Search PubMed⌕ Search

Biomedical subjects

E Voigt

Publications and source records attributed to E Voigt.

At least 19 recordsLinked to original sources
PubMed2006

Structured treatment interruptions following immediate initiation of HAART in eight patients with acute HIV-1 seroconversion.

BACKGROUND: The immunological and clinical benefits of structured treatment interruptions (STIs) during primary HIV-1 infection remain largely unclear. PATIENTS AND METHODS: Eight patients identified during primary HIV-1 infection were immediately treated with HAART and underwent subsequent STIs after reaching complete viral suppression of HIV-RNA in peripheral plasma. HAART was re-initiated if either HIV-1 RNA >5000 copies/ml, CD4-cells <200 cells/microl or symptomatic HIV-1 disease was observed. RESULTS: After treatment discontinuation, four of eight patients were able to persistently control HIV-1 viremia below 5000 copies/ml until the last time point of follow-up (median 3 years). CD4-cell counts were within the interquartile range of untreated individuals compared to historical reference data from the MACS cohort. In the remaining study subjects persistent virological control was not reached despite repeated STIs. Moreover, compared to the MACS cohort repetitive virological failures during STIs appeared to induce an accelerated decline of CD4-cells. CONCLUSION: Spontaneous HIV-1 control after treated primary HIV-1 infection was possible in four out of eight individuals, however, if STIs after treated primary infection ameliorate the overall HIV-1 disease progression remains unknown. In the absence of viral control, repetitive viral exposure during STIs might be associated with accelerated decline of CD4-cell counts.

Acute Disease↗
PubMed2004

Safety, efficacy and development of resistance under the new protease inhibitor lopinavir/ritonavir: 48-week results.

BACKGROUND: Within this open-label, uncontrolled prospective trial we evaluated safety, efficacy and development of genotypic resistance under the new protease inhibitor lopinavir/ritonavir (LPV/r) in antiretroviral (ARV) HIV patients. PATIENTS AND METHODS: 58 patients with virological failure under their current ARV therapy were started on a LPV/r containing regimen. Median baseline HIV RNA and CD4 count were 4.6 log(10) cps/ml (range 2.1-6.4) and 128 x 10(6)/l (0-767), respectively. CD4 count, HIV RNA and metabolic parameters were assessed at weeks 0, 4, 8, 12, 16, 24, 32, 40, 48. Genotypic resistance testing was performed at baseline and again at weeks 12, 24 and 48 in the event of virological failure. RESULTS: Until week 48, viral load (VL) decreased by a median of 1.9 log(10) cps/ml (-0.8-3.8). A VL below 80 cps/ml was found in 20/58 patients (34.5%) at week 48. In parallel, CD4 cells increased to a median of 332 x 10(6)/l (8-905). Nine patients discontinued study treatment. At 48 weeks, median triglyceride and cholesterol levels increased significantly. While the median number of overall protease mutations at baseline was four in all patients, it was six in patients virologically failing on LPV/r. The average number of mutations increased significantly to eight at week 48. Several mutations were detected considerably more often in the event of failure than in response to treatment, e. g. at amino acid positions 10, 24, 54, 71, 82, 84. CONCLUSION: LPV/r is effective in heavily pretreated patients. Discontinuation due to adverse events is infrequent. No individual mutation can be associated with failure on LPV/r. However, a greater number of protease mutations at baseline is associated with poorer treatment outcome and several mutations seem to be related to treatment failure.

Adult↗
PubMed2002

First-line ritonavir/indinavir 100/800 mg twice daily plus nucleoside reverse transcriptase inhibitors in a German multicentre study: 48-week results.

