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Biomedical subjects

D Stürchler

Publications and source records attributed to D Stürchler.

At least 73 records · Page 4Linked to original sources
PubMed1981

[Clinical and therapeutic study of a group of 217 patients with intestinal giardiasis and amebiasis].

In 15 months of the years 1979-1980, 158 patients with giardiasis and 69 patients with intestinal amebiasis were diagnosed and treated in the outpatient department of the Swiss Tropical Institute. Repeated examination of merthiolate-iodine-formol-fixed stools was the method of choice for detecting intestinal protozoa. Parasitological investigation of duodenal fluid (Enterotest) was less effective. Fewer than 30% of the cases were symptomatic, usually mentioning diarrhea (73-85%) or abdominal discomfort (20-44%). Treatment was by ornidazole single dose (2 g in adults; 40 mg/kg in children) for asymptomatic cases and a five-day treatment schedule (2 X 500 mg/day in adults, 20 mg/day in children) for symptomatic cases. In amebiasis a luminal amebicide (diloxanide furoate) was prescribed in all instances after the first stool examination. Parasitological cure rates were excellent (95%) in all cases of giardiasis but only 59 and 65% respectively in cases of asymptomatic and symptomatic amebiasis. Drug tolerance was excellent. Ornidazole is the drug of choice for all forms of giardiasis, even in a single dose. As a luminal amebicide, however, its efficacy is not superior to other nitroimidazole derivatives.

Drug Administration Schedule↗
PubMed1981

[Liver fascioliasis with unusual abscess formation. Case report].

The case is reported of a 34-year-old Swiss who presented with signs of liver abscess after returning from South America. The symptoms regressed under trial treatment with a tissue amoebicide. The initial blood hypereosinophilia could be explained only 8 months later by the presence of eggs of Fasciola hepatica in the patient's faeces. Serological investigations were negative for amoebiasis an hydatid disease but positive for fascioliasis. The possibility of abscess formation by infestation with F. hepatica is discussed.

Adult↗
PubMed1981

[Parasitic disease in schoolchildren in a village in Swiss Jura].

In a village of the Swiss Jura we examined 134 schoolchildren (7 to 16 years old) clinically, parasitologically and serologically for parasites. Half of the children showed an insufficient hygiene of hands, feet and/or anus. In 7 out of 107 anus-scotch-tests there were eggs of Enterobius vermicularis. Protozoans could be demonstrated in 8 of 133 MIF-stool-samples (2 cases of Giardia lamblia, 2 Endolimax nana and 4 Jodamoeba bütschlii). Using the procedure of enrichment of Telemann no helminth eggs were detected. Altogether parasites were found in 10% of the children. 31 children have antibodies against Toxoplasma gondii (IF titre greater than or equal to 1:40). 5 children showed a positive Toxocara-serology, additional 5 an uncertain positive reaction. The immunodiagnostic of Echinococcosis (ELISA, IF, IHA, CIE) was doubtfully positive in 4 children. In this study, intestinal protozoans and E. vermicularis were the most commonly occurring parasites followed by asymptomatic toxocariasis.

Adolescent↗
PubMed1981

Immunodiagnosis of schistosomiasis outside endemic areas: use of histamine release from basophils by schistosomal antigens and radioallergosorbent test.

Specific allergic histamine release from leucocytes, radioallergosorbent tests (RAST) and indirect fluorescent antibody tests (IFAT) were applied for immunodiagnosis of schistosomiasis in patients outside endemic area. Of 10 parasitologically verified cases--all of them exhibiting a low and irregular egg output--8 were detected by histamine release, whereas 4 patient with filariasis, 3 with trichuriasis and 31 parasitologically normal controls were negative in this respect. By a combination of the histamine release test, RAST and IFAT all 10 cases were diagnosed. RAST and IFAT applied to 29 patients with active or treated schistosomiasis were positive in 14 (48%) and 20 (69%) cases, respectively.

Adolescent↗
PubMed1980

[Incidence of hepatitis virus infections and diseases in travelers returning from the tropics].

Travellers' hepatitis has been investigated by comparing clinical and serological data. The histories of 876 persons examined after their return from tropical countries were analysed for type, location, and length of stay abroad, prophylactic administration of gamma-globulin and past hepatitis. In addition to clinical investigations, 528 of the patients underwent radioimmunoassays for hepatitis markers. HBs antigen was detected in 1.1%, anti-HBs antibodies in 14.2%, and anti-HA antibodies in 37.3% of the patients. The prevalence of anti-HA antibodies increased with age, but the mean value for those over 20 years was only 8% above the mean for the corresponding age groups of Swiss residents. Significant differences in prevalence of anti-HA antibodies were only observed in persons who had stayed in the tropics for more than 5 years. The prevalence of hepatitis B markers was 2-3 times higher in persons returning from the tropics than in volunteer Swiss blood donors. Contrary to hepatitis A, the hepatitis B markers were related neither to age nor to the length of stay abroad. Patient's histories and serological tests revealed a high frequency of unapparent infections, i.e. 74% of hepatitis A and 88% of hepatitis B infections. Acute viral hepatitis was newly diagnosed in 17 out of the 2032 tropical patients who consulted us during 1979. The yearly incidence of hepatitis in this population was thus 8.5%, which is about 10 times higher than that estimated for the Swiss population as a whole. Only 5 of the 17 cases showed hepatitis of type A. One third of the cases were anicteric. The study clearly shows the importance of non-A hepatitis among travellers. In consequence, questions arise as to the prophylactic use of gamma-globulin and the epidemiology of traveller's hepatitis.

Acute Disease↗
PubMed1980

[The value of the anamnesis in diseases following a stay in tropical regions].

