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C Aebi

Publications and source records attributed to C Aebi.

At least 55 records · Page 3Linked to original sources
PubMed1998

Complications of varicella in a defined central European population.

AIMS: To describe complications of varicella requiring hospitalisation in a defined population (canton of Bern) and to compare the hospitalisation rates for varicella with published data. METHODS: Retrospective analysis of hospital records of patients less than 16 years of age admitted with complications of varicella to the hospitals serving this population (University Children's Hospital of Bern and the Wildermeth Children's Hospital of Biel, Switzerland), and calculation of hospitalisation rates for varicella and its complications based on birth rates and varicella antibody prevalence rates. RESULTS: From 1986 to 1996, 113 cases (median age, 5.6 years) were identified. Younger siblings were overrepresented (odds ratio (OR), 1.42; 95% confidence interval (CI), 1.09 to 1.84). Central nervous system (CNS) complications (26 patients; 23%) were found predominantly in previously healthy children (relative risk, 7.1; 95% CI, 1.01 to 49.86). Group A beta haemolytic streptococci were recovered from only one of 35 patients with bacterial complications. The hospitalisation rates for primary varicella (9.2/10(4) cases; 95% CI, 7.4 to 11/10(4), skin infections (2.0/10(4) cases; 95% CI, 1.2 to 2.9/10(4), and pneumonia (0.8/10(4) cases; 95% CI, 0.3 to 1.3/10(4)) were significantly lower than reported previously. The CNS complication rate (2.2/10(4) cases; 95% CI, 1.3 to 3.1/10(4) was among the highest rates reported. CONCLUSIONS: The low hospitalisation rate in comparison with studies from elsewhere indicates that there is a large regional variability in complications associated with varicella. Such data should be taken into consideration when local varicella immunisation strategies are developed.

Birth Order↗
PubMed1997

Intravenous ribavirin therapy in a neonate with disseminated adenovirus infection undergoing extracorporeal membrane oxygenation: pharmacokinetics and clearance by hemofiltration.

Intravenously administered ribavirin (20 mg/kg per day) was given to a neonate with disseminated adenovirus infection requiring extracorporeal membrane oxygenation and hemofiltration. Plasma concentrations at steady state were 4.81 to 8.47 micrograms/ml, hemofiltration sieving-coefficient was 0.85, and hemofiltration clearance (0.046 L/kg per hour) was similar to the renal clearance reported with normal kidney function. Despite low plasma concentrations, results of viral cultures were negative within 48 hours of initiation of ribavirin therapy, suggesting that plasma concentrations may not adequately predict inhibition of adenovirus replication in vivo.

Adenovirus Infections, Human↗
PubMed1997

Characterisation of an outer membrane protein of Moraxella catarrhalis.

To elucidate potential vaccine antigens, Moraxella catarrhalis outer membrane proteins (OMPs) were studied. We have previously shown an OMP to be a target for human IgG and have now further characterised this OMP which appears to have a molecular mass of 84 kDa and to be distinct from the 81-kDa OMP, CopB. Human transferrin was shown to bind the 84-kDa OMP alone. N-terminal sequencing of this OMP and purified M. catarrhalis transferrin binding protein B (TbpB) revealed homology both with each other and with the TbpB of Haemophilus influenzae and Neisseria meningitidis. Adsorption of human anti-serum with purified TbpB from two M. catarrhalis strains abolished or reduced binding of IgG to the 84-kDa OMP from three M. catarrhalis isolates. IgG binding to CopB was unaffected. It is clear that the 84-kDa OMP is distinct from CopB and is a likely homologue of TbpB.

Adult↗
PubMed1997

Screening for complement deficiency in bacterial meningitis.

Seventy-seven children with bacterial meningitis were screened for complement deficiency. Both the classical and the alternate pathways were normal in 75 patients. Transiently reduced total haemolytic activity of the classical pathway was documented in a boy with meningococcal meningitis. Total haemolytic activity of both the classical and the alternate pathways were reduced in another patient with pneumococcal meningitis: individual complement components determination indicated predominant activation of the alternate pathway.

