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Biomedical subjects

E B Helm

Publications and source records attributed to E B Helm.

At least 73 records · Page 4Linked to original sources
PubMed1986

[Spontaneous course of LAV/HTLV-III infection. Follow-up of persons from AIDS-risk groups].

543 persons in AIDS risk groups were examined for LAV/HTLV-III infection. Antibodies against LAV/HTLV-III were demonstrated in 377, during an observation period of 3 months to 3 years. Patients were divided into 5 groups, according to clinical, serological and immunological criteria. Severity of symptoms and incidence of recurrences of the lymphadenopathy syndrome correlated positively with an increase in cellular immune deficiency. At the end of the observation period only 30 of 307 antibody-positive patients were well. The AIDS incidence of all antibody-positive patients increased with time from 3% (6-11 months) to 19.4% (24-36 months). If one takes into account only those patients who had marked immune deficiency (stage 2b) at the initial examination, the AIDS incidence during the same periods was 10 and 57%, respectively. At the same time, the condition worsened by at least one stage in half of all patients in stages 1b-2a observed for 1-2 years. A change of stage was observed in up to 80% of patients followed for longer periods. Long-time prognosis of LAV/HTLV-III infection is remarkably bad.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Isolation of variants of lymphocytopathic retroviruses from the peripheral blood and cerebrospinal fluid of patients with ARC or AIDS.

LAV/HTLV-III/AAV viruses were isolated from 20 German patients with ARC/AIDS in order to investigate strain variation. Virus was isolated from the peripheral blood and/or cerebrospinal fluid (CSF) in umbilical cord peripheral blood lymphocyte (PBL) cultures. Isolates were identified by their cytopathic effect (CPE), by reverse transcriptase assays on cell-free infected culture supernatant fluid (SNF), and one or more of the following: immunofluorescence assays on infected cells for viral antigen using HTLV-III reference sera, Western blot analysis of cell-free infected culture SNF, electron microscopy of infected cells, and Southern blot restriction analysis and specific HTLV-III probing of DNA extracted from infected cultured PBL. The isolates could be classified into three groups according to differences in growth rate and cytopathic effect: Most showed what was regarded as the typical CPE, while some either grew rapidly and induced a striking CPE and others grew slowly with minimal CPE. In one patient, virus producing typical CPE was isolated from the peripheral blood while the isolate from his filtered cell-free CSF produced atypical slow CPE, suggesting that antigenic variation may occur with persistent infection or that superinfection may occur. Southern blot DNA restriction analysis of the DNA of three selected isolates showed that two of the isolates were similar but that the restriction pattern of all three differed from patterns previously published. Our results supplement the accumulating evidence of genetic variation among LAV/HTLV-III strains. The extent of this variation needs to be evaluated for any effect on the sensitivity of diagnostic tests, on the strategy of vaccine development, on tissue tropism by altering the viral surface receptor-binding sites, and possibly on the development of specific chemotherapy.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Treatment of AIDS-related Kaposi's sarcoma with recombinant gamma-interferon.

Four patients with the acquired immunodeficiency syndrome and Kaposi's sarcoma were treated with subcutaneous human recombinant gamma-interferon at a dosage of 200 micrograms = 2 X 10(6) U twice daily for at least 28 days. While the dosage of interferon was well tolerated, progressive disease was observed in all four patients studied. These results might be due to the selection of the patients presenting advanced stages (3 out of 4) with recurrent disease after previous chemotherapy.

Acquired Immunodeficiency Syndrome↗
PubMed1986

[Acute exanthematous eruption of multiple Kaposi sarcomas of the AIDS type in a female drug-addict. Successful chemotherapy with vincristine, bleomycin and dactinomycin].

In a 30-year-old German women who appeared to be in good general health, numerous Kaposi sarcomas of the AIDS type appeared on her face and trunk within a few days. Her arms, legs and oral mucosa were also affected. The patient has been a prostitute for more than 10 years and an i.v. drug addict for 5 years. Her face and upper trunk were densely covered with livid red tumors that were up to the size of coffee beans, with a longitudinal axis that followed the relaxed skin tension lines. HTLV III antibodies were present. No severe cellular immune defect could be demonstrated (OKT4 + to OKT8 + cell ratio 1.15; later control = 2.4). Recall antigens were negative. Since no severe immune defect was present, cytostatic therapy with vincristine, bleomycin and dactinomycin was carried out. Infiltrates began to regress after just one cycle. After four cycles, the facial lesions had completely disappeared. On the chest slight erythemas remained, but there were no histological signs of Kaposi sarcoma. On the legs there were still some solitary brown infiltrates. It was shown that the AIDS type of Kaposi sarcoma responds to combined chemotherapy.

Acquired Immunodeficiency Syndrome↗
PubMed1985

[Chemiluminescence measurement in AIDS, lymphadenopathy and hemophilia patients].

