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Biomedical subjects

E Vanek

Publications and source records attributed to E Vanek.

At least 19 recordsLinked to original sources
PubMed2006

Molecular epidemiology of rabies viruses in Europe.

Several different strains of classical rabies virus co-circulate in Europe. In order to investigate the roles of the host species and topography on the molecular epidemiology of these viruses, a 400 bp region of the nucleoprotein gene was sequenced and compared with more than 500 European virus isolates. Viruses from 21 European countries were represented including some unique panels of archived isolates from the former Republic of Yugoslavia, Estonia, the Czech Republic, Poland and Austria. Phylogenetic analysis of 198 unique sequences demonstrated numerous groups of viruses clustered at both geographical and host-species levels.

Animals↗
PubMed1993

[Relevant problems of persistent bacterial infections].

The persistance of human bacterial infections is influenced by different factors and varies in duration. Besides genetical defects of the immune system the persistance of bacteria may also be enfavored by underlying diseases also. Regarding the duration of the persistance the long or even life long lasting infections are of special clinical, epidemiological and public health interest. The topic deals with present problems only, the tuberculosis is excluded and discussed in another presentation.

Bacterial Infections↗
PubMed1992

Human pancreatic tissue concentration of bactericidal antibiotics.

Pancreatic infection represents the most important cause of fatal outcome in human acute pancreatitis. In a comparative analysis, human pancreatic tissue concentrations of 10 different bactericidal antibiotics were determined in 89 patients undergoing pancreatic surgery. Concentrations of the antibiotics were determined in the blood and pancreatic tissue using high-pressure liquid chromatography. Pancreatic tissue concentrations 120 minutes after intravenous administration were as follows: mezlocillin, 19.0 mg/kg; piperacillin, 20.3 mg/kg; cefotaxime, 9.1 mg/kg; ceftizoxime, 7.9 mg/kg; netilmicin, 0.4 mg/kg; tobramycin, 0.4 mg/kg; ofloxacin, 1.7 mg/kg; ciprofloxacin, 0.9 mg/kg; imipenem, 6.0 mg/kg; metronidazole, 3.5 mg/kg. Three groups of antibiotics were established: group A, substances with low tissue concentrations (netilmicin, tobramycin), which were below the minimal inhibitory concentrations of most bacteria found in pancreatic infection; group B, antibiotics with pancreatic tissue concentrations which were sufficient to inhibit some but not all bacteria in pancreatic infection (mezlocillin, piperacillin, ceftizoxime, cefotaxime); group C, substances with high pancreatic tissue levels as well as high bactericidal activity against most of the germs present in pancreatic infection (ciprofloxacin, ofloxacin, imipenem). These data could serve as the basis for adequate antibiotic prophylaxis or treatment of pancreatic infection.

Adult↗
PubMed1991

Introducing quality improvement thinking to medical students: the Cleveland asthma project.

This article describes a medical school's effort to introduce quality improvement (QI) concepts and methods through experiential learning to students as part of a required eight-week primary care clerkship. Each student describes a patient with asthma, investigates the cost of care, and assesses the outcome through an interview with the patient. These patients are considered together as recipients of an areawide process of care. The statistical tools of QI were adapted in a workbook to help students understand care as a process and their role as physicians in improving it.

Algorithms↗
PubMed1990

Resin versus standard blood culture media used with the new BACTEC automated infrared system: an evaluation in febrile granulocytopenic patients.

Resin-containing aerobic and anaerobic blood culture media (NR 16A and NR 17A) for use with the new BACTEC infrared blood cultures system were compared with standard BACTEC media (NR 6A and NR 7A) in their efficacy to detect bacteremia in febrile granulocytopenic patients receiving antimicrobial treatment. A total of 1185 sets of blood cultures obtained from 341 patients during a 12-month period were evaluated. There were 109 positive cultures (9.2%) with 128 pathogenic organisms isolated from 52 patients (15.2%). Statistically significant differences were found between aerobic media, but not between anaerobic media. Aerobic resin bottles (NR 16A) were more often positive (90 versus 78, p less than 0.05) than standard aerobic bottles (NR 6A). They yielded a higher number of microorganismS (98 versus 80, p less than 0.05) per culture and per culture-positive patient (53 versus 42, p less than 0.01). NR 16A cultures also were more often positive after 1-day incubation (44% versus 21%, p less than 0.01) than NR 6A cultures and allowed earlier subcultivation. The use of NR 16A medium instead of resin-free aerobic NR 6A medium may enhance the detection of bacteremia in selected groups of patients receiving antimicrobial treatment, and can shorten the time until detection of bacteremia.

Agranulocytosis↗
PubMed1989

[Fish breeder granuloma: infection caused by Mycobacterium marinum and other atypical mycobacteria in the human. Analysis of 8 cases and review of the literature].

