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Biomedical subjects

W Moser

Publications and source records attributed to W Moser.

17 recordsLinked to original sources
PubMed2001

The AMOR study: a randomized, double-blinded trial of omeprazole versus ranitidine together with amoxycillin and metronidazole for eradication of Helicobacter pylori.

BACKGROUND: Besides antibiotics, additionally effective acid inhibition is necessary for the eradication of Helicobacter pylori. OBJECTIVE: To assess the significance of acid suppression and, in particular, treatment with proton pump inhibitors (PPIs) compared with H2 receptor antagonists (H2 RAs). The primary target parameter for the study was H. pylori eradication. In addition, the ulcer healing rate, speed of pain reduction, score for gastritis in the antrum and gastric body, and rate of side effects were recorded. DESIGN: Randomized, double-blinded, multicentre study. PARTICIPANTS: A total of 456 patients between the ages of 18 and 80 years with H. pylori-positive duodenal ulcers were included in the study. METHODS: Using a randomization list, patients were assigned either to a treatment group receiving omeprazole 40 mg once daily, amoxycillin 750 mg three times a day, and metronidazole 500 mg three times a day (OAM), or to a group receiving ranitidine 300 mg once daily, amoxycillin 750 mg three times a day, and metronidazole 500 mg three times a day (RAM). The treatment period was 7 days in both groups. Long-term acid-suppressant treatment was not given. RESULTS: The eradication rate was 87.1% (169/194, intention to treat [ITT]) in the OAM group and 77% (137/ 178, ITT) in the RAM group. The difference of 10.1% (95% CI 2.5-18%) is statistically significant (P= 0.0104). The ulcer healing rate was 93.3% in the OAM group (181/194, ITT) and 92.1% in the RAM group (164/178, ITT, NS). With regard to the speed and intensity of pain reduction, the OAM group was superior to the RAM group. In patients in whom H. pylori eradication was successful, the reduction in the antral and gastric body gastritis score was significantly greater than in patients without eradication. In the OAM group, 39.1% of the patients (n = 90) reported one or more side effects, compared with 44.7% (n = 101) in the RAM group (P= 1.5449, NS). CONCLUSION: Omeprazole (40 mg once daily in the morning) is significantly more effective than ranitidine (300 mg once daily in the morning) with respect to H. pylori eradication when used together with amoxycillin (750 mg three times a day) and metronidazole (500 mg three times a day) for a 7-day treatment period.

Adolescent↗
PubMed2001

Reliability of nurses' neurological assessments in the cardiothoracic surgical intensive care unit.

BACKGROUND: Alterations in mental status are common among patients in the cardiothoracic surgical intensive care unit. Changes in mental status can be caused by metabolic factors, medications, or brain injury. In this setting, reliable, serial neurological evaluations are critical for assessing the effectiveness of treatment and the need for additional studies. OBJECTIVES: To estimate the reliability of the Rancho Los Amigos Cognitive Scale and the newly developed Neurologic Intensive Care Evaluation as measures of cognitive function in the cardiothoracic surgical intensive care unit. METHODS: Nurses used 1 of the 2 scales as part of routine neurological assessments of patients in the cardiothoracic surgical intensive care unit. For each test, scores of different observers were correlated and a reliability estimate formed. RESULTS: Interrater reliability was high for both evaluations (Rancho scale, 0.91; Neurologic Intensive Care Evaluation, 0.94). Correlations between the scores of different pairs of observers were also high (mean rho values, 0.84 for the Rancho scale and 0.77 for the Neurologic Intensive Care Evaluation). CONCLUSIONS: Both scales are reliable indicators of the neurological state of patients in the cardiothoracic surgical intensive care unit. These scales measure different, although limited, aspects of cognitive function. Each test was simple to administer and did not take more time than the standard nursing neurological examination. Most of the variability in scoring was related to the different degrees of stimulation used by examiners when assessing patients, not to differences in the interpretation of patients' responses.

Cognition↗
PubMed2001

Enabling guidelines for computer-based decision support--process and tools.

Many guideline only implicitly or vaguely define the process of health care delivery. However, an explicit model of the medical tasks comprising this process is needed before active decision support at the patient encounter can take place. We propose to use a structured, but semi-formal representation as intermediate step in the process of enacting a guideline. This allows for the application independent representation of the content of a guideline enabled for decision support. The process and the tools of the methodology have been applied to enable guidelines from the field of Diabetes mellitus.

Decision Making, Computer-Assisted↗
PubMed1998

Transport characteristics of peptidomimetics. Effect of the pyrrolinone bioisostere on transport across Caco-2 cell monolayers.