Adolescent↗
PubMed1997

A protective epitope of Moraxella catarrhalis is encoded by two different genes.

The high-molecular-weight UspA protein of Moraxella catarrhalis has been described as being both present on the surface of all M. catarrhalis disease isolates examined to date and a target for a monoclonal antibody (MAb 17C7) which enhanced pulmonary clearance of this organism in a mouse model system (M. E. Helminen et al., J. Infect. Dis. 170:867-872, 1994). A recombinant bacteriophage that formed plaques which bound MAb 17C7 was shown to contain a M. catarrhalis gene, designated uspA1, that encoded a protein with a calculated molecular weight of 88,271. Characterization of an isogenic uspA1 mutant revealed that elimination of expression of UspA1 did not eliminate the reactivity of M. catarrhalis with MAb 17C7. In addition, N-terminal amino acid analysis of internal peptides derived from native UspA protein and Southern blot analysis of M. catarrhalis chromosomal DNA suggested the existence of a second UspA-like protein. A combination of epitope mapping and ligation-based PCR methods identified a second M. catarrhalis gene, designated uspA2, which also encoded the MAb 17C7-reactive epitope. The UspA2 protein had a calculated molecular weight of 62,483. Both the isogenic uspA1 mutant and an isogenic uspA2 mutant possessed the ability to express a very-high-molecular-weight antigen that bound MAb 17C7. Southern blot analysis indicated that disease isolates of M. catarrhalis likely possess both uspA1 and uspA2 genes. Both UspA1 and UspA2 most closely resembled adhesins produced by other bacterial pathogens.

Amino Acid Sequence↗
PubMed1996

Bacterial complications of primary varicella in children.

Bacterial complications of varicella in 84 patients younger than 16 years of age (48 females; median age, 2.9 years) who required hospitalization between 1985 and 1995 were retrospectively analyzed. The purpose of the study was to describe demographics, clinical manifestations, bacteriology, and factors affecting outcome. Seventy-six percent of patients were younger than 5 years of age. The eldest children in households were significantly underrepresented (P = .00025). Skin infections occurred in 61 patients (73%), and deep-seated infections and/or shock occurred in 23 (27%). The latter complications were significantly associated with thrombocytopenia (P = .011) and bacteremia (P = .014) at the time of admission, prolonged fever (P = .001), prolonged hospitalization (P < .0001), intensive care management (P < .0001), and fatal outcome (P = .019). Group A beta-hemolytic streptococcus (59% of isolates) and Staphylococcus aureus (28%) were the predominant isolates. Before and after 1990, five (31%) of 16 and 13 (62%) of 21 streptococcal complications, respectively, were invasive infections (P = .09). These data underscore the need for universal immunization against chickenpox.

Adolescent↗
PubMed1996

Expression of the CopB outer membrane protein by Moraxella catarrhalis is regulated by iron and affects iron acquisition from transferrin and lactoferrin.

The amino acid sequence of the cell-surface-exposed, 81-kDa CopB outer membrane protein of Moraxella catarrhalis was found to be similar to those of TonB-dependent outer membrane proteins of other gram-negative bacteria. Expression of CopB was affected by the availability of iron in the growth medium, and the extent of overexpression of CopB in response to iron limitation varied widely among the M. catarrhalis strains tested. Wild-type M. catarrhalis strains were found to be able to utilize ferric citrate, transferrin, lactoferrin, and heme as sources of iron for growth in vitro. However, an isogenic copB mutant was severely impaired in its ability to utilize transferrin and lactoferrin as sole sources of iron for growth, whereas this same mutant grew similarly to the wild-type parent strain when supplied with ferric citrate as the iron source. The copB mutant was not significantly different from its wild-type parent strain in its ability to bind transferrin and lactoferrin. In addition, the wild-type parent strain and the copB mutant exhibited equivalent rates of uptake of 55Fe from ferric citrate. However, the copB mutant was markedly less able than the wild-type strain to take up 55Fe from transferrin and lactoferrin. These results indicate that lack of expression of the CopB protein exerts a direct or indirect effect on the ability of M. catarrhalis to utilize iron bound to certain carrier proteins.

