Methimazole-induced agranulocytosis and granulocyte-colony stimulating factor.
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Biomedical subjects
Publications and source records attributed to B Heinrich.
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We have observed two patients with AIDS suffering from severe watery diarrhea refractory to conventional medical treatment. In the first patient the reason for the diarrhea could not be revealed in spite of extensive investigations; however, the clinical picture suggested cryptosporidia infection. In the second patient cytomegalovirus could be shown in colonic biopsy specimens. After failure of several attempts of symptomatic, antibiotic, and antiviral therapy, the long-acting somatostatin analogue SMS 201-995 was administered to the patients subcutaneously in a dose between 2 x 50 micrograms and 3 x 100 micrograms/day. This treatment resulted in a prompt reduction of stool volume and bowel motions. Somatostatin may be a useful addition to the symptomatic treatment of refractory diarrhea in AIDS.
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The major pathological abnormalities of HIV encephalopathy are infiltrates of macrophages, multinucleated giant cells, microglial nodules and demyelination. Elevated myelin basic protein (MBP) levels in the cerebrospinal fluid (CSF) provide a marker for central nervous system demyelination. The purpose of this study was to investigate the possible role of CSF MBP as a useful and early marker for HIV encephalopathy. The CSF of 40 consecutive patients with HIV infection of various clinical stages was investigated, including 13 patients with clinical signs of HIV encephalopathy. CSF MBP was elevated in 2 patients (5.0 and 5.3 ng/ml), both of whom had moderate to severe HIV encephalopathy. The course of the disease was rapid in both patients. In the remaining 38 patients, CSF MBP levels were marginally elevated (n = 12) or normal (n = 26). Our results suggest that CSF MBP is not a sensitive marker for the diagnosis and evaluation of HIV encephalopathy, but may be an indicator of prognosis for the course of the disease. There were only few findings of elevated CSF MBP levels in patients with HIV encephalopathy in the current study, and this may be because the disorder progressed slowly in most patients. It is possible that CSF MBP levels in HIV encephalopathy may only be elevated with acute clinical deterioration but are normal in slowly progressive forms of demyelination, as seen in multiple sclerosis.
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The reliability of laboratory parameters for the prediction of impending manifestation of AIDS in HIV-1 infected patients was investigated. Over a mean observation period of approximately 1 year (5 to 33 months) 56 patients were studied. Eleven patients progressed to AIDS (group 1) and 45 remained free of AIDS-defining disease (group 2). Eight candidate-predictor variables were measured on each patient at the beginning of the observation period: neopterin, hemoglobin, lymphocytes, CD4 counts, CD8 counts, platelets, gammaglobulins, and erythrocyte sedimentation rate. In a linear discrimination analysis, a stepwise entry of these parameters into the discriminant function was effected according to which variable added most to the separation into groups 1 and 2. Neopterin proved to be most discriminating with no improvement of separation when adding further variables. Thus, a final allocation rule was computed using neopterin alone. This rule assigns neopterin levels above 21.9 nmol/l to group 1 and levels below to group 2. We conclude, tentatively, that in HIV-infected patients neopterin levels of 22 nmol/l and over may indicate the manifestation of AIDS in the year to come.
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In an in vitro system, bacterial cultures were exposed to concentrations following the kinetics of 4-quinolones in human serum. Both killing kinetics of staphylococci and enterococci and selection of resistant mutants were shown to be influenced by the pharmacokinetik parameters of the individual substances.
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48 essential hypertensives were randomly assigned to (1) a behavioral treatment (n = 20), (2) a pharmacological treatment (n = 20), or (3) self recordings of BP (n = 8). Group 1 and 2 showed during 1 year of therapy comparable significant decreases of systolic and diastolic BP, whilst group 3 showed significant increases after 3 months of therapy.
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