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Biomedical subjects

J Lähdevirta

Publications and source records attributed to J Lähdevirta.

At least 55 records · Page 3Linked to original sources
PubMed1990

Acute schistosomiasis mansoni in Finnish hunters visiting Africa: need for appropriate diagnostic serology.

Three symptomatic and 3 asymptomatic patients with acute schistosomiasis mansoni are described. The index case presented with fever and eosinophilia 4-6 weeks after swimming in the Pipi River of the Central African Republic, suggesting acute schistosomiasis (Katayama fever). A fortunate early diagnosis led to early treatment of these schistosomiasis patients. Diagnosis was obtained based on the finding of one Schistosoma mansoni egg in the index case and positive serology in all cases. A commercially available passive haemagglutination test for serum bilharzia antibodies was negative in all cases prior to, and 2 weeks after treatment. However, antibodies against gut-associated antigens (GAA) of adult S. mansoni worms could be demonstrated using the indirect immunofluorescence technique. These cases illustrate the importance of using appropriate diagnostic assays for the early demonstration of infection by schistosomes in previously unexposed "nonimmune" patients with atypical symptoms and in asymptomatic individuals at risk even after brief exposure to schistosome-containing water in endemic countries. Careful (and repeated) stool examination and appropriate serological tests are the keys to prompt diagnosis of S. mansoni infection.

Adult↗
PubMed1990

Acute phase response in Pneumocystis carinii pneumonia.

The acute phase response induced by 19 episodes of Pneumocystis carinii pneumonia (PCP) was analysed in a retrospective study. There were 9 men and 1 woman with HIV, aged 25-45 years (mean 37.2) and 4 men and 4 women with other immunodeficiencies, aged 18-35 years (mean 26.2). The outcome of these two groups with PCP did not differ: in the HIV group 4 died and in the non-HIV group 2 died. In the HIV group, peak serum C-reactive protein (S-CRP) ranged 41-228 mg/l, mean 126 (77.3), and in the non-HIV group 19-290 mg/l, mean 105 (89.1) (NS). The patients with a fatal outcome had higher mean peak S-CRP: 186 (73.8) mg/l versus 85.3 (63.5) mg/l in the survivors (p = 0.007). The HIV infection itself did not increase the S-CRP concentration, which was normal before or after PCP in all 7 survivors of the 11 episodes. Thus, PCP induces a clear-cut S-CRP response, which may be used for monitoring the treatment and evaluating the prognosis of the patient.

Acute-Phase Reaction↗
PubMed1989

T-cell response towards HIV in infected individuals with and without zidovudine therapy, and in HIV-exposed sexual partners.

HIV-specific T-cell response in HIV-infected individuals at different stages of the disease and during zidovudine therapy was studied using HIV and HIV-envelope derived native and recombinant proteins as antigens. Neither antibody-negative at-risk individuals nor HIV-infected individuals responded to HIV or its envelope-derived proteins, even though they responded to a recall antigen, purified protein derivative of tuberculin (PPD). However, five out of 14 antibody- and antigen-negative sexual partners of known HIV-positive men did respond to HIV, native gp 120 and recombinant envelope and core proteins. Some AIDS-related complex (ARC) and AIDS patients treated with zidovudine also showed a low T-cell response which diminished along with clinical deterioration. A synthetic peptide representing one of the major T-cell epitopes in HIV envelope, frequently recognized by immunized and infected primates, gave only marginal stimulation in man. Our findings suggest that HIV infection in man results in a T-helper cell anergy directed against viral proteins. The response observed in the antibody- and antigen-negative sexual partners and in some of the zidovudine-treated patients implies that at least some epitopes on HIV envelope are immunogenic in man.

Acquired Immunodeficiency Syndrome↗
PubMed1989

CSF and serum beta-2-microglobulin in HIV infection related to neurological dysfunction.

Elevated (greater than 2.2 mg/l) CSF beta-2-microglobulin (beta 2m) level was found in 9 of 16 neurologically symptomatic patients but in only 4 of 21 who were neurologically symptom-free (P less than 0.01). Serum beta 2m concentration was elevated (greater than 2.5 mg/l) in 12 of 16 neurologically symptomatic patients but in only 8 of 21 symptom-free patients (P less than 0.01). When the CSF and serum beta 2m levels were related to various stages of HIV infection, the highest mean values for both CSF and serum were found in patients with acquired immunodeficiency syndrome (AIDS), followed by lower values in AIDS-related complex (ARC), lymphadenopathy syndrome (LAS), and asymptomatic seropositive individuals (ASX), in decreasing order of preference. Our results suggest that elevated beta 2m in CSF and serum is related to the stage of general HIV infection and that elevated CSF beta 2m in the presence of intact BBB may be useful in evaluating CNS involvement in HIV-infected patients.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Prospective study of the etiology of diarrhea in adult outpatients and inpatients.

