[First use of a narcotic steroid in the treatment of delirium tremens].
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Anesthetics↗
Biomedical subjects
B Weber
Publications and source records attributed to B Weber.
[Recent therapeutics for delirium tremens; use of a new derivative of corticosteroids: hydroxydione-21-succinate pregnandione].
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Anesthetics↗
Six enteropathogens isolated from a case of acute gastroenteritis.
Isolation of six different gastrointestinal pathogens (Entamoeba histolytica, Plesiomonas shigelloides, Campylobacter jejuni and three different Salmonella species [Salmonella typhimurium, Salmonella blockley and Salmonella hadar]) in the feces of a German female tourist suffering from acute diarrhoea after a trip to Bali.
Acute Disease↗
Laboratory diagnosis of congenital human cytomegalovirus infection using polymerase chain reaction and shell vial culture.
Congenital HCMV infection was diagnosed at the 22th week of gestation. The infection was suspected because HCMV IgM was detected in a serum sample obtained from the woman's husband. HCMV infection was detected in the amniotic fluid by polymerase chain reaction, shell vial culture (immunoperoxidase assay) and conventional virus isolation. Serologic testing in paired sera of the woman and in umbilical cord blood for specific IgM and IgA remained negative. As serological data (preconceptional HCMV serostatus) were incomplete, a clear differentiation between primary and secondary infection could not be achieved; consequently, risk quantification could not be determined. Viruria was detected in the offspring during the 1st week post partum. No clinical signs of cytomegalic inclusion disease were diagnosed up to six weeks post partum. Our case report indicates that for pregnancy surveillance, serologic testing for HCMV antibody should also be performed in the spouse.
Adult↗
Improvement of serological diagnosis of human cytomegalovirus infection in renal transplant recipients by testing for specific immunoglobulin E by ELISA.
The kinetics of human cytomegalovirus (HCMV)-specific immunoglobulin E (IgE), M (IgM), A (IgA) and G (IgG) were studied in 421 sera obtained from 19 renal allograft recipients by enzyme-linked immunosorbent assay (ELISA). Cytomegalic inclusion disease (CID) occurred in 11 (57.9%) patients. HCMV infection was diagnosed in all (100%) of these patients by testing for specific IgE. In contrast, increased levels of IgM and IgA class antibody against HCMV were detected in only 45.5% and 18.2% patients suffering from primary or recurrent HCMV infection, respectively. Concerning the time interval between the onset of clinical symptoms and the first positive test, no significant differences in the kinetics of HCMV-specific immunoglobulins E, M, A and G were observed. Elevated specific IgE levels persisted for longer time intervals than the other immunoglobulin classes. As shown by the present study, specific IgE proved to be a more reliable serologic marker than IgM and IgA for the serologic detection of HCMV infection in renal allograft recipients.
Adult↗
Congenital rubella syndrome after maternal reinfection.
This report concerns a case of congenital rubella syndrome (CRS) with atypical immune response affecting an infant whose mother had repeated evidence of immunity before pregnancy. Laboratory diagnosis of CRS could only clearly be achieved by virus isolation after the second month of life despite typical clinical features of CRS and multiple organ involvement. After the first month of age, low concentrations of specific IgM antibodies were revealed by ELISA and confirmed by a reference test system (IgM-specific haemagglutination inhibition assay). Persistent and increasing high levels of IgM antibodies were detected only after the 6th month of life. Later on IgG antibody levels decreased. Immunological investigations showed an IgG1-hypoglobulinaemia. The unusual feature of the present case report is not only the failure of the maternal rubella immunity to prevent CRS, but the defect of the child's immune system, probably attributable to congenital infection. As a consequence, laboratory diagnosis of CRS could not be achieved initially by the proved serological methods.
Adult↗
Unusual course of herpes simplex virus encephalitis after acyclovir therapy.
This is a report on a case of herpes simplex encephalitis (HSE) taking an unusual course after initially successful acyclovir therapy. The etiology of HSE was proven serologically, by repeated detection of herpes simplex virus (HSV)-specific DNA sequences in cerebrospinal fluid (CSF) with polymerase chain reaction (PCR) and was supported by cerebral imaging. After both the neurological symptoms and laboratory findings had improved initially under acyclovir therapy, the patient's clinical condition deteriorated accompanied by a renewed increase in CSF pleocytosis and protein content. Nuclear magnetic resonance (NMR) imaging confirmed the finding of bilateral, mainly temporal lesions compatible with a diagnosis of relapsing HSE. The patient responded well to a second cycle of antiviral therapy but required a third treatment cycle due to renewed deterioration later on. HSV-specific DNA sequences could not be demonstrated in several consecutive CSF samples taken after the first week of illness but increased inflammatory changes typical of HSE were seen on NMR during phases of deterioration. IgM-class antibodies against HSV were detected in CSF 4 weeks after onset of symptoms and stayed positive for at least 7 weeks. Reasons for the repeated deterioration and possible explanations for the absence of HSV DNA in spite of what could be seen as relapses are discussed.
