proved fruitful that a statistician was engaded in the evaluation and also in developing the protocol and in carrying out the study.

Acute Disease↗
PubMed1975

Genetic differences in the cortisol concentration of the adrenal and other tissues of white and coloured guinea-pigs.

The effect of genetic difference (white v. coloured) on the cortisol content of ten different organs and tissues, including the adrenals, of white and coloured guinea-pigs of both sexes and of different ages was studied by protein-binding techniques. Tissue cortisol concentration was significantly higher in all the tissues and adrenals of white animals of both sexes compared with coloured animals. The difference in tissue cortisol content between white and coloured animals was higher before (range 41-5-134-1%) than after puberty (range 10-1--82-5%). The age-dependent decrease of cortisol concentration in different tissues and adrenals in adults was more marked in white guinea-pigs of both sexes (mean 30-6%, range 0-0--71-5%) than in coloured (mean 16-9%, range 0-0--63-1%. In adult animals the liver contained significantly (11-8--36-4%) more cortisol than in prepubertal animals. This pattern was the same in white and coloured guinea-pigs of both sexes.

Adrenal Glands↗
PubMedDate not supplied

Prevention of recurrent bleeding in cirrhotics with recent variceal hemorrhage: prospective, randomized comparison of propranolol and sclerotherapy.

To compare the efficacy of endoscopic paravariceal sclerotherapy and oral propranolol in the prevention of recurrent upper gastrointestinal bleeding, 78 cirrhotic patients were randomly assigned to either treatment after an endoscopically proven bleed from esophageal varices. After randomization, but before treatment had been started, a total of eight patients had to be withdrawn from the study due to early rebleeding (requiring emergency sclerotherapy) or violations of the protocol. Among the 70 patients analyzed (36 sclerotherapy, 34 propranolol), both treatment groups were comparable with respect to demographic, clinical and laboratory data. The groups also did not differ with respect to continued alcohol intake. Sclerotherapy was performed twice weekly using 1% polidocanol as the sclerosing agent until the varices were eradicated or well-covered by fibrous tissue. Propranolol was given twice daily at a dose reducing the resting heart rate by 25% (60 to 320 mg per day; mean +/- SD = 161 +/- 80 mg per day). Patients were followed for up to 2 years with visits at 3 monthly intervals (mean follow-up = sclerotherapy, 14 months; propranolol, 9.2 months). Life table analysis of patients without rebleeding from nonvariceal sites revealed a tendency in favor of propranolol; however, the difference did not reach statistical significance. No significant difference was observed between sclerotherapy and propranolol in the proportion of patients rebleeding from esophageal varices or from all sources of upper gastrointestinal bleeding. Furthermore, survival was similar in both treatment groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Bacteriological data on a prospective multicenter study of the effect of two different regimens for selective decontamination in patients with acute leukaemia.

In this paper we described the results of bacteriological monitoring of oropharynx and stool samples from granulocytopenic patients with leukaemia who received oral infection prophylaxis with two different regimens for selective decontamination of the digestive tract. Patients were prospectively randomized either into a group receiving non-absorbable antimicrobial drugs for selective decontamination (polymyxin and neomycin: group A) or into a group receiving polymyxin and co-trimoxazole (group B). The oropharynx was, or became, free of gram-negative bacilli within one week of treatment in 94% and 90%, respectively, of the patients in group A and group B. The stool samples were, or became, negative after the same treatment interval in 91% and 80%, respectively, of the two patient groups. Antibiotic therapy during selective decontamination treatment significantly increased the incidence of positive cultures from the oropharynx and stools. The sensitivity of the gram-negative bacilli isolated during selective decontamination treatment to the drugs administered did not influence the average response to treatment. Both resistant and sensitive gram-negative bacteria appeared to disappear from the patients' samples, mostly within a week, without the need to adjust the selective decontamination treatment. Yeasts behaved in almost the same way as gram-negative bacilli. All patients received oral amphotericin B; some patients occasionally yielded oropharyngeal or faecal cultures which were positive for yeasts.

Acute Disease↗
PubMedDate not supplied

Prevention of infection in acute leukemia: a prospective randomized study on the efficacy of two different drug regimens for antimicrobial prophylaxis.

In a prospective study patients with acute leukemia undergoing remission induction therapy were randomized to receive either a regimen of non-absorbable antimicrobial drugs (colistin and neomycin) or of absorbable and non-absorbable drugs (trimethoprim-sulfamethoxazole [TMP-SMZ] and colistin) for antibacterial prophylaxis. For antifungal prophylaxis patients in both groups were given oral amphotericin B. The proportion of patients without acquired infections and the median of study time to the first acquired infection did not differ significantly between the two treatment groups (p greater than 0.05). Septicemias occurred in nine out of 49 recipients of colistin and neomycin and in one out of 56 patients receiving TMP-SMZ and colistin (p = 0.03). Localized infections and fever episodes without proven infections were equally distributed between the two groups. The incidence of febrile days and of days on parenteral antibiotic therapy was significantly lower in the group given TMP-SMZ and colistin (p less than 0.05). The duration of severe granulocytopenia and thrombocytopenia did not differ significantly between the two groups (p greater than 0.05).

Adolescent↗
PubMedDate not supplied

Ciprofloxacin and norfloxacin for selective decontamination in patients with severe granulocytopenia.

In a randomized multicenter study, ciprofloxacin and norfloxacin, each in two different dose regimens and in combination with non-absorbable antimycotics, were administered to 51 patients with acute leukaemia undergoing aggressive remission induction chemotherapy for infection prevention. Both drugs showed an effective elimination of gram-negative potential pathogens and Staphylococcus aureus not affecting the anaerobic flora of the gastrointestinal tract. A low incidence of side effects and a satisfactory patient compliance could be observed. A daily dosage of 1,000 mg ciprofloxacin or 800 mg norfloxacin is recommended for infection prevention in severely granulocytopenic patients.

Acute Disease↗