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PubMed1991

[The clinico-allergic indices of yersiniosis patients].

Eighty patients with yersiniosis (40 with intestinal yersiniosis, 40 with pseudotuberculosis) were examined for clinical and allergic characteristics (collection of allergological histories, identification of the most common allergic symptoms of the disease and determination of the index of mast cell degranulation). According to the data obtained, the patients with yersiniosis are admitted to the hospital with an aggravated premorbid condition in the form of body allergization, in whose origin both hereditary and acquired factors are of importance. The allergic manifestations of the disease are more pronounced in patients with pseudotuberculosis. In the acute disease period, noticeable allergization of the sick body develops whatever the gravity of the disease in both infections whereas during convalescence, only in patients with the recurrent infectious process.

Cell Degranulation↗
PubMed1994

Treatment of growth retardation in juvenile chronic arthritis with recombinant human growth hormone.

OBJECTIVE: To evaluate the effect of recombinant human growth hormone (rhGH) on the linear growth of children with persistently active juvenile chronic arthritis (JCA), most of whom were receiving steroid therapy. All of them were severely growth retarded, but had adequate GH secretion. METHODS: After monitoring height velocity for one year, children were treated for the following year with either 12 IU/m2 or 24 IU/m2 of rhGH. During this period disease activity, drug treatment, dietary intake and bone maturation as well as linear growth were documented. RESULTS: There was a significant increase in height velocity in almost all children during the treatment period. Children with mild to moderate disease activity grew at a better rate than those with very active disease. Children with polyarticular disease responded better than those with systemic JCA. Those children receiving high dose rhGH grew significantly more than those on the low dose regimen. Bone maturation did not exceed chronological age. CONCLUSION: We conclude the rhGH significantly increases the height velocity during one year of treatment. However, its effect on ultimate adult height remains unknown. Thus extensive longterm studies are required to evaluate the risk benefit ratio of this costly treatment.

Adolescent↗
PubMed1987

Periodic activity in electroencephalography.

We report ana analysis of 12 cases in which periodic activity was observed in more than one EEG recording in patients with subacute sclerosing panencephalitis (4 cases), encephalitis of unknown etiology (1 case) and vascular disease (7 cases). In the patients with infective disease periodic high voltage potentials were elicited from all over the brain and the background rhythm was markedly impaired. In the patients with vascular disease the bursts were localized, reversible and sometimes recurrent. The impression gained is that a periodic EEG pattern denotes a pathological modification of behavior of the cerebral cortex rather than any particular disease.

Adolescent↗
PubMedDate not supplied

Significance of the adenine nucleotide translocator in the pathogenesis of viral heart disease.

We found recently autoantibodies against the adenine nucleotide translocator (ANT), a carrier in the inner mitochondrial membrane, in sera of patients with myocarditis and dilated cardiomyopathy. To elucidate whether these antibodies are of pathophysiological importance, we investigated the function and expression of the adenine nucleotide translocator (ANT) in the heart muscle tissue of patients suffering from myocarditis and DCM. We found a markedly lowered transport capacity of the translocator accompanied by an elevation in total ANT protein content. The alteration in ANT protein amount is caused by an ANT isoform shift characterized by an increase in ANT 1 isoform protein associated with a decrease in ANT 2 isoform and an unchanged ANT 3 content. It could be shown that the isoform shift is not a progressive process during the disease period but an event in the early period of illness which becomes permanent. Simulating the effect of pathogenetic factors of autoimmunological diseases, we infected A/J mice with the enterovirus Coxsackie B3 and immunized guinea pigs with myocardial ANT protein. Both treatments led to autoimmunological responds and to a lowered myocardial transport capacity of ANT, to a disturbed energy metabolism and consequently to a depression of heart function.

Animals↗
PubMed1997

Circadian changes in body temperature during the menstrual cycle of healthy adult females and patients suffering from premenstrual syndrome.

The biological rhythm of females is closely related to the menstrual cycle, and this rhythm is believed to influence circadian changes in body temperature. This study investigated and compared the patterns of circadian changes in the body temperature of healthy adult females and patients suffering from premenstrual syndrome or major depression. Body temperature was measured both rectally and sublingually in healthy subjects, and only sublingually in the patients. During the luteal phase in healthy adult females, both the average and lowest nocturnal body temperatures increased, the amplitude of the circadian changes decreased, and the times of the lowest and highest temperatures within a 24-hour period were delayed by 2-3 h. In the patients, the amplitude decreased during disease periods, especially in the follicular phase, whereas in the luteal phase, circadian changes showed great variation each day, although the decrease in amplitude was not as remarkable. The results show that (i) the biological rhythm of females is intrinsically unstable in the luteal phase, although this rhythm is stable in the follicular phase; and, (ii) symptoms were often aggravated with the decreases in amplitude experienced in the luteal phase.