Acyclovir↗
Can retinopathy be prevented?
Clinical retinopathy eventually develops in the majority of insulin dependent diabetics during several decades of metabolic abnormality. Early structural lesions short of clinical significance may occasionally be detected in children much more frequently, however, after puberty. Major factors modulating the development of retinopathy are duration of diabetes, glycemic control and blood pressure.
Adolescent↗
Low correlation of serology with detection of Chlamydia trachomatis by ligase chain reaction and antigen EIA.
The aim of the present study was to evaluate the diagnostic accuracy of serology by using new assays for the detection of genus and species-specific IgG, IgM, IgA and secretory IgA antibody in female sex workers. Cervical swabs and first void urine (FVU) from 314 female sex workers were submitted to nucleic acid amplification by ligase chain reaction (LCx, Abbott). Concomittantly, blood samples were tested for the presence of IgG, IgM and IgA antibodies using a genus-specific assay (rELISA, Medac) and species-specific test (SeroCT, Orgenics). Chlamydia trachomatis infection was detected in a total of 30 (9.6%) female sex workers by LCR. With rELISA, seroprevalences for IgG, IgM, and IgA antibody to Chlamydia were 88.9%, 19.1% and 62.7%, respectively. IgG and IgA antibody prevalences against C. trachomatis (SeroCT) were 65.0% and 23.9%, respectively. In comparison to the positive LCR results obtained from cervical swab and/or FVU, the sensitivity of rELISA for Chlamydia IgG, IgA and IgM detection was 93.3%, 83.3% and 16.7%, respectively. With SeroCT, the sensitivity for C. trachomatis-specific IgG and IgA detection was 86.7% and 33.3%, respectively. The specificities of both serologic tests in comparison to LCR were very low. In conclusion, the correlation of serology with active C. trachomatis infection of the lower genital tract is very low. According to our results, serologic testing for Chlamydia can exclude active infection of the lower genital tract with a high reliability (> or = 95%). However, detection of C. trachomatis can only be reliably achieved by nucleic acid amplification assays.
Antibodies, Bacterial↗
Replication of human herpesvirus type 6 (strain AJ) in JJHan cells grown in protein-free medium.
The human T-cell line JJHan, commonly used as a substrate for human herpesvirus type 6 (HHV-6) replication, was established in a protein-free 1:1 mixture of Ham's F12 and Iscove's modified Dulbecco's medium. After 250 passages (4 years) in protein-free medium, the cells, designated JJHan-PF, were cocultured with JJHan cells chronically infected with strain AJ of HHV-6 conventionally grown in serum-supplemented medium. The production of viral antigen was monitored by indirect immunofluorescent antibody staining. The infectivity of the virus in JJHan-PF cells was similar to that in JJHan cultures as shown by HHV-6 antigen detection using a convalescent phase serum. The results show that JJHan-PF cells provide a sensitive substrate for HHV-6 replication without the interference of serum or other proteins usually added to the culture medium.
Cell Line↗
Prolonged Th2 cell activation and increased viral replication in HIV-Leishmania co-infected patients despite treatment.
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AIDS-Related Opportunistic Infections↗
The role of mineralocorticoid receptors in the circadian activity of the human hypothalamus-pituitary-adrenal system: effect of age.
The purpose of this study was to test the role of the mineralocorticoid receptor (MR) in the circadian activity of the hypothalamus-pituitary-adrenal (HPA) system of elderly healthy subjects. Nine elderly subjects (age: 66.2 +/- 7.7 years) were treated for 8 days with both the MR antagonist spironolactone and a placebo in a randomized, single-blind cross-over order. After treatment, we studied the circadian profiles of ACTH, plasma cortisol and saliva cortisol. No significant change in ACTH concentrations emerged. However, there were significant increases in circadian minimal (52.4 +/- 26.7 versus 33.3 +/- 14.4 nmol/l), mean (166.2 +/- 24.9 versus 133.0 +/- 18.3 nmol/l), and maximal cortisol concentrations (389.7 +/- 57.7 versus 335.4 +/- 45.0 nmol/l). Also, in the diurnal trough, we found an increase in saliva cortisol concentrations. Compared to young healthy controls, spironolactone treatment had stronger effects in the elderly. We therefore conclude that: 1) MR is involved in the human HPA system regulation; 2) the MR participates in the regulation of circadian nadir and peak activity of the HPA system; and 3) the HPA system in the elderly is more vulnerable to dysregulation at the level of the MR.
