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T Weinke

Publications and source records attributed to T Weinke.

At least 37 records · Page 2Linked to original sources
PubMed1994

Complicated tuberculosis and residual disease.

Complicated and extrapulmonary manifestations of tuberculosis (TB) may cause prolonged suffering for the individual patient and represent a high economic burden for the society concerned. Complications of pulmonary TB may be the consequence of reduced individual resistance, immunosuppression or specific immune defects. In HIV patients, pulmonary TB is often associated with extrapulmonary lesions, while the radiologic appearance of lung infiltrates may be less prominent compared to HIV negative persons. The present review summarizes data obtained during a 12-year study of extrapulmonary TB in Berlin, Germany, and outlines the role of residual TB lesions for disease reactivation in later life. Indications and limitations of INH preventive chemotherapy will be discussed.

HIV Seropositivity↗
PubMed1994

Malaria prophylaxis: identifying risk groups for non-compliance.

To investigate behaviour in the use of drug prophylaxis against malaria and the risk factors for non-compliance, 507 European or North American travelers returning from endemic areas were studied retrospectively at Berlin in a 11-year period from 1980 to 1990. Compliance was significantly correlated with shorter travel duration: the group with good compliance stayed 37.2 +/- 38.5 days (mean +/- SD) in contrast to 69.8 +/- 93.5 days in the group of patients with no compliance (p = 0.00001). Older patients were significantly more compliant than patients aged < 55 years (20/27 compliant at > 54 years vs. 175/476 at < 55 years; p = 0.0001). Compliance was significantly affected by travel destination (Southern and East African regions; p = 0.0054), age (< or = 15 and > or = 55 years, respectively; p = 0.0001), and reason of travel (package tours; p = 0.0001). CART analysis confirmed logistic regression analysis with respect to age and travel type, and revealed that patients using only one information source were significantly more compliant than those using two or more information sources. Travel agencies were nearly as well informed as Institutes of Tropical Medicine, but family doctors had a significant incidence of giving wrong advice. This study should enable medical personnel dealing with prophylactic advice against malaria to identify patients at high risk for non-compliance, and to educate them more carefully than other travellers regarding antimalarial drug prophylaxis.

Adolescent↗
PubMed1993

[Halofantrine in the treatment of imported malaria in nonimmune travelers].

The efficacy (criteria: cure rate, time to resolution of fever or absence of parasites) and safety (criteria: clinical side effects, altered laboratory parameters) of halofantrin were investigated in a multi-centre study of 96 non-immune patients (71 men, 25 women, mean age 34.3 [21-62] years) with malaria imported from regions of high resistance into Germany or Switzerland. The initial 63 patients received one-day treatment (three doses of 500 mg halofantrin), while the last 33 patients received an additional course of treatment one week later. Treatment was curative in all patients in the second group, but relapses occurred in five of the 41 patients (12.2%) with falciparum malaria who received one-day therapy. Fever resolved after a mean of 45 hours and parasites were absent after a mean of 66 hours. There were small increases in transaminase values (most probably because of the infection) in five patients, but all became normal again within a few days. Halofantrin is a safe drug and is suitable for both therapy and stand-by therapy of resistant Plasmodium infections. Treatment should be repeated after 7 days.

Adolescent↗
PubMed1992

[Malaria tropica].

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Exchange Transfusion, Whole Blood↗
PubMed1992

Association between Staphylococcus aureus nasopharyngeal colonization and septicemia in patients infected with the human immunodeficiency virus.

In an attempt to identify risk factors for Staphylococcus aureus septicemia, 136 consecutive HIV-infected patients were investigated for the presence of nasopharyngeal colonization with Staphylococcus aureus and subsequent Staphylococcus aureus infection. Sixty of 136 (44.1%) HIV-infected patients had staphylococci which were detected in the nasopharynx on initial culture compared to 12 of 39 (30.8%) patients with chronic diseases and 11 of 47 (23.4%) healthy hospital staff. Another 12 HIV-infected subjects proved to be Staphylococcus aureus carriers on follow-up cultures. Patients with full-blown AIDS had a higher carriage rate compared to subjects who were only HIV-positive (p < 0.05), indicating that Staphylococcus aureus colonized patients were more severely ill. Eight patients with Staphylococcus aureus septicemia were observed, all of whom were carriers; no septicemia occurred in the non-colonized patients (p < 0.01). Colonized patients with neutropenia (< 1000/microliters) were significantly more likely to develop septicemia (p < 0.01). Nasopharyngeal colonization with Staphylococcus aureus and the presence of an indwelling catheter were established to be factors that help identify patients at risk of acquiring subsequent Staphylococcus aureus infection.

Adult↗
PubMed1992

Malaria therapy in 452 patients, with special reference to the use of quinine.

We investigated the efficacy and toxic potential of antimalarial therapy regimens in 452 malaria patients treated between 1980 and 1990. Drug regimens in 330 non-immune travellers were compared with those of 122 semi-immunes with acute malaria; 71% patients acquired their infection in tropical Africa, and the 288 Plasmodium falciparum infections were the most prevalent species. Because of increasing drug resistance or toxicity of chloroquine, pyrimethamine-sulfadoxine and even mefloquine, quinine proved to be the most effective antimalarial against P. falciparum and the only one which did not lead to recrudescences. These occurred in 10% patients after chloroquine and 6% after mefloquine. Cinchonism occurred in 25% of those treated with quinine, but it was fully reversible and never necessitated withdrawal of the drug. We conclude that quinine is highly effective in the treatment of P. falciparum infection and is mandatory if the clinical condition requires a fast-acting blood schizonticide, in cases of hyper-parasitaemia and if multi-drug resistance occurs; its use should not be restricted by reversible side-effects such as cinchonism.