Adult↗
PubMed1995

The distribution of incubation periods of infectious disease. 1949.

1. Characteristics of the distribution of incubation periods of a number of infectious diseases, as reported in the literature, have been reviewed. 2. The usual frequency curve of incubation time takes the form of a logarithmic normal curve. This appears to be equally true of diseases with very short and very long incubation periods. 3. The measure of variation in incubation periods used in this study, termed the dispersion factor, is the antilogarithm of the logarithmic standard deviation. Dispersion factors for most of the diseases studied range from 1.2 to 1.5 and are independent of mean length of incubation. 4. Some epidemiological uses for a knowledge of the distribution of incubation time are discussed.

Communicable Diseases↗
PubMed1994

The severity of rheumatoid arthritis: a 6-year followup study of younger women with symptoms of recent onset.

OBJECTIVE: In rheumatoid arthritis (RA), not only outcome measurements taken at a single point in time, but also the severity during the entire disease period is important. In this investigation we measured severity in terms of the course of disease activity. It is the activity of the disease which leads to most suffering in the patient, and which we try to alleviate. METHODS: Patterns of disease activity were investigated in 132 female patients who were followed yearly from an early phase of the disease for a mean duration of 6 years. RESULTS: Sixty-seven patients (50.8%) continuously had < or = 4 swollen joints (low activity), 23 patients (17.4%) continuously had > or = 4 swollen joints (high activity), in 10 patients (7.6%) disease activity decreased from high to low, in 8 patients (6.1%) disease activity increased from low to high, and 24 patients (18.2%) had fluctuating levels of disease activity. The outcome of the disease as measured by the functional ability, the radiological abnormalities, and number of prescribed 2nd line drugs, was best in patients with continuously low levels of disease activity, and worst in patients with continuously high or increasing levels of disease activity. CONCLUSION: For about half of the female patients presenting to a rheumatology outpatient clinic, the severity of RA after 6 years of disease duration is characterized by continuous but low disease activity, and sufficient preservation of functional ability. For the other half of the patients RA is a progressive and disabling disease.

Adult↗
PubMed1998

The effect of different diagnostic thresholds on incidence of disease progression.

Detection of periodontal disease progression occurs when a predetermined threshold of attachment loss is exceeded during longitudinal monitoring. The incidence of disease progression in a population may be dependent on the method and threshold utilized to identify significant changes in attachment level measurements. The aim of this study was to investigate the effect of utilizing different methods and thresholds on the incidence of disease progression in an untreated periodontitis population. The relationship between baseline clinical parameters and disease progression was also examined. A total of 411 interproximal sites in 46 individuals were monitored monthly over a 6-month period. Disease progression was determined by the cumulative sum (CUSUM) method and by the absolute change in relative attachment level between months 0 and 6 utilizing 3 different thresholds for attachment level change (0.58 mm, 1.16 mm, and 1.74 mm) based upon examiner repeatability using an automated probe. Utilizing the CUSUM method, 49 of 411 sites (11.9%) demonstrated attachment loss over the 6-month observation period. When attachment level changes > or = 0.58 mm, > or = 1.16 mm, and > or = 1.74 mm were used to identify disease progression, the percentage of sites exhibiting deterioration were 19.5%, 8.8%, and 2.9%, respectively. These results demonstrate that the apparent incidence of disease progression was dependent on the method and threshold utilized to detect progressive sites. When utilizing the CUSUM and 0.58 mm thresholds a significant (P < 0.05), but weak relationship (r = -0.26) was observed between baseline relative attachment level measurements and sites exhibiting disease progression. This finding suggests that sites with significant but relatively less attachment loss may be more likely to experience further breakdown compared to sites with a history of greater periodontal destruction.

Analysis of Variance↗
PubMed1981

Age at onset of genetic diseases: an application for Sartwell's model of the distribution of incubation periods.

