Search PubMed⌕ Search

Biomedical subjects

H D Nothdurft

Publications and source records attributed to H D Nothdurft.

At least 19 recordsLinked to original sources
PubMed2006

[33 year old Libanese woman with recurrent haemoptysis and cystic lesion of the lung].

A 33 year old woman from Lebanon presented with recurrent hemoptysis, subfebrile temperature, dyspnoe in stress, fatigue, weight loss, and pruritus. Serological tests and results from chest X-ray and computer tomography revealed cystic echinococcosis with pulmonary involvement. After refusal of surgical therapy a medical treatment with albendazole was implemented. Two months after the start of the therapy only a small fibrotic residuum in the lung was seen. A spontaneous healing success seems unlikely because of the duration of the pulmonary cyst and the progressive symptoms before treatment.

Adult↗
PubMed2004

[The risk of contracting hepatitis A or hepatitis B run by visitors to the Mediterranean and Eastern Europe].

Hepatitis A and B continue to represent a risk for travelers. Those traveling to tropical countries are usually aware of this risk, while those visiting a Mediterranean country often are not. This investigation presents a destination-related risk assessment and vaccination recommendations for travellers, on the basis of incidences and prevalences of hepatitis A and hepatitis B. For hepatitis B, the WHO classification based on HBsAg prevalence has been selected. For hepatitis A, countries have been categorized as low-, moderate- or high-risk. A comparison of infection risk with the numbers of airline passengers showed that in particular the large number of travelers to Tunisia, Turkey and Egypt, in conjunction with hygienic conditions in those countries, represent a source of imported hepatitis A. With regard to destinations in the Mediterranean and Eastern Europe, too, the risk of contracting hepatitis A or hepatitis B is not always negligible, so that vaccination may need to be recommended.

Egypt↗
PubMed2003

Prophylaxis failure due to probable mefloquine resistant P falciparum from Tanzania.

Failures of mefloquine prophylaxis in travellers returning from Africa have been reported repeatedly. Non-compliance to chemoprophylaxis is considered to be a major factor for failure. Only few reports on mefloquine prophylaxis failure in sub-Saharan Africa were able to report blood levels of the drug that were sufficient for prophylactic effectiveness. We report the case of a 44-year-old German female who travelled to Tanzania for 3 weeks. The patient reported that she never missed a dose of mefloquine during her weekly prophylaxis schedule. Four weeks after returning from Tanzania, the patient presented with fever, headache and myalgia. Only a few trophozoites of Plasmodium falciparum were found in a thick film. Blood levels of mefloquine at that stage were at 1400 ng/ml, thus largely excluding non-compliance and malabsorption. To our knowledge, this is the first case of confirmed prophylaxis failure due to mefloquine resistance in East Africa.

Adult↗
PubMed2002

A new accelerated vaccination schedule for rapid protection against hepatitis A and B.

BACKGROUND: Increasing travel stresses the requirement for rapid protection against infections such as hepatitis A and B. METHODS: This randomised, multicentre study investigated an accelerated vaccination schedule using a combined hepatitis A and B vaccine (Twinrix, Smithkline Beecham Biologicals) compared with simultaneous administration of the two corresponding monovalent vaccines. The combined vaccine was administered on days 0, 7 and 21, whereas the comparison group received hepatitis A vaccine on day 0 and hepatitis B vaccine on days 0, 7 and 21. All subjects received booster vaccination at month 12. RESULTS: At month 1, 100% of subjects in the combined group and 99% of the controls were seropositive for anti-HAV antibodies. The corresponding seroprotection rates for anti-HBs antibodies were 82.0 and 83.9%, respectively. Examination of the 95% confidence intervals (CIs) for the treatment differences showed the two vaccines to be equivalent in terms of immunogenicity 1 week after the initial vaccination course. Just prior to the booster, the seropositivity rate for anti-HAV was 96.2% in the combined group and 95% in the control group. For anti-HBs, this was 94 and 91.6%, respectively. All subjects were seropositive for anti-HAV and seroprotected against hepatitis B at month 13. The anti-HAV GMCs were 9571mIU/ml with the combined vaccine and 5206mIU/ml in control subjects. The anti-HBs titre was 26002 and 29,196mIU/ml, respectively. Both groups had a similar reactogenicity profile. CONCLUSIONS: The accelerated schedule of the combined vaccine provides a good immune response against hepatitis A and B antigens and is suitable for last minute immunisation.

Adolescent↗
PubMed2001

Diagnostic significance of blood eosinophilia in returning travelers.

This study was conducted to investigate the predictive value of blood eosinophilia (total white blood cell count with > or =8% eosinophils) for the diagnosis of travel-related infections in 14,298 patients who returned from developing countries. The data show that blood eosinophilia in travelers returning from developing countries has only limited predictive value for the presence of travel-related infections. However, the likelihood of the presence of helminth infections increases considerably with the extent of eosinophilia.

Adolescent↗
PubMed2001

Atovaquone-proguanil versus mefloquine for malaria prophylaxis in nonimmune travelers: results from a randomized, double-blind study.

Concerns about the tolerability of mefloquine highlight the need for new drugs to prevent malaria. Atovaquone-proguanil (Malarone; GlaxoSmithKline) was safe and effective for prevention of falciparum malaria in lifelong residents of malaria-endemic countries, but experience in nonimmune people is limited. In a randomized, double-blind study, nonimmune travelers received malaria prophylaxis with atovaquone-proguanil (493 subjects) or mefloquine (483 subjects). Information about adverse events (AEs) and potential episodes of malaria was obtained 7, 28, and 60 days after travel. AEs were reported by an equivalent proportion of subjects who had received atovaquone-proguanil or mefloquine (71.4% versus 67.3%; difference, 4.1%; 95% confidence interval, -1.71 to 9.9). Subjects who received atovaquone-proguanil had fewer treatment-related neuropsychiatric AEs (14% versus 29%; P=.001), fewer AEs of moderate or severe intensity (10% versus 19%; P=.001), and fewer AEs that caused prophylaxis to be discontinued (1.2% versus 5.0%; P=.001), compared with subjects who received melfoquine. No confirmed diagnoses of malaria occurred in either group. Atovaquone-proguanil was better tolerated than was mefloquine, and it was similarly effective for malaria prophylaxis in nonimmune travelers.

