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Biomedical subjects

H Timm

Publications and source records attributed to H Timm.

At least 19 recordsLinked to original sources
PubMed2005

The experiences of and the nursing care for breast cancer patients undergoing immediate breast reconstruction.

This study explores the experiences of and the nursing care for nine women with breast cancer undergoing immediate breast reconstruction (IBR) with a TRAM-flap. The study was prospective and descriptive and source and method triangulation was used. Source triangulation consisted of the patients' and nurses' perspectives, whilst method triangulation combined interviews, questionnaires and medical records. One result is that the meaning of IBR for the women operated is related to feelings of hope, normality and 'wholeness'. Another result is that not all the needs of the patients are assessed and met; the nursing care during admission is mainly focused on the physical care and after dismissal the patients are left in a situation characterized by vulnerability and a sense of emptiness. The study points to some implications in the means of quality development and rehabilitation.

Adaptation, Psychological↗
PubMed2000

Application of a fluorogenic PCR assay for typing and subtyping of influenza viruses in respiratory samples.

A fluorogenic PCR-based method (TaqMan-PCR) was developed for typing and subtyping of influenza virus genomes in clinical specimens. The TaqMan-PCR employs a probe technology that exploits the endogenous 5'-3' nuclease activity of the Taq DNA polymerase to allow direct detection of the amplicon by release of a fluorescent reporter during the PCR. Therefore, post-PCR analysis is avoided since hybridization with the fluorogenic probe and quantification of the amplified product is performed simultaneously during PCR cycling. The specificity of the method was evaluated on 86 influenza A (25 H1N1 and 61 H3N2) and 49 influenza B virus reference strains and isolates. The sensitivity of the technique was found to be at the level of 0.1 50% tissue culture infective dose. This TaqMan-PCR was applied prospectively to surveillance work by community-based sampling in Germany during the last two influenza seasons. Seven hundred five throat swabs were analyzed during the winter of 1997-1998. A total of 195 of 705 samples (28%) were positive by PCR. Influenza viruses could be isolated from 125 specimens (18%). During the 1998-1999 season, 1,840 respiratory samples were received. Influenza viruses were isolated from 281 specimens (15%) out of 525 throat swabs (29%) which were positive for influenza A or B virus by TaqMan-PCR. Further differentiation of influenza A virus-positive swabs revealed an intensive circulation of the subtype H3N2 during both seasons, 1997-1998 and 1998-1999. The TaqMan-PCR was much more sensitive than culture and revealed an excellent correlation for typing and subtyping of influenza viruses when samples were positive by both methods.

DNA Primers↗
PubMed1999

Identification of human cytomegalovirus variants by analysis of single strand conformation polymorphism and DNA sequencing of the envelope glycoprotein B gene region-distribution frequency in liver transplant recipients.

Single strand conformation polymorphism analysis (SSCP) of PCR-amplified DNA and subsequent DNA sequencing of human cytomegalovirus (HCMV) glycoprotein B (gB) gene were applied to identify known HCMV strains and to detect new virus variants. 61 HCMV PCR positive patients were studied out of a cohort of 410 patients after liver transplantation (LTX). SSCP was able to distinguish between strains Davis, AD169, and Towne, and in addition could identify five new virus variants (Berlin B, C, E, F, and H). Their frequency, gB and gH types were determined. Simultaneous infections with two or three strains or variants, as well as a switch from one virus to another virus were observed during long-term follow-up. No correlation between the occurrence of certain virus strains or gB types and defined clinical manifestations of HCMV infection after LTX was drawn.

Base Sequence↗
PubMed1999

An echovirus 30 outbreak with a high meningitis attack rate among children and household members at four day-care centers.

Echovirus 30 (E 30) outbreaks in defined cohorts have rarely been reported. In June 1996, an outbreak of E 30 occurred in four day-care centers (DCCs) in neighboring villages in Germany. A retrospective cohort study of DCC children, employees and household members was done to determine the extent of the outbreak and risk factors for illness. Forty-two percent (39/92) of DCC children, 13% (30/228) of their household members, 5% (1/19) of employees and 2% (1/49) of household members of employees were ill. Onsets occurred over 31 days. Thirteen percent (12/92) of DCC children had meningitis. In only one of 16 households with multiple family members ill, illness in a family member preceeded that of the DCC child. Household members of ill DCC children were 15 times more likely to report illness than those of non-ill DCC children. We conclude that this outbreak was associated with a very high incidence of meningitis, the outbreak began in the DCCs and then spread to household members, and that household members of ill children compared to those of non-ill children were much more likely to report illness.

