Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Jan 2000
[Pericardial effusion in celiac disease--an incidental finding?].
Ultrasound revealed evidence of pericardial effusion in 13 out of 26 children with coeliac disease. In a prospective study, we tried to analyse the causes underlying this high incidence of pericardial effusion. ⋯ The high incidence of pericardial effusion in patients with coeliac disease appears to be governed by a multifactorial mechanism. A high endomysial antibody titre as well as selenium deficiency may play a role as a predisposing factor. Viral infection due to reduced immunological competence in conjunction with a hampered ability to eliminate toxic free radicals might cause blood vessel dysfunction, resulting in (asymptomatic) pericardial effusion. The fact that most of these patients were diagnosed during the cold season, with anamnestic evidence of viral infection shortly before the diagnosis, and the fact that adult patients with dilative cardiomypathy show a greater prevalence of coeliac disease, supports the view that coeliac disease is systemic in nature.
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From 1990 to 1996 a total of 67 adult patients with typical erythema migrans (EM) and a previously identified immunocompromised condition were investigated at the University Medical Centre, Department of Infectious Diseases, Ljubljana, Slovenia. The course and outcome of borrelial infection were compared with 67 previously healthy age and sex-matched individuals with EM who were examined at our institution in the same year. ⋯ Re-treatment was required in 13 (19.4%) patients of the immunocompromised group and only in five (7.5%) patients of the control group (p = 0.0762). However, in spite of the more severe course and the more frequent need for re-treatment among patients whose immune system was impaired, the outcome of borrelial infection after one year was favourable in both groups.
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From 1994 to 1996, 114 consecutive patients older than 15 years who presented at the Department of Infectious Diseases, University Medical Centre, Ljubljana, fulfilled the criteria for inclusion into this study on the borrelial aetiology of peripheral facial palsy (PFP). The study was restricted to patients without a conceivable explanation for their PFP, erythema migrans or history of erythema migrans, clinical signs/symptoms of frank meningitis or any other neurological manifestation in addition to PFP. In 22 (19.3%) of these 114 patients borrelial infection was confirmed by one of the following: in 3 (13.6%) by the isolation of Borrelia burgdorferi sensu lato from cerebrospinal fluid (CSF), in 11 (50%) by the presence of intrathecal antibody production, and in 8 (36.4%) by seroconversion to borrelial antigens. ⋯ In Slovenia which is a highly endemic region for Lyme borreliosis, borrelial infection is a frequent cause of PFP in adult patients. PFP may occur early in the course of LB, prior to measurable antibody response, indicating the need for serologic follow-up. Abnormal CSF results and the presence of additional local and/or systemic symptoms are factors indicating a higher possibility of borrelial aetiology of PFP and should alert physicians to suspect LB.
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Wien. Klin. Wochenschr. · Nov 1999
Indoor factors and their association to respiratory symptoms suggestive of asthma in Austrian children aged 6-9 years.
The ISAAC (International Study of Asthma and Allergy in Childhood) was founded in 1990 in order to maximise the value of epidemiological research into asthma and allergic diseases, to describe the prevalence of asthma and allergic disease in children living in different locations, to make comparisons within and between countries, to provide a framework for further etiological research and to find prevention strategies. We analysed a sub-sample of a population-based study (1995 to 1997) in Upper Austria. ⋯ Smoking of the mother during pregnancy and/or during breastfeeding (OR 1.28; 95% CI 1.08-1.48), smoking of the mother at the present time (OR 1.25; 95% CI 1.12-1.41), a bird (OR 1.40; 95% CI 1.06-1.85) or rabbit (OR 1.37; 95% CI 1.03-1.82) as a domestic pet, synthetic bedding (OR 1.33; 95% CI 1.18-1.49) and dampness or mould at home (OR 1.43; 95% CI 1.24-1.65) are associated with a significantly increased risk of childhood wheezing in the last 12 months. Other variables such as "smoking of the father", "cooking with gas", "gas central heating" and other "pets" do not achieve statistical significance.