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R Steffen

Publications and source records attributed to R Steffen.

At least 235 records · Page 13Linked to original sources
PubMed1986

[Accepted principles for the prevention and therapy of travelers' diarrhea].

Diarrhea is the most frequent health problem in travellers to developing countries. The syndrome is usually caused by an infection acquired by ingesting fecally contaminated food or beverages. Various bacteria, viruses and protozoa may cause traveller's diarrhea, the leading pathogen being enterotoxigenic E. coli. Antimicrobial drug prophylaxis is not recommended in view of the potential side effects. A more sensible approach is self-therapy with anti-motility agents in mild and uncomplicated cases, while for more severe illness an antimicrobial drug may be used. However, in view of the usually mild, self-limited disorder, therapy should be considered optional. Oral rehydration should be instituted when necessary.

Anti-Bacterial Agents↗
PubMed1986

Sponge aggregation factor: in situ localization by fluorescent monoclonal antibody techniques.

The aggregation factor (AF) from sponges mediates a heterophilic interaction of homologous cells. Applying electron microscopical means, we succeeded only very rarely in identifying the 90 S AF particle in tissue sections from Geodia cydonium. By means of a fluorescent antibody technique, we have now localized the cell binding domain of the AF in situ. Previous studies in this laboratory have led to the identification of the 47-kDa cell binding protein of the AF, using the monoclonal antibody (mab) 5D2-D11 [Gramzow M, Bachmann M, Zahn RK, Uhlenbruck G, Dorn A, Müller WEG, J Cell Biol, 102: 1344-1349, 1986]. This mab and mab 7D5, directed against a 92-kDa protein in the AF complex, were chosen for the fluorescent studies. By using mab 5D2-D11, the plasma membranes of cells from different regions in the sponge could be brightly stained. However, mab 7D5 reacted only very weakly with the sponge surfaces. By applying the immuno-blotting technique it was furthermore demonstrated that the cell binding protein is present both in the associated form with AF complex and in a free state. Moreover, it was established that the 47-kDa binding protein is not present in homologous glycoconjugates, lectin, or collagen; these components are known to be involved in cell-matrix interaction.

Animals↗
PubMed1986

[Experiences with intradisk injection treatment with chymopapain and collagenase].

In a comparative study 71 patients were treated by intradiscal injection of collagenase and 93 patients by chymopapain injections. Indication, technique of injection and post-injection treatment were based on uniform criteria and followed standardised procedure. In practically all cases, monosegmental injections were performed almost exclusively in the last two discs of the lumbar vertebral column; in cases where the x-ray and clinical findings were unequivocal, the injections were performed at one level of the lumbar vertebral column. After collagenase injection, patients suffered more from low back pain, needed higher doses of strong analgesics, and had a longer hospital stay. Results after one year were almost equal with success rates of 75% (chymopapain) and 72% (collagenase). In each group about three-quarters of the patients with unsatisfactory results were operated on.

Chymopapain↗
PubMed1986

Prevention of traveler's diarrhea by the tablet form of bismuth subsalicylate.

In a randomized double-blind study, Swiss adults traveling to tropical countries for 12 to 28 days took a solid formulation of bismuth subsalicylate (1.05 or 2.1 g/day on a twice-daily regimen) or placebo. Efficacy was evaluated in 231 volunteers. Diarrheal incidence was reduced by 41% in persons taking the high dose (P = 0.007) and by 35% in those taking the low dose (P = 0.03) with excellent compliance. No serious adverse reactions occurred, but objectionable taste, constipation, and nausea were seen more frequently with active medication (P = 0.04). Twenty patients provided stool samples: no bacteria were detected in the 8 volunteers who were on active medication, but various bacteria were found in 5 of the 12 patients who had taken placebo (P = 0.04).

Bismuth↗
PubMed1986

[Functional treatment of fresh outer ligament ruptures using an Aircast splint].

Functional treatment with an Aircast splint can reduce pathological inversion of the ankle joint. Now that we have used the splint since 1981, we report our experience with a small group of patient who have been reviewed three times in the last 4 years. The patients reported good-to-excellent results. Objective evaluation was slightly better in the first follow up evaluation with increased laxness in the stress tests in the last control. However only one patient needed ligament reconstruction. The Aircast splint provides good-to-excellent subjective results and good objective results in 75% of cases. The following indications are valid for operative treatment: Laxity with a talar tilt of definitely more than 15 degrees, or with an anterior drawer of the talus of more than 12 mm in a young athlete who is dependent on complete stability. Patients with osteochondral lesions and avulsed fibular fragments. History of pre-existing recurrent subluxations, possibly in combination with a ligament reconstruction.

Adolescent↗
PubMed1985

[Typhus epidemiology in Switzerland 1980-1983. Slight or lack of effectiveness of the live vaccine Vivotif in tropical travel].