PURPOSE: To compare the permeation characteristics of amide bond-containing HIV-1 protease inhibitors and their pyrrolinone-containing counterparts across Caco-2 cell monolayers, a model of the intestinal mucosa. METHODS: Transepithelial transport and cellular uptake of three pairs of amide bond-containing and pyrrolinone-based peptidomimetics were assessed in the presence and absence of cyclosporin A using the Caco-2 cell culture model. The potential of the peptidomimetics to interact with biological membranes was estimated by IAM chromatography. RESULTS: In the absence of cyclosporin A, apical (AP) to basolateral (BL) flux of all compounds studied was less than the flux determined in the opposite direction (i.e., BL-to-AP). The ratio of the apparent permeability coefficients (Papp) calculated for the BL-to-AP and AP-to-BL transport (P(BL-->AP)/P(AP-->BL)) varied between 1.7 and 36.2. When individual pairs were ompared, P(BL-->AP)/P(AP-BL) ratios of the pyrrolinone-containing compounds were 1.5 to 11.5 times greater than those determined for the amide bond-containing analogs. Addition of 25 microM cyclosporin A to the transport buffer reduced the P(BL-->AP)/P(AP-->BL) ratios for all protease inhibitors to a value close to unity. Under these conditions, the amide bond-containing peptidomimetics were at least 1.6 to 2.8 times more able to permeate Caco-2 cell monolayers than were the pyrrolinone-containing compounds. The intrinsic uptake characteristics into Caco-2 cells determined in the presence of 25 microM cyclosporin A were slightly greater for the amide bond-containing protease inhibitors than for the pyrrolinone-containing analogs. These uptake results are consistent with the transepithelial transport results determined across this in vitro model of the intestinal mucosa. CONCLUSIONS: The amide bond-containing and pyrrolinone-based peptidomimetics are substrates for apically polarized efflux systems present in Caco-2 cell monolayers. The intrinsic permeabilities of the amide bond-containing protease inhibitors are slightly greater than the intrinsic permeabilities of the pyrrolinone-based analogs through Caco-2 cell monolayers.

Biological Transport↗
PubMed1998

Increased activity of 16-membered lactone ring macrolides against erythromycin-resistant Streptococcus pyogenes and Streptococcus pneumoniae: characterization of South African isolates.

The susceptibility of 40 erythromycin-resistant isolates of Streptococcus pyogenes and 40 multiply-resistant isolates of Streptococcus pneumoniae to six macrolide antibiotics, representing 14-, 15- and 16-membered lactone ring structures, was tested. The genetic basis for macrolide resistance in the strains was also determined. Both erm and mef determinants were encountered in the 36 S. pneumoniae isolates tested, but only mef in the five S. pyogenes isolates tested. All isolates showed cross-resistance among the 14-membered macrolides erythromycin, clarithromycin and roxithromycin and the 15-membered macrolide, azithromycin. However, the erythromycin-resistant S. pyogenes isolates retained full susceptibility to spiramycin and josamycin (16-membered agents). These latter two antibiotics were also more active than the other macrolides against erythromycin-resistant S. pneumoniae isolates, especially josamycin which was 8-64 times more active than erythromycin; spiramycin was only two to eight times more active than erythromycin.

Anti-Bacterial Agents↗
PubMed1995

Integrated development of a knowledge-based CPR system for quality assurance in diabetes outpatient clinics.

Many approaches for the development of computer-based patient record (CPR) systems consider only implicitly the inferences a user wants to accomplish in using the system. However, the integration of knowledge-based support into the routine work flow requires an explicit model of the inferences during routine work. Such a model helps to structure the interface of the system and to identify those inference steps which could benefit from knowledge-based support. This paper describes the approach used in developing a CPR system taking into account its future role as a platform for the integration of knowledge bases into routine work.

Ambulatory Care Facilities↗
PubMed1994

Death of neurons in the neonatal rodent and primate globus pallidus occurs by a mechanism of apoptosis.

