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  • 1
    Electronic Resource
    Electronic Resource
    Antimyotonic therapy with tocainide under ECG control in the myotonic dystrophy of curschmann-steinert (1985)
    Springer
    Journal of neurology 232 (1985), S. 271-274 
    Details
    ISSN: 1432-1459
    Keywords: Antimyotonic treatment ; Tocainide ; Myotonic dystrophy ; 24-h ECG ; ECG
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Ten patients suffering from advanced myotonic dystrophy with severe myotonic symptoms were treated with 800–1200 mg/day of the anti-arrhythmic drug tocainide (Xylotocan). All patients reported a marked subjective improvement of myotonia, which was confirmed by objective tests. Except for a slight QT-prolongation in one patient, the ECG was not significantly altered by the treatment. Twenty-four-hour ECG after treatment disclosed that pre-existing ventricular arrhythmia disappeared in three cases. The occurrence of complex ventricular arrhythmia in two patients under treatment was not necessarily due to specific effects of the drug but might be explained by the high spontaneous variability of rhythm disorders. In these patients suffering from myotonic dystrophy with typical cardiomyopathy no deleterious effects of the drug were observed, especially no cardiac arrhythmias which would have necessitated interruption of treatment. Therefore, the authors recommend symptomatic therapy with tocainide for myotonia and paramyotonia congenita, as well as in myotonic dystrophy patients suffering from marked myotonic stiffness. ECG and 24-h ECG should be carefully recorded as necessary in any treatment with anti-arrhythmic drugs.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00313863
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  • 2
    Electronic Resource
    Electronic Resource
    Haemodilution therapy in ischaemic stroke: Plasma concentrations and plasma viscosity during long-term infusion of dextran 40 or hydroxyethyl starch 200/0.5 (1987)
    Springer
    European journal of clinical pharmacology 31 (1987), S. 705-710 
    Details
    ISSN: 1432-1041
    Keywords: dextran ; hydroxyethylstarch ; haemodilution ; ischaemic stroke ; plasma viscosity ; pharmacokinetics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary In 21 patients with ischaemic strokes we have monitored plasma viscosity, total plasma concentration, numeric average molecular weight (Mn), and weight average molecular weight (Mw) of Dextran 40 (dextran) and hydroxyethylstarch 200/0.5 (HES) during 10 days of treatment (days 1–4, 2×500 ml; days 5–10, 1×500 ml). Plasma concentrations of dextran increased during the first 4 days (8.3 mg·ml−1 on the first day to 18.0 mg·ml−1 on the fifth day), reached an apparent steady state of 17.2 mg·ml−1 during the next 6 days, and declined subsequently with a half-time (t1/2) of 4.03 days. After ten days treatment Mn and Mw were shifted towards higher values. Plasma viscosity increased from 1.26 mPas to 1.69 mPas on Day 10 (p〈0.01) and was linearly correlated with the total plasma concentration of dextran (p〈0.001; r=0.88). Total plasma concentrations of HES averaged 11.7 mg·ml−1 on Day 1 and 12.4 mg·ml−1 on Day 5. The molecular weight distribution did not change during the infusions but decreased in comparison with the administered solution. Plasma viscosity fell from 1.40 mPas to 1.30 mPas at Day 10 (p〈0.05) and was not related to the concentration of HES. The haemodiluting effect, as indicated by a decrease of the haematocrit, was 22% and 16.8% for dextran and HES respectively. These data suggest several advantages of HES compared with dextran in haemodilution therapy of ischaemic stroke.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00541299
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  • 3
    Electronic Resource
    Electronic Resource
    Beta-blockade in acute aneurysmal subarachnoid haemorrhage (1993)
    Springer
    Acta neurochirurgica 121 (1993), S. 119-122 
    Details
    ISSN: 0942-0940
    Keywords: Subarachnoid haemorrhage ; autonomic deregulation ; beta-blockade ; metoprolol