214 cases of typhoid fever (TF) occurring in Switzerland between January 1980 and December 1984 were analyzed for travel history, vaccine status and nationality. A subgroup of Swiss tourists who acquired TF in India was compared to a sample of healthy Swiss tourists who travelled to India in 1983 to determine the factors predisposing to TF. Eighty cases of TF occurred in Swiss tourists to the Third World, of whom 26 had travelled in India. Among the latter, the length of stay was longer than in the control sample of 258 healthy tourists, and "trekking" (travelling off the usual tourist routes with backpacking) was more frequent. 20 of the 80 patients had been vaccinated with the live oral typhoid vaccine Vivotif (strain S. typhi Ty 21a, contained in gelatine capsules, to be taken with bicarbonate capsules), marketed in Switzerland in 1981-1984. Comparison of the vaccination rates in case and control groups indicated that the vaccine efficacy was not significantly different from 0% during the time of observation. This lack of efficacy may be related to inadequate dosage and to the lack of stability of the vaccine. Forty cases of TF occurred in Swiss who had travelled in European countries, of whom 8 had not travelled outside Switzerland. The remaining 94 cases occurred in non-Swiss travellers, a majority of whom were from Mediterranean countries. TF in Switzerland was associated with a history of travel in 96% of cases. The live oral typhoid vaccine Vivotif was ineffective between 1981 and 1983.(ABSTRACT TRUNCATED AT 250 WORDS)

Carrier State↗
PubMed1985

[Viral hepatitis and AIDS-associated HTLV III/LAV virus infections in drug addicts].

In 1984 intravenous drug users accounted for 25% of all cases of acute hepatitis B and for 32% of all cases of non-A/non-B hepatitis recorded in the Canton of Zürich. Drug addicts also represented an important risk group for hepatitis A, which occurred in small epidemics. Among 141 "healthy" drug users, 10 (7%) individuals showed signs of ongoing hepatitis B virus (HBV-) infection, 26 (19%) individuals had the finding "anti-HBc-alone" (unresolved HBV-infection) and another 69 (49%) individuals were HBV-immune. 30%, 23% and 16% of the three above groups of individuals with HBV-markers were also anti-delta virus positive. Of the 141 "healthy" drug users 23 (16%) showed signs of an ongoing hepatitis A virus (HAV-) infection and 63 (45%) individuals were HAV-immune. Anti-HTLV III/LAV was detected in 69 (49%) of the i.v. drug users, with a higher prevalence (60%) in females than in males and with a higher prevalence in individuals with HBV-markers (50-62%) than in those without such markers (19%). Thus the i.v. drug users are at high risk for infections with hepatitis viruses A, B, D and those responsible for non-A/non-B hepatitis, as well as with the AIDS-associated virus HTLV III/LAV. Preventive measures should include a reduction of needle sharing and of promiscuity, which is abundantly practised by i.v. drug users.

Adult↗
PubMed1985

[Pre-exposure rabies vaccination using a new duck embryo vaccine].

An economical, highly purified and concentrated duck embryo rabies vaccine (PDEV) was investigated in relation to pre-exposure rabies prophylaxis. The vaccine was injected subcutaneously according to the then prescribed scheme for human diploid cell rabies vaccines (HDCV). Additionally, a third dose was given on day 120. Serum anti-rabies antibody levels were determined on days 0, 56, 120, und 170. On day 56 all volunteers showed an anti-rabies antibody level of at least 1.0 IU/ml, indicating that PDEV is sufficiently immunogenic to allow its use according to the pre-exposure schedules for HDCV. Some rather low titers noted on day 120 indicate that an early booster dose or a third primary immunization dose is justified, as recently recommended by the WHO.

Animals↗
PubMed1985

Inefficacy of the commercial live oral Ty 21a vaccine in the prevention of typhoid fever.

The efficacy of the live oral typhoid fever vaccine Ty 21a marketed in Switzerland in 1981 was investigated. Forty-seven Swiss travellers to Third World countries contracted typhoid fever in 1982 and 1983; 20 (43%) of these persons had been vaccinated with Ty 21a. The incidence of typhoid fever in vaccinees was 1.1 per 10,000 doses of Ty 21a vaccine sold, which was similar to the incidence of 0.9 per 10,000 doses for the ineffective killed Ty 2 vaccine. Comparison of the incidence of vaccination in patients with typhoid fever in 1983 and in healthy travellers to India revealed vaccination efficacy rates which were not significantly different from zero. It is suggested that Ty 21a vaccine in the form marketed in Switzerland in 1981-1983 is not sufficiently potent or heat-stable, so that the doses of viable bacteria ingested were too low.

Administration, Oral↗
PubMed1985

Hepatitis B vaccination campaign in a low endemicity area.

Between January 1982 and December 1983 14,666 high-risk individuals in the Canton of Zurich, which has one million inhabitants, received 36,234 hepatitis B vaccine injections. The annual number of acute hepatitis B cases dropped from an estimated 220 to 280 in 1981 to 177 in 1982 and 133 in 1983. This drop of 40-50% resulted mainly from reduced numbers of cases among health care workers, drug addicts and homosexuals. Vaccination was a factor responsible for the reduced incidence of hepatitis B among health care workers and drug addicts, high-risk categories substantial proportions of which had been vaccinated. There was no evidence of a secondary protective effect of vaccination extending to other high-risk groups.

Hepatitis B↗
PubMed1985

'Boil it, cook it, peel it or forget it': does this rule prevent travellers' diarrhoea?

A total of 688 out of 2240 air charter passengers in flight to Kenya, West Africa or Sri Lanka/Maldives volunteered to participate in a follow-up study investigating the influence of various food and beverage items on the incidence of travellers' diarrhoea. Within the first three days of their stay abroad, 98% accepted food or beverages whose avoidance is traditionally recommended. The incidence of diarrhoea, which was 19.5%, was proportionate to the number of dietary mistakes committed. The most dangerous items were those whose avoidance was traditionally recommended.

Adolescent↗
PubMed1985

Travelers' diarrhea.

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Combined Modality Therapy↗