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Biomedical subjects

H Jäger

Publications and source records attributed to H Jäger.

At least 73 records · Page 4Linked to original sources

A liquid chromatographic method for determination of theophylline in serum and capillary blood--a comparison.

A simple, fast and reliable liquid chromatographic method for the determination of theophylline in serum and capillary blood after a solid phase extraction is described for therapeutic drug monitoring. The employment of capillary blood permits the determination of an individual drug profile and other pharmacokinetic studies in neonates and infants. There were no differences in venous- and capillary-blood levels but these values compared poorly with those in serum. An adjustment of the results by correction of the different volumes of serum and blood by haematocrit was unsuccessful. Differences in the binding of theophylline to erythrocytes could be an explanation for the differences in serum at blood levels of theophylline.

Capillaries↗

Risk of transfusion-associated HIV transmission in Kinshasa, Zaire.

Between 5 March and 12 April 1990, we assessed transfusion practices and the risk of transfusion-associated HIV transmission in all the hospitals and medical centres in Kinshasa, Zaire. Of the 733 hospitals and medical centres surveyed, 62 (8.5%) transfuse blood. Of 3741 units of blood transfused in February 1990, 1045 (27.9%) were not screened for HIV infection. Eighteen out of 62 centres (29%) received HIV test kits on a regular basis. Twenty of the centres (32.3%) recorded HIV test results. Major blood group cross-matching was done by 9.7% (six out of 62) of the centres. Bacteriological results indicated contamination in 17% (four out of 23) of stocked blood units, 6.4% (four out of 62) of solutions for disinfections, and 22% (13 out of 59) of sterilized instruments (possessed by 59 centres only). Transfusion practices in Kinshasa are associated with considerable health risks. The establishment and appropriate supervision of HIV screening facilities should be integrated into primary health-care programmes in order to increase safe transfusions in Kinshasa.

Academic Medical Centers↗

[MRT and 99mTc-HM-PAO SPECT of the brain in myasthenia gravis].

Fourteen patients suffering from myasthenia gravis underwent cranial MRI and 99mTc-HM-PAO SPECT examinations. T2-WI revealed solitary white matter and/or basal ganglia lesions in four, multiple lesions in eight patients. The evaluation of the rCBF demonstrated a circumscript decrease of cortical perfusion in one patient whereas eight patients showed multiple cortical areas of hypoperfusion. In the context of an increased incidence of intrathecal immune reaction as well as of a constantly impaired cognitive performance of these patients, imaging findings might be a correlate of a primary cerebral manifestation of myasthenia.

Adult↗

[Use of computer-assisted Doppler sonography and rheography in acral vascular diagnosis in progressive systemic sclerosis].

For the quantitative characterization of the blood flow of patients with progressive systemic sclerosis a combined computer-assisted Doppler sonographic as well as rheographic measuring place was established. An aimed examination of the peripheral situation of the blood supply was performed in 15 patients with progressive systemic sclerosis in comparison to a control group of patients with healthy vessels. The demonstration of the corresponding parameters of time and form of the curves resulted in significant differences for the two examination groups, particularly of the pulsation index (PI) and the index of the peripheral resistance (PWI) in the Doppler flow curves as well as for the maximum increase (A) and the peak time (GZ) in the rheogrammes. The computer-assisted functional-diagnostic investigation methods in the peripheral vascular region offer themselves for the objectivation and the assessment of the course of the participation of the vessels in the collagenoses.

Blood Flow Velocity↗

Immune activation markers to predict AIDS and survival in HIV-1 seropositives.

Neopterin concentrations in body fluids of HIV-1 seropositives provide predictive information. In 1986, we examined serum and urine neopterin concentrations in 29 HIV-1 seropositives. Serum levels of soluble IL-2 receptor (sIL2R), soluble CD8 (sCD8), tumour necrosis factor alpha (TNF-alpha) and circulating immune complexes (CIC) were retrospectively analysed in 1989. All individuals had increased serum and urine neopterin, sIL2R and CIC concentrations, 27/29 had increased sCD8 concentrations, whereas all had normal TNF-alpha levels. During a 3-year follow-up, high urine and serum neopterin concentrations were significantly associated with progression to AIDS and with the occurrence of AIDS-associated death. Both neopterin variables were of similar predictive value (p less than 0.001, generalized Wilcoxon test). sIL2R concentrations were of borderline significance in predicting the onset of AIDS (p = 0.05). All other parameters lacked predictive information in our study. We conclude, that chronic immune activation is detectable in almost all HIV-1 seropositives. Chronic immune activation may be associated with HIV-1 replication and may contribute to the immunopathology of HIV-1 infection.

Acquired Immunodeficiency Syndrome↗

Prevention of transfusion-associated HIV transmission in Kinshasa, Zaire: HIV screening is not enough.

The purpose of this study was to develop a strategy to reduce transfusion-related HIV transmission which went beyond the limits of routine HIV screening of blood donors. Current blood transfusion practices were assessed in 1044 patients for whom staff physicians had requested a transfusion between 5 September and 19 October, 1988. Children under 5 years of age with malaria, and pregnant women with acute anaemia requiring blood transfusion were the two highest risk groups. Many of the transfusions were given without an obvious medical indication; 22.7% (214 out of 955) of the recipients were transfused without prior laboratory tests [haemoglobin (Hb) or haematocrit (Hct)], 7.2% with Hb greater than 6g/100ml or Hct greater than 25% and 16.6% without clinical signs of severe anaemia (pulse less than 100/min without shortness of breath). The data of this study were used to organize a workshop for all the physicians responsible for blood transfusions in Kinshasa and two nearby health zones. A consensus statement on the indications for blood transfusion was developed. Subsequently, transfusion centres adopted this consensus statement instead of previous guidelines.

