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Biomedical subjects

N A Peterslund

Publications and source records attributed to N A Peterslund.

15 recordsLinked to original sources
PubMed1991

[Hepatitis C antibody in hematological patients who underwent multiple transfusions].

The frequency of hepatitis C virus antibodies in serum as detected by the "Ortho Antibody Elisa Test System", was investigated in a consecutive series of multitransfused haematological patients who had received a total of 3,627 transfusions. Two out of 43 patients (4.6%; 95% confidence interval 0.6-15.8%) were found seropositive. Among Danish blood donors the frequency of seropositivity has been reported to 0.2-0.3%. The clinical significance of the seropositivity is underlined by the finding at autopsy of chronic active hepatitis in one of the two patients found anti-HCV positive.

Adult↗
PubMed1991

[Autologous bone marrow transplantation in malignant blood diseases].

The authors present the organisation and preliminary experience with a comprehensive autologous bone marrow transplantation (ABMT) program in patients with malignant blood diseases. The procedure involves harvesting of bone marrow from patients in complete remission, purification of mononuclear cells and cryopreservation of these at -196 degrees C. After bone marrow cultures show that a sufficient number of hemopoietic progenitor cells (CFU-GM) are present in the marrow to reconstitute the patient, he/she is conditioned with chemo- (busulphan/cyclophosphamide (Bu + Cy)) or chemo/radiotherapy (total body radiation/cyclophosphamide (TBI + Cy)) in doses equal to those commonly used in allogeneic BMT. From February 1988 to July 1990 bone marrow (BM) was harvested from 24 patients. The median yield of mononuclear cells (MNC) was 1.2 x 10(8)/kg body weight (range 0.55-3.7). After buffy coat preparation, density gradient centrifugation, cryopreservation and thawing out, 0.60 x 10(8) MNC/kg (0.18-3.3) corresponding to 9.3 x 10(4) CFU-GM/kg (2.28-144) could be recovered. Twelve patients have received transplants, five with AML (after Bu + Cy conditioning), six with lymphoblastic lymphoma and one with Hodgkin's disease (with TBI + Cy conditioning). The median number of days to obtain greater than 1.0 x 10(9) leucocytes/l, greater than 0.5 x 10(9) neutrophils/l, greater than 50 x 10(9) thrombocytes/l and last requirement for erythrocyte transfusion were 21 (12-49), 28 (10-60), 55 (21-270) and 55 (12-129) days, respectively. Four patients had sepsis and the median duration of hospitalization was 39 (22-58) days. The most severe complications were seen in the AML patients, two of whom died during the posttransplant period (one of septicemia, one of thrombocytopenic bleeding).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Herpesvirus infection: an overview of the clinical manifestations.

Herpesviruses include seven human viruses and numerous animal viruses. The human herpesviruses, in addition to their trivial names, are named from 1 to 7. The two most recently discovered herpesviruses thus being Human herpesvirus 6 and 7. Human herpesvirus 6 is the aetiologic agent causing exanthema subitum. Human herpesvirus 7 has, as yet, not been associated with any disease. A characteristic feature of the herpesviruses is the persistence in a latent form after primary infection which may later cause reactivated infection resulting in considerable morbidity, for example, in genital herpes. The clinical spectrum of herpes infections is very broad. In general, the primary infection is more severe than the reactivated. Other important determinants of morbidity are the patients' age and immune status. Many severe herpes infections are almost exclusively seen in immunocompromised patients. This review deals with the clinical manifestations of herpetic infections in normal and immunocompromised hosts with emphasis on the clinical recognition.

Chickenpox↗
PubMed1989

Roxithromycin in the treatment of pneumonia.

An open multicentre study of the efficacy and side effects of roxithromycin, a new macrolide antibiotic, in the treatment of community acquired pneumonia was undertaken. The diagnosis was verified by transtracheal aspiration. Fifty-three patients were studied. In the 49 patients evaluable the clinical efficacy rate was 92% (95% confidence limits 84-100%). Only by measurement of the fall in serum C-reactive protein was it possible to detect a difference in response between pneumonia due to Streptococcus pneumoniae and Haemophilus influenzae. The drug was well tolerated clinically and laboratory abnormalities included transient eosinophilia and elevated liver enzymes in two patients.

