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Biomedical subjects

J Jost

Publications and source records attributed to J Jost.

At least 37 records · Page 2Linked to original sources
PubMed1994

[HIV infection, fever and cholestasis].

A 35-year-old Swiss woman with AIDS experienced fever, jaundice and cough. Laboratory evaluation revealed signs of an infection and cholestasis. The examination by ultrasound showed thickening of the intra- and extrahepatic bile ducts and gallbladder wall, without dilatation or stones. Endoscopic retrograde cholangiography demonstrated diffuse sclerosing cholangitis like lesions in the biliary tract and confirmed the diagnosis of a HIV related cholangiopathy. The cause was a cytomegalovirus infection as shown by liver biopsy with detection of cytomegalovirus early antigen. The treatment with ganciclovir was of some efficacy with improvement of jaundice.

AIDS-Related Opportunistic Infections↗
PubMed1994

Plasma and platelet catecholamine and catecholamine sulfate response to various exercise tests.

We tested the hypothesis that platelet and plasma catecholamine sulfates (CA-S) and platelet catecholamines (CA) reflect the overall sympathoadrenergic activation by exercise of 1 h duration. Ten well-trained subjects performed a low-intensity [62% maximum O2 consumption (VO2max); LI] and a high-intensity exercise test (77% VO2max; HI) and two tests at a similar average power output that consisted of 20 min at 77% VO2max and 40 min at 62% VO2max (HI/LI) and vice versa (LI/HI). Plasma norepinephrine sulfate (NE-S) increased to higher levels after HI than after LI exercise (15.5 +/- 2.1 vs. 8.9 +/- 0.7 nmol/l). Immediately after HI/LI and LI/HI plasma NE-S was similarly increased (9.59 +/- 1.1 vs. 9.96 +/- 1.3 nmol/l), whereas norepinephrine was higher after LI/HI than after HI/LI (23.0 +/- 3.2 vs. 15.7 +/- 2.3 nmol/l). Platelet CA and CA-S were increased only after HI. In conclusion, the plasma NE-S response to exercise parallels the overall sympathetic activation. These results support the hypothesis that plasma NE-S measured immediately after exercise reflects the overall sympathoadrenergic activity over prolonged periods of exercise. Platelet CA and CA-S poorly reflect sympathoadrenergic activation.

Adult↗
PubMed1994

Reduction of homologous blood requirements by blood-pooling at the onset of cardiopulmonary bypass.

This study was done to investigate whether an intraoperative autologous blood donation (pooling) at the onset of cardiopulmonary bypass can reduce homologous blood requirements during and after operations for myocardial revascularization. Ninety patients were assigned equally to two groups. In group C, serving as the control group, cardiopulmonary bypass was done with a membrane lung primed with 1500 ml of Ringer's solution. The cardiopulmonary bypass flow ranged between 2.4 L/min per square meter in normothermia and 1.5 L/min per square meter in moderate hypothermia of 30 degrees to 32 degrees C. In group P the same devices were used as in group C; however, at the onset of cardiopulmonary bypass 500 to 1000 ml of heparinized blood was "pooled" in a bag and substituted by the same volume of Ringer's solution. The lower hemodilution limit was set to a hematocrit value of 20%. The pooled blood was retransfused after the aorta was decannulated. The main parameter of interest was the total volume of red cell concentrates and fresh frozen plasma required during the operation and the subsequent stay in the hospital. The results were that group C received on average 792 +/- 639 ml and group P 337 ml +/- 382 ml of red cell concentrates. Very small amounts of fresh frozen plasma were used on average: group C, 56 ml; group P, 0 ml. These differences were highly significant (p < 0.001). Remarkably, 44% of patients in group P did not require any homologous blood products compared with 16% in group C. In conclusion, modern oxygenators, which provide sufficient oxygen transport capacity, make it feasible to decrease the hematocrit to 20% by "pooling" blood at the beginning of cardiopulmonary bypass and replacing it with saline solution. This procedure led to a highly significant saving of homologous blood.

Blood Transfusion↗
PubMed1991

[Anti-retroviral therapy of HIV-infection. With preliminary results of the Swiss postmarketing surveillance of zidovudine].