Adolescent↗

Voluntary blood donor recruitment: a strategy to reduce transmission of HIV-1, hepatitis-B and syphilis in Kinshasa, Zaïre.

We evaluated the use of voluntary blood donor recruitment in Kinshasa, Zaïre, as a means of reducing transmission of HIV-1 and other infectious agents by blood transfusion. Between January 1, 1989, and April 7, 1989, 2,237 blood donors were enrolled in the study at the transfusion centre of the Mama Yemo Hospital. Each donor was tested for antibodies to HIV-1 confirmed by IFA and Western blot, Treponema pallidum, antibodies to hepatitis B virus (HBV) core antigen and screened for the presence of the HBV surface antigen. Test results were related to the data of the blood donors: age, sex, haematocrit, voluntary blood donor, family member donor, paid donor. The serological results of all donors for Anti-HIV-1. Anti-HBc, HBsAg and TPHA were 4.8%, 70.9%, 13.1% and 13.3% respectively. Lower seroprevalence rates were found among voluntary blood donors. However, only TPHA seroprevalence was significantly lower in voluntary blood donors (8.4%, 23/275) compared with paid donors (15.2%, 87/571) (p less than 0.01). A greater proportion of voluntary donors provides a store of blood which allows more extensive screening of blood for HIV-1 and other infectious diseases. Voluntary blood donor recruitment is critical for the provision of safe blood supplies in Kinshasa.

Acquired Immunodeficiency Syndrome↗

[Thorotrastosis--a rare disease picture in internal medicine].

The report deals with the late effects following administration of thorotrast in a 63-year-old patient: liver cirrhosis developed after application of thorotrast 25 years ago. The clinical findings are described and attention is drawn to the relevance of this disease at present time. The authors refer to the significance of the routine X-ray diagnosis and of the CT for finding a diagnosis with thorotrastosis.

Humans↗

[Ultrasound-controlled fine-needle puncture with a specially prepared puncture needle].

The described puncture needle with dual amplified point has been successfully applied at the Medical Clinic of the County Hospital Halle for more than half a year now. Better reflecting capacity in both vitro and vivo results from preparation of the needle point's surface. The more clear visibility of the needle point in the ultrasonic sectional view results in a better display during the whole process of puncture and makes possible a better locating also under difficult sonographic conditions. By the application of the described puncture needle the safety of the ultrasonic directed fine-needle puncture increases for both patient and examiner.

Biopsy, Needle↗

[Trace element concentrations in HIV infected patients].

The serum concentrations of Ca, Cu, Fe, K, Mg, P, Se and Zn and the absolute number of T4 cells were determined in 59 HIV-infected men. Serum levels of Ca, Cu and Fe were significantly higher, those of P and Se significantly lower in the infected, compared to healthy controls. In the HIV-infected cases the concentrations of Se and Zn, of Ca with Cu and Fe, and of Fe with P, were directly correlated. In the controls, the correlation between the levels of K and Mg was direct, and inverse between those of Zn and P. WR-stage and trace element levels did not correlate. The absolute number of T4-lymphocytes was directly correlated with the serum Mg concentration.

Calcium↗

[Incidence and pathogenesis of ocular symptoms in HIV infection].

202 patients with HIV infections of different stages [1 (n = 59): symptomless HIV seropositivity, 2 (n = 64): pre-AIDS (LAS = Lymphadenopathy syndrome, ARC = AIDS related complex), 3 (n = 79): AIDS] were prospectively examined. The findings of the first examination were analyzed statistically in a cross-section-study. In 15 AIDS autopsy cases the eyes were examined histopathologically and with immunohistochemical techniques. Patients with stage 1 had only some Sicca syndromes (3%) and neuroophthalmological signs (dyscoria with neurosyphilis) (2%). 14% of the patients with stage 2 had a microvascular retinal syndrome, 11% a Sicca syndrome and 2% neuroophthalmological signs. Among the AIDS patients (stage 3), however, 61% had a microvascular syndrome of the retina, 24% a retinitis resp. choroiditis as an opportunistic infection (in 15% Cytomegalovirus was the causative organism), 16% had neuroophthalmological symptoms, 14% a Sicca syndrome and 5% Kaposi's sarcoma of the eyelids or conjunctiva. The microvascular retinal syndrome was found to be the most sensitive ocular indicator for an advanced stage of HIV infection. Further changes of the anterior eye segments (especially conjunctival vessel abnormalities and precipitates of the corneal endothelium in Cytomegalovirus retinitis) are demonstrated.

Adult↗

[Computer-assisted evaluation and analysis of bacteriologic findings].

A computer-aided information system was developed for registration and analysis of microbiological findings. The base of the system is a microcomputer with a 16-bit-processor and a hard disc ensuring the analysis of a great number of material. Besides the printing of bacteriological findings for the senders detailed questions can be analysed to give informations about the distribution and frequency of bacterial species in certain specimens, about the bacterial resistance in dependence on a definite time and about the choice of combinations of chemotherapeutics as well as the existence of multiple resistances.

Bacterial Infections↗