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effects of beta-blockade to prevent autonomic disorders after acute aneurysmal subarachnoid haemorrhage were prospectively investigated. 11 patients were treated with the beta-1-selective beta-blocker metoprolol (up to 200 mg/die intravenously). 14 patients received standard therapy as controls. Pulse rate, blood pressure and dosage of the additional antihypertensive medication as signs of sympathetic disturbance were registered. The main result was the normalizing of the pulse rate especially during the first two weeks in contrast to the control group. The patients in the beta-blocker group did not need further antihypertensive medication. This was mainly a result of the reduction in sympathetic activation. No severe side-effects were documented and the survival was better in the treated group. Thus, beta-blockade is able to prevent and reduce autonomic disorders, especially activation of the sympathetic tone, in subarachnoid haemorrhage. Metoprolol as a so called cardioselective beta-blocker seems to be one of the suitable agents and is considered superior to the non-selective agents.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01809261
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  • 4
    Electronic Resource
    Electronic Resource
    Toscana virus infection in german travellers returning from the mediterranean (1997)
    Springer
    Infection 25 (1997), S. 325-325 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01720413
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  • 5
    Electronic Resource
    Electronic Resource
    The Erve Virus: Possible Mode of Transmission and Reservoir (2000)
    Springer
    Infection 28 (2000), S. 164-166 
    Details
    ISSN: 1439-0973
    Keywords: Key Words Erve virus ; Lyme disease ; Transmission ; Reservoir
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The Erve virus is suspected to cause severe headache in humans, lasting several days (thunderclap headache). Mice are characterized as a probable reservoir for the Erve virus. We tested 396 wild mice for Erve virus using an immunofluorescence test and found Erve virus antibodies in five cases, showing that small mammals form a reservoir for Erve virus. If ticks are the vector for the virus, a coincidence with borreliosis should exist. We were unable to confirm this in a homogeneous cohort of 955 young men, 62 of whom tested positive for borreliosis. This group did not test positive significantly more often in the immunofluorescence test than a gender- and age-matched control group.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s150100050072
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  • 6
    Electronic Resource
    Electronic Resource
    Tick-borne encephalitis diagnosis in patients with inflammatory changes in the cerebrospinal fluid in a region with very low prevalence (1996)
    Springer
    Infection 24 (1996), S. 400-402 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung FSME-IgG-Antikörper werden zum serologischen Nachweis eines Antigen-Kontaktes infolge einer Infektion oder einer Immunisierung verwendet. In dieser Untersuchung wurde der ELISA bei einer Risikogruppe von Patienten mit entzündlichen Liquorveränderungen mit Hilfe eines Western Blot verifiziert. Ein FSME-IgG-ELISA ergab bei 47 der 904 untersuchten Seren einen positiven Befund. Eine Western-Blot-Untersuchung bestätigte dieses Ergebnis in nur 31,8% der Fällen. Bei 134 der 904 Untersuchten ergab die ELISA-Testung ein grenzwertiges Ergebnis. Bei 5,5% dieser Seren reagierte der Western-Blot spezifisch. 723 Seren waren im ELISA negativ. Von 15 zufällig aus diesen 723 ausgewählten Proben war keine im Western-Blot positiv. Die hohe Zahl falsch positiver ELISA-Ergebnisse kann durch die hochselektionierte Patientengruppe und die niedrige FSME-Prävalenz in der untersuchten Region erklärt werden. Bei Patienten mit einer Meningitis oder Enzephalitis sollte bei positiven ELISA-Testergebnissen und uncharakteristischer klinischer Symptomatik an die Möglichkeit von unspezifischen Reaktionen mit Entzündungsmediatoren oder an Kreuzreaktionen mit anderen Flaviviridae gedacht werden. Die “ELISA-Diagnose” einer FSME sollte daher sowohl anamnestisch und klinisch als auch mit weiterführenden serologischen Untersuchungen (Western-Blot, Hämagglutinationstest, Neutralisationstest) überprüft werden.