For diseases of well-defined genetic etiology and with onset after birth, the age at onset corresponds to the incubation period of the disease. The lognormal model, as used by Sartwell to study the distribution of incubation periods in infectious diseases (Am J Hyg 1950;51:310-8), was applied in this study to the distribution of the ages at onset of genetic diseases. The literature was reviewed for reports of genetic diseases having frequency distributions of ages at onset. Fourteen diseases with well-specified genetic etiology as well as nine other diseases where the contribution of the genetic component to the etiology is not well defined were studied. A graphic method as well as a goodness of fit test were applied to the different age at onset distributions to assess their conformity to the lognormal model. For most of the genetic diseases that have an underlying biochemical abnormality, the age at onset distributions approximated a logarithmic normal model. In seven series of cases of diseases with an established pattern of inheritance but with no defined biochemical abnormalities, only two showed a good fit to the lognormal model. For diseases with ill-defined genetic etiology or strong environmental influences, these distributions of the age at onset did not fit the lognormal model. In a multifactorial model for disease etiology, the present method may be used as a crude way for differentiating the relative importance of etiologic factors acting before and after birth.

Adolescent↗
PubMed1987

Late manifestation of chronic liver disease in adults with alpha-1-antitrypsin deficiency.

A review of 19 adult patients with alpha-1-antitrypsin deficiency (A1AT deficiency) and chronic liver disease revealed a late onset of symptomatic hepatic abnormalities in this condition. Thirteen patients (68%) were 60 years or older when the liver disease was discovered. The mean age of the patients with the ZZ, SZ, and MZ phenotypes was 58, 66, and 72.5 years, respectively; this suggested a later onset of the liver disease in the heterozygotes. At the time of diagnosis, the hepatic condition usually was advanced; in eight patients (42%) the survival was less than two years. The most important associated condition was chronic obstructive lung disease which was found in 10 patients (53%). We conclude that advanced age and the high incidence of obstructive lung disease make it unlikely that liver transplantation will become a common therapeutic option for adult patients with A1AT deficiency and associated liver disease. Periodic screening of liver function may be indicated in patients with A1AT deficiency so that chronic liver disease can be diagnosed early, particularly if current attempts to develop effective medical therapy for this condition are successful.

Adult↗
PubMed1994

Reinfection with Legionella pneumophila documented by pulsed-field gel electrophoresis.

A 50-year-old man with chronic lymphocytic leukemia experienced two episodes of community-acquired legionnaires' disease. For determining whether this was the result of relapse or reinfection, Legionella pneumophila strains, cultured from sputum specimens and his home water supply, were characterized by pulsed-field gel electrophoresis. Analysis of the restriction patterns and the clinical data indicated that the second disease period was most likely the result of reinfection. We conclude that after diagnosis of community-acquired legionnaires' disease in an immunocompromised patient, culturing of the domestic water supplies for L. pneumophila should be considered; if such cultures are positive, adequate measures to prevent reexposure have to be taken.

Anti-Bacterial Agents↗
PubMedDate not supplied

Development rate of mutilans fingers in patients with rheumatic disease.

OBJECTIVE: To describe arthritis mutilans (AM) deformity during the progression of rheumatic disease. METHODS: The development of mutilans-like hand deformities in 2 patients with juvenile chronic arthritis (JCA) and in 2 patients with adult onset rheumatoid arthritis (RA) are presented. The hands of these patients were evaluated at least at two time points during the course of disease using two different scoring methods based on differently summed Larsen grades of the hand joints. RESULTS: Two patients (one with JCA and one with RA) showed AM changes after a disease period of less than 10 years and 2 not until after 30 years. The patients with adult onset disease were young at the onset of joint disease. Early wrist fusions were performed on both patients showing a slow development rate. CONCLUSIONS: The development rate of AM is very variable, even in patients with the same diagnoses. Wrist fusion prevents shortening of the carpus and may decrease the development rate of AM.

Adult↗
PubMed1990

[Phospholipid spectrum and the indicators of lipid peroxidation in the cerebrospinal fluid of newborn infants with perinatal lesions of the central nervous system].

A study was made of the phospholipid content and lipid peroxidation (LPO) in the cerebrospinal fluid of neonates in the early neonatal period. LPO was found to be activated in neonates with perinatal lesions of the CNS, correlating with the disease gravity. Appreciable changes in the phospholipid spectrum of the cerebrospinal fluid were revealed in all the components. The rise of the content of lysophosphatidyl choline turned out most significant. The interrelation between activation of LPO processes in the cerebrospinal fluid and changes in its phospholipid spectrum is under discussion. The characteristics under study may serve an additional diagnostic criterion for assessing the gravity of CNS lesion in neonates and should be taken into consideration in carrying out rational therapy in the acute disease period.

