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Biomedical subjects

R Bialek

Publications and source records attributed to R Bialek.

At least 55 records · Page 3Linked to original sources
PubMed1990

HIV-1 infection in a cohort of haemophilic patients.

The course of HIV infection in 53 haemophilic patients aged 5-20 years was evaluated by clinical examination and laboratory tests. During the evaluation time (median 30 months) two patients died of AIDS and 32 patients (60%) deteriorated when assessed by the Brodt-Helm classification. Nineteen patients (37%) had decreased absolute helper cell counts (less than 500 CD4 positive cells/microliters), and 45 patients (87%) had reduced helper cell to lymphocyte ratios (less than 0.35). HIV-1 was isolated from peripheral lymphocytes in 29 of 46 patients. As the disease progressed the number of positive viral cultures increased. Considerable progression of the HIV infection was seen in haemophilic children and adolescents during the median evaluation period of 30 months. The transition from symptomless HIV infection to immunodeficiency was easily recognised. A lowered ratio of helper cells to lymphocytes seems to be a useful marker of the beginning of the deterioration of the immune system.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Fatal Streptococcus suis septicemia in an abattoir worker.

A 51-year-old abattoir worker became ill with high fever and was admitted to hospital late in the evening, where he died 4 h later. Smears of peripheral blood taken 7 h after death showed numerous cocci. Cultures of the blood grew beta-hemolytic streptococci exhibiting the biochemical properties of Streptococcus suis II. A complete autopsy with extensive microscopical studies showed numerous bacteria in small vessels of several organs, but no bacterial colonisation of tissues, meningitis, or other relevant lesions were found. The group R antigen of the bacteria could be demonstrated by immunofluorescence in paraffin sections of the kidney and the adrenal gland. Two similar cases of fulminant fatal Streptococcus suis II septicemia have been reported from Denmark. This appears to be the first case observed in the Federal Republic of Germany.

Abattoirs↗
PubMed1988

[Aeromonas hydrophila dacryocystitis. Case report].

The present paper reports on a case of severe dacryocystitis with a dacryolith, caused by Aeromonas hydrophila. On the basis of this case the authors show that a therapy effective in vitro does not lead to elimination of bacteria in all cases, so that further therapeutic considerations are necessary.

Abscess↗
PubMed1988

Common surface epitope of Bartonella bacilliformis and Chlamydia psittaci.

A serosurvey revealed intense cross-reactivity between Bartonella bacilliformis and Chlamydia psittaci. One of the cross-reacting Bartonella antigens was identified as lipopolysaccharide which reacted with Bartonella as well as with Chlamydia serum antibodies. A monoclonal Bartonella antibody bound to Bartonella lipopolysaccharide as well as to the surfaces of Bartonella bacilliformis and Chlamydia psittaci. It was thus demonstrated that Chlamydia psittaci carries a surface epitope identical to an epitope of Bartonella lipopolysaccharide. The lipopolysaccharide was preliminarily characterized by polyacrylamide gel electrophoresis and by a lectin-binding assay. The lipopolysaccharides of Bartonella bacilliformis and Chlamydia psittaci are not identical.

Antibodies, Bacterial↗
PubMed1987

Human dirofilariasis with reactive arthritis--case report and review of the literature.

A 43-year-old German man suffered from an insect bite, which was followed by a severe local inflammation and lymphadenitis. A year later, he developed dry cough, chest pain, and an oligoarthritis of the ankle and knee joints. While other causes of the symptoms could be excluded, serologic findings suggested a dirofilarial infection with reactive arthritis due to the parasite. The observation points out, that in cases of unclassifiable mono- or oligoarthritis, reactive arthritis due to parasites should be considered in the spectrum of differential diagnoses. The disease is rare at present, but its frequency might be underestimated because of the diagnostic difficulties. Dirofilarial infection should be borne in mind after a stay abroad. The present case, however, shows, that the disease also occurs in patients who had not travelled to regions of risk in recent years.