Granulomatous lesions of the skin and tendon sheaths after exposure to fish tank or aquarium water are frequently caused by non-tuberculous so-called atypical mycobacteria. Mycobacterium marinum is the species most often isolated from such lesions. Rarely, other non-tuberculous species of mycobacteria may be isolated. In contrast to swimming-pool granuloma as the epidemic form of Mycobacterium marinum infection of man, fish tank granuloma seems to be a rare sporadic human disease that is often misdiagnosed. We report eight cases of fish tank granuloma. Five patients had sporotrichoid lesions, and one patient had a singular lesion. Three patients presented with tenosynovitis. Culture-proven Mycobacterium marinum infection was found in four patients, in one patient the causative organism isolated from the biopsy specimen was identified as Mycobacterium kansasii. In three patients with typical appearance of the lesions and exposure to fish tank water, biopsy specimens for culture were not available, and the diagnosis was histopathologically confirmed. Surgical treatment had an unfavourable outcome in two of three patients. Conservative antimicrobial therapy was evaluated in six patients. Similar to published reports, the treatment with rifampicin in combination with other agents seemed to be a useful therapy. Complete remission was, however, also achieved with doxycycline monotherapy. Microbiological diagnosis should be attempted in suspected cases of fish tank granuloma, and, if therapy is indicated, we strongly suggest primary medical treatment.

Adult↗
PubMed1988

[Bismuth subsalicylate treatment in chronic Campylobacter pylori-associated erosive gastritis].

In a prospective open study 21 patients with upper abdominal complaints and chronic active gastritis as well as endoscopically proven erosions were treated with bismuth subsalicylate (4 X 30 ml/day, corresponding to 4 X 314 mg Bi3+) for three weeks. In 20 patients (95%) Campylobacter pylori (CP) was found in at least two of three examinations (culture, CLO quick-test, special histology). After the treatment 17 of 21 patients (81%) were CP negative, and the clinical symptoms had gradually disappeared. The histologically demonstrated degree of activity had regressed significantly after the three-week treatment; in 90% of patients the inflammatory process had completely abated. These results demonstrate that bismuth subsalicylate is highly effective in the acute treatment of CP-associated chronic erosive gastritis.

Adult↗
PubMed1988

A peer review process to assess the quality of graduate medical education.

Accreditation standards for graduate medical education require the internal evaluation of programs. In this paper, the authors describe a system of peer review instituted to meet these requirements and report on the supporting administrative structure and outcome of the peer review process. Although time-consuming and in some cases causing apprehension among staff members and residents, the experience of a peer review process was useful for staff members, residents, and administrators. Peer review was found to be effective in identifying program strengths and weaknesses and in increasing communication among staff members and between administrators and staff members about the teaching programs.

Internship and Residency↗
PubMed1988

In vitro antibacterial activity of imipenem in combination with newer quinolone derivatives.

The antibacterial activity of imipenem combined with norfloxacin, ciprofloxacin, or ofloxacin against 43 gram-positive cocci and 53 aerobic gram-negative rods compared to results obtained with the combination of imipenem with amikacin. Synergistic antibacterial action (defined as FIC index less than or equal to 0.5) was found for 28% of strains with imipenem/amikacin and imipenem/norfloxacin, in 23% with imipenem/ofloxacin, and in 18% with imipenem/ciprofloxacin. Antagonistic activity (FIC index greater than 1.0) was found in 21, 21, 32, and 23% respectively. These rates were not statistically different for gram-positive and gram-negative isolates. Antagonistic activity seemed to occur more frequently with Pseudomonas spp. and enterococci than with staphylococci or Enterobacteriaceae. A tendency for increased rates of antagonism was noted in strains with higher MIC values. Clinically significant and meaningful positive interactions (defined as a decrease of imipenem MICs to below 2.0 micrograms/ml) were found with imipenem/amikacin against several Pseudomonas spp., with imipenem/ofloxacin or ciprofloxacin against Streptococcus faecium and with all combinations against Proteus spp. We conclude that continuous treatment with newer quinolone derivatives for selective decontamination in neutropenic patients receiving imipenem antibacterial therapy for treatment of infection should not be regarded as effective combination therapy.

Amikacin↗
PubMed1987

[Lyme borreliosis in South Germany. Epidemiologic data on the incidence of cases and on the epidemiology of ticks (Ixodes ricinus) carrying Borrelia burgdorferi].

Among 2403 ticks (Ixodes ricinus) tested in 1985 for Borrelia 328 (13.6%) were carriers (adults about 20%, nymphs about 10%, larvae about 1%). The highest prevalence of infected ticks was among adult ticks in the Isar region north of Munich (33.8%). Among 9383 persons whose serum had been examined by fluorescence serology in 1985 and 1986, 1035 (11%) had raised Borrelia-specific IgG and/or IgM antibodies greater than or equal to 1:64. In 18.7% only IgM antibodies were demonstrated. Among 375 proven cases there were 78 with erythema migrans, 211 with neurological signs, 48 with Lyme arthritis and 36 with acrodermatitis. Seasonal incidence peaks were in June-August for erythema migrans, July-September for neurological signs, with no clear-cut seasonal peaks with Lyme arthritis and acrodermatitis. The incubation time for 80% of cases of each abnormality was 5-29 days for erythema migrans, 20-59 for neurological signs and 2-8 months for Lyme arthritis. Erythema migrans was most frequent among those aged 30-60 years, neurological signs among children and juveniles up to 20 years and those aged 40 to 70 years, Lyme arthritis among those aged 30-60 years, and acrodermatitis among those aged 40-80 years. Significantly more women than men developed acrodermatitis.