Adolescent↗
PubMed1992

The efficacy of halofantrine in the treatment of acute malaria in nonimmune travelers.

A multicenter prospective trial was performed to investigate the efficacy and the tolerability of halofantrine in nonimmune patients with malaria imported from areas with drug-resistant falciparum parasites (mainly Africa). Forty-five of the 74 subjects were treated with a one-day regimen (3 x 500 mg) of halofantrine, and the other 29 received the same regimen with an additional treatment on day 7. In the second group, a 100% efficacy rate was demonstrated, but in the group receiving the one-day regimen, four recrudescences were observed in patients with falciparum malaria. Only five mild adverse reactions were seen, which disappeared spontaneously after the end of the treatment. We conclude that halofantrine is highly effective in curing malaria in nonimmune subjects. The treatment scheme for such persons should include an additional treatment on day 7 for nonimmune individuals. This drug was well tolerated in our patients, indicating that halofantrine will be useful in the treatment of multidrug-resistant malaria in nonimmune persons.

Acute Disease↗
PubMed1991

Neuropsychiatric side effects after the use of mefloquine.

This study describes neuropsychiatric side effects in patients after treatment with mefloquine. Reactions consisted mainly of seizures, acute psychoses, anxiety neurosis, and major disturbances of sleep-wake rhythm. Side effects occurred after both therapeutic and prophylactic intake and were graded from moderate to severe. In a risk analysis of neuropsychiatric side effects in Germany, it is estimated that one of 8,000 mefloquine users suffers from such reactions. The incidence calculation revealed that one of 215 therapeutic users had reactions, compared with one of 13,000 in the prophylaxis group, making the risk of neuropsychiatric reactions after mefloquine treatment 60 times higher than after prophylaxis. Therefore, certain limitations for malaria prophylaxis and treatment with mefloquine are recommended.

Adult↗
PubMed1991

[Clinical experiences with mefloquine in tropical malaria--a prospective study].

The therapeutic effects and side effects of mefloquine in falciparum malaria were investigated in an open prospective trial involving 20 patients. None of them had a history of neurologic or psychiatric disorders. Mefloquine was given in a total dose of 1500 mg base. The cure rate was 100%, fever and parasitemia subsided within 3 days. Side effects were vomitus and nausea in 25% of the patients. No neurological or psychiatric disorders were observed. Mefloquine was shown to be a safe therapeutic agent in the dosage used. However, regular follow-up examinations should be done in short intervals because of the possibility of late neuropsychiatric side effects; the patients and their relatives should be informed about this fact.

Adolescent↗
PubMed1990

[Malaria tropica in HIV infection].

This is a case report of a 24 year-old woman who is HIV-infected since three years (stage III B, CDC). She developed malaria tropica during her touristic stay in the Cameroons, Africa. No clinical complications were detectable even though she had a high parasitemia of 18% blood cells infected with Plasmodium falciparum. After quinine therapy defervescence occurred and blood smears were continuously free of malaria parasites. P. falciparum infection may increase HIV-related immunosuppression which favours the earlier occurrence of AIDS indicative opportunistic infections. Malaria in combination with HIV-infection can lead to a higher parasitemia; this does not necessarily lead to a higher rate of complications.

Animals↗
PubMed1990

Malaria prophylaxis in travellers to tropical Africa.

This study investigated travellers to tropical Africa with regard to prophylactic treatment of malaria. A total of 5703 travellers completed a questionnaire on their flights back to the Federal Republic of Germany; 4116 passengers (73.7%) had visited East Africa, while 808 (14.5%) had been to West Africa. The results indicate that 90.2% took a regular chemoprophylaxis against malaria. Nevertheless, 8.1% of the travellers used no antimalarials and in 9.3% chemoprophylaxis was inadequate due to inappropriate advice; for example, 7.5% still took pyrimethamine-sulfadoxine as prophylactic. Mefloquine was correctly taken by 38.9% of the travellers in East Africa; 12.6% used it in West Africa where it is not necessary. Antimosquito measures have a high priority for travellers to tropical Africa and dissemination of this fact must be improved since only 72.6% followed through on such advice.

Africa↗
PubMed1990

[Multiple amebic liver abscesses: ultrasound diagnosis and ultrasound-controlled puncture].

Amebic colitis and amebic liver abscess were diagnosed in a 45-year-old patient who had returned from Thailand. Ultrasound scans performed after starting treatment with metronidazole showed an abscess located above the right kidney that had enlarged to a maximum diameter of 9.7 cm. Since rupture of this lesion was felt to be imminent, ultrasound-guided needle biopsy was performed and 300 ml of abscess fluid evacuated. The patient experienced rapid relief of his symptoms. The role of ultrasound imaging in the diagnosis and follow-up of amebic liver abscesses and the indications for ultrasound-guided needle aspiration are discussed.

Animals↗
PubMed1990

Prevalence and clinical importance of Entamoeba histolytica in two high-risk groups: travelers returning from the tropics and male homosexuals.

This study was undertaken to learn the prevalence of amebiasis and to assess the clinical importance of Entamoeba histolytica in two high-risk groups: 2700 travelers returning from the tropics and 320 male homosexuals. Some 16.3% of the homosexual men and 4.0% of the travelers had E. histolytica infections. Only five travelers showed a pathogenic zymodeme of E. histolytica, which correlated closely with invasive amebiasis with positive amebic serology and clinical symptoms with diarrhea. The homosexual group had neither a pathogenic isoenzyme pattern nor positive amebic serology. Currently, travelers to the tropics have a risk of 0.3% (1:340) of acquiring invasive amebiasis; 92.5% of all E. histolytica infections in travelers remain asymptomatic and are confirmed by serology and zymodeme status. No homosexual presented with invasive amebiasis.

Adult↗