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Biomedical subjects

H Albrecht

Publications and source records attributed to H Albrecht.

At least 181 records · Page 10Linked to original sources
PubMedDate not supplied

Thrombotic microangiopathies and HIV infection: report of two typical cases, features of HUS and TTP, and review of the literature.

Haemolytic uraemic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP) are thrombotic microangiopathies increasingly reported in patients with HIV infection. However, characteristic features of thrombotic microangiopathies associated with HIV disease have not been defined yet. The typical courses of HUS and TTP in two patients are presented. The data as well as the analysis of cases published in the literature demonstrate the association of thrombotic microangiopathies with late-stage HIV disease. Moreover, differences between HUS and TTP can be detected. Patients with HUS present with more severe immunologic deterioration. Although clinical symptoms are fewer, HUS implicates a very poor prognosis. Life expectancy rarely exceeded 1 year after diagnosis. HUS and TTP should therefore be added to the international AIDS classification.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Response to treatment of chronic hepatitis C with interferon alpha in patients infected with HIV-1 is associated with higher CD4+ cell count.

The aim of this study was to assess the efficacy and tolerance of interferon alpha (IFN alpha) treatment of chronic hepatitis C in HIV-seropositive patients. Seventeen patients with actively replicating hepatitis C were consecutively enrolled and treated with IFN alpha 5 MIU three times a week and followed up for at least 6 months after cessation of treatment. Eight patients responded to IFN alpha therapy with a complete remission of signs of active hepatitis and viral replication (ALT, HCV-RNA) at the end of treatment with IFN alpha. A sustained complete remission (ALT, HCV-RNA) for at least 6 months after the end of treatment was achieved in five of these eight patients. Complete responders had higher CD4+ cell counts (median 525/microliter) compared to non-responders (median 245/microliter) (p < 0.001). All patients but one completed at least 4 months of treatment. No severe toxicity (> WHO grade 2) due to IFN alpha treatment occurred. The results indicate that IFN alpha treatment of chronic hepatitis C in HIV-seropositive patients is successful in a considerable number of cases. Success of treatment with IFN alpha is related to higher CD4+ cell counts.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Expression of CaMV ORF IV in Escherichia coli.

A CaMV DNA fragment corresponding to nucleotides 2200-3992 and including the coding sequence (2200-3670) of open reading frame IV was inserted in the pTG908 prokaryotic expression vector. In the recombinant pTG-IV plasmid, ORF IV, which codes for the coat protein precursor, was fused to the N-terminal coding sequence of the lambda CII gene, which is under transcriptional control of the lambda PL promoter. The expected fusion protein CII-ORF IV had a calculated molecular weight of 58.4 Kd. Nevertheless, temperature induction of the PL promoter resulted in synthesis of a major 76-Kd fusion protein: the coat protein precursor migrated abnormally on SDS polyacrylamide gel.

Blotting, Western↗
PubMedDate not supplied

Disseminated cryptococcosis in a patient with AIDS.

We report the case of a 31-year-old AIDS patient who had generalized cryptococcal disease with involvement of the lungs, bone marrow, gastrointestinal tract and skin as well as chorioretinitis which may have been due also to Cryptococcus neoformans infection. Initially there was no involvement of the central nervous system. The patient recovered after 43 days' treatment with fluconazole and amphotericin B and flucytosine initially. Four months later he presented with a cryptococcal splenic abscess despite secondary prevention with fluconazole and twice-weekly liposomal amphotericin B. After splenectomy the patient was discharged in good health. One year later he died of cryptococcal meningitis.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Aortic xenograft valve performance at eight years. A comparative study.

The medium-term performance of commercially available xenograft prostheses in the aortic position, was evaluated in 198 patients operated upon since 1975. No associated procedures were performed in these patients in whom a variety of prostheses was employed. The valve behaviour has been compared with other xenograft series, homografts and synthetic prostheses. There was a 5.5% hospital death rate and a 7.5% late mortality. Five late deaths were valve related, five were unrelated to the valve and four were of unknown cause but in elderly patients. At eight years, 86.1% of patients were alive, the majority functionally improved. Thromboembolic events were considerably fewer than those experienced with most non-biological prostheses, all but three events being transient. Re-operation for primary valve dysfunction was a safe procedure but re-operation for infected prostheses carried a high mortality. In comparing the aortic xenograft with other prostheses, severe dysfunction was found to occur with similar frequency in all prostheses up to eight years and was rare. Mild prosthetic dysfunction (asymptomatic diastolic murmur) occurs in about 25% of all tissue valves at eight years, including the homograft. The progression, or otherwise, of mild dysfunction has yet to be evaluated in currently available xenograft prostheses.

Adolescent↗
PubMedDate not supplied

Left ventricular aneurysm surgery. Determinants of results.

Between 1967 and 1983, 154 patients had reduction of left ventricular aneurysms by resection or plication. Seventy percent of patients had predominant angina; the remainder had predominant dyspnoea. Fifty-eight percent had associated coronary bypass grafting. Within the group, there were included 26 patients who had aneurysm resection for dyspnoea and who were evaluated by radionuclide angiography at a mean follow-up of 17 + 11 months. There was a 20% early mortality; this fell to 5% in the latter half of this experience. Patients whose major symptom was angina had a 5% early mortality. Those whose major symptom was severe dyspnoea had an early mortality of 30%. Patients who had aneurysm reduction alone had an early mortality of 17% and those who had associated bypass grafting had an early mortality of 9%. There was a 48% late mortality, attrition occurring at a steady rate and being predominantly due to cardiovascular causes. Of 95 patients available for review between one and thirteen years after operation, 60% were in New York Heart Association (N.Y.H.A.) functional class I, 36% in functional class II and 4% in classes III and IV. In patients whose predominant symptom was dyspnoea, radionuclide studies showed that global left ventricular performance at rest was not significantly changed by operation, despite clinical improvement. Long-term clinical outcome was determined more by pre-operative global ventricular function than by function of the residual contractile segment. Within the whole group, however, both early mortality and symptomatic improvement were more likely in patients with predominant angina.

Adult↗
PubMedDate not supplied

Treatment of chronic hepatitis C with interferon-alpha in patients infected with the human immunodeficiency virus.

BACKGROUND/AIMS: The incidence of hepatitis C infection is increased in subjects with human immunodeficiency virus infection, although the relative frequency of hepatitis b infection is higher than that hepatitis c. The present study assessed the effect of IFN-a on chronic hepatitis C in HIV infected patients. MATERIAL AND METHODS: Twenty patients with chronic hepatitis C, nine positive for antibodies to the human immunodeficiency virus and eleven HIV-seronegative, were treated with interferon a-2b. RESULTS: Five HIV-positive patients responded to therapy with a complete (three) or partial (two) remission of hepatitis at the end of treatment. A sustained response was achieved in four patients. From the HIV-negative patients eight responded with a complete (six) or partial (two) remission. The response was sustained in six patients. Hepatitis C virus-RNA became at least temporarily undetectable in three HIV-positive and six HIV-negative patients. No severe toxicity of interferon treatment was seen in either the HIV-positive or the HIV-negative patients. CONCLUSION: The present results indicate that interferon treatment of chronic hepatitis C in HIV-positive patients is successful in a considerable number of individuals. However it might be inferior to the results in HIV-negative patients.

Adult↗