In order to reveal the activity of polymorphonuclear neutrophil leukocytes (PMNL) representing the first step of defence against infections, measurements of chemiluminescence (CL) were performed in patients suffering from acquired immune deficiency syndrome (AIDS), lymphadenopathy, or hemophilia. In comparison with healthy controls, AIDS patients revealed significant reduction (about 50 per cent) of phagocytic, i.e. CL activity of neutrophils, which had been induced by Zymosan. Only part of the patients suffering from lymphadenopathy answered with decreased granulocyte activity on the application of Zymosan. If concanavalin A was used as stimulant of metabolic activity of PMNL-independently of phagocytosis-again AIDS and some of the lymphadenopathy patients showed a markedly reduced neutrophil response. In conclusion it should be stated that there is some evidence for at least two defects of cellular immunity associated with AIDS and to some extent, with AIDS-endangered homosexuals suffering from lymphadenopathy: first the defect of PMNL to answer to concanavalin A with increased metabolic activity, and secondly the defect of PMNL to start phagocytosis induced by Zymosan with a subsequent release of oxygen radicals which are measurable as chemiluminescence. The appraisal of granulocyte activity by means of measurements of chemiluminescence might become an additional criterion for AIDS diagnostics.

Acquired Immunodeficiency Syndrome↗
PubMed1985

[Toxoplasmosis encephalitis in patients with AIDS].

Toxoplasmosis encephalitis developed in three male homosexuals with AIDS. Clinical symptoms of encephalitis began with a nonspecific organic mental syndrome. In two cases there developed late focal symptoms. There were light to moderately severe generalized EEG changes with additional focal signs. CSF findings and toxoplasmosis titres were not diagnostically altered. Computed tomography demonstrated multiple areas of decreased density in cortex and cerebellum. Administration of pyrimethamine and sulfamethoxydiazine to the three patients brought about clinical improvement within a few days and regression of abnormal CT changes within a few weeks of onset of treatment. One patient died after an encephalitis recurrence: autopsy demonstrated toxoplasma pseudocysts in immediate proximity to small necrotic foci in the brain. The possibility of toxoplasma encephalitis should be considered in AIDS patients who develop an organic mental syndrome. Often the diagnosis can only be made after response to a trial of toxoplasmosis treatment.

Acquired Immunodeficiency Syndrome↗
PubMed1985

[AIDS in the female].

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Acquired Immunodeficiency Syndrome↗
PubMed1985

[AIDS--a new threat].

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Acquired Immunodeficiency Syndrome↗
PubMed1984

[Clinical aspects and observations on patients with lymphadenopathy syndrome].

Since November 1982, patients with symptoms suggesting a lymphadenopathy syndrome (LAS) or acquired immune deficiency syndrome (AIDS), as well as their contacts and persons in high risk groups were examined as out-patients. The examinations have now been concluded in 101 patients. The patients were divided into 3 groups according to clinical symptoms and the OKT4+/OKT8+ ratio: 30 patients with normal ratio (group I), 59 patients with LAS and a ratio of less than 1 (group II) and 12 patients with fully developed AIDS (group III). During a follow-up time of 18 months, 3 patients of group I developed LAS and 1 patient in group II developed toxoplasma encephalitis. In a further 2 patients with LAS, uncharacteristic symptoms such as fever, tiredness and loss of weight increased, while at the same time the number of OKT4+ cells and thus the ratio fell significantly. In 4 cases the immunological parameters and the clinical picture improved. In 52 patients the clinical picture and the laboratory findings did not change. The demonstration of retrovirus HTLV III would seem to provide the cause of LAS and AIDS. Nonetheless, follow-up observation of contacts and patients with LAS remain important.

Acquired Immunodeficiency Syndrome↗
PubMed1984

[Streptococcus A septicemia. An analysis of 18 cases in adults].

Within a 13-year period (1970-1982) there were seen 18 cases of A-streptococcal septicaemia (age range 18-77 years), 1.3% of all septicaemia cases in this time. The portal of entry was most often a banal skin infection. Typically the disease occurred suddenly and took a fulminating course with the clinical picture of severe septicaemia. In more than half the patients septic complications occurred. Despite correct antibiotic treatment pyrexia disappeared only slowly. Four patients died of septic shock. In every case with an acute septic course and a suspicious cutaneous focus, one should think of A-streptococcal septicaemia and, if necessary, give penicillin in high dosage even before the bacterial culture result is known.

Acute Disease↗
PubMed1984

[Pseudomonas septicemia after endoscopic interventions on the bile duct system].

In the first half of 1982 there was an increase in septicaemia cases, especially among patients with biliary-tract drainage. The septicaemia incidence rose from 1.25% to 4.4%. The proportion of Pseudomonas septicaemias was especially high: of 20 patients (21 episodes of septicaemia) nine had infections with Pseudomonas aeruginosa alone, three a mixed septicaemia. In ten of these twelve patients there was impaired drainage by a malignant tumour. Three patients with a tumour stenosis died, mainly of the septicaemia. The cause of this increased incidence of Pseudomonas septicaemias lay in contamination of the instruments; it was in part sustained by the Endo-Washer. The connection between the septicaemia after endoscopic-retrograde cholangiography and recontamination of the endoscope was discovered after sero- and pyocin-typing of the Pseudomonas strains. By changing the methods of disinfection the Pseudomonas incidence among endoscopies fell. However, in individual samplings Pseudomonas can still be demonstrated on instruments as well as on the Endo-Washer.

Blood↗