Acrodermatitis↗
PubMed1987

Specificity of routine parasite serological tests in autoimmune disorders, neoplastic disease, EBV-induced mononucleosis, and HIV infection.

Sera from 120 patients with rheumatological disorders, neoplastic disease, infectious mononucleosis, and HIV infection, and from 30 healthy blood donors were tested for nonspecific reactivity in 13 routinely used parasite serological tests. Responses were detected in 3/30 healthy blood donors (10%) vs 25/120 patients (21%). Of 40 responses in these 28 responders most were weakly reactive, and 25 out of 40 responses were only at borderline level. Response rates were highest in patients with mononucleosis presumably due to heterophile antibodies. Only four patients had responses in at least two different serodiagnostic tests for the same parasitic infection. Response patterns indicative of a possible underlying, concurring, or superimposed parasitic infection, thus, were rare. Especially susceptible to nonspecific reactivity seemed to be immunofluorescent antibody tests for filariasis, schistosomiasis, and amebiasis. In conclusion, compared to healthy controls, false-positive serological responses seem to be more frequent in certain disease groups dependent on the test methods used. Second, the use of more than one serodiagnostic test for the same parasitic disease will substantially facilitate the identification of nonspecific reactivity. Third, for better defining the specificity of parasitological serodiagnosis, more studies should include control sera from patients with nonparasitic diseases that frequently show immunological abnormalities.

Acquired Immunodeficiency Syndrome↗
PubMed1987

High risk of streptococcal septicemia after high dose cytosine arabinoside treatment for acute myelogenous leukemia.

Twenty-nine adult patients with acute myelogenous leukemia AML who received 40 treatment courses with high dose cytosine arabinoside (HD-A), alone or combined with other cytotoxic drugs, for remission induction (RI) or postremission intensive consolidation (IC) were retrospectively analysed for types and severity of infectious complications. In this paper, we report the unusually high rate of streptococcal septicemia in our patients. Of 13 bacteremic infections in a total of 45 infectious episodes, 10 were caused by streptococci (9 viridans streptococci, 1 group B hemolytic streptococcus). Three of them were lethal. After reviewing all documented cases of streptococcal septicemia in the same study period, four additional cases among adult patients with AML were identified. Three of them have had antileukemic chemotherapy without HD-A, while one have had HD-A as a conditioning regimen for bone marrow transplantation. Only three cases were documented to occur in adult patients with AML. Patients treated with HD-A for RI or IC had a significantly lower risk of streptococcal septicemia during previous chemotherapy-associated febrile neutropenic episodes (1/55 vs 10/45; P = 0.01). Neither prophylactic regimens including trimethoprim-sulfamethoxazole nor those without it were effective in preventing streptococcal septicemia. Further studies are needed to confirm these data before the value of additional or alternative prophylactic antibiotics is proven necessary.

Adolescent↗
PubMed1987

[Campylobacter pylori--is there a connection with peptic ulcer?].

In 67 patients, mucosal biopsies were taken in gastroduodenoscopy and culture set up to demonstrate Campylobacter pylori. Campylobacter pylori was cultured from 91% of the patients with peptic ulcer, in 76% of patients with gastritis and in 28% of patients without histological detection of gastritis. Electron microscopic investigations of duodenal mucosa showed that this bacterium attaches to the metaplastic cells of the antral type. This cell type is regularly encountered in the duodenal mucosa in healing duodenal ulcer. The ultrastructural features permit a clear distinction between Campylobacter pylori and other Campylobacter species. Campylobacter pylori may possibly have a pathogenic effect on the mucosa owing to its penetration into the interstitial spaces between the cells and into the interior of the cells.

Adult↗
PubMed1987

[Functions of intrinsic defense against anaerobic bacteria in healthy probands and patients with chronic-septic granulomatosis].

Different strains of Bacteroides fragilis exhibit great differences in sensitivity towards serum from healthy volunteers. In the presence of 10% autologous serum, neutrophilic granulocytes and monocytes (macrophages) caused significant killing of B. fragilis. The measured phagocytic and killing activity of the cells is comparable to their activity against aerobic bacteria (S. aureus). In four patients with chronic granulomatous disease of childhood, phagocytosis was normal but killing of B. fragilis and S. aureus in granulocytes or monocytes (macrophages) was appreciably lowered. This malfunction of the cells was accompanied by a disturbance in oxidative metabolism and inadequate iodination after phagocytosis of B. fragilis. The results suggest that granulocytes and monocytes play an important role in host defense against endogenous infections with anaerobes.

Abscess↗