    Notes: Summary Tick-borne encephalitis (TBE)-IgG antibodies are used for the serologic detection of antigen contact caused by TBE infection or immunization. In the present study, enzyme-linked immune sorbent assay (ELISA) results from a group of patients with inflammatory changes in the cerebrospinal fluid (CSF) were re-examined using Western blot technology. The result of the TBE-IgG-ELISA was positive in 47 of the 904 sera samples tested. Retesting the sera with a Western blot confirmed this result in only 31.8% of the positive cases. In 134 of the 904 sera, the ELISA result was borderline. In 5.5% of these sera, the Western blot reacted specifically. The remaining 723 sera samples tested negative with the ELISA. Of these sera, 15 were selected randomly and retested with the Western blot; none of them tested positive. The high number of false positive ELISA results can be explained by the highly selected group of patients and the low prevalence of TBE in the region studied. In patients with meningitis or encephalitis with positive ELISA results and uncharacteristic clinical symptoms, the treating physician should consider the possibility of nonspecific reactions involving inflammatory mediators or cross-reactivity with other flaviviruses. The ELISA-mediated diagnosis of TBE should therefore be verified by means of the patient's history and clinical symptoms, as well as further serologic tests including the Western blot, the hemagglutination test and the neutralization test.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01716095
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  • 7
    Electronic Resource
    Electronic Resource
    Detection of the tick-borne encephalitis virus (TBEV) in ticks in several federal “Länder” of Germany by means of the polymerase chain reaction (PCR) — Characterization of the virus (1996)
    Springer
    Infection 24 (1996), S. 403-404 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Das Ziel der vorgelegten Studie ist die Einschätzung der aktuellen epidemiologischen Situation der Frühsommer-Meningoenzephalitis in den fünf neuen Bundesländern und im Saarland mit Hilfe des Nachweises von FSMEV-RNA in ungesogenen Zecken (Ixodes ricinus) durch eine RT-PCR-Technik. 22 273 Zecken wurden in den fünf neuen Ländern (einige auch in Bayern und Baden-Württemberg) gesammelt und in 294 Pools untersucht. Der spezifische RNA-Nachweis gelang viermal in Zecken aus Mecklenburg-Vorpommern, einmal in solchen aus Brandenburg und einmal aus Thüringen. In Bayern und Baden-Württemberg gelang der Virus-RNA-Nachweis dreimal. Die Sequenzdaten der PCR-Amplifikate zeigten, auch im Vergleich mit denen des Prototypstammes Neudoerfl, den hohen Grad der Konservierung im Bereich der 5′ NCR. 8780 saarländische Zecken aus allen Gebieten des Bundeslandes wurden in 21 Pools untersucht, positive PCR-Signale konnten in zwei Pools aus Saarlouis und Perl und Umgebung gefunden werden. Der relativ seltene FSMEV-RNA-Nachweis in den neuen Ländern und im Saarland berechtigt nicht, eine generelle Impfempfehlung für diese Gebiete zu geben. Ein Impfschutz sollte jedoch vor Einreise in die Endemiegebiete Bayerns und Baden-Württembergs bestehen.
    Notes: Summary The aim of the present study was to analyse the current epidemiological situation with respect to TBE in the new federal “Länder” of Germany and in Saarland through detection of the TBEV genome in unengorged ticks using an RT-PCR technique. 22,273 ticks (Ixodes ricinus) were collected in the five new “Länder” (and some in Bavaria and Baden-Württemberg) and divided into 294 pools. It was possible to detect TBEV RNA in six pools of ticks from Mecklenburg Western-Pomerania [4], Brandenburg [1], Thuringia [1] (and in three pools from Bavaria and Baden-Württemberg). The nucleotide sequence data of the PCR products were analysed and compared. In Saarland 8,780 ticks were collected in 70 habitats from all the geographic regions and analysed using the PCR in 21 pools; two pools produced positive PCR signals (Saarlouis, Perl). We cannot as a result make a general recommendation that TBE-immunization be introduced in Saarland and in the new federal Länder of Germany. In Germany, however, TBE immunoprophylaxis in Bavaria and Baden-Württemberg is very important.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01716096
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  • 8
    Electronic Resource
    Electronic Resource
    Diagnosis of tick-borne encephalitis: Evaluation of sera with borderline titers with the TBE-ELISA (1996)
    Springer
    Infection 24 (1996), S. 405-406 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Das Virus der Frühsommer-Meningoenzephalitis (FSME) zählt zur Familie der Flaviviridae. Verschiedene Viren dieser Familie zeigen untereinander starke serologische Kreuzreaktionen. Die Diagnostik von Flavivirus-Infektionen wird dadurch sehr erschwert, insbesondere bei Verwendung kreuzreagierender Teste, wie z. B. des ELISA. Wir testeten 238 im FSME-ELISA grenzwertig oder schwach positiv reagierende Seren mittles Indirekter Immunofluoreszenz oder Neutralisationstest gegen weitere Flaviviren (Gelbfieber-, Dengue-, West Nil Virus). Damit sollten mögliche kreuzreagierende Antikörper aufgrund vorangegangener Flavivirus-Infektionen oder Flavivirus-Impfungen ermittelt werden. Dabei reagierte eines der getesteten Seren mit allen Flavivirus-Antigenen positiv, ein Reaktionsmuster, das auf eine Flavivirus-Infektion (z. B. Dengue-Fieber) schließen läßt. Zwei weitere Seren reagierten schwach positiv nur gegen Gelbfieber, ein Hinweis auf eine zurückliegende Gelbfieber-Impfung. Alle anderen Seren zeigten keine Reaktivität in den von uns verwendeten Testen, ein Hinweis auf falsch positive Reaktionen im FSME-ELISA. Insbesondere Seren, die im FSME-ELISA niedrigtitrig reagieren, sollten in einem anderen Testsystem (vorzugsweise im Neutralisationstest) getestet werden zum Ausschluß von Kreuzreaktionen mit anderen Flaviviren und zur Bestätigung der Spezifität der nachgewiesenen Antikörper.