Adolescent↗
PubMed2001

Detection of Giardia lamblia and Entamoeba histolytica in stool samples by two enzyme immunoassays.

Two commercially produced enzyme immunoassays (EIAs) to detect antigens of Giardia lamblia and Entamoeba histolytica in stool specimens were evaluated. A total of 276 stool specimens were collected from patients who presented with various medical complaints in the outpatient clinic of the Department of Infectious Diseases and Tropical Medicine, University of Munich. Every specimen was examined by conventional microscopy and tested by both EIA kits. When microscopy was used as the reference standard, the EIA kit detecting Giardia lamblia showed a sensitivity of 100% and a specificity of 99.6%. The EIA kit detecting Entamoeba histolytica had a sensitivity of 81.8% and a specificity of 99.2%. Both tests showed no cross-reactivity with other intestinal protozoa. Antigen detection by EIA has the potential to become a valuable tool capable of making stool diagnostics more effective, although it should not be considered as a replacement for microscopic examination, since other potential pathogens could otherwise escape detection.

Animals↗
PubMed2001

[Malaria--rapid diagnostic tests and emergency self-medication].

WHO recommendations have adopted the option of stand-by emergency treatment (SBT) for travellers to areas where malaria is endemic and medical attention may not be obtained within 24 hours after onset of symptoms. Indication and choice of drugs for SBT depend on use and kind of a chemoprophylactic regimen, situation of plasmodial resistance at the destination, and contraindications and tolerability in the individual traveller. However, the diagnosis of malaria on clinical grounds alone is unreliable, and fever occurs frequently during travel to malaria endemic areas from various reasons. The possibility of malaria has to be considered in all cases of unexplained fever that starts after the 7th day of stay in an endemic area. Studies in European travellers have shown that only 0.5-1.4% of all travellers to whom SBT medication has been prescribed, will finally use it. SBT use in febrile travellers (8.1-10.4% of all travellers) has been 4.9-17%, but plasmodial infection could be confirmed retrospectively in 10.8-16.7% of SBT-users only. The recent introduction of rapid diagnostic tests (RDT) for malaria has provided a potential tool to self-diagnose and treat a possible malaria attack when medical attention or microscopic diagnosis is not available. However, the utilisation of currently available RTDs by travellers has been shown to be technically problematic. Healthy volunteers were able to learn how to perform the tests, especially when standard written instructions were supplemented with verbal information (75 vs. 90% successful performance). But their interpretation of test results was unsatisfactory, with a high rate of false-negatives (14.1%). In another study in febrile European tourists in Kenya, only 68% of patients were able to perform the RDTs correctly, and 10 out of 11 with microscopically confirmed malaria failed to diagnose themselves accurately. Thus, besides appropriate training before departure, technical improvements are required before such RDT kits can be recommended for self-use by travellers.

Africa↗
PubMed2000

Atovaquone-proguanil versus chloroquine-proguanil for malaria prophylaxis in non-immune travellers: a randomised, double-blind study. Malarone International Study Team.

BACKGROUND: Chloroquine plus proguanil is widely used for malaria chemoprophylaxis despite low effectiveness in areas where multidrug-resistant malaria occurs. Studies have shown that atovaquone and proguanil hydrochloride is safe and effective for prevention of falciparum malaria in lifelong residents of malaria-endemic countries, but little is known about non-immune travellers. METHODS: In a double-blind equivalence trial, 1083 participants travelling to a malaria-endemic area were randomly assigned to two treatment groups: atovaquone-proguanil plus placebos for chloroquine and proguanil, or chloroquine, proguanil, and placebo for atovaquone-proguanil. Follow-up was by telephone 7 and 60 days after travel and at a clinic at 28 days. Serum samples were tested for antibodies to a malaria circumsporozoite protein. Blood and serum samples of participants with a potential malaria diagnosis were tested in a reference laboratory. FINDINGS: 7 days after travel, at least one adverse event was reported by 311 (61%) of 511 participants who received atovaquone-proguanil and 329 (64%) of 511 who received chloroquine-proguanil. People receiving atovaquone-proguanil had a lower frequency of treatment-related gastrointestinal adverse events (59 [12%] vs 100 [20%], p=0.001), and of treatment-related adverse events of moderate or severe intensity (37 [7%] vs 56 [11%], p=0.05). There were fewer treatment-related adverse events that caused prophylaxis to be discontinued in the atovaquone-proguanil group than in the chloroquine-proguanil group (one [0.2%] vs ten [2%], p=0.015). INTERPRETATION: Overall the two preparations were similarly tolerated. However, significantly fewer adverse gastrointestinal events were observed in the atovaquone-proguanil group in than in the chloroquine-proguanil group.

Adolescent↗
PubMed1999

Self-use of rapid tests for malaria diagnosis by tourists.

In a survey among febrile European tourists in Kenya, only 68% were able to carry out immunochromatographic dipstick tests for detection of Plasmodium falciparum antigen correctly, and ten of 11 with malaria failed to diagnose themselves correctly. Rapid tests for self-diagnosis by tourists cannot be recommended without appropriate training before departure.

Female↗