In the last few years, the treatment of HIV infection has advanced considerably due to the development of active antiretroviral compounds. Many substances with different mechanisms of action show strong activity against HIV in vitro and many of them are now under clinical investigation. But immense effort is needed to develop a clinically effective and tolerable drug for daily use from a substance active in vitro. Presently, zidovudine is the only drug that can be used for the treatment of HIV infection outside of clinical studies. The efficacy of zidovudine was demonstrated in patients with symptomatic HIV infection as well as in patients with advanced asymptomatic disease. The clinical signs of efficacy are significantly delayed progression of HIV infection and lower frequency of opportunistic infections, with decreased severity. It is evident that zidovudine does not cure the HIV infection. In Switzerland treatment with zidovudine is evaluated by post-marketing surveillance (PMS). All patients on zidovudine are seen periodically in the hospitals with a specialized division for HIV infection. Clinical and laboratory follow-ups are recorded. Until the beginning of October 1990, 1171 patients with symptomatic HIV infection have been treated with zidovudine in the setting of this PMS. 62% of all registered patients are currently receiving zidovudine. 20% died of AIDS. 15% of all patients received at least one blood transfusion. Hematotoxicity is the most frequent and serious side effect of zidovudine and can require definitive termination of therapy. The side effects are dose related and occur more severely in patients with advanced disease. The ideal dosage of zidovudine has not yet been defined. Recently published studies showed efficacy with doses as low as 500 mg/d. Consequently, patients in Switzerland receive 10 mg zidovudine/kg body weight as the maximum dose, divided into two or more single daily doses. Patients with asymptomatic HIV infection are regularly treated with 500 mg/d. Zidovudine-intolerant patients with symptomatic HIV infection can currently enter a controlled clinical trial of antiretroviral therapy with dideoxyinosine (ddI), which has a different spectrum of side effects but is only minimally toxic to bone marrow.

Didanosine↗
PubMed1990

[Extraintestinal strongyloidiasis in the acquired immunodeficiency syndrome].

A 41-year old man of Brazilian origin, suffering from AIDS for one year, fell ill with pyrexia of over 39 degrees C, dyspnoea, chest pain and deterioration in his general condition. At the same time he noted a discrete skin eruption, mainly on the upper limbs. Diarrhoea began later. A chest radiograph revealed bilateral infiltrates. The blood showed leucocytosis (11,000/microliters) with pronounced increase of eosinophil granulocytes (47.5%). Alkaline phosphatase was raised to 170 U/l. Suspicion of strongyloidiasis was confirmed by the discovery of numerous Strongyloides stercoralis larvae in the faeces. A few days after starting treatment with mebendazole, 400 mg daily, he felt better and the diarrhoea stopped. However, as the lung infiltrates remained unchanged and hilar lymph node enlargement now appeared, the dose of mebendazole was raised to 2500 mg daily. The abnormal findings then cleared up: Strongyloides stercoralis larvae ceased to be demonstrable and the patient gained 10 kg in weight.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Sympathoadrenergic regulation and the adrenoceptor system.

We investigated the effects of endurance and high-intensity training periods on the plasma catecholamine (CA) concentration at rest; on the basal alpha- and beta-adrenoceptor density, regulation, and function on circulating cells; and on the cardiovascular adaptation in long-distance runners and swimmers. The findings of each period were compared with those of untrained men. Endurance training of the long-distance runners and the swimmers led both to a reduced sympathetic activity at rest, indicated by lower CA values, and to a lower beta-receptor density and responsiveness on circulating lymphocytes and an increased alpha 2-receptor sensitivity on circulating platelets. During the high-intensity training period beta-receptor density and responsiveness increased, alpha 2-receptor sensitivity normalized, and heart rate as well as blood pressure values increased in both trained groups. The basal sympathetic activity remained reduced, but the norepinephrine-to-epinephrine (NE/EPI) ratio increased. The NE/EPI ratio might play an important part in the regulation of adrenoceptor density during these different training periods. Swimming-specific characteristics caused different physiological impacts compared with running training, but an attenuated baroreceptor sensitivity might be indicated in both intensively trained groups.

Adenylyl Cyclases↗
PubMed1990

[HIV infections].

Explore the source record for details and available documents.

Antiviral Agents↗
PubMed1989

[Clinical counseling and management of HIV-positive patients--secondary individual prophylaxis in patients with HIV infection].

In patients with HIV infection, secondary prophylaxis should prevent HIV-associated complications caused by opportunistic infections and psychosocial morbidity. This overview presents the possibilities of chemoprophylaxis and control of transmission to prevent opportunistic and non-opportunistic infections. Indications for immunization in HIV-positive patients are also discussed. Both medical treatment and psychological and social support are equally important for optimal patient care.