Adrenocorticotropic Hormone↗
[Retinoblastoma gene analysis in a patient with osteosarcoma following previous bilateral retinoblastoma].
In a native osteosarcoma specimen of a patient cured of a bilateral retinoblastoma eight years before we found a homozygous deletion of a 7.5 kb Hind III-fragment within the retinoblastoma gene and a hemizygous deletion of the same fragment in its constitutional cells. In a native osteosarcoma tissue of a lung metastasis of a patient with sporadic osteosarcoma the Rb-gene-analysis did not reveal any deletion within the gene. This might be due to the fact that the used c-DNA-probe did not detect point mutations. Nevertheless, the possibility of additional or alternative transforming events should be kept in mind.
Brain Neoplasms↗
Patient satisfaction with conscious sedation for ambulatory colonoscopy in a community hospital.
Patient acceptance of ambulatory colonoscopy is important for colon cancer screening programs to be successful. The goal of this study was to assess patient satisfaction with the method of conscious sedation that is standard in most endoscopy units. The authors also attempted to identify patient characteristics associated with a poor sedation experience. The findings suggest that 90% of ambulatory patients undergoing colonoscopy are adequately sedated with the standard meperidine midazolam regimen. The only patient characteristic found to predict poor sedation response was the preceding use of a prescription narcotic as an outpatient.
Adult↗
Burn nursing Delphi study. Setting research priorities.
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Bacterial Infections↗
Research priorities for burn nursing: patient, nurse, and burn prevention education.
Fifteen of the 101 research questions that were assigned priorities in the Burn Nursing Delphi study by Marvin et al. (Marvin JA, Carrougher GJ, Bayley EW, Weber B, Knighton J, Rutan RL. Burn nursing Delphi study: setting research priorities. J BURN CARE REHABIL 1991;12:190-7) addressed education from the perspectives of patients, their families, and burn nurses; the study also addressed the issue of burn prevention education. Questions concerning patient education were assigned the highest priority in this education subgroup with respect to the potential for research that would have an impact on patient welfare. The question that rated highest as a priority for its potential impact on the profession of burn nursing addressed the core competencies needed for safe and effective burn nursing practice. Prevention education was generally found to be a low priority in the Delphi study. Many of the questions in the education subgroup can best be answered by comparative or experimental studies designed to explain and predict the effects of various teaching strategies on behavioral outcomes. Research on patient, nurse, and burn prevention education provides a fertile ground for nurse researchers and an opportunity to contribute knowledge of vital importance to clinicians, educators, managers, and the public.
Burn Units↗
Research priorities for burn nursing: report of the psychosocial issues group.
This study was designed to identify nursing research priorities in burn care. The Delphi technique of sequential questionnaires was used for data collection. Ninety-four participants completed four rounds of questionnaires. One hundred and one research questions were identified, and priorities were assigned according to their impact on patient welfare and on the profession of burn nursing. Twenty-two of these research questions concerned psychosocial issues. This group of questions was then analyzed for priority research issues. The top five ranked questions in the psychosocial issues group for impact on patient welfare concerned: (1) stress reduction techniques, (2) social reentry strategies, (3) management of psychosis and post-traumatic stress disorder, (4) strategies to assist patients with impaired communication capabilities, and (5) the role of recovered burn survivors in encouraging patient compliance with treatments. Similarly, the top five ranked questions for impact on the profession of burn nursing concerned: (1) stress reduction strategies, (2) coping techniques for burn survivors, (3) management of psychosis and post-traumatic stress disorder, (4) nursing's supportive role in regard to "do not resuscitate" orders, and (5) coping strategies to be used with patients who express a desire to die.
Adaptation, Psychological↗
Research priorities for burn nursing: report on physiologic issues.
This Delphi study was designed and conducted to identify the issues of greatest concern to care of patients with burns and to the profession of burn nursing, so that nursing research could be directed toward these ends. One hundred and one questions were prioritized by the 94 participants who completed the four sequential rounds of questionnaires. A total of 11 questions (10.9%), which addressed physiologic-based issues, were identified.
Attitude of Health Personnel↗