Amino Acid Sequence↗
PubMed1995

The age at onset of chronic Pseudomonas aeruginosa colonization in cystic fibrosis--prognostic significance.

To evaluate the prognostic significance of the age at onset of chronic Pseudomonas aeruginosa colonization (OPCP) with respect to pulmonary disease progression in patients with cystic fibrosis (CF), a retrospective long-term analysis using annual chest radiographs was performed on 54 CF patients. Thirty-seven patients (68%) were chronically colonized before the age of 12 years (group 1), 17 patients (32%) thereafter (group 2). These two groups did not significantly differ in terms of mean duration of follow up (16.2 +/- 5.9 years), sex, CF genotypes, colonization with other respiratory pathogens, supportive medical treatment and death rate during the study period. Chest radiographs were evaluated according to the Chrispin-Norman score, increasing scores representing increasing severity of respiratory disease. In both groups, progression of score means was not accelerated of score means was not accelerated up to 6 years after OCPC (Scores at OCPC set 0; mean score +/- SEM 6 years prior to OCPC -5.6 +/- 2.0; 10 years after OCPC +3.6 +/- 0.7 points). Patients chronically colonized prior to age 12 years (group 1) scored significantly higher between age 2 and 11 years (maximum difference at age 8 years [mean +/- SEM]: 9.4 +/- 0.7 vs. 4.3 +/- 1.3 points; P = 0.002) as compared to group 2. After age 11 years, mean scores were similar in both groups, since in group 2 scores increased rapidly after age 8 years. We conclude that OCPC did not cause an immediate acceleration of CF lung disease judged by serial chest radiographs. Rapid progression in group 2 (OCPC after age 12 years) was independent of OCPC since it occurred earlier. These data indicate that OCPC may be a marker rather than the cause of respiratory disease progression.

Adolescent↗
PubMed1994

[TBE-immunoglobulins--a critical assessment of efficacy].

Since there is no specific treatment for tick-borne encephalitis (TBE), immunoprophylaxis is used in endemic areas for controlling this disease. Active immunization has been shown to be effective and safe, and a restrictive immunization policy is generally accepted in Switzerland. However, the use of TBE-immunoglobulin for passive immunization after tick exposure is controversial. This article demonstrates that the published reports on the protection rate of TBE-immunoglobulin do not stand up to critical analysis. Efficacy has never been proved. Therefore, the use of TBE-immunoglobulin must be based upon practical or theoretical arguments. Routine administration of this preparation in endemic areas cannot be recommended.

Encephalitis Viruses, Tick-Borne↗
PubMed1994

Incidence and duration of breast-feeding of ill newborns.

The many biological advantages of breast milk call for promoting breast-feeding. The extent to which separation of ill newborns from their mothers negatively influences breast-feeding is not known. By means of a written inquiry, we investigated the prevalence of exclusive, partial, and no breast-feeding of 536 newborns hospitalized at a tertiary care neonatal center with no inborn patients. Three hundred twenty-seven questionnaires were completed correctly. Fifty percent of the mothers eventually succeeded in exclusive breast-feeding, 25% in partial breast-feeding, and 25% never breast-fed. The frequency of breast-feeding was similar to the Swiss average for the first 4 months of life in healthy newborns and declined more rapidly thereafter. Univariate and multivariate statistical analyses have shown that the following conditions influence breast-feeding negatively: gestational age < or = 33 weeks, maternal age > 25 years, and lower professional status of the father. Additionally, multivariate analysis revealed a promoting effect of previous breast-feeding. Exclusive breast-feeding has eventually been possible in half of the newborns who had initially been separated from their mothers due to illness. Knowledge of the conditions influencing breast-feeding in such populations should help to promote breast-feeding more specifically in tertiary neonatal centers.

Adult↗
PubMed1993

Respiratory response to salbutamol (albuterol) in ventilator-dependent infants with chronic lung disease: pressurized aerosol delivery versus intravenous injection.