Anti-Bacterial Agents↗
PubMed1989

Comparison of sympatho-adrenergic regulation at rest and of the adrenoceptor system in swimmers, long-distance runners, weight lifters, wrestlers and untrained men.

The effects of different physical training regimes on the plasma catecholamine values at rest and the density and responsiveness of adrenergic receptors at rest were investigated. The changes during well-defined training periods of swimmers, long-distance runners, weight lifters and wrestlers were compared with untrained male volunteers. The training of swimmers and long-distance runners, building up endurance, resulted in a significantly lower basal plasma norepinephrine (NE) concentration and a significantly or possibly lower ratio NE:EPI (epinephrine). Both values indicated reduced sympathetic activity and resulted also in a significantly lower beta-receptor density and a higher alpha 2-receptor sensitivity compared with the other groups investigated. However, swimming-specific characteristics provoked labile hypertensive blood pressure regulation with an unchanged heart rate in swimmers. Static training of weight lifters, building up power, also led to a lower NE concentration compared with untrained subjects, whereas beta-receptor density was unchanged and alpha 2-receptor density and sensitivity were decreased. Elevated blood pressure values were observed in weight lifters and swimmers due to a reduced baroreceptor sensitivity. The dynamic training of wrestlers affected only basal heart rate and alpha 2-receptor sensitivity, both of which were decreased. Different kinds of physical training caused various adaptations of the basal activity of the autonomic nervous system in which adrenergic receptors also became adapted. In this context, the stronger adrenergic circulatory component of overall sympathetic activity at rest in swimmers and long-distance runners resulted in lower beta-receptor density, and the reduced noradrenergic component sensitized alpha 2-receptors.

Adenylyl Cyclases↗
PubMed1988

[HIV-associated thrombocytopenia].

Thrombocytopenia is a relatively frequent hematological complication of HIV (human immunodeficiency virus) infection. The incidence of thrombocytopenia in a cohort of 359 homo- or bisexual men with HIV infection was 3%, while it was 9% in a cohort of 321 HIV positive persons with a history of intravenous drug abuse. We followed 42 thrombocytopenic patients prospectively to study the clinical significance of thrombocytopenia in these patients. Thrombocytopenia was significantly more severe in intravenous drug abusers than in homo- or bisexual men: 52% of the drug abusers had thrombocyte counts below 10,000/mm3, compared with only 9% of the homo- or bisexual men. Symptoms of bleeding, almost always harmless skin or mucosal bleeding, were found in 45% of patients with a history of intravenous drug abuse and in 18% of the homo- or bisexual men. Life-threatening bleeding episodes did not occur during a median observation period of approximately one year. Prednisone was the most commonly used drug in symptomatic thrombocytopenia and had demonstrable effect only while being administered. After medication was stopped the thrombocyte counts usually fell to pretreatment values. Our findings suggest that therapy of HIV-associated thrombocytopenia should be reserved for severely symptomatic patients, particularly since this symptom of HIV infection rarely causes serious complications and we do not know the influence of drugs such as corticosteroids on the progression rate of HIV-infection.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Humoral regulation of the orthostatic reaction.

A tilt-table test was performed on 12 untrained subjects to evaluate the humoral adaptation to postural change. The observed peripheral reaction with a reversible short-term rise of norepinephrine (NE) and plasma renin activity (PRA) allowed us to divide the syndrome of the orthostatic dysregulation into a hyponoradrenergic and hypernoradrenergic type. This classification can be helpful for the clinical evaluation and therapy of orthostatic lability. The central excessive stimulation of the antidiuretic (ADH) and adrenocorticotropic hormone (ACTH) follow-ing orthostatic symptoms such as weakness or dizziness was not completely reversible within the observation period of 30 min. The ADH and ACTH increase was not different between the hypo- and the hypernoradrenergic type of dysregulation but was the most sensitive indicator of orthostatic lability: 41% of all subjects showed a hypernoradrenergic orthostatic dysregulation with pronounced NE response and alpha 2-adrenoceptor down-regulation. By use of antiembolism stockings (AES) or dihydroergotamine (DHE) this rate decreased to 16%. This was associated with a significantly reduced NE and PRA response and a diminished alpha 2-adrenoceptor number.

Adrenocorticotropic Hormone↗