Adult↗
PubMed1999

Community-wide outbreak of enteroviral illness caused by echovirus 30: a cross-sectional survey and a case-control study.

BACKGROUND: In June, 1997, 21 children from a single community in Germany were hospitalized with aseptic meningitis. An epidemiologic investigation was conducted to determine the extent of the outbreak and risk factors for illness. METHOD: The extent of the outbreak was assessed with a cross-sectional survey of every 10th child listed in the town register among the 2240 town children < 16 years old. A case-control study determined risk factors for illness. Sixty-two cases were identified through the cross-sectional survey from hospitalized persons and from persons seen by local physicians. Controls were 114 asymptomatic persons identified from the cross-sectional survey. RESULTS: The overall attack rate was 16%, with the highest attack rates (24%) among the 6- to 8-year olds. Onsets occurred during a 37-day period. Among the 2240 town children <16 years of age, an estimated 353 met the case definition for enteroviral illness, 168 visited a doctor and 21 were hospitalized. Data from the case-control study indicated that contact with an ill household member [odds ratio (OR) = 6.3; 95% confidence interval (CI) 2.6 to 15.5], day-care attendance (OR = 2.6; 95% CI 1.1 to 6.2) and playground use, either two to three times per week (OR = 3.7; 95% CI 1.3 to 10.2) or daily (OR = 4.3; 95% CI 1.6 to 11.3), were risk factors for illness. CONCLUSION: Echovirus 30 caused substantial morbidity during this community outbreak caused by person-to-person spread. Household contacts, day-care centers and playgrounds were prominent risk factors for transmission.

Adolescent↗
PubMed1998

Influenza A outbreak among adolescents in a ski hostel.

An outbreak of influenza A H3N2 with a high attack rate (49%) and abrupt onset (69% became ill within 2 days) occurred among 81 ski school participants who stayed in a crowded hostel in Austria in early 1997. Two students were hospitalized with pneumonia; one of them died. Cultures of blood and/or respiratory secretions from the hospitalized students yielded toxin-producing Staphylococcus aureus. Influenza A H3N2 was confirmed serologically in four participants, including one surviving hospitalized student, and by polymerase chain reaction of lung tissue from the deceased student. This investigation demonstrates that influenza can cause an explosive outbreak among skiers in a crowded hostel, leading to severe complications among previously healthy adolescents.

Adolescent↗
PubMed1995

Comparison of polymerase chain reaction from plasma and buffy coat with antigen detection and occurrence of immunoglobulin M for the demonstration of cytomegalovirus infection after liver transplantation.

We compared the value of PCR on plasma with PCR on buffy coat leukocytes, Ag assay, and the determination of IgM antibodies by ELISA for the diagnosis and follow-up of cytomegalovirus infection. Thirty patients were followed after liver transplantation (LTX). We compared the tests to assess their clinical usefulness. Fourteen of 30 (46%) patients were both positive in plasma and buffy coat PCR and Ag test. Sixteen patients were negative in both procedures. There was a 97.2% concordance between PCRs done from plasma or buffy coat. The concordance of results of PCR and Ag test in single samples was 94.3%. Discordant results were found in 5.6% of samples. Discordance was observed in the early and the late phase of CMV infection and was due to positive PCRs preceding positive Ag tests for 1-3 weeks in one-half of the patients. IgM antibodies were first observed after a median period of 8 weeks (range, 6-11 weeks) after LTX. Positive PCRs and Ag tests preceded clinical manifestation of CMV disease by a 1 week median (range, 0-3 weeks), whereas positive IgM ELISAs occurred after a median period of 2.5 weeks (range, 0-4 weeks) after the onset of CMV disease. The sensitivity and specificity of both PCR and Ag test were identical, 100% and 76%, respectively. However, for the IgM ELISA, the sensitivity was only 66%, and the specificity was 84%. In conclusion, plasma or buffy coat PCR and Ag test are equally reliable procedures for early detection and monitoring of CMV infection. PCR can become positive earlier than the Ag test, but it is technically more demanding to perform. The demonstration of IgM antibodies is of little practical help because an antibody response occurs too late in relation to infection.

Adult↗
PubMed1995

Presence of antibodies reacting with porcine circovirus in sera of humans, mice, and cattle.