OBJECTIVES: To evaluate safety and efficacy of the protease inhibitor combination ritonavir/indinavir 100/800 mg twice daily plus 2-3 nucleoside reverse transcriptase inhibitors (NRTI) in antiretroviral-naive patients. METHODS: Within this open-label, uncontrolled multicentre trial, antiretroviral-naive patients (n = 57) with median baseline HIV-RNA of 308,000 copies/mL (range 170-3.01 million copies/mL) and median CD4 cell count of 50 cells/microL (range 0-853 cells/microL) were started on 2-3 NRTIs plus ritonavir/indinavir 100/800 mg twice daily. CD4 cell counts and HIV-RNA were determined at weeks 0, 4, 8, 12, 16, 20, 24 and 48. Statistical analysis was performed on treatment as well as intent-to-treat. RESULTS: Viral load decreased by a median of 3.79 log10 copies/mL (range 2.0-4.60 log10 copies/mL) until week 48. At week 48, 23/57 (40%, intent-to-treat) patients showed a viral load </= 80 copies/mL. In parallel, median CD4 cell counts increased by a median of 149 cells/microL (range -60-420 cells/microL). Median triglycerides and cholesterol increased from baseline 160 mg/dL (range 33-364 mg/dL) to 218 mg/dL (range 110-527 mg/dL) at week 48 and from 166 mg/dL (range 63-262 mg/dL) to 233 mg/dL (range 95-359 mg/dL), respectively. Twenty-seven of fifty-seven patients (47%) discontinued study medication, 19 (33%) due to nephrolithiasis. Two patients changed their antiretroviral regimen after failing virologically. CONCLUSION: Ritonavir/indinavir 100/800 mg twice daily appears to be effective up to 48 weeks despite high baseline viraemia and low CD4 cell count in antiretroviral-naive patients. However, discontinuation due to adverse events, especially nephrotoxicity, is frequent and limits treatment duration. Therefore, extra hydration appears inevitable with this combination.

Adult↗
PubMed2001

[Association of primary sclerosing cholangitis and sarcoidosis].

BACKGROUND: Primary sclerosing cholangitis and sarcoidosis are rarely associated diseases. CASE REPORT: We report the case of an 42-year-old woman with primary sclerosing cholangitis confirmed by endoscopic cholangiography, biopsy of the liver and serum neutrophil cytoplasmatic antibodies. Furthermore radiological and histological signs of pulmonary and hepatic manifestation of sarcoidosis were observed, besides there were alopecia areata and choledocholithiasis. CONCLUSION: The present case report gives a brief survey of the literature, reflects the theories to unknown etiology and reports actual aspects of diagnosis and therapy of both diseases.

Adult↗
PubMed2001

Cutaneous manifestations in inflammatory bowel disease.

UNLABELLED: Numerous extraintestinal manifestations in various organ systems have been reported to be associated with inflammatory bowel disease (IBD). Aim of the present paper was to evaluate the frequency of cutaneous manifestations in Crohn's disease (CD) and ulcerative colitis (UC) with respect to their location, the activity and location of the underlying disease, the treatment options and the time to remission. METHODS: The medical records of 1043 inpatients with CD and UC were screened retrospectively for extraintestinal symptoms with special regard to cutaneous manifestations. RESULTS: The prevalence of cutaneous manifestations in IBD was 22/1043 (2.1%; 18 women, 4 men; age: 31.41 +/- 9.9 [21-51] yrs.). In 15/22 patients (68.2%) the cutaneous manifestations were associated with CD, in 7/22 patients (31.8%) UC was confirmed. In 6/22 patients (27.3%) pyoderma gangrenosum (PG) was diagnosed, in 16/22 patients (72.7%) erythema nodosum (EN). EN and PG predominately occurred at the lower legs: in 68.1% the tibia was the main affection site. Other locations like breast or anus were rare. In 16/22 patients (72.7%) an acute phase of the underlying disease was evident, in 6/22 patients (27.3%) CD or UC were in remission. In patients with CD a colonic involvement was found in 86.7%. Arthritis was the most frequent coexisting extraintestinal manifestation in CD (53.3%) and UC (28.8%). Drug treatment was performed with high doses of glucocorticoids and salicylates. The time to remission in patients with EN was significantly shorter as compared to PG (5.3 +/- 1.8 vs. 19.6 +/- 14.2 weeks; p < 0.001). In 5/22 patients (22.7%) cutaneous manifestations reoccurred after a symptom-free interval. All efflorescenses reoccurred during an active phase of the underlying disease at the same manifestation site as the initial presentation. CONCLUSION: In this series the prevalence of cutaneous manifestations in IBD was 22/1043 (2.1%). EN and PG were more frequent in women with IBD, in CD, and during the acute phases of the underlying disease. EN and PG predominately affect the lower legs. Cutaneous manifestations respond well to an acute phase therapy of the underlying disease. The time to remission was significantly shorter in EN as compared to PG. However, relapses have to be considered in a relevant subgroup of patients.