The question whether an illness occurring after a stay in the tropics is tropical or not often arises in clinical practice. In seeking the answer, the following points in the patient's history are of particular importance: 1. Where has the patient been, and for how long? 2. When did the patient come home and when were the first symptoms noted? 3. What was the nature of his exposure during his stay? 4. What prophylactic measures were taken? The significance of the geographical history is illustrated by the example of South East Asia. The interval between the return home and appearance of the first symptoms is related to the course of tropical diseases, prepatency and survival time of parasites.

Bacterial Infections↗
PubMed1980

[Is Plasmodium falciparum, the parasite responsible for tropical malaria, resistant to fansidar?].

A world-wide increase of malaria infections is observed. Malaria is imported into Switzerland mainly by tourists and recently by refugees from South East Asia. The strains of P. falciparum resistant to treatment are of increasing importance. A patient with P. falciparum infection from Cambodia is reported, who suffered from three episodes of malaria recrudescence within ten weeks, in spite of adequate therapy with quinine and Fansidar. The definition, the significance and the geographical distribution of resistances and the possible cause for a P. falciparum recrudescence are discussed. For the treatment of repeating recrudescence quinine and Fansidar are recommended, followed by a suppressive Fansidar prophylaxy for 4--8 weeks.

Drug Resistance, Microbial↗
PubMed1979

[Overview of the epidemiology of stonefish poisonings, their treatment and preventive measures].

A review is presented of work on envenomation by stonefish (Synanceja spp.), which represent not only a danger for the inhabitants of tropical coasts but also for tourists. Stonefish are common in shallow water of reef areas by the shores of the Indian and Indopacific Ocean. The bizarrely shaped fish is often taken for a weed-covered stone and accidents occur when swimmers, divers or fishermen step on the stings of the dorsal fin. These stings are provided with poison glands. The venom has neurotoxic, myotoxic and hemorrhagic effects. The case of a 39-year-old diver is cited who suffered a stonefish stab which lasted for several weeks. Generally envenomations by Synanceja cause severe local pain and enormous swelling of the limb; systemic symptoms as usually found with neurotoxins are common; death may occur by shock, by paralysis of the diaphragm or cardiac arrest. For first aid bathing of the limb in hot water is recommended. Clinical measures are local analgesia, local neutralization of the venom, if possible antiserum therapy and intensive care with symptomatic treatment of systemic complications. The most effective prevention is adequate foot protection when wading in the sea.

Adult↗
PubMed1978

Radioallergosorbent and indirect fluorescent antibody tests in immunodiagnosis of schistosomiasis.

Radioallergosorbent tests for specific IgE antibodies to Schistosoma haematobium and S. mansoni were positive in 82 and 72%, respectively, of sera from 136 African schistosomiasis patients. 99% of sera from controls (5 free of parasitic disease, 75 infested with hookworm, Ascaris, Trichuris, and/or Onchocerca) were negative. When titres in indirect fluorescent antibody tests were set at the same level of specificity only 38% of patients' sera were positive. A cut-off at a higher concentration increased sensitivity to 65% but lowered specificity (10% controls positive).

Adolescent↗
PubMed1978

[Epidemiology and clinical aspects of malaria in Switzerland].

Plasmodium falciparum is the predominant plasmodium species in Africa south of the Sahara to a proportion of 80% and more. Two thirds of all cases of malaria in Switzerland are imported from Africa. Accordingly, malignant malaria is more frequently diagnosed in Switzerland than tertian malaria. Malignant malaria usually presents atypically, e.g. as acute gastrointestinal disease or as shock. The lethality is high. The majority of Swiss travellers are not protected effectively against malaria. A group particularly at risk are tourists of 20--30 years of age. It is suggested that travel agencies, official bodies and the medical profession should intensify public information regarding the dangers and prevention of malaria.

Adult↗
PubMed1978

[Clinical aspects, diagnosis and therapy of tropical pulmonary eosinophilia].

In Switzerland, tropical pulmonary eosinophilia occurs in subjects who have stayed in endemic areas of lymphatic filariasis (mainly India and South East Asia) and in adopted children from these countries. Clinically, the disease manifests itself as asthmatic bronchitis or pneumonia. Blood eosinophilia is regularly present and chest X-ray shows various types of infiltrate. Tropical pulmonary eosinophilia is distinguished from Loeffler's syndrome by (a) the severe and protracted course, (b) measurable antibodies against filarial antigens, and (c) the therapeutic response to diethylcarbamazine. The pathogenesis of both syndromes may be explicable by the fact that soluble parasitic allergens bind to cellules of the respiratory tract and induce hypersensitivity reactions under the influence of reagins. Both syndromes must be differentiated from parasitoses of the lung tissue, from side effects of drugs, and from allergic, non-parasitic bronchial asthma. The clinical aspects of both syndromes are illustrated by three cases.

Adult↗
PubMed1976

[Filariasis in patients returned from the tropics. Studies on 64 cases].

A discussion is presented on the epidemiological and clinical aspects of filariasis in persons returning from tropical countries. In our population filariasis is mainly imported from central and western Africa, especially Cameroon. Missionaries and voluntary workers spending periods of years in the tropics are particularly exposed. About 50% of the patients are normal on clinical examination and 40% do not even evidence symptoms due to the low parasite density. Therefore, demonstration of the parasite, which is the diagnostic aim, is often very difficult and requires special techniques. Whenever parasite demonstration is impossible, itching, eosinophilia and a positive immunofluorescence reaction are important diagnostic signs, but they may occasionally develop years after the subject's return. Treatment is by diethylcarbamazine and suramine; their administration and side effects are described and 2 cases involving severe reactions due to inadequate treatment are cited.

Adult↗