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Biomedical subjects

M Wolff

Publications and source records attributed to M Wolff.

At least 253 records · Page 14Linked to original sources
PubMed1990

[HIV infection and "malignant" strongyloidiasis].

Disseminated Strongyloides stercoralis infection occurs in immunocompromised patients. Despite the epidemiological overlap of HIV infection and strongyloidiasis observed in certain parts of the world, only six cases of dissemination have been reported in AIDS patients. The clinical presentation has no special features, except for the frequency of other opportunistic infections. The prognosis is poor. This lack of association between disseminated strongyloidiasis and HIV infection had led to the exclusion of extra-intestinal forms of this paraistosis from the revised classification of AIDS.

HIV Infections↗
PubMed1990

Severe tuberculosis in patients with human immunodeficiency virus infection.

Tuberculosis has now been well documented as a complication of infection with human immunodeficiency virus (HIV), but no studies concern patients requiring admission to the ICU. We report 12 cases of severe disseminated tuberculosis in patients who were seropositive for HIV. Eight patients had diffuse pulmonary involvement responsible for acute respiratory failure, 7 of whom required mechanical ventilation. Four developed septic shock, and in 3 blood cultures were positive for M. tuberculosis. Four patients had central nervous system involvement, with coma requiring mechanical ventilation 3 times. Rapid diagnosis was permitted in 10 patients by acid-fast smears of pulmonary specimens (8 patients) and/or tissue biopsies (4 patients). Seven patients died despite intensive therapy; autopsy was performed in 4 patients, showing disseminated tuberculosis. On the basis of this report, tuberculosis in HIV infection may present as an overwhelming systemic disease and thus requires an aggressive diagnostic and therapeutic approach.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Comparison of the activity of three antibiotic regimens in severe Legionnaires' disease.

Comparison of the activity of different antibiotic regimens in Legionnaire's disease has never been made because of the rarity of well documented cases of that disease. We have retrospectively compared severe cases of Legionnaires' disease treated with pefloxacin alone or in combination with erythromycin and/or rifampicin using computer-matched cases treated either with erythromycin or with erythromycin in combination with rifampicin. This study suggests that: (1) combined therapy including erythromycin, rifampicin and/or pefloxacin is superior to therapy with erythromycin alone; (2) combinations including pefloxacin may be the most active ones; and (3) pefloxacin alone may be as active as combination therapy. Although these results are in agreement with data obtained in cell and in animal models of legionella infection they need to be further confirmed by the study of larger number of patients.

Cause of Death↗
PubMed1990

Modulation of the production of erythropoietin by cytokines: in vitro studies and their clinical implications.

The etiology of the anemia of chronic disorders is complex. Factors which clearly contribute to the suppression of erythropoiesis are (a) reduced iron availability and (b) stimulation of the synthesis of immunomodulatory peptides such as IL-1, TNF-alpha and IFN-gamma, which inhibit the proliferation of erythrocytic progenitors in the bone marrow. The question as to whether lack of EPO is of general importance in the pathogenesis of the anemia of chronic inflammatory and malignant diseases is still a subject of controversy. The present in vitro studies show that IL-1 and TNF-alpha, but not IFN-gamma significantly lower the pO2-dependent formation of EPO in HepG2 cultures. In addition, clinical examples are given of anomalously low or high EPO levels in association with diseases involving the immune system. It is proposed that monokines and related immunomodulatory peptides could play a role in the control of the production of EPO.

Erythropoietin↗
PubMed1990

[The use of the ion exchange polymer Wofatit CP for sample preparation of drugs from urine for high pressure liquid chromatographic and spectrophotometric determinations].

The sample preparation of the alkaline drugs dioxopromethazinehydrochloride and trapidil from urine was studied systematically. The weak acid cation exchanger Wofatit CP was used as stationary phase. Batch mode and column chromatographic sample preparation were compared. The usable capacity of the ion exchanger for the analyte is an important characteristic for the sample preparation. The great influence of pH and ionic strength of the sample on the usable capacity was proved.

Acrylic Resins↗
PubMed1990

[Retinitis disclosing subacute sclerosing panencephalitis].

SSPE is a panencephalitis who involves children and who leads to death. It is due to a defective measles virus. Ophthalmologic features are frequent and may be the first manifestation of the disease. The most typical ocular involvement is retinitis which can be misdiagnosed as a toxoplasmosis.

Adult↗
PubMed1989

Prognosis of ruptured intracranial mycotic aneurysms: a review of 12 cases.