A prospective study of the etiology of diarrhea in 253 adult outpatients and inpatients was conducted in Helsinki in 1985-86. The outpatients constituted 84.6% of all patients studied. A broad panel of diagnostic techniques was applied, including detection of bacteria and parasites in the feces and determination of the serologic responses to campylobacter, salmonella, Yersinia enterocolitica, and several viruses. Pathogens were identified for 28.5% of the patients. The commonest findings were Campylobacter jejuni/coli in 13.0% and Salmonella species in 7.1% of the patients. Mixed infections of several pathogens were found in 16 patients.

Adult↗
PubMed1989

Diagnosis of falciparum malaria delayed by long incubation period and misleading presenting symptoms: life-saving role of manual leucocyte differential count.

In countries where malaria is not endemic the diagnosis of the disease is often delayed or overlooked, particularly if the clinical symptoms are atypical and if automated cell analyzers are used instead of blood films for leucocyte differential counts. We report 2 cases of severe Plasmodium falciparum malaria with unusual clinical features: a 46-year-old man with an exceptionally long incubation period and a 22-year-old woman with presenting symptoms suggesting viral hepatitis. In both cases the diagnosis of malaria was unexpectedly made by observant laboratory technicians examining stained blood films for differential counts.

Adult↗
PubMed1989

Ciprofloxacin in the elimination of enteric Salmonella carriage stage.

According to the present experience, ciprofloxacin seems to be a new promising drug for the treatment of enteric salmonella carriage stage. This paper reviews results with ciprofloxacin and older drugs. While the cure rates in previous studies were about 70%, it was at least 90% with ciprofloxacin although the treatment time was shorter and the rate of side effects was lower. However the final place of ciprofloxacin on this indication needs to be investigated further.

Carrier State↗
PubMed1988

Reactive arthritis associated with Shigella sonnei infection.

Several studies have failed to show an association between Shigella sonnei dysentery and reactive arthritis. We describe 3 patients who had reactive arthritis and a recent or concurrent S sonnei infection. To our knowledge, this is only the second study to suggest this association. We propose that S sonnei should be considered as a triggering agent for reactive arthritis.

Adult↗
PubMed1988

Elevated levels of circulating cachectin/tumor necrosis factor in patients with acquired immunodeficiency syndrome.

PURPOSE: In order to evaluate the relationship between cachectin/tumor necrosis factor (TNF) and cachexia in the acquired immunodeficiency syndrome (AIDS), we studied the serum levels of endogenous cachectin/TNF in subjects with human immunodeficiency virus (HIV) infection. PATIENTS AND METHODS: Fifty-three serum samples were obtained from 39 HIV-seropositive patients. The condition of each patient was clinically classified as either asymptomatic, lymphadenopathy syndrome (LAS), AIDS-related complex (ARC), or AIDS. Control sera were obtained from 29 healthy male blood donors. A double antibody radioimmunoassay was used to measure the serum levels of cachectin/TNF. RESULTS: Cachectin/TNF levels were within the reference range of the control values in all (eight of eight) asymptomatic HIV-infected subjects and in 11 of 13 of the patients with LAS. In contrast, all patients with AIDS (nine of nine) and five of nine of the patients with ARC had raised levels of cachectin/TNF. Fluctuation of the levels of cachectin/TNF occurred during follow-up, but initially raised levels remained elevated. CONCLUSION: Since cachectin/TNF suppresses lipoprotein lipase in adipocytes in vitro, and causes weight loss under experimental conditions, the findings of raised levels of cachectin/TNF in patients with AIDS may have relevance to the pathogenesis of cachexia.

AIDS-Related Complex↗
PubMed1988

Fatal encephalitis caused by a bat-borne rabies-related virus. Clinical findings.

The clinical findings are described in the first reported European case of fatal encephalitis of bat origin caused by a rabies-related virus. A bat zoologist developed the symptoms of rabies 51 days after his last exposure to a bat bite. The clinical disease of 23 days duration was a combination of the paralytic and 'furious' forms of rabies. Serial BAEP and EEG recordings, CT and MR scans of the brain, as well as CSF findings, demonstrated severe ascending destruction of the brain. An unusual progression from isolated brainstem death to cortical brain death occurred. Neuropathologically, the brain showed severe lytic changes. The presence of rabies-related virus antigens in brain smears was shown using a panel of fluorescent antibodies. The virus was inoculated into and isