European journal of medical research
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Clinical Trial Controlled Clinical Trial
Effects of a mistletoe preparation with defined lectin content on chronic hepatitis C: an individually controlled cohort study.
Despite advances in the therapy of chronic hepatitis C for some hepatitis C virus (HCV) genotypes interferon and ribavirin combination therapy is effective in less than 50% of patients. Abnobaviscum Quercus (AQ) is a mistletoe preparation containing defined amounts of mistletoe lectins (ML). It has shown immunomodulatory properties in vitro and in vivo. ⋯ A significant eosinophilia (p=0.0001) occurred between month 2 and 6 during treatment. 9 month treatment with a ML containing mistletoe preparation has no effect on viral load or ALT as markers of activity in patients with chronic hepatitis C. However, frequency and intensity of clinical signs and symptoms in our patients decreased significantly, similar to reports of improved quality of life in tumour patients treated with such preparations. A significant eosinophilia suggests that ML containing mistletoe preparations induce a T-helper 2 immune response.
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This research assessed the prevalence of cigarette smoking among Iranian medical students, resident physicians and attending physicians. ⋯ Of the participants 16.79% of males and 0.69% of females were smokers. Of the medical students, 18.48% of students, 12.5% of pre-externship students, 7.19% of externship students and 16.95% of internship students were smokers. Of resident physicians 11.11% were smokers. Among attending physicians 7.57% were smokers. The most common causes of current cigarette smoking were need (avoid withdrawal symptoms), pleasurable purposes and release of tension, respectively. Foreign filter tipped cigarette was the most common type of cigarette used. The mean of cigarette per day was 6.29 cigarettes and the mean age of starting cigarette was 19.71 years.
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We report on a 64-year old woman with an interstitial lung disease which had characteristics of hypersensitivity pneumonitis. Severe febrile attacks with impairment of ventilation and diffuse poorly defined radiodensities and ground glass opacities on chest x-ray occured repeatedly. Laboratory data showed hypoxemia, leukopenia and circulating Candida albicans (C.a.)-antigen. ⋯ Intradermal skin test with C.a. showed a positive immediate and late phase reaction and inhalative provocation test with C.a.-antigen was positive. After antimycotic treatment the symptoms resolved completely and long-lasting. We conclude that the disease was induced by C.a.-antigen reaching the lungs from the intestinal tract via the bloodstream.
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Cardiopulmonary bypass generally leads to an unspecific increase of inflammatory parameters after cardiac operations. Increased Procalcitonin (PCT)-levels in serum, particularly after contamination with bacterial endotoxines, can be used as a marker for specific infections. The objective of this prospective study was to evaluate the course of PCT after cardiac surgery for the differential diagnosis of infections/unspecific inflammatory reactions, compared to routine infection parameters. ⋯ Based on its different course from other parameters in infection development between 4.-6. days, PCT can probably be used as a predictive marker in bacterial infections after cardiac surgery. The cost of the used immunoassay however will set the limits for a routine application.
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Randomized Controlled Trial Clinical Trial
Therapy of special HIV-associated diseases: HCV-HIV-co-infection and AIDS-related Kaposi's sarcoma - official satellite to the 7th European Conference on Clinical Aspects and Treatment of HIV-infection, October 23, 1999 in Lisbon, Portugal.
In the era of highly active antiretroviral therapy (HAART), certain complications of HIV-disease as e.g. opportunistic infections and Kaposi s sarcoma (KS) have significantly diminished. New insights in pathological pathways revealed the role of co-viruses as HHV-8 and HCV so that in our days AIDS-associated KS and chronical hepatitis C (CHC) in HIV-infected persons can be considered as the result of opportunistic infections with HHV-8 or HCV respectively. - Though the overall incidence of AIDS-KS is declining, it remains as a reason of severe disease complication and fatal outcome. Actual therapeutic strategies have to be evaluated regarding safety and efficacy as a major option, while cost-effectiveness of treatment and quality of life aspects for the patient must also be included to assess a successful disease management within the up to now merely palliative setting. HIV-infection evidently triggers the natural course of CHC in terms of more progressive liver disease. Otherwise there seems to be no clinical benefit of HAART on CHC. Until recently IFN-alfa treatment was the only therapy available for patients with CHC. As initial therapy with a combination of IFN-alfa and ribavirin turned out to be more effective than IFN-monotherapy in HCV-infected persons, it has now to be considered to include anti-HCV-combination treatment into the therapeutic program of HIV-HCV-coinfected patients under HAART. - Within the 7th European Conference on Clinical Aspects and Treatment of HIV-Infection, which took place in Lisbon from October 23 to 27 1999, a satellite symposium was organized to evaluate actual treatment options in the management of special HIV-associated complications focussing on AIDS-KS and HCV-HIV-coinfection. ⋯ As the combination therapy of IFN-alfa-2b with ribavirin is the first treatment in CHC, there is an urgent need to consider the therapeutical strategies in this field in HCH-HIV coinfected patients. (ABSTRACT TRUNCATED)