Adult↗
PubMed1999

Polymyositis of the skeletal muscles as an extraintestinal complication in quiescent ulcerative colitis.

Myositis of the skeletal muscle is a rare complication of inflammatory bowel disease. We report about a 33-year-old woman with quiescent ulcerative colitis known since 1995. She had suffered from recurring fever and pain in the thighs for about 4 weeks. Electromyography of quadriceps and deltoid muscles revealed myopathic changes. Diagnosis of polymyositis was confirmed by magnetic resonance imaging indicating edematous changes in the distal extremity muscles. The symptoms rapidly responded to high doses of steroids. Review of the literature indicates only a few cases describing an association of ulcerative colitis and myositis, most of them during acute exacerbations of the disease. In contrast, the present patient was in remission. Diagnosis of myositis should be considered in inflammatory bowel disease patients complaining of myalgia or muscular weakness. Magnetic resonance imaging may show specific features and can be used in addition to laboratory investigations and muscle biopsy for diagnosis of polymyositis.

Adult↗
PubMed1992

Protocol for studying depth of anesthesia using the spectral edge frequency.

The preliminary results of a multicenter study designed to determine the utility of the processed EEG in combination with heart rate and blood pressure for estimating anesthetic depth are reported. The study is planned to include 1,000 ASA I, II, and III patients undergoing surgery with at least a 60-minute duration of anesthesia. The preliminary results indicate that the use of EEG and clinical signs may provide better control of anesthetic depth. The study design provides ideal conditions for determining whether spectral edge frequency is a useful criterion for management of routine general anesthesia in a typical clinical environment.

Anesthesia, General↗
PubMed1983

[Atelectasis - bronchoscopy and unilateral ventilation].

Atelectasis in the postsurgical patient or patients on artificial ventilation problems is a frequently occurring complication. Bronchoscopy, local secretion removal by suction, lavage and vigorous positive pressure ventilation in many cases fail to re-expand the collapsed lung. Intubation after bronchoscopy by a double lumen tube permits systematic overinflation of the collapsed lung whereas the other lung is open to atmospheric pressure. In this manner the opening pressure of the collapsed lung can be overcome without overdistension of the other lung. The result is a marked improvement of oxygenation by reducing the venous admixture in lung.

Adolescent↗
PubMed1981

[The influence of LAP and cardiac output on the pulmonary gas exchange. Intraoperative studies in cardio-surgical patients (author's transl)].

In 21 patients haemodynamic parameters and pulmonary gas exchange were investigated after open heart surgery with cardio-pulmonary bypass (aortic valve replacement, AVR (n = 8); mitral valve replacement, MVR (n = 6); aorto coronary bypass; ACB (n = 7). For describing gas exchange function of the lung the O2-CO2 diagram was used. Stepwise increase of left atrial pressure (LAP) was followed by increasing cardiac output (CO) only in the AVR and ACB groups, whereas in the MVR group CO did not increase. Rising venous admixture (Qs/Qt) under these circumstances was related to CO only in the AVR and ACB groups. In the MVR group Qs/Qt did not change. Qs/Qt is related to low VA/Q areas in the lung. Increased CO leads to rising Qs/Qt from these low VA/Q-areas.

Carbon Dioxide↗
PubMed1981

[Resuspension of erythrocyte concentrates: clinical examinations with human albumin and oxypolygelatine].

The acid-base status of packed red cells and the influence of resuspension with human albumin, oxypolygelatine (Gelifundol), Human-serum and physiological saline were examined. It was found that the severe metabolic acidosis of packed red cells increased only slightly with storage time, while the resuspension exerted divergent effects: Human albumin and physiological saline increased the metabolic acidosis slightly, but significant. Humanserum and oxypolygelatine diminished it because of their bicarbonate content. The clinical significance especially in massive transfusion is discussed.

Acid-Base Equilibrium↗
PubMed1981

[Optimal left ventricular filling pressure after cardiopulmonary bypass (author's transl)].

