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Biomedical subjects

G Diridl

Publications and source records attributed to G Diridl.

11 recordsLinked to original sources

[Management of patients with traveler's diarrhea].

Traveler's diarrhea starts 5 to 15 days after arrival with 3 or more watery bowel movements daily in 4 to more than 50% of travelers depending on geographical regions. Enterotoxin producing strains of E. coli are isolated in 20 to 50% of patients, followed by shigella, salmonella, campylobacter and vibrio spp. Rarely giardia lamblia, entamoeba histolytica and cryptosporidia are causative organisms. The cornerstone of treatment is oral rehydration. The efficacy of anti-diarrhetics is not convincingly proved and as to loperamid this drug may prolong invasive forms of diarrhea. Antibiotics are indicated if leucocytes or blood are found in stool. Cotrimoxazole and aminopenicillins are loosing efficacy because of growing resistance. The minimal. In a double blind placebo controlled trial with 500 mg ciprofloxacin b.i.d. for 5 days we were able to demonstrate a significant clinical and bacteriologic effect in 132 patients with salmonellosis and campylobacteriosis.

Anti-Bacterial Agents↗

[HDL cholesterol as a sensitive diagnostic parameter in malaria].

In patients with malaria the lipid parameters triglycerides, cholesterol, and HDL-cholesterol were determined routinely. At the time of admission hypertriglyceridemia, hypocholesterolemia, and an extreme decrease in HDL-cholesterol were found. This dyslipoproteinemia was present in cases of falciparum malaria, as well as in cases of benign tertian malaria. The extent of HDL-cholesterol decrease showed no correlation to the severity of the clinical course of disease. HDL-cholesterol has proven to be an independent diagnostic laboratory finding in cases of suspected malarial infection. This parameter displays high diagnostic sensitivity, but no specificity for malaria.

Adult↗

Frequency of occurrence and characterization of catalase negative Campylobacter isolated from human feces in Vienna.

Of a total of 124 Campylobacter (C.) strains isolated 1988 from fecal specimens, 4 (3.2%) were catalase-negative. Two strains were catalase-negative variants of C. jejuni. The other two were identified as C. upsaliensis on the basis of their biochemical properties and of the results of DNA-DNA hybridization with biotinylated probes from C. upsaliensis and C. jejuni. Both had been isolated from patients after their return from Asia (India and Thailand, respectively). In one case, a significant decrease of the antibody titre was observed within 12 months when the patient strain was used as an antigen. Since this patient had been suffering from diarrhoea during her stay and since with the exception of amoebic cysts, no other intestinal pathogen was isolated, C. upsaliensis is thought to have been the reason for the diarrhoeal episode.

Adult↗

Clinical efficacy of ciprofloxacin compared with placebo in bacterial diarrhea.

In a double-blind, randomized trial, 85 adult patients with acute diarrhea (more than three watery stools per day) received either 500 mg of ciprofloxacin twice daily or placebo for five days. Seventy-six patients were evaluated, 38 patients in the ciprofloxacin group (16 with Salmonella species, 19 with Campylobacter jejuni, and three with Shigella species) and 38 patients in the placebo group (21 with Salmonella species, 11 with C. jejuni, and six with Shigella species). The duration of fever in patients treated with ciprofloxacin was 1.3 days versus 3.1 days in the placebo group (p less than 0.05). The mean duration of diarrhea in the ciprofloxacin group was 1.5 days versus 2.9 days in the placebo group (p less than 0.001). The corresponding numbers in patients with salmonellosis were 1.9 versus 3.4 days (p less than 0.01). In the ciprofloxacin group, all stool culture results became negative within 48 hours of treatment. Relapse occurred in four patients with salmonellosis within three weeks after the end of treatment. In the placebo group, only four of 38 patients had negative stool culture results during treatment and results were negative in only 13 at one week after the treatment period (p less than 0.001). Modest transient elevation of serum transaminase levels was detected in three patients in the ciprofloxacin group and in two patients in the placebo group. Epigastric pain occurred in one patient, and leukopenia occurred in one patient in the ciprofloxacin group. Gastrointestinal discomfort was recorded in two patients and rash was found in one patient in the placebo group.

Adult↗

Ciprofloxacin in the treatment of acute bacterial diarrhea: a double blind study.

In a double-blind, randomized, placebo-controlled trial 50 adult patients with acute diarrhea received either 500 mg ciprofloxacin b.i.d. or a placebo for five days. Results were evaluated in 21 patients in the ciprofloxacin group (10 with Salmonella spp., 11 with Campylobacter jejuni) and 25 patients in the placebo group (16 with Salmonella spp., 5 with Campylobacter jejuni, 4 with Shigella spp.). The duration of fever in patients treated with ciprofloxacin was 1.5 days versus 2.3 days in the placebo group; the difference was not statistically significant. The duration of diarrhea in the ciprofloxacin group was 1.4 days versus 2.6 days in the placebo group (p less than 0.01); the corresponding figures in patients with salmonellosis were 1.6 versus 3.2 (p = 0.01). In the ciprofloxacin group all stool cultures became negative 48 h after start of treatment and remained negative during the follow-up period of three weeks. In the placebo group only one of the 25 patients had negative stool cultures during therapy and only seven after the treatment period (p less than 0.001). Ciprofloxacin was very well tolerated and was found to be a safe compound without major adverse effects.

Acute Disease↗

[Comparison of the ELISA (lipopolysaccharide) and Widal reactions (O antigen) in the diagnosis of Salmonella infections].

At various times after the onset of disease 50 sera of patients with bacteriologically proven salmonella infections were investigated for O-antigen specific antibodies in ELISA and Widal-tests. 21 of these sera were derived from patients with typhoid fever, 10 from patients with gastroenteritis due to various species of salmonella group D and 19 from patients with group B salmonella-gastroenteritis. Additional 44 sera stemming from patients without such infection were included in the investigation as a control. With ELISA the sera were examined for antibodies of the IgM- and IgG-class separately. As antigens lipopolysaccharide W-preparations from S. typhi ("group D-antigen") and S. typhimurium ("group B-antigen") were used in the ELISA. High reciprocal titers (geometric means: 1404, 2560, and 1020) of IgM were demonstrable in sera drawn 11-30 days after onset of the disease with group D- and group B-antigen respectively (Fig. 1, Table 1 and Table 2). With increasing distance of time from the onset of the disease these titers decreased rapidly. The titers of agglutinating antibodies as measured in the Widal-test behaved similarly to those of IgM (Fig. 1, Table 1 and 2), and the correlation between both was high (r = +0.93, Fig. 2). In contrast, titers of IgG-antibodies reached their maximum later, namely 31-60 days after onset of the disease (Table 1), and the correlation to the agglutinin-titers (r = +0.33, Fig. 3) was much lower. In sera of patients with typhoid fever reciprocal titers of IgM against the homogeneous group antigen surmounted those of IgG at the average by about 5 log2-step (mean g: 1404 and 79 respectively) between the 11th and 30th day of disease. At this stage of the disease also sera from patients with gastroenteritis due to both salmonella D or B demonstrated clearly an IgM-dominated ratio. After a period of more than 2 month this ratio was about 1:1 in sera of patients with typhoid fever or with salmonella group D-gastroenteritis, but was clearly IgG-dominated in sera obtained from patients with group B-gastroenteritis. This might be due to the fact that most of the sera classified as "obtained greater than 2 months after onset" stemmed from excreters of salmonella B species.(ABSTRACT TRUNCATED AT 400 WORDS)

Antibodies, Bacterial↗