OBJECTIVE: To compare the effects of intravenously injected with inhaled salbutamol in ventilator dependent infants with chronic lung disease (CLD). DESIGN: Prospective randomized study which each patient served as his/her own control. SETTING: Multidisciplinary neonatal and pediatric ICU. PATIENTS: 8 ventilator dependent premature infants with CLD. INTERVENTIONS: Salbutamol, 10 micrograms/kg was given intravenously, and 10-19 h later, twice 100 micrograms as pressurized aerosol, or vice versa, sequence randomized. The pressurized aerosol was delivered by a metered dose inhaler into a newly developed aerosol holding chamber, integrated into the inspiratory limb of the patient circuit. Respiratory system mechanics were assessed by the single breath occlusion method before and 10 and 60 min after drug administration. MEASUREMENTS AND RESULTS: Compliance improved significantly after intravenous injection (0.48 +/- 0.18 to 0.67 +/- 0.16, p < 0.01 and 0.59 +/- 0.23 ml/cmH2O/kg, NS, (mean +/- 1 SD) and after inhalation (0.46 +/- 0.19 to 0.64 +/- 0.32, p < 0.01 and 0.56 +/- 0.31 ml/cmH2O/kg, NS). Resistance decreased after iv. use (0.38 +/- 0.17 to 0.25 +/- 0.11, p < 0.001 and 0.25 +/- 0.10 cmH2O/ml/s, NS) and after inhalation (0.35 +/- 0.12 to 0.27 +/- 0.09, p < 0.01 and 0.28 +/- 0.12 cmH2O/ml/s, NS). Heart rate increased significantly after both routes of application, whereas mean arterial pressure, respirator settings, FIO2, transcutaneous SO2 and capillary PCO2 did not change. CONCLUSIONS: Inhaled and intravenous salbutamol improves pulmonary mechanics to the same extent with comparable side effects, and may therefore be used to facilitate weaning from respirators.

Administration, Inhalation↗
PubMed1992

Lung mechanics and gas exchange in ventilated preterm infants during treatment of hyaline membrane disease with multiple doses of artificial surfactant (Exosurf)

Eight premature infants ventilated for hyaline membrane disease and enrolled in the OSIRIS surfactant trial were studied. Lung mechanics, gas exchange [PaCO2, arterial/alveolar PO2 ratio (a/A ratio)], and ventilator settings were determined 20 minutes before and 20 minutes after the end of Exosurf instillation, and subsequently at 12-24 hour intervals. Respiratory system compliance (Crs) and resistance (Rrs) were measured by means of the single breath occlusion method. After surfactant instillation there were no significant immediate changes in PaCO2 (36 vs. 37 mmHg), a/A ratio (0.23 vs. 0.20), Crs (0.32 vs. 0.31 mL/cm H2O/kg), and Rrs (0.11 vs. 0.16 cmH2O/mL/s) (pooled data of 18 measurement pairs). During the clinical course, mean a/A ratio improved significantly each time from 0.17 (time 0) to 0.29 (time 12-13 hours), to 0.39 (time 24-36 hours) and to 0.60 (time 48-61 hours), although mean airway pressure was reduced substantially. Mean Crs increased significantly from 0.28 mL/cmH2O/kg (time 0) to 0.38 (time 12-13 hours), to 0.37 (time 24-38 hours), and to 0.52 (time 48-61 hours), whereas mean Rrs increased from 0.10 cm H2O/mL/s (time 0) to 0.11 (time 12-13 hours), to 0.13 (time 24-36 hours) and to (time 48-61 hours) with no overall significance. A highly significant correlation was found between Crs and a/A ratio (r = 0.698, P less than 0.001). We conclude that Exosurf does not induce immediate changes in oxygenation as does the instillation of (modified) natural surfactant preparations. However, after 12 and 24 hours of treatment oxygenation and Crs improve significantly.(ABSTRACT TRUNCATED AT 250 WORDS)

Carbon Dioxide↗