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Biomedical subjects

H Vellend

Publications and source records attributed to H Vellend.

At least 19 recordsLinked to original sources
PubMed1992

Infectious complications following isolated lung transplantation.

STUDY OBJECTIVE: To ascertain the incidence, types, morbidity, and mortality of infectious episodes in isolated lung transplant recipients. DESIGN: Retrospective chart review of patients who have undergone transplants over a six-year period in one institution. PATIENTS: Twenty-three single and 17 double lung transplants followed up between 2 and 68 months. RESULTS: Fifty-one episodes of infection occurred in the group with a slight predominance in the double lung transplants. The 32 episodes of bacterial infection constituted the largest group of infection and more than half of these were pneumonias. Organisms identified were predominantly Gram negative. While bacterial processes made up the bulk of infections, fatalities were rare. Viral and fungal infections were less common, but more often fatal. Of six cases of viral pneumonitis, two were fatal; two of five cases of invasive fungal infection were also fatal. Overall, six patients died of infection. CONCLUSION: Our findings support previous reports from heart-lung centers documenting a high rate of infectious complications, particularly pneumonia, in recipients of lung grafts. In our experience, bacterial infections are the most common (two of three infections), but have the lowest mortality. Efforts should be directed toward establishing effective prophylaxis programs and early detection of infection.

Bacteria↗
PubMed1989

Cyclosporine-induced deterioration in patients with AIDS.

Eight patients with AIDS (acquired immune deficiency syndrome) but free of life-threatening infection were treated with the immunosuppressive drug cyclosporine for a mean of 53.9 days. The serum cyclosporine levels were maintained in the desired therapeutic range. All eight patients experienced severe toxic symptoms, which necessitated discontinuation of cyclosporine therapy in six. The serum levels of creatinine, urea and potassium rose during treatment and fell after therapy was stopped. The total leukocyte count, hemoglobin level, platelet count, total T-cell count, and T4- and T8-cell counts all fell markedly during treatment. The total leukocyte count, platelet count, and T4- and T8-cell counts rose after therapy was stopped, but the hemoglobin level remained low. No patient experienced resolution of symptoms during therapy, and the condition of all patients improved after treatment was stopped. The results of this pilot study indicate that cyclosporine does not alleviate, and may worsen, the symptoms and laboratory findings in patients with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Role of fluoroquinolones in lower respiratory tract infections.

Oral quinolones such as ciprofloxacin are promising agents in the treatment of serious bronchopulmonary infections due to susceptible gram-negative micro-organisms such as Haemophilus influenzae, Branhamella catarrhalis, Klebsiella pneumoniae and even Pseudomonas aeruginosa. Their moderative activity against Streptococcus pneumoniae may limit the use of these agents in the treatment of acute exacerbations of chronic bronchitis and in the empiric management of community-acquired bacterial pneumonia. Further prospectively designed studies are needed to address this issue. The ability of quinolones to effectively penetrate bronchial mucosa and to be concentrated within macrophages may afford additional advantage to these agents. They should not be used as a sole agent in the treatment of aspiration pneumonia nor anaerobic pleuropulmonary disease. Quinolones are very active in experimental models of Legionnaire's disease and deserve further clinical study. Ciprofloxacin is a promising alternative to standard parenteral drugs in the management of Pseudomonas aeruginosa infections in adults with cystic fibrosis. The potential for drug interactions with theophylline must be kept in mind for patients on both of these drugs.

Animals↗
PubMed1987

AIDS, otolaryngology and a case of adenoid cystic carcinoma of the parotid arising in a patient with the AIDS-related complex.

The incidence of acquired immunodeficiency syndrome (AIDS) and AIDS-related complex (ARC) is increasing, and as head and neck manifestations of this entity are common it is important that otolaryngologists have an up-to-date knowledge of this condition. In this paper the epidemiological aspects of the disease are reviewed and the head and neck manifestations discussed. An interesting case of adenoid cystic carcinoma of the parotid arising in a patient with ARC is presented.

AIDS-Related Complex↗
PubMed1986

The relationship between 2-5A synthetase levels and persistent lymphadenopathy in homosexual men with antibodies to HTLV-III.

This study compared clinical and laboratory parameters in 37 individuals with serologic evidence of exposure to human T-cell lymphotropic virus type 3 (HTLV-III) and generalized lymphadenopathy. Basal levels of the interferon-induced enzyme, 2-5A synthetase were also measured and compared with the clinical parameters. A significant linear relationship (p less than .05) was demonstrated between the logarithm of the basal synthetase level and both the number and size of palpable nodes in the posterior cervical triangles of the men studied. No other lymph node chains demonstrated such a relationship. In addition, men with more than 3 palpable nodes (the median number) in the posterior triangles had lower mean levels of lymphocytes, reduced mean mitogen responses to PWM, PHA, and ConA, elevated mean levels of IgG, IgA, and IgM, and were more frequently anergic on skin testing. These findings suggest the need for further longitudinal study of the possibility that extent of lymphadenopathy and level of 2-5A synthetase might serve as useful parameters to monitor disease activity.

2',5'-Oligoadenylate Synthetase↗
PubMed1986

Malignant external otitis.

Malignant external otitis was first identified by Chandler in 1968 as a significant otologic entity. Since then its mortality rate has steadily declined. This is due to increased awareness, earlier diagnosis and appropriate antibiotic therapy. A review of five years' experience with this condition at Mount Sinai Hospital, Toronto, is presented. The use of radionuclide scanning in diagnosis and determining duration of therapy is stressed.

Aged↗
PubMed1985

Q-fever. The liver and bone marrow pathology.

Eighteen liver and seven bone marrow biopsies from 44 patients with clinically and serologically proven Q-fever seen during a recent outbreak were studied. Highly distinctive fibrin-ring granulomas were found in seven liver and four bone marrow specimens. Lipid or nonspecific granulomas often containing neutrophils and variable numbers of giant cells were noted in 13 livers and seven bone marrows. A wide variety of nongranulomatous histological changes, frequently including steatosis and nonspecific "reactive" hepatitis, were seen in the liver biopsies. Identifiable rickettsiae were not present in tissue sections studied by microbiologic stains or electron microscopy. The histological response pattern to Coxiella infection is varied, and Q-fever should always enter the differential diagnosis of a granulomatous disease encountered in liver and bone marrow specimens.

Animals↗