Intracranial mycotic aneurysms (IMA) occur in 1-3% of all infective endocarditis. Although spontaneous resolution was evidenced on serial angiograms in many asymptomatic cases, the prognosis, if they rupture, is reported to be worse and partly contingent on the therapeutic approach. Among 12 patients (six acute and six subacute endocarditis) with ruptured IMA, six were treated surgically and four were treated medically. Two patients died during rupture before any treatment could be started. Six patients had a sudden rupture manifested by coma, less clear consciousness seizures, hemiparesis unilateral mydriasis. CT-Scan showed intracerebral, intraventricular and subarachnoid haemorrhage. Ten angiograms showed 11 IMA. For patients with ruptured IMA, the decision for surgical treatment was made in the presence of deepening coma and extensive mass-lesion on CT-scan (one of six died in the postoperative period). Others received medical treatment (four cases: all survived) and were followed-up with serial angiographies. Of the nine patients who survived, five remained free of any disability 1-4 years later. We suggest that the prognosis of ruptured IMA (25% mortality rate) is not as bad as previously reported if surgery following angiography is performed early in the presence of deepening coma and extensive lesion.

Adolescent↗
PubMed1989

Diffusion of ofloxacin into cerebrospinal fluid of patients with purulent meningitis or ventriculitis.

The penetration of ofloxacin was studied in 22 patients with purulent meningitis or ventriculitis treated with conventional antibiotics. Three successive doses of 200 mg were infused at 12-h intervals during the acute stage of the disease. Ten patients received three additional doses when the meninges were considered to be healed. Cerebrospinal fluid (CSF) was drawn 0.5, 3, 6, or 12 h after the last infusion. Serial plasma and CSF samples were also obtained from patients with ventricular drainage. Concentrations in CSF ranged from 0.96 +/- 0.15 to 1.80 +/- 0.29 microgram/ml, depending on sampling time. The percentage of penetration in ventricular fluid, expressed as the ratio of the CSF area under the curve from 0 to 12 h to the plasma area under the curve from 0 to 12 h, was 73 +/- 6. Ofloxacin readily diffuses into CSF of patients with meningitis or ventriculitis and may be useful for treatment of CSF infections caused by susceptible pathogens.

Adolescent↗
PubMed1989

[Immunization in adults and post-exposure prophylaxis].

A general review of vaccines is presented. The available vaccines, their composition, route and dose recommendations and side effects are discussed. Underutilization of vaccines in the adult population is the rule. Vaccines of potential use in adults are presented. The susceptibility of adults to tetanus and the need for periodic booster immunization is stressed. A detailed discussion of the role of influenza, typhoid, pneumococcal and hepatitis B vaccination is included. Post exposure prophylaxis for vaccine preventable diseases and hepatitis A is reviewed. A different dose scheduled is recommended for vaccination against rabies with a locally manufactured product. A simplified recommendation for tetanus prophylaxis in the adult population is presented.

Adult↗
PubMed1989

[Gentamicin and amikacin nephrotoxicity: comparative study in patients with initially normal renal function].

The purpose of this study was to compare the nephrotoxic potential of amikacin (AK) and gentamicin (GM) in patients (pts) with normal renal function at the beginning of the treatment (Tx) in an open comparative and prospective trial. Nephrotoxicity (NFTX) was defined as a blood creatinine (Cr) increase of at least 50% from the basal (normal) level, or an increase to higher than normal level during, at the end or after Tx. Peak and trough blood GM and AK levels were determined at 72 h of Tx to make proper adjustments in dosing. The two groups (GM, n = 27 and AK, n = 38) were similar in population composition, underlying pathology and infectious process requiring antimicrobials. Patients in the GM group tended to be older (mean age, 56 years) than the AK (mean age, 48 years) p NS; the latter had received more frequently aminoglycoside Tx (69 vs 11%) p less than 0.0005. The GM group received a comparatively lower dose than the AK (x = 2.87 mg/k/d and 16 mg/k/d respectively) but duration of Tx was similar. Fifteen of 27 pts receiving GM (56%) and 7 of 38 receiving AK (18.2%) developed NFTX, p less than 0.004. Five pts in the GM group (18.5%) and 2 in the AK (5.2%) had clinical NFTX. The difference in NFTX persisted after age adjustment. There were no intra or inter group significant differences between pts with or without NFTX. In conclusion, in pts with initial normal renal function gentamicin was significantly more nephrotoxic than amikacin.

Adult↗