To determine the optimal left ventricular filling pressure (LAP) after cardiopulmonary bypass (CPB) left ventricular function curves were constructed in ten patients with coronary heart disease, seven with aortic stenosis and normal left ventricular filling pressures (NLVFP), eight with aortic stenosis and pathologic elevated left ventricular filling pressure (ELVFP), and nine with mitral valve disease, cardiac index = CI, stroke index = SVI, left ventricular stroke work index = LVSWI were plotted against left atrial pressure = LAP and correlated with myocardial lactate extraction. After CPB, CI and LVSWI increased 52 to 53% and 50 to 80%, respectively, in the patients with NLVFP. In the patients with preoperatively ELVFP SVI did not increase significantly with increasing LAP, resulting in no augmentation of CI and LVSWI. Total systemic resistance increased in these patients, and myocardial lactate metabolism shifted to production in the patients with severe aortic stenosis. Thus, the results show that SVI, CI and LVSWI cannot be augmented by increasing LAP above 15 mm Hg if preoperative left ventricular function is already impaired. Elevation of LAP above 20 mm Hg can induce myocardial ischemia and cause low cardiac output with increased peripheral vascular resistance.

Aortic Valve Stenosis↗
PubMed1981

[The oxygen dissociation curve for the differentiation of peripheral anoxia (author's transl)].

By using a desk top calculator and a four-colour X-Y-plotter the standard and actual oxygen dissociation curves can easily be visualized. The pO2.50 and arteriovenous oxygen difference give information about the peripheral oxygen supply. Different types of peripheral anoxia can readily be evaluated by this graphical representation of the measured and derived data.

Biological Transport↗
PubMed1981

[Systolic time intervals during increasing left ventricular filling pressure following extracorporeal circulation. A comparative impedance-cardiographical study (author's transl)].

In 26 patients invasively measured haemodynamic parameters and impedance cardiographically determined systolic time intervals have been compared after open heart surgery with cardio-pulmonary bypass (aortic valve replacement, AVR (n = 7); mitral valve replacement, MVR (n = 7); aorto-coronary bypass, ACB (n = 10)). In both the AVR and ACB group an increase of left atrial pressure resulted in 1) a significant increase of left ventricular stroke work index (LVSWI), 2) a significant decrease of the relation of the pre-ejection period to left ventricular ejection time (PEP/LVET), and 3) a significant increase of cardiac output (thermodilution technique and impedance cardiography), whereas no significant alterations were found in the MVR group. Furthermore cardiac output determination using both the direct thermodilution technique and the indirect impedance method revealed a close correlation (n = 63, range cardiac output 1.5-12.51/min, r = 0.852). These data clearly demonstrate the utility of the non invasive impedance cardiography method compared with invasive methods with respect to measurement of cardiac and haemodynamic parameters, even in critical situations.

Adult↗
PubMed1981

[Lung function after thoracic trauma. A contribution to the assessment of late functional lesions (author's transl)].

Respiratory function was investigated in 32 patients not later then 5 years after thoracic trauma. Forced expiration curves (volume/time and flow/volume mode) and nitrogen washout methods (single breath, multiple breath) were used including blood gas analyzes and thorax-X-rays. The typical effect of chest injury is mild to moderate restriction, which was found in 72% of the patients. Usually all volumes (FVC, FRC, TC) are reduced. 5 patients had slight to moderate obstruction, which we do not consider to be immediate consequence of trauma. 12 patients had signs of ventilatory maldistribution, which can be explained by reduced FRC in more or less all cases and obstruction in the above mentioned 5 patients. Observation of two cases leads us to conclude that chest injury may initiate development of chronic respiratory disease and that such a disease may be aggravated by thoracic injury. Motivation, young age, quality of rehabilitation, dorsal location of fractured ribs may help to improve the pulmonary status of the patient, existing or developing chronic lung disease, smoking, old age, lateral localisation of fractured ribs with dislocation will hinder improvement.

Adult↗
PubMed1980

The colorimetric determination of HbA1c in normal and diabetic subjects.

The parameters which influence the determination of the major glycosylated haemoglobin fraction (HbA1c) with the thiobarbituric acid (TBA) method are described. Conditions for an optimal determination method are given. The correlation with the fast haemoglobin determination by column chromatography is greater than 0.9. The influence of storage on blood, washed erythrocytes and haemolysate in respect to HbA1c values obtained with the method described, was also investigated. Normal and pathological values from 78 patients correlate well with the fasting blood sugar levels (r greater than 0.9).

Blood Glucose↗