We have examined the developing rat, mouse and marmoset globus pallidus for evidence of cells dying by a process of "naturally occurring" or programmed cell death. We have demonstrated that cells in the developing mammalian globus pallidus die by a process of apoptosis and that by day 7 after birth many of the apoptotic cells possess a neuronal phenotype. Light microscopic and ultrastructural evidence of apoptotic cell death included cell shrinkage, blebbing of the extracellular membrane and condensation of the nuclear chromatin. Additionally we used an in situ nick translation method to assess the integrity of the DNA within the dying cells. This revealed that cells with the morphological characteristics of apoptosis also possessed fragmented DNA typical of cells undergoing Type 1 programmed or apoptotic cell death. The lack of lysosomal enzyme activity within the dying cells and the frequent observations of phagocytosis by neighbouring cells also suggest that the form of programmed cell death is apoptosis and not Type 2 autophagic degeneration. We found no evidence for cells dying by Type 3 non-lysosomal degeneration since all dying cells examined under the electron microscope possessed intact intracellular organelles and cell membranes. We developed a sensitive silver stain which detected balls of condensed chromatin within the apoptotic cells. This enabled identification of apoptotic cells in the developing globus pallidus at low magnification and so allowed us to map the numbers and distribution of dying cells with time. The incidence of apoptotic cells in the neonatal globus pallidus was greatest at birth and then declined such that few cells were detected at one week and none was seen in the adult rat. Although the loss of large numbers of cells in the developing nervous system is a well documented phenomenon, there are only a limited number of reports of the mechanism by which neuronal cells die, and few of these are in the developing mammalian brain. There are at least four different morphological categories of neuronal cell death which are discriminated on morphological and biochemical criteria. Our analysis suggests that apoptotic or Type 1 cell death is the major form of programmed cell death occurring in the mammalian globus pallidus in the first week of life. This report also describes the use of two methods for the ready identification of apoptotic cells at the light microscope level. Because these methods are suitable for use on tissue sections they provide a means to assess the incidence of apoptotic cell death, in parallel with other analyses of the expression of gene products which control cell fate.

Acid Phosphatase↗
PubMed1992

[Necrosis of the tongue in temporal arteritis. Case report].

Because of the rich blood supply ischemic necrosis of the tongue is extremely rare. But if it happens though, the reason is most often due to temporal arteritis. It predominantly occurs in elderly women, like in our case. The correct diagnosis should be established as soon as possible because high-dose cortisone therapy both relieves the patient's complaints and prevents life-threatening complications.

Aged↗
PubMed1986

[Modern aspects of contraception].

As the ideal contraceptive has not been found after a quarter century of global contraception research, this is an attempt to assess the advantages and drawbacks of the so-called "safe" methods of contraception currently in use. The most persuasive arguments in favour of oral contraceptives which other reversible methods cannot claim are their unsurpassed safety as well as the simplicity of their application. The disadvantage of potential damages through the perennial intake of hormones can be minimized with the low dosages of modern compounds. Recommendations are made concerning the controlled use of the various kinds of ovulation-inhibitors. Likewise, the use of ovulation-inhibitors with adolescents, at the end of reproductive age, and with women afflicted with diabetes mellitus are discussed. Advantages and drawbacks of contraception through the exclusive use of progestagen are briefly stated. Despite good applicability in single cases, intrauterine contraception should rather be viewed as a second choice only. Yet the standard problems, such as menstrual disturbances, increased tendency toward inflammations and individual incompatibility remain unsolved. Moreover, the rate of failure of 3% is ten times as high as with the ovulation-inhibitors. In their instructions some producers recommend too short a period of placement of the device in the uterus. Most IUD's can stay in place for a longer period of time. Repeated references to the possible complications of the use of IUD's with nulliparous women are made. As an emergency method to prevent a pregnancy after intercourse without contraceptives a hormonal method as well as the post-coital insertion of an IUD are discussed. After completed family planning the definitive sterilization presents itself as the ideal method of contraception, either through tubal sterilization in case of the woman, or vasectomy in case of the man. Rates of complications, failure rates, and chances of reversibility of both methods are specified.

Austria↗
PubMed1986

[Formation and transport of ozone and other photochemical oxidants].

Photochemical oxidants (O3, PAN, HCHO) are the typical pollutants in photochemical Smog. They can be formed as the result of the sunlight induced oxidation of precursor pollutants emitted into the atmosphere (NOx, CxHy). Other important precursor substances and reactive intermediates are compounds of the organic hydroxyl group (-O-H, for instance the methoxy radical CH3O), hydroxyl radical .OH, hydroperoxy radical HO2, and singlet oxygen O. For the production of photochemical oxidants in smog, especially ozone, NOx primarily act as catalysator. But CxHy serve as "combustibles". The quantities of the several formed photooxidants are mainly dependent on intensity and duration of daily sunshine, temperature, oxidant concentrations at the beginning of a build-up period, and on emission rates and concentrations of primary pollutants (NO, CxHy). Maximum mixing ratios of secondary pollutants often occur at certain distances downwind of primary pollutant sources, dependent on meteorological conditions (wind velocity, rel. humidity, etc.) and on rate constants for oxidant formation cycles. During the period of July 5 to 11, 1984, for instance, 6 kilometers SW from Zürich we found maximum ground-level mixing ratios of about 150 ppbv ozone, 4 ppbv PAN and 9 ppbv formaldehyde, that is 5 (ozone) to 10 (PAN) times above the supposed oxidant concentrations of unpolluted continental air. The increase in ozone in the late morning and early afternoon is accompanied by an increase in PAN and HCHO and by a decrease in NOx. This shows that in this case HCHO originates from photochemical reactions rather than being emitted directly to the atmosphere from vehicles.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetates↗