Humans↗
PubMedDate not supplied

[Digestive cytomegalovirus disease in AIDS patients].

BACKGROUND: In this paper we study the digestive manifestations of cytomegalovirus (CMV) in AIDS patients. Also, we evaluate the antiviral treatment and the necessity of maintenance therapy. METHODS: Retrospective review of medical charts of all patients with AIDS and digestive CMV disease diagnosed and followed-up since 1983 to december 1993. RESULTS: Of 720 AIDS patients, 96 presented a CMV disease. Among them, 30 patients (31%) complained digestive manifestations. These were 26 males and 4 females, mean age: 37.4 y-old. Risk factors for HIV were: 13 homosex and 12 intravenous drug abusers. Average of time between AIDS diagnosis and digestive CMV disease: 13.4 months. Fourteen patients had esophagitis, 9 proctocolitis, 3 hepatitis, 3 pancreatitis, 2 gastric ulcerations, one small bowel disease and other an oral ulceration. Two patients had a concomitant CMV chorioretinitis. CD4 lymphocytes were below 0.05 x 10(9)/l in 29 patients. Twenty-four patients received antiviral treatment during the acute disease period, with a clinical curation rate of 60%. Seven patients received maintenance therapy and remained free of CMV disease until death. Eleven patients didn't received maintenance treatment. Of them, one patient presented a digestive relapse and two developed a CMV chorioretinitis. Mortality in the first month from diagnosis was 23% and the median of survival time for patients who cured and initial episode of digestive CMV disease was 208 days, wether or not the patient received maintenance therapy or not. CONCLUSIONS: One third of ours patients with AIDS and CMV infection have a digestive disease. This CMV digestive disease appears in patients with a severe immunosuppression. Acute phase mortality was 23%. The median survival was 7 months, independently or receiving maintenance treatment or not.

AIDS-Related Opportunistic Infections↗
PubMed1990

[The functioning of the glutathione system in patients with acute viral hepatitis B].

As many as 160 patients with acute virus hepatitis B (AVHB) were examined over time. Spectroscopy was used to study the activity of glucose-6-phosphate dehydrogenase (G-6-PDH), glutathione peroxidase-1 (GP1), glutathione peroxidase-2 (GP2), glutathione reductase (GR), glutathione transferase (GT) and to measure the concentration of reduced glutathione (GSH) in the blood serum and in red blood cells. Within the first days of the icteric period, the activity of all the enzymes rose, followed by reduction of the activity of G-6-PDH, GP1, GP2, GR and the concentration of GSH at the height of the disease. The GT activity remained high throughout the entire disease period.

Acute Disease↗
PubMed1989

[Siderophilic erythrokaryocytes of the bone marrow at various periods during the course of acute leukemia].

Investigation of the iron-containing granules in erythrokaryocytes of bone marrow from 89 patients with acute leukemias at different disease periods has demonstrated that siderophilia of the nuclear elements of red blood cells depends in many respects on the function of erythropoiesis which is materially influenced by various kinds of chemotherapy (induction, consolidation, maintenance and antirelapsing). Nevertheless, since the established correlation is marked to a moderate degree, the other factors may exist that influence granular siderophilia of medullary erythrokaryocytes, particularly the distribution of iron between the leukemic tissue and erythroid cells, manifesting dissimilarly in different patterns and variants of acute leukemias.

Adolescent↗
PubMed1991

[Indicators of osmotic homeostasis and blood rheology in the acute period of cerebrovascular disorders].

Examination of 80 patients with ischemic and hemorrhagic brain strokes has revealed definite phasic alterations that occur in osmotic homeostasis and hemorheology. In the acute disease period, the intensity of the hyperosmolar syndrome is dependent on the levels of hyperglycemia, azotemia, hypernatremia and is provoked by the impairment of the central and peripheral mechanisms of regulation of water-electrolyte metabolism and osmotic homeostasis as a result of the direct effect of the pathological focus or secondary impairment of the brain stem due to brain edema associated with dislocation of the median and stem structures. That the disease exhibits in the presence of progressively increasing hyperosmia, the decreased parameters of hemolysis coupled with a gradual decline of the aggregation capacity of platelets and red blood cells, blood viscosity, with the high fibrinogen indicators being preserved, points to the failure of the functional potentialities of blood cell elements. The data obtained can serve as a prognostic criterion for the disease outcome and efficacy of infusion and dehydration therapy.

Acute Disease↗