Search PubMed⌕ Search

Biomedical subjects

R Lüthy

Publications and source records attributed to R Lüthy.

At least 109 records · Page 6Linked to original sources
PubMed1989

[Pneumothorax as a complication of Pneumocystis carinii pneumonia].

A pneumothorax occurred in a 29-year-old HIV-positive woman with rapidly progressive dyspnoea at rest and left-thoracic pain, dry cough and fever. Sputum test revealed Pneumocystis carinii pneumonia. Treatment was started with 20 mg/kg trimethoprim and 100 mg/kg sulfamethoxazole, but was poorly tolerated and changed for pentamidine, 4 mg/kg i.v. from the fifth day onwards. A chest drain was inserted, but pleurodesis became necessary after two further lung collapses. After three weeks secondary prophylaxis of the Pn. carinii pneumonia was started with pentamidine inhalations (60 mg every two weeks). The patient gradually improved under this regimen. Pneumothorax is a rare complication of Pn. carinii pneumonia, but should be considered in patients with rapid respiratory deterioration. In addition, Pn. carinii pneumonia should be considered in HIV-positive patients with pneumothorax.

Adult↗
PubMed1989

Co-infection with human immunodeficiency virus-type 1 (HIV-1) and cytomegalovirus in two intravenous drug users.

A mononucleosis-like illness is frequently recognized retrospectively as the first manifestation of infection with human immunodeficiency virus-type 1 (HIV-1). This acute but transient retroviral syndrome may include symptoms such as malaise, fever, sweats, myalgia, arthralgia, maculopapular rash, diarrhea, and lymphocytic meningitis. We observed two intravenous drug users who developed a severe, febrile illness with subsequent oral thrush (one also had biopsy-proven esophageal candidiasis). Both patients had weight loss, arthralgia, myalgia, and fatigue. These symptoms occurred two weeks after needle-sharing and persisted for 7 weeks in one patient and 10 weeks in the other. Both patients had serologic evidence for both acute HIV-1 and cytomegalovirus infection. Cytomegalovirus enhances HIV-1 replication in vitro, presumably by stimulating HIV-1 gene expression. Thus, the observed syndrome suggests that this viral interaction may be clinically significant because it appears to cause severe additional morbidity, which is not typical for primary infection with HIV-1. After 6 months of follow-up, one patient is completely asymptomatic but shows markedly reduced CD4+ lymphocytes. The other patient developed persistent lymphadenopathy after the acute illness, but is feeling well 21 months after infection.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[The natural history and laboratory parameters of HIV infection].

Since 1983 the morbidity and mortality rates as well as results of haematological, immunological and (later) HIV serological tests were recorded prospectively for 497 HIV-positive patients during 1837 clinic visits at least twice within at most six months for a median period of observation of 18 months (range 6-64 months). The rate of progression to a higher stage was calculated according to the method of Kaplan-Meier. The rate for asymptomatic patients was 16% after one and 33% after two years; for patients with persisting generalized lymphadenopathy it was 13% and 21%, respectively, for those with AIDS-related complex 28% and 47%, respectively, and for those with AIDS 33% and 82%, respectively. As for results of laboratory tests, patients with progressive disease had significantly lower titres of anti-HIV nuclear antibodies, as well as a higher incidence of HIV-p24 antigen. Haemoglobin levels, platelet and lymphocyte counts and number of CD-4-positive lymphocytes were significantly lower, Neopterin and beta 2-microglobulins higher (P less than 0.01).

AIDS-Related Complex↗
PubMed1989

[Aspecific and lymphocytic interstitial pneumonia in HIV infections].

The results of 115 bronchoscopic examinations and one autopsy in 105 adults with HIV-infection and pulmonary complications are presented. Whereas 51.7% of the events were caused by Pneumocystis carinii pneumonia (PCP), nonspecific interstitial pneumonitis (NIP) without evidence of an infectious or neoplastic condition was the second most frequent diagnosis in 14 patients (12.1%), four of whom exhibited features of lymphocytic interstitial pneumonia (LIP). The clinical, radiological and prognostic aspects of NIP/LIP, which are very similar to those of PCP, and the possible pathogenesis are discussed. The importance of an adequate diagnostic pulmonary workup is emphasized. We suggest classifying patients with NIP/LIP as stage IV E (CDC) and evaluating the efficacy of a treatment with azidothymidine (AZT) in a controlled clinical study.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Rhodococcus equi infection in HIV disease].