    Notes: Summary Tick-borne encephalitis (TBE) is a member of the Flaviviridae family. Strong cross-reactions can occur between members of this family, so that it may be difficult to diagnose specific flavivirus infections, especially when tests with frequent cross-reactions e. g. ELISA tests are used. We tested 238 sera with borderline titers for TBE using the indirect immunofluorescence or neutralization test for other flaviviruses (yellow fever, dengue, West Nile) to detect cross-reactions due to other flavivirus infections or flavivirus vaccination. Only one serum reacted against all the flaviviruses tested, indicating cross-reactivity due to infection with any of the flaviviruses. Two other sera exhibited low antibody titers against yellow fever, which could be confirmed by the neutralization test, indicating recent yellow fever vaccination. None of the other sera reacted at all against any of the flaviviruses tested in the tests used, which indicates false positive reactions with the TBE-ELISA. Sera with borderline titers in the TBE-ELISA in particular should be retested using other test systems (preferably neutralization) and for other flaviviruses (yellow fever, dengue, West Nile) to detect cross-reactions and to confirm positive results.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01716097
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  • 9
    Electronic Resource
    Electronic Resource
    Tick-borne encephalitis in the Saarland and the Rhineland-Palatinate (1996)
    Springer
    Infection 24 (1996), S. 242-244 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Das Saarland und Rheinland-Pfalz gelten nicht als Frühsommer-Meningoenzephalitis (FSME)-Endemiegebiete. Daher wurde in dieser Region nicht zu einer Impfung gegen FSME geraten und es wurde auch nur selten serologisch auf diese Krankheit untersucht. 1994 wurde in Baden-Württemberg eine deutliche Zunahme der Erkrankungsfälle registriert. Ferner wurde in diesem Jahr die erste im Saarland erworbene FSME dokumentiert. Zur Klärung der Frage, wie hoch das Infektionsrisiko für TBE im Saarland und Rheinland-Pfalz ist, wurden seit 1989 durchgeführte 2123 serologische FSME-Untersuchungen aufgearbeitet und 904 tiefgefrorene Seren von Patienten mit entzündlichen Liquorveränderungen serologisch nachuntersucht. Bei insgesamt 15 Patienten fanden wir IgG- und IgM-Antikörper gegen den Erreger der FSME. 4 Fälle wurden klinisch und serologisch als FSME gesichert, wobei eine Erkrankung sicher und eine weitere wahrscheinlich im Saarland erworben wurden. Bei drei weiteren Patienten fanden wir serologische Hinweise auf einen FSME-Virus Kontakt. Die Untersuchungsergebnisse legen den Verdacht nahe, daß im Saarland mit vereinzelten Erkrankungsfällen gerechnet werden muß. Das Infektionsrisiko ist jedoch sehr gering.
    Notes: Summary The Saarland and the Rhineland-Palatinate are not considered endemic regions for tick-borne encephalitis (TBE), and patients in this region have not been routinely advised to undergo vaccination or serologic testing for TBE. In 1994, a significantly increased incidence of TBE cases was noted in the neighbouring state of Baden-Württemberg. In the same year, the first TBE acquired in the Saarland was diagnosed. To investigate the infection risk for TBE in the Saarland and Rhineland-Palatinate, the records of 2,123 serologic tests for TBE collected since 1989 were systematically examined. In addition, 904 frozen sera of patients displaying inflammatory changes in the cerebrospinal fluid (CSF) were analyzed. IgG and IgM antibodies against TBE virus were found in 15 patients, four of which were verified clinically and serologically as TBE. One of these four cases was certainly and another was probably acquired in the Saarland. Three other patients displayed serologic signs of a TBE virus contact. The results of this study suggest that the occurrence of single cases in the Saarland has to be considered, but the risk is very small.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01781102
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  • 10
    Electronic Resource
    Electronic Resource
    Introduction (1996)
    Springer
    Infection 24 (1996), S. 393-393 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01716091
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