Antibodies↗
PubMed1987

Cerebral cysticercosis in a European patient: problems of disease activity and therapeutic implications.

The case of a German patient who was treated with two courses of praziquantel for parenchymal cerebral cysticerosis (CC) is reported. Efficacy of the treatment could not reliably be distinguished from the natural course of the disease. After a brief review of the literature concerning problems with assessment of the activity of CC, the criteria recommending praziquantel therapy are discussed.

Adult↗
PubMed1985

Shaping public policy from the perspective of a data builder.

During the past six decades, data analysis and research studies have been instrumental in shaping public and private health care policy. Policymakers obtain the knowledge they need for making policy decisions through exposure to and examination of data generated through research studies, experimentation, demonstrations, and analyses. In this article, U.S. hospital care policy has been divided into phases. As the development of health care policy has progressed in each phase, decisionmakers have consistently increased their reliance on data.

Health Policy↗
PubMed1985

Human fascioliasis in Cajamarca/Peru. I. Diagnostic methods and treatment with praziquantel.

In a prospective study 34 Peruvian fascioliasis patients were followed up for three months after treatment with praziquantel. The rapid sedimentation of faeces was demonstrated to be the most appropriate parasitological technique for the diagnosis of Fasciola hepatica infections in man compared to the MIF concentration or the examination of duodenal fluid by Enterotest. After therapy with different doses of praziquantel only 21% of the patients stopped to excrete worm eggs although 17 patients had been treated repeatedly. During the period of observation all patients presented a decreasing number of symptoms. It is concluded that praziquantel is not very active against F. hepatica in man.

Adolescent↗
PubMed1983

[Intestinal protozoal infestation in persons with occupational sewage contact].

Intestinal protozoal infestation and antibodies against Entamoeba histolytica were determined in 614 employees of the Hamburg sewage works and compared with control groups without occupational sewage contact. The protozoal infection rate was significantly higher in sewer-men than in control persons. There was a positive correlation between the duration of exposure to sewage and the frequency of intestinal protozoal infestation. The risk of infection by sewage was higher than by a short journey to tropical or subtropical countries. Immunodiagnostic results showed no significant differences of invasive activity of E. histolytica between both investigated groups. On the basis of parasitological results classification of amoebiasis and giardiasis as occupational diseases in exposed persons is recommended.

Entamoeba histolytica↗
PubMedDate not supplied

Reimbursement for preventive services: can we construct an equitable system?

This report examines alternative methods of paying for clinical preventive care services. First, the extent of coverage of preventive health care services in public and private health insurance plans is reviewed. Included in this review are Medicare, Medicaid, health maintenance organizations, and private health insurance plans. Second, four alternative methods for paying for preventive care are discussed. These options are: 1) fee-for-service; 2) a periodic preventive health visit fee; 3) capitation; and 4) a preventive services account. The report concludes with recommendations for constructing an equitable system for increasing access to preventive services. A multi-pronged approach is recommended involving improvements in public and private coverage of these services; development of a periodic preventive health visit fee payment mechanism; initiation of additional research and demonstration efforts designed to determine cost-effectiveness of services and payment approaches; and modifications to the current coding system that would lead to a more appropriate method for reimbursement of preventive care services.

Abstracting and Indexing↗
PubMedDate not supplied

The probability of acquiring primary Toxoplasma infection in HIV-infected patients: results of an 8-year retrospective study.

There is much hope that HIV-infected patients and AIDS patients can reckon with a prolonged survival in future. The increased survival of AIDS patients with positive Toxoplasma serology is not necessarily associated with an increased risk of developing Toxoplasma encephalitis. For HIV-infected patients with negative Toxoplasma serology, the probability of acquiring a primary Toxoplasma infection in highly endemic areas such as Germany had not been studied to date. One hundred eighty-three HIV-infected patients were followed up between 1987 and 1995 in a retrospective study. Within the cohort, 95% of the patients were male and 83% haemophiliacs. The initial (1987) and final (1995) prevalence rate of Toxoplasma antibodies was 33.3% and 36.6%, respectively. The annual rise of the primary infection rate was calculated as 0.41%. The dye test was used for the detection of Toxoplasma-specific antibodies. This assay proved to be reliable and stable during long-term observation. The rate of primary toxoplasmosis found in this long-term study was not higher than that of pregnant women in Germany. Chemoprophylactic measurements for seronegative HIV-infected patients are therefore not recommended, but regular serological screening to detect seroconverters is.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Is there an effect of immunoglobulins and G-CSF on neutrophil phagocytic activity in preterm infants?