Antibodies reacting with porcine circovirus (PCV) were found in sera of humans, mice, and cattle by means of an indirect immunofluorescence assay (IFA) and an ELISA. In man, the highest seroprevalence (23.9% in IFA and 30.2% in ELISA) was found among hospitalized patients with fever of partially unclear etiology. Non-hospitalized "healthy" persons of the former German Democratic Republic showed a significantly higher number of positive sera (IFA = 20%) than blood donors from Berlin-West (IFA = 8.6%). Murine sera reacted positive with PCV in IFA between 12 to 69% in different breeding groups and about 35% of cattle sera were found reactive with PCV in IFA. Double-staining IFAs, immuno-electron microscopy and immunoblotting showed that non-porcine antibodies reacted with PCV structural antigen. Mathematical analysis revealed that in ELISA, non-porcine antibodies reacted specifically with PCV. Loss of binding specificity of non-porcine antibodies in ELISA after storage of sera and lower maximal optical densities obtained at equal titers in ELISA with non-porcine than with porcine sera suggest that antibodies in man, mice and cattle are caused by related species specific viruses sharing antigenic epitopes with PCV.

Adult↗
PubMed1995

[Results of neutron therapy in recurrent malignant salivary gland tumors in the head and neck area].

PURPOSE: The records of 33 patients of recurrent salivary gland tumors of the head and neck regions were analysed. PATIENTS AND METHODS: 33 patients with recurrent salivary gland tumors were treated with fast neutrons of a 14 MeV DT generator. All patients had been operated several times. 10 patients had been irradiated before with photons or electrons. 24 patients had macroscopic tumor. In many cases advanced tumors were treated. RESULTS: The median follow-up of our patients is 33 months. 6 patients are still alive without disease. 5 patients are alive with local recurrence or tumor progression. The calculated survival rate for all patients is 45% at 5 years. The calculated control rate for all patients is 43% at 5 years. Most of the late side effects according to the RTOG/EORTC-score were moderate. Only in one case severe late side effects could be observed. CONCLUSION: According to the literature advanced recurrences of salivary gland tumors should be treated with fast neutrons.

Adult↗
PubMed1994

Safety of alternating ganciclovir and foscarnet maintenance therapy in human immunodeficiency virus (HIV)-related cytomegalovirus infections. An open-labeled pilot study.

In the treatment of cytomegalovirus (CMV) disease in patients with AIDS, a life-long suppression therapy following an induction therapy consisting of ganciclovir or foscarnet is essential. Due to drug-related toxicities, anti-CMV therapy frequently has to be discontinued. To determine whether toxicities and side effects may be reduced with an alternating combination therapy consisting of ganciclovir and foscarnet (ganciclovir: 5 mg/kg every other day; foscarnet: 120 mg/kg every other day), 10 AIDS patients with CMV disease received this maintenance therapy for a median time of 18.5 weeks (5-51 weeks). Side effects were reported from 5 patients (nausea 5, malaise/fatigue 2, penile ulcers 1). Hematological or renal toxicities were mild, 1-week discontinuation of therapy due to neutropenia was necessary in 1 patient. Progression of CMV disease was observed in 3 patients at 2, 6, and 30 weeks of maintenance therapy. Median relapse-free interval for all patients was 105 days. We conclude that combination therapy with ganciclovir and foscarnet can be used safely for induction and maintenance therapy. Therefore, this regimen should be assessed in further trials to evaluate safety, efficacy, and the development of resistance in comparison to ganciclovir or foscarnet monotherapy.

AIDS-Related Opportunistic Infections↗
PubMed1994

[Possibilities of driver fitness diagnosis and training using a stationary training car].

The study presented had dealt with the potential of a stationary training car in assessing and improving the driving skills of patients having neurological disorders, with reaction testing and reaction training carried out by means of the training car. The aim had been to verify whether, and to what extent, such a device might contribute to driving fitness diagnosis and improvement. The sample was comprised of patients who, mostly following brain injury, participated in an in-patient rehabilitation programme. It was found that an individual's driving fitness cannot be diagnosed on the basis of laboratory testing alone. The deficits elicited by the tests have to be verified concerning their impact in real road traffic in every individual case, taking adaptive potential into account. In view of improved driving skills, the findings show performance improvements in various reaction tests as well as better driving sample ratings.

Adult↗
PubMed1994

Demonstration of cytomegalovirus after bone marrow transplantation by polymerase chain reaction, virus culture and antigen detection in buffy coat leukocytes.

