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Biomedical subjects

W Weidner

Publications and source records attributed to W Weidner.

At least 37 records · Page 2Linked to original sources
PubMed2005

The role of antibiotics in chronic bacterial prostatitis.

The role of antibiotic treatment in prostatitis is described. The selection of an appropriate antimicrobial agent with optimal pharmacokinetics for prostatic secretion and tissue is important, particularly in chronic bacterial prostatitis (CBP). The theoretical background of drug penetration into the prostate is outlined, emphasising the phenomenon of ion trapping and the role of non-ionic diffusion of weak acids, bases and amphoteric drugs across biological membranes with a pH gradient. Determination of drug concentrations in human prostatic secretion is problematic because of possible urinary contamination. Studies have been carried out mainly in healthy volunteers. The results must be interpreted with caution if no care was taken to rule out or at least to identify urinary contamination. Analysing the concentrations of various fluoroquinolones in prostatic and seminal fluid as well as in prostatic tissue, it becomes obvious that the fluoroquinolones differ not only in plasma concentrations but also in their penetration to these sites. In spite of intensive investigations, our knowledge is still limited regarding the mechanisms that govern the transport of antibiotics into and their activity in the various prostatic compartments and how these findings can be applied clinically. Nevertheless, the concentrations at the site of infection of most of the fluoroquinolones should be sufficient for the treatment of CBP and vesiculitis caused by susceptible pathogens.

Anti-Bacterial Agents↗
PubMed2005

Emergence of antibiotic resistance amongst hospital-acquired urinary tract infections and pharmacokinetic/pharmacodynamic considerations.

Bacterial urinary tract infections (UTIs) are frequent infections in the nosocomial setting. Nosocomial UTIs are almost exclusively complicated UTIs, although the complicating factors may be very heterogenous. The bacterial spectrum of nosocomial UTIs is broad and antibiotic resistance is common. The results of international and national surveillance studies on the bacterial spectrum and antibiotic resistance of nosocomial uropathogens are provided. The treatment of nosocomial UTIs encompasses treatment of the complicating factors as well as antimicrobial chemotherapy. At least in serious UTIs, adequate initial antibiotic therapy results in lower mortality. Therefore, the initial antibiotic regimen must provide sufficient antibiotic cover. However, this can only be achieved if the bacterial spectrum and antibiotic resistance patterns of uropathogens in the institution are followed continuously. Provisional microbiological findings, such as reports on Gram stain or certain biochemical results, can lead to early stratification of pathogens and allow more tailored empiric antibiotic therapy. Antibiotic therapy of nosocomial UTIs has to consider two different aspects: (1) therapeutic success in the individual patient; and (2) prevention of emergence of antibiotic-resistant mutants. The emergence of resistance can possibly be lowered by adequate drug selection and dosing. Increasing antibiotic resistance requires more prudent use of antimicrobial drugs.

Anti-Infective Agents, Urinary↗
PubMed2005

Influence of motility and vitality in intracytoplasmic sperm injection with ejaculated and testicular sperm.

The vitality of spermatozoa used for intracytoplasmic sperm injection (ICSI) is a crucial factor for fertilization, establishment and outcome of a pregnancy in assisted reproductive technique cycles. The sperm origin may also be a limiting factor, although little is known about this issue. It is known that the motility of injected spermatozoa and their origin from ejaculate or testicular biopsies are important predictors in terms of fertilization, pregnancy and birth rates. Oocytes of patients in 2593 cycles were retrieved in our in vitro fertilization programme and inseminated via ICSI. We used motile (group 1, n = 2317) or immotile ejaculated spermatozoa (group 2, n = 79), motile sperm retrieved from testicular biopsies (group 3, n = 62) and immotile spermatozoa from testicular biopsies (group 4, n = 135). Female age and number of oocytes retrieved did not differ significantly among the groups. The fertilization rates were as follows: 67.1% in group 1, 49.8% in group 2, 68.3% in group 3 and 47.8% in group 4. The pregnancy rates in cases where three embryos had been transferred amounted to 35.7% in group 1, 17.3% in group 2, 38.3% in group 3 and 20.5% in group 4. The embryo quality showed no differences between groups 1 and 3 (14.5), and between groups 2 (11.8) and 4 (10.8). The abortion rate was similar in groups 1-3, but increased in group 4 (26.6%, 27.3%, 31.6% and 55.5%). Irrespective of their origin, the fertilization potential of injected spermatozoa was found to be influenced by motility. The resulting pregnancy and birth rates, i.e. the potential of the resulting embryos to implant and to achieve viable pregnancies, seem to be additionally dependent on the sperm origin. This was well shown by declining rates when spermatozoa in a relatively early stage of maturity had been used. We see increasing evidence that the degree of sperm maturity has an important impact on the outcome of ICSI. In obstructive azoospermia, spermatozoa retrieved from the epididymis should be used rather than testicular biopsy spermatozoa, or testicular sperm should be preincubated in culture medium before ICSI.

Adult↗
PubMed2005

Apoptosis in non-tumorous adult human testis tissue. Comparison of so-called 'normal' testis tissues.

INTRODUCTION: Apoptosis seems to play an important role in tumorigenesis, prognosis and therapy of testicular tumors. To understand its biological significance, it is important to quantify the amount of apoptosis and to compare the rate of apoptosis to that of a normal, unaffected reference tissue. Usually tissue from the unaffected site of the testis in patients with testicular cancer or testis tissue from patients who underwent surgical castration due to prostate cancer is used as the reference tissue. However it is not known, if both tissues are equivocal with respect to their apoptotic index. The purpose of the study was to compare the two most often used reference tissues for the quantification of apoptosis in testicular tissues with regard to their apoptotic index. MATERIALS AND METHODS: The apoptotic indices of both tissues were compared, using two standard apoptosis detection methods, i.e. in situ end labeling and a morphological approach. RESULTS: The apoptotic index in testis tissue from patients who were surgically castrated for anti-hormonal treatment of prostate cancer was shown to be significantly higher than the apoptotic index of tumor free but tumor-associated testicular tissue of testis cancer patients. There was a strong relationship between the apoptotic index and the age of the patients. CONCLUSION: Although there might be genetic changes in the tumor-associated testicular tissue influencing the apoptotic index, it seems advisable to use tumor-associated tissue rather than testis tissue of patients with prostate cancer as the reference tissue, due to the significant age dependence of the apoptotic index.

Adult↗
PubMed2004

[Sexual disorders in the aging male].

Sexual dysfunction in the aging male has only recently found widespread attention. As apposed to enduring conceptions of "asexual" elderly, recent representative surveys show that the majority of men maintain sexual wishes and fantasies into old age. Sexual activity primarily depends on the availability of a partner and on maintaining intimacy and sexuality in the face of changes in the sexual response cycle and increasing morbidity. Sexual dysfunctions in aging result from physical, psychological, partner-related changes and lifestyles. These should be considered in the diagnosis and treatment of sexual dysfunctions in the aging male.

Adolescent↗
PubMed2004

[Chronic pelvic pain and its comorbidity].

The diagnosis of chronic pelvic pain syndrome takes into account the fact that no clear etiology has been identified underlying chronic prostatitis and its associations with multiple somatic and psychological complaints. Based on a representative survey, this study enquires into the prevalence of pelvic pain in the community, its association with sexual dysfunction, somatic complaints and aging. Of the 770 men surveyed, 60 (7.8%) fulfilled the criteria for pelvic pain syndrome. This was assessed by a validated Giessen Prostatitis Symptom Score. Sexual dysfunction (particularly erectile dysfunction and loss of libido) were more frequently reported by men with pelvic pain than by men without a pain syndrome. The great majority of men afflicted by pelvic pain complained of additional pain symptoms (particularly back and joint pain) and fatigue. While sexual and somatic complaints were age-associated in the asymptomatic men, this was not the case for the symptomatic men. Our findings stress the fact that chronic pelvic pain syndrome is a major health problem in middle and late adulthood in men. Differentiated knowledge about comorbidity is a prerequisite for developing new interdisciplinary approaches to the diagnosis and therapy of this to date unsatisfactorily treated syndrome.

Adolescent↗
PubMed2004

[Symptoms or complaints in the aging male--which questionnaires are available?].

Age associated hypoandrogenism and related changes in sexual function, as well as multiple physical complaints, and affective and cognitive changes have all been described in the aging male. In addition to decreased testosterone levels, clinical symptoms are required in order to perform substitution therapy. The assessment of symptoms and complaints in the aging male is discussed based on scientific test criteria. Commonly used questionnaires have the advantages of economy and independence from the investigator. In order to cover the broad range of age associated changes, numerous standardized and reliable procedures are available. However, these have usually not been developed specifically in order to assess androgen dependent changes. Preliminary, specific "aging male" questionnaires do not correlate reliably with the levels of testosterone. Thus there is a need for research and development in order to identify and assess androgen dependent complaints.

Age Factors↗
PubMed2004

Possible hemodynamic pathways of intraurethral prostaglandin-E1 (MUSE).

Intraurethral application of prostaglandin-E1 (MUSE) is a well-tolerated pharmacotherapy for erectile dysfunction. However, the physiological mechanisms of drug transfer into the cavernous bodies are not completely clear. Using spongiosography in 35 patients, our study tried to elucidate existing shunt mechanisms. The X-rays show venous drainage through the deep dorsal vein up to the plexus Santorini. The circumflex veins are also contrasted and the cavernous bodies show opacification in their distal portion only. Structures shunting directly between the corpus spongiosum and the cavernous bodies were not demonstrable. Retrograde filling of the cavernous bodies through the deep dorsal vein and its circumflex braches seems to be the most relevant way of drug transfer after intraurethral application of prostaglandin-E1. Diffusion into the cavernous bodies or a systemic mechanism of action does not seem probable.

Adolescent↗
PubMed2004

Periurethral abscess formation due to Neisseria gonorrhoeae.

Abscess formation secondary to chronic urethritis of the posterior male urethra caused by Neisseria gonorrhoeae has become an atypical and rare urological complication. Periurethral abscess formation has been reported to be associated with gonococcal infections, but in such rare cases a delay in the diagnosis of gonococcal infection seems to have been the cause for this periurethral complication. A case with a primary diagnosis of periurethral abscess with N. gonorrhoeae infection is reported--successful treatment included transurethral incision and antibiotic therapy.

Abdominal Abscess↗