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  • 1
    Electronic Resource
    Electronic Resource
    Intestinale Permeabilität bei Patienten mit erworbenem Immundefekt — Syndrom (AIDS) (1991)
    Springer
    Journal of molecular medicine 69 (1991), S. 715-721 
    Details
    ISSN: 1432-1440
    Keywords: Intestinal permeability ; AIDS ; HIV-enteropathy ; Lactulose/rhamnose-ratio ; Crohn's disease ; Ulcerative colitis ; Celiac disease ; Small bowel
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Intestinal permeability has been assessed as a parameter of the small intestinal barrier function in 33 patients with AIDS (WR 6), in 25 healthy volunteers, 32 patients with Crohn's disease, 18 patients with ulcerative colitis and in 12 patients with untreated coeliac disease. Permeability was measured by means of the 5 hour urinary excretion of lactulose and rhamnose after administration of these sugars (1 g rhamnose, 10 g lactulose) which allowed to calculate the urinary lactulose/rhamnose — ratio (L/R-r) as an index of intestinal permeability. Compared to the controls (L/R-r=0,014±0,010) patients with AIDS had significantly increased lactulose/rhamnose — ratios (0,189+0,164;p〈0.01) indicating abnormal permeation both of lactulose and rhamnose. This alteration of intestinal permeability was more pronounced than the significant increase of the L/R-r in the patients with either Crohn's disease or coeliac disease. However, intestinal permeability was not altered in the patients with ulcerative colitis. Among the patients with AIDS, the most abnormal permeability ratios were observed in two subjects with intestinal cryptosporidiosis. This investigation demonstrates by means of the “double sugar ratio”, that intestinal permeability in patients with AIDS is highly abnormal, the impairment being even more abnormal than in patients with other small intestinal disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01649441
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  • 2
    Electronic Resource
    Electronic Resource
    AIDS-free survival and overall survival in HIV infection: the new CDC classification system (1993) for HIV disease and AIDS (1994)
    Springer
    Journal of molecular medicine 72 (1994), S. 283-287 
    Details
    ISSN: 1432-1440
    Keywords: Acquired immunodeficiency syndrome ; Natural history ; Survival ; Classification system
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The clinical history of 1538 HIV positive patients was analyzed on the basis of the new CDC classification system of HIV disease and AIDS. This classification system combines three CD4 cell categories (1, 2, and 3) with three clinical categories (A, B, and C) into nine subgroups AI–C3. We examined the overall survival for all subgroups and the AIDS-free survival for subgroups Al–B3. AIDS-free survival for patients in subgroups Al, A2, and B1 was considerably longer than survival in patients from subgroups A3, B2, and B3 (P 〈 0.0001). According to these findings, the new CDC classification system could be simplified into three stages, stage I and II comprising the above mentioned six subgroups, and stage III comprising clinical AIDS defining categories C1, C2, and C3. These three stages correspond to different periods in the management of HIV positive patients, i.e., period of observation, period of prophylaxis, and period of treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00180041
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  • 3
    Electronic Resource
    Electronic Resource
    Treatment of diarrhoea in human immunodeficiency virus-infected patients with immunoglobulins from bovine colostrum (1992)
    Springer
    Journal of molecular medicine 70 (1992), S. 588-594 
    Details
    ISSN: 1432-1440
    Keywords: Diarrhoea ; Colostrum-acquired immunodeficiency syndrome ; Human immunodeficiency virus ; Cryptosporidiosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Diarrhoea and weight loss are found in more than 50% of patients with the acquired immunodeficiency syndrome (AIDS). In some patients the symptoms can be very severe, leading to death even in the absence of opportunistic infections. In 30% of these patients, enteric pathogens cannot be identified, and approximately only half of the identifiable aetiologic agents of diarrhoea in patients infected with the human immunodeficiency virus (HIV) were treatable with antibiotics. Immunoglobulins from bovine colostrum (Lactobin, Biotest, Dreieich, FRG) contain high titers of antibodies against a wide range of bacterial, viral and protozoal pathogens as well as against various bacterial toxins. Lactobin (LIG) is quite resistant to 24-h incubation with gastric juice. In a multi-center pilot study 37 immunodeficiency patients with chronic diarrhoea [29 HIV-infected patients, 2 patients with common variable immunodeficiency (CVID), one unidentified immunodeficiency, five patients with graft versus host disease (GvHD) following bone marrow transplantation] were treated with oral LIG (10 g/day for 10 days). Good therapeutic effects were observed. Out of 31 treatment periods in 29 HIV-infected patients 21 gave good results leading to transient (10 days) or long-lasting (more than 4 weeks) normalisation of the stool frequency. The mean daily stool frequency decreased from 7.4 to 2.2 at the end of the treatment. Eight HIV-infected patients showed no response. The diarrhoea recurred in 12 patients within 4 weeks (32.4%), while 19 patients were free of diarrhoea for at least 4 weeks (51.3%). In 5 patients intestinal cryptosporidiosis disappeared following oral LIG treatment. LIG treatment was also beneficial in 4 out of 5 GvHD patients. No serious side effects were recorded in any of the treated patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00184800