We prospectively monitored buffy coat leukocytes of 47 patients after 50 marrow transplantations (autologous n = 18, allogeneic n = 32) by polymerase chain reaction (PCR) for the presence of cytomegalovirus (CMV). None of the 18 autologous graft recipients (9 seropositive, 9 seronegative) had positive PCR results or CMV disease throughout the post-transplantation course. Six of 32 allograft recipients (19 seropositive, 13 seronegative) became PCR positive, four of whom developed CMV disease. PCR positive patients were found more often (5 of 10) in the group with acute GVHD grade II-IV compared with 1 of 22 in the group without or with grade I acute GVHD (p = 0.002). Comparison of PCR with antigen assay and virus culture showed an agreement in 90 of 96 (94%) samples. Discordant results were due to a higher sensitivity of the PCR compared with antigen assay (n = 4) and virus culture (n = 6). In conclusion, PCR helps to identify those patients who will not develop CMV disease and narrows down the number of patients who eventually will suffer symptomatic CMV infection. Furthermore, PCR is a useful tool for following the post-transplantation course with respect to CMV and for judging the effect of antiviral treatment.

Adolescent↗
PubMed1993

Demonstration of cytomegalovirus by polymerase chain reaction after liver transplantation.

The polymerase chain reaction (PCR) is a highly sensitive and specific technique for detection of cytomegalovirus DNA. With this method we prospectively analyzed buffy coat leukocytes at weekly intervals over 3 months in 60 patients after liver transplantation (LTX). The PCR results were correlated with the pretransplant donor/recipient CMV antibody status and with the occurrence of CMV-induced disease. Thirty-three of 60 (55%) patients became PCR-positive during their posttransplant course. None of the 27 patients with permanent negative PCRs developed CMV disease. Of 33 patients with positive PCRs, 13 (39%) became ill. CMV disease developed in 9 of 22 (41%) antibody-negative recipients but only in 4 of 38 (10%) seropositive graft recipients. The incidence of CMV disease was 75% (9 of 12 patients) in seronegative recipients who converted to positive PCR results and 19% (4 of 21 patients) in seropositive patients with positive PCR findings. The predictive value of a positive PCR was 75% in seronegative patients but it was low (19%) in seropositive recipients. The predictive value of a negative PCR is 100%. Thus, PCR determinations are useful in identifying patients who will not develop CMV disease and in narrowing down the number of individuals who will become sick. Further, PCR is a helpful tool in the follow-up of patients under antiviral treatment.

Adult↗
PubMed1990

Cytomegalovirus associated oral ulcerations in HIV-infected patients.

Oral ulcerations associated with disseminated cytomegalovirus (CMV) infection were observed in four patients with AIDS manifestations showing low CD4 counts. Virus cultures of urine and saliva samples were positive for CMV in all cases. The lesions were characterized by a punched-out appearance, non-indurated borders, low bleeding tendency and lack of inflammatory wall. Light microscopy revealed granulation tissue containing "owl's eye" like cells in all specimens. Presence of CMV was confirmed by immunohistochemistry and in situ hybridization. The ulcerations were infiltrated with T-lymphocytes of the helper, suppressor and cytotoxic subset, most were positive for HLA DR. Despite the local invasion with immunocytes and high serum titers of serum antibodies the patients experienced progressive CMV disease.

Adult↗
PubMed1989

[Gastrointestinal cytomegalovirus manifestations in AIDS].

Cytomegalovirus (CMV) infection is one of the most important intestinal opportunistic infections in AIDS. In severe cases ulcerations and colitis are the commonest manifestations. 184 HIV positive patients with gastrointestinal symptoms were investigated by endoscopy of the gastrointestinal tract. While culture, immunohistochemical staining and histology from biopsies were performed, the results of all three methods were compared. In one third the cases CMV associated lesions could be found by endoscopy. Erosions or ulcerations are the most frequent tissue lesions. In 95% the culture was positive. In addition, immunohistochemical staining in 75% and histology in 61.7% were positive in patients with more serious manifestations. For early diagnosis endoscopy of the gastrointestinal tract and histological, histochemical and microbiological investigations of biopsies are essential.

Acquired Immunodeficiency Syndrome↗
PubMed1975

[The effect of Voltaren on the gastrointestinal excretion of blood (author's transl)].

24 subjects were treated with Voltaren 150 mg per day for 21 days, or with Naproxen 750 mg per day and ASA 3.0 g per day. In all patients the physiological excretion of blood from the intestine markedly increased, to a very great extent with Naproxen and ASA. From this aspect, Voltaren is highly significantly superior in maximal doses to the other two medicaments.

Adult↗