A case of Rhodococcus equi pneumonia associated with septicemia and metastatic brain abscess in an HIV-infected male is presented. Clinical findings and the diagnostic and therapeutic approach are discussed. Cavitating pulmonary disease was rapidly improved by six-week combined oral and parenteral antibiotic treatment. However, pulmonary relapse and brain abscess were documented after one month. Therapy with ceftriaxone, ciprofloxacin and cotrimoxazole on an outpatient basis again led to clinical and radiological improvement after four weeks. Surgical resection of localized processes should be considered early, and prolonged antibiotic therapy over months is recommended.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Bisexuality and AIDS. Implications for heterosexual HIV infections in women].

One of the possible pathways into heterosexual population is the transfer of HIV-virus from bisexual men to their female partners. Therefore sexual behaviour of HIV-positive and -negative bisexual men (n = 31) before and after Aids-disease was analysed. Prior to the Aids-epidemic promiscuous behavior towards male partners (about one female partner per year versus 10 male partners per year). Relatively common contacts to woman occurred within steady relationships. After contact with HIV-test and personal counselling sexual practice became significantly different. The number of female and male contacts was markedly reduced, especially female chance acquaintances were avoided; safer sex was preferred and readiness to inform female partners about bisexuality was increased. This study suggests that reduction of risk for HIV-infection of female partners by homosexual men can be achieved by means of a HIV-test and personal counselling, a possibility that should be considered in preventive concepts.

Acquired Immunodeficiency Syndrome↗
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

Novel reconstitution and enzymatic assay of the mitochondrial tricarboxylate carrier.

The tricarboxylate carrier from beef liver mitochondria was reconstituted into liposomes using a protocol based on the absorption of Triton X-100 to hydrophobic Amberlite XAD-2 beads. The activity of the reconstituted carrier was determined spectroscopically by measuring the citrate/isocitrate exchange with an enzymatic assay. The Km for citrate obtained with this method was 35 microM and the Ki of 1,2,3-benzenetricarboxylate was 27 microM.

Animals↗
PubMed1989

Long-term accuracy of fluorescence polarization immunoassays for gentamicin, tobramycin, netilmicin and vancomycin.

External quality control was performed during six years to determine the accuracy over time of the Abbott TDx fluorescence polarization system for assaying antibiotics. Unknown spiked serum samples of gentamicin, tobramycin, netilmicin and vancomycin were provided monthly by the British national external quality assessment scheme. Comparison of the 209 assay results with the target concentrations showed good correlations in all four assays. No significant deviations from linearity, from slope 1.0, and from intercept 0.0 were detected by regression analysis. Relative deviations were less than 10% and less than 15% for 78% and 90% of all specimens, respectively. On an average the same calibration curves could be used over a period of 19 weeks. Fluorescence polarization immunoassays provided rapid and reliable results over the entire study period.

Anti-Bacterial Agents↗
PubMed1988

[Malignant lymphomas in HIV-infected patients].

Eleven patients with non-Hodgkin's lymphoma and three patients with Hodgkin's disease were observed among 876 anti-HIV-positive subjects attending the AIDS clinic at the University Hospital, Zurich, Switzerland. Compared to the general population this represents a 50-fold (95% confidence limits: 25-90) increased risk of non-Hodgkin's lymphoma and an 11.4-fold (2.3-33) increased risk for Hodgkin's disease in anti-HIV-positive men. High malignancy, advanced stage of disease at the time of diagnosis, and extranodal localization are characteristic of non-Hodgkin's lymphoma in AIDS patients, which carries a poor prognosis. However, remissions and prolonged disease-free survival are possible in individual cases. Only one opportunistic infection was observed during 92 months of treatment and observation using a mild chemotherapeutic regimen (m-BACOD). Less myelosuppressive chemotherapeutic schedules appear to be more beneficial than aggressive regimens in anti-HIV-positive patients due to the lower incidence of opportunistic infections.

Acquired Immunodeficiency Syndrome↗