Psychiatric illness and the role of religion in a developing country.
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Adult↗
Biomedical subjects
E Schmutzhard
Publications and source records attributed to E Schmutzhard.
Infections following tickbites. Tick-borne encephalitis and Lyme borreliosis--a prospective epidemiological study from Tyrol.
We present here a prospective study on infections following tickbites in military recruits in the province of Tyrol (Austria). 84 recruits experienced tickbites and underwent clinical and serological examination twice at four-week intervals for signs of tick borne encephalitis (TBE)-virus or Borrelia burgdorferi infections. 56 and 50 recruits could be evaluated for TBE-virus and Borrelia infection, respectively. Whereas no recruit was found with clinical or laboratory evidence of TBE-virus infection, two (4%) recruits showed an erythema chronicum migrans as primary manifestation of a Borrelia burgdorferi infection and 11 (20%) recruits had a significant increase in the titer of anti-Borrelia burgdorferi antibodies. Our results support the predominance of a subclinical course of a tick-transmitted borrelia infection in the population under observation, and shed some light on the epidemiological situation of tick-transmitted diseases in Tyrol.
Animals↗
Syndrome of the anterior spinal artery as the primary manifestation of aspergillosis.
Aspergillosis of the central nervous system (CNS) is an uncommon infection, mainly occurring in immunocompromised patients. Beside cerebral involvement spinal cord lesions are extremely rare. To our knowledge, aspergillosis initially presenting with acute paraplegia due to mycotic thrombosis of the anterior spinal artery in a formerly healthy patient has, so far, not been reported. Neither a primary focus nor an underlying disease had been detected.
Acute Disease↗
CT and MR imaging in neuro-Behçet disease.
Computed tomography and magnetic resonance (MR) studies were done in one case of Behcet disease and showed a focal lesion in the upper brain stem. Early institution of therapy was followed by a complete clinical remission and disappearance of the CT and MR changes. Computed tomography and MR are important modalities for the early detection of Behcet disease when reversibility of the pathological changes is still possible.
Adult↗
Prognostic value of intraventricular blood in perimesencephalic nonaneurysmal subarachnoid hemorrhage.
INTRODUCTION: Perimesencephalic nonaneurysmal subarachnoid hemorrhage (PNSH) is a distinct type of subarachnoid hemorrhage with a characteristic bleeding pattern, and an excellent clinical outcome. However, the clinical course of patients presenting with a perimesencephalic nonaneurysmal bleeding pattern and intraventricular blood has not yet been investigated. MATERIALS AND METHODS: In this retrospective study we describe the cisternal blood distribution and the clinical course of 34 PNSH patients with (10 patients) and without (24 patients) intraventricular blood. RESULTS/DISCUSSION: Patients without intraventricular blood were in good clinical condition on admission; the in-hospital course was uneventful except for acute hydrocephalus, which was detected in two cases and improved spontaneously in both patients. All patients resumed their previous lifestyles. In contrast, two patients with PNSH and intraventricular blood were drowsy and had focal neurologic deficits on admission. Four patients developed an acute hydrocephalus, and two of these patients needed ventricular shunting. There was evidence for delayed cerebral ischemia in one of these patients. Outcome was excellent in eight cases, and one patient was moderately and one patient was severely disabled at dismissal from the hospital. Rebleeding did not occur in all patients, and repeated four-vessel angiography did not reveal the source of bleeding in any of our patients. CONCLUSION: Our data indicate that the presence of intraventricular blood may be a good indicator for the development of acute hydrocephalus in PNSH. Moreover, our results suggest that PNSH patients with ventricular blood may have a higher complication rate and a poorer outcome compared with PNSH patients without intraventricular blood.
Acute Disease↗
Evaluation on HIV serology and immune-stimulation on patients in Tanzania.
Antibodies against human immunodeficiency virus, other infectious agents and neopterin levels were determined in 253 patients in a rural area of North-West Tanzania. Seroprevalence for HIV was 3.2%. In one case serology was positive for HIV-1 and HIV-2 antibodies and questions whether there was a real double infection or a cross reaction not only concerning core region proteins but also transmembrane protein. The specificity in the diagnosis of HIV-infection is markedly increased with newer serological methods using recombinant peptides but did not improve sensitivity on African sera. Neopterin was determined as a sensitive indirect marker for the activation of T-cells and is therefore correlated with the susceptibility of HIV infection and with progression of disease. High seroprevalence rates for various infectious agents were determined and may explain the high rate of elevated neopterin levels in 80% of the Africans. Neopterin levels were even higher in HIV patients. Viral p24 antigen was found only in two persons, one of whom had no antibodies detectable.
Acquired Immunodeficiency Syndrome↗
Menstrual cycle dependent right-to-left shunting: a single-blinded transcranial Doppler sonography study.
BACKGROUND AND PURPOSE: Menstruation has been described as risk factor for neurological decompression sickness in divers. In considering this for paradoxical gas embolism, we hypothesized that there may be a link between cycle-dependent hormonal changes and the manifestation of a right-to-left shunt (RLS). METHODS: 40 women with a regular cycle of 28 days underwent transcranial Doppler sonography examinations (TCD) on day 1 and on day 15 of the menstrual cycle. Cerebral high intensity transient signs (HITS) proved a RLS. RESULTS: We found a 25% RLS incidence consistent with the literature. In 7 of 10 shunt-positive women it was detected mainly or exclusively on day 15. This difference in PFO detection rate is statistically significant (p = 0.031), indicating more RLS during the peri-ovulatory period. CONCLUSIONS: Our results do not support menstruation as a risk factor for neurological decompression sickness. The peri-ovulatory estrogen peak, which leads to systemic vasodilation, may explain our data. Factors that increase the risk for developing a RLS and thereby paradoxical embolism should be avoided, perhaps including diving during the peri-ovulatory period of the menstrual cycle. Furthermore, contrast PFO testing in fertile females may be most sensitive if conducted mid-cycle.
Adolescent↗