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  • 4
    Electronic Resource
    Electronic Resource
    Elimination of bacteria in biliary tract infections during ceftizoxime therapy (1982)
    Springer
    Infection 10 (1982), S. 67-70 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei sechs Patientinnen mit Choledocholithiasis wurde wegen drohender Steineinklemmung eine transpapilläre Verweilsonde gelegt. In der durch die Sonde entnommenen Galle waren sechsmalEscherichia coli und in je einem Fall zusätzlichKlebsiella sp. bzw.Salmonella sp. nachweisbar. Alle Keime waren gegenüber Ceftizoxim empfindlich (die MHK lag zwischen 0,007 und 0,06 mg/l). Vor und unter der Behandlung wurden die Keimzahlen in der Galle mittels Membranfiltration bestimmt. In allen sechs Fällen kam es zu einem raschen Rückgang der Erreger in der Galle. Die gleichzeitig bestimmten Gallespiegel betrugen ein Vielfaches der MHK von Ceftizoxim gegenüber den entsprechenden Erregern. Insgesamt war das Behandlungsergebnis von Ceftizoxim gut. Drei der acht Keime waren nach acht bzw. 24 Stunden aus der Galle eliminiert. In einem Fall war es nach 24 Stunden zu einem Erregerwechsel gekommen. Nach 48 Stunden waren vier von acht vor der Behandlung in der Galle nachweisbaren Erregern eliminiert. Nach 72 Stunden war die Keimzahl bei sechs Patientinnen kleiner als 10 Keime pro ml. Bei zwei Patientinnen war es zu einem Erregerwechsel gekommen; bei einer Patientin mußte die Behandlung nach der ersten Injektion wegen Urtikaria abgebrochen werden.
    Notes: Summary A transpapillary indwelling catheter was inserted to prevent stone impaction in six female patients who were suffering from choledocholithiasis. The bile withdrawn via the catheter was infected on six occasions withEscherichia coli. In one of these casesKlebsiella sp. and in anotherSalmonella sp. were also identified. All bacteria were sensitive to ceftizoxime (the MIC was between 0.007 and 0.06 mg/l). The bacterial counts in the bile were determined before and during treatment by means of membrane filtration. In all six cases there was a rapid decline in the colony count. The concentration of ceftizoxime in bile samples was several times higher than the MIC of ceftizoxime for the corresponding pathogens. Overall, the therapeutic results with ceftizoxime were good. Three of eight pathogens were eliminated from the bile within eight to 24 hours. In one case a change of pathogen was seen after 24 hours. Forty-eight hours after beginning treatment, four of eight pathogens had been eliminated from the bile. After 72 hours the colony count in six patients was less than 10 pathogens/ml. In two patients a change of pathogen occurred; in one patient treatment had to be stopped after the first injection because of urticaria.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01816726
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  • 5
    Electronic Resource
    Electronic Resource
    Markers for HIV-disease progression in untreated patients and patients receiving AZT: Evaluation of viral activity, AZT resistance, serum cholesterol, β2-microglobulin, CD4+ cell counts, and HIV antigen (1991)
    Springer
    Infection 19 (1991), S. S77 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Um Parameter zu finden, die es erlauben, den klinischen Status HIV-Infizierter exakt zu bestimmen, wurden die Virusanzucht auf Lymphozyten und Makrophagen, CD4+-Zellzahlen, Cholesterin-Werte, β2-Mikroglobulin-Spiegel und virales Antigen hinsichtlich ihres prädiktiven Wertes verglichen. Wie bereits für die Virusanzucht auf Lymphozyten beschrieben, war auch die HIV-Kultur auf Makrophagen vom Gesundheitszustand der Patienten (bestimmt nach CDC) abhängig und hat somit hohen prädiktiven Wert. Eine multivariante Diskriminanzanalyse zeigte, daß das Ergebnis der Viruskultur unabhängig vom Zellsystem durch eine Kombination von β2-Mikroglobulin, Virusantigen, CD4+-Zellzahlen und HDL-Cholesterin-Werten zu 80% voraussagbar ist. HDL-Cholesterin verdient daher, als neuer prognostischer Parameter weiter erforscht zu werden. Die Analyse von HIV-Isolaten aus AZT-behandelten Patienten zeigte eine 20–200- fachein vitro Resistenz gegenüber der Substanz nach sieben bis 24 Monaten der Therapie. Sequenzbestimmungen bei einem der 100fach resistenten Isolate ergaben nur zwei der in der Literatur beschriebenen Aminosäure-Austrausche und eine neue Mutation (Val60 zu Ile) in einem Virus nach 32 Monaten der Therapie.
    Notes: Summary In order to find parameters which allow the assessment of the clinical state of HIV patients with or without antiviral therapy, viral cultures on lymphocytes and monocytes/macrophages, CD4-cell counts, HIV antigen, β2-microglobulin and serum cholesterol were evaluated for their predictive value. As had been shown previously for lymphocytes, the efficiency of viral isolation on macrophages also depends on the disease stage (CDC) of the patients and thus has a high predictive value. A multivariant discriminant analysis showed that the combination of β2-microglobulin, viral antigen, CD4+ cell count and HDL cholesterol predicted the outcome of viral cultures with 80% accuracy. While viral antigen, CD4+ cell counts and β2-microglobulin had been known, HDL cholesterol deserves further evaluation as prognostic parameter. The analysis of HIV derived from patients with AZT showed a 20–200-foldin vitro drug resistance after seven to 24 months of therapy. DNA sequence determination of such strains isolated from AZT patients over time showed only two of the amino acid exchanges described in the literature for resistant strains and an additional Val60-Ile transition after 32 months of therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01644472
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  • 6
    Electronic Resource
    Electronic Resource
    Fluconazole prophylaxis of recurrent oral candidiasis in HIV-positive patients (1991)
    Springer
    European journal of clinical microbiology & infectious diseases 10 (1991), S. 917-921 
    Details
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In a randomized, open study, the efficacy of fluconazole as a prophylaxis of recurrent oral candidiasis in patients with advanced stages of HIV-infection (CD4 cell count〈100/mm3) was studied. For this purpose, the frequency of episodes of oral candidiasis during two different prophylaxis regimens (50 mg/day vs. 100 mg/day) were compared to an untreated control group. Sixty-five HIV-positive patients were included in the study from May, 1989 to January, 1990. Of these, 58 were evaluated over an observation time of 137–215 days. Prophylaxis with fluconazole clearly reduced the occurrence of oral candidiasis. In 20 out of 21 patients in the untreated control group, a total of 60 relapses occurred. In the prophylaxis group receiving 50 mg/day (group 2), two out of 18 patients had four relapses. In the group receiving 100 mg/day (group 3), four out of 19 patients had nine relapses in total. Of 3575 observation days in the control group, treatment due to oral candidiasis was necessary on 393 days (28 %). In group 2, on 57 of 3316 days (2 %), fluconazole in a higher dosage was administered for treatment. In group 3, relapse treatment with fluconazole 200 mg/day, or treatment with ketoconazole, became necessary in 116 out of 3314 observation days (3 %). In all relapses,Candida albicans cfu〉103/ml were isolated in the oral wash-outs. As compared to the untreated control group, fluconazole prophylaxis in a daily dosage of 50 as well as 100 mg led to significantly less frequent relapses of oral candidiasis (p〈0.01). The lower dosage of 50 mg/day, as compared to the higher dosage of 100 mg/day, resulted in no significant difference in the frequency of relapses (p=0.66). The fact that the patient gains more quality of life by longer symptom-free periods outweighs the disadvantages emerging from increased drug intake and higher costs.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02005444
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