The percentage of neutrophils phagocytosing group B streptococci (GBS) in vitro was determined in ten healthy preterm infants (< 32 weeks of gestation) and adult controls by using an acridine orange fluorescence whole blood assay. When GBS were opsonized with adult serum, no difference in phagocytic activity was found between both groups after 10 and 30 min (preterms: 40% and 68%, adults: 32% and 56%, respectively). Phagocytosis rates in preterm infants decreased significantly to 6% and 18% (at 10 and 30 min) when pool serum of preterm infants was used instead. Supplementation of the preterm serum with either intravenous immunoglobulin or IgM-enriched immunoglobulin did not change the results significantly. The addition of granulocyte colony-stimulating factor (G-CSF) accelerated phagocytosis significantly after 10 min, but did not increase the overall phagocytic activity after 30 min in either group. Hence the potential benefits of intravenous immunoglobulins and G-CSF in neonatal sepsis may not be attributable to an immediate increase in and direct effect on neutrophil phagocytic activity.

Adult↗
PubMedDate not supplied

[Moyamoya syndrome. An unusual case report in an 8-year-old boy and review of the literature].

A Moyamoya disease in an 8-year-old german boy is reported. Medical history revealed attacks of hemiparesis and aphasia. The cerebral angiogram showed a typical, bilateral stenosis of the internal carotid arteries, collateral vessels as well as an occlusion of the basilar artery. Etiology, clinical findings, diagnostic procedures, differential diagnosis, therapy and prognosis of this rare disease is discussed on the basis of literature.

Carotid Artery Diseases↗
PubMedDate not supplied

[Complicated malaria tropica in an infant].

We report on a five month-old infant from Cameroon, who was admitted because of febrile gastroenteritis after living in Germany for two weeks. Since the patient was somnolent, had a parasitaemia of Plasmodium falciparum of 230,000/microliter, a haemoglobin concentration of 5.3 g/dl and a thrombocytopenia, a complicated falciparum malaria was diagnosed. Treatment was started immediately with intravenous 20 mg quinine/kg bw as a loading dose, followed by 10 mg/kg bw every 12 hours, combined with intravenous clindamycin 10 mg/kg bw bd. Red blood cells were transfused once. The parasitaemia dropped to 2000 trophozoites/microliter within 48 hours. No asexual stages were detectable from the third day of treatment on. Weekly controls for the following four weeks remained negative. The mortality rate of complicated malaria is 50% in the first year of life, which can be reduced by early treatment. We present this case to draw attention to therapeutic options in infants.

Animals↗
PubMedDate not supplied

[Parasitic infections in pregnancy and congenital protozoan infections. Part I.: Protozoan infections].

Intestinal protozoan disease diagnosed in pregnancy is mostly controlled by symptomatic treatment. Specific therapy can be delayed until after delivery. Only severe cases, i.e. continued diarrhea leading to malnutrition of either mother or fetus, require an immediate specific drug therapy, which might be harmful to the fetus due to toxic and teratogenic potentials. Vertical transmission of intestinal protozoa has not been described. Invasive protozoan infections can be lethal to the mother making immediate drug therapy mandatory, even if the potentials of fetotoxicity or teratogenicity are known. Vertical transmission occurs independent of maternal symptoms, causing clinical disease in the child either directly after birth or during the first months of life. The knowledge of endemic regions and of the maternal travel history is essential for early diagnosis and treatment of protozoan disease in pregnancy and of congenital protozoan infections.

Adult↗