Adult↗
PubMed1989

Electroencephalographic changes in patients with herpes zoster.

EEGs of 42 patients with herpes zoster and 6 with herpes zoster-associated encephalitis were studied to characterize the nature and prevalence of EEG abnormalities in apparently uncomplicated herpes zoster. Thirty-one percent of herpes zoster patients had EEG changes with reduced rhythm frequency ranging from 7 to 2 Hz activity. Frontotemporal localization was observed in 54% of the abnormal EEGs. When compared to EEG in herpes zoster associated encephalitis, the findings were qualitatively the same, but tended to be more severe in the encephalitis cases. No effect of acyclovir on the EEG could be demonstrated.

Adolescent↗
PubMed1989

Beta-2-microglobulin in the cerebrospinal fluid of patients with infections of the central nervous system.

Beta-2-microglobulin was determined in 147 patients admitted to hospital because of suspicion of CNS disease. Patients with meningism were chosen as control group. The concentration of beta-2-microglobulin in the spinal fluid of control patients was correlated with age. Reference values for 0-40 years were 0.34-1.58 mg/l. Above 40 years of age the values were 0.46-3.14 mg/l. CSF beta-2-microglobulin levels of patients with meningism, aseptic and bacterial meningitis overlap too much to be relevant in distinguishing between these entities. Five patients with herpes simplex encephalitis had markedly elevated levels ranging from 4.4 to 9.0 mg/l. Ten patients with herpes zoster-associated encephalitis had values from 1.1 to 6.1 mg/l. In the patient groups with CNS infections, the ratio of serum to spinal fluid beta-2-microglobulin was significantly more frequently less than 1 as compared with the meningism group, indicating intrathecal production of the protein. Further studies on the clinical relevance of CSF beta-2-microglobulin in the diagnosis of encephalitis seem warranted.

Adolescent↗
PubMed1988

Management of varicella zoster infections in immunocompetent hosts.

Varicella in otherwise healthy children usually requires no antiviral treatment. In severe cases, however, such as are seen in neonates and adults, treatment must be given. Anecdotal evidence suggests the efficacy of intravenous acyclovir in such patients. Herpes zoster in immunocompetent patients may be severe enough to warrant antiviral therapy, particularly in elderly patients. Both idoxuridine and acyclovir have been investigated in placebo-controlled double-blind studies. Due to its low toxicity, ease of administration, and the possibility of systemic administration, acyclovir has largely replaced older antivirals in the management of herpes zoster in the normal host. Recent studies have shown the efficacy of oral acyclovir. In addition, oral acyclovir may prevent the ocular complications of ophthalmic zoster. When acyclovir is given, it should be administered as early as possible, preferably no later than four days after the onset of the rash. The combination of acyclovir and prednisolone for the prevention of post-herpetic neuralgia has not proved effective.

Acyclovir↗
PubMed1988

Acyclovir crystalluria.

Acyclovir crystals in the urine of a 28-year-old woman are described. The patient received intravenous acyclovir for herpes encephalitis. The crystalluria was accompanied by impairment of the renal tubules as evidenced by increased urinary beta-2-microglobulin excretion. Consecutive series of 60 patients on oral acyclovir and 20 patients on intravenous acyclovir were studied in order to define the frequency of acyclovir crystalluria. None of the patients studied had crystalluria, and none elevated serum creatinine levels. It is suggested that acyclovir crystalluria might be an early sign of acyclovir crystal nephropathy.

Acyclovir↗
PubMed1988

Herpes zoster associated encephalitis: clinical findings and acyclovir treatment.

The clinical course of herpes zoster associated encephalitis (HZAE) with special emphasis on the treatment with acyclovir is described from the experience in 14 own patients and 47 review cases. Immunosuppression and dissemination involved increased risk of HZAE, whereas cranial zoster implied no or only a slightly increased risk. The symptoms were mainly disturbances of mental function and ataxia. Nuchal rigidity was noted in approximately one third of cases. The median duration from dermatomal lesion to HZAE was 15 days in immunosuppressed patients versus 5 days in non-immunosuppressed patients. Abnormal spinal fluid findings included mononuclear pleocytosis, occasionally with low glucose concentration. Protein was elevated in half of the patients. Serum sodium levels were often low. Brain CAT scans were generally normal and EEGs always abnormal. Recurrence of HZAE was noted in 2 patients. Treatment with acyclovir seemed to have a beneficial effect. The results, however, need cautious interpretation due to the heterogenous patient material. Two patients developed signs of HZAE while on treatment with desciclovir but recovered during ongoing therapy.

Acyclovir↗
PubMed1987

Evidence that bacteria induce translocation of protein kinase C activity in human polymorphonuclear leukocytes.

Particulate fraction associated protein kinase activity was studied in human polymorphonuclear leukocytes stimulated by bacteria. Staphylococcus aureus was found to increase particulate fraction associated protein kinase C activity in a time and concentration dependent manner. The increase comprised both the phospholipid dependent and independent kinase activity and was augmented by addition of serum. Similar observations were done using Staphylococcus epidermidis and Klebsiellae pneumoniae. However, Escherichia coli only increased the phospholipid independent kinase activity in the particulate fraction, which suggests the presence of protease activity.

Bacterial Physiological Phenomena↗
PubMed1987

Prednisolone does not prevent post-herpetic neuralgia.

In a randomised, double-blind, controlled study of the effect of prednisolone on the development of post-herpetic neuralgia 78 patients with herpes zoster whose pain and exanthema had been present for less than 96 h were given 800 mg acyclovir five times daily for 7 days and prednisolone in a total dose of 575 mg, starting with 40 mg daily in the first week and tapering off over the next 2 weeks. 18 (23%) of the patients had post-herpetic neuralgia at 6 months after the acute zoster, 9 (24.3%) having received prednisolone and 9 (22.5%) placebo. The 95% CI for the difference between the placebo and prednisolone groups in the proportion of patients having pain at 6 months was minus 17% to plus 20%. Prednisolone, however, relieved pain for the first 3 days. The 1-2 week interval between admission and reappearance of pain and development of triggered pain seems to be the time needed to establish neuralgia. Once established, the type and intensity of pain remained largely unaltered.

Acyclovir↗
PubMed1987

Open study of 2-amino-9-(hydroxyethoxymethyl)-9H-purine (desciclovir) in the treatment of herpes zoster.

An oral pro-drug of acyclovir, 2-amino-9-(2-hydroxyethoxymethyl)-9H-purine (desciclovir) was evaluated in an open study comprising of 20 patients with herpes zoster. The clinical effects were comparable to those obtained with oral and intravenous acyclovir, even with a dosage of only 125 mg thrice daily. There was adequate absorption though considerable individual variation occurred. No effects of concomitant food intake were demonstrated. The finding of possible impaired conversion of desciclovir to acyclovir in one patient was unexplained and deserves attention in future studies. Likewise, more studies are needed to understand the occurrence of transient high peak plasma concentrations of acyclovir. Side-effects other than those already known with the use of acyclovir, namely reversible tubular damage, were not observed.

Acyclovir↗
PubMed1985

Creatine kinase in the serum of patients with acute infections of the central nervous system.

Serum creatine kinase was assessed in 94 consecutive patients without convulsions admitted to hospital due to suspicion of infection of the central nervous system. No reliable discrimination between patients with aseptic and those with bacterial meningitis was obtained. Patients with bacterial meningitis and brain oedema, as well as patients with encephalitis, had significantly higher values (P less than 0.01) than patients with meningism, aseptic meningitis and bacterial meningitis without cerebral oedema. Very high values, above 2500 U/1, were encountered in only the most severe cases of bacterial meningitis. The highest serum CK value found in patients with encephalitis was 725 U/l. Reference values for control patients with meningism were 16-269 U/1. In a subset of 9 patients creatine kinase isoenzyme analysis was performed. In all cases only muscle type (MM) isoenzyme was found.

Adolescent↗
PubMed1985

The treatment of herpes zoster infections.

A review of the many past and present therapeutic attempts in herpes zoster is given. Serious candidates are interferon, idoxuridine, adenine arabinoside, and acyclovir. Cumbersome administration and risk of side effects make acyclovir today's choice. The treatment with acyclovir has been improved by the availability of an oral formulation. The development of a well-absorbed prodrug, 6-deoxyacyclovir may in the future replace conventional acyclovir tablets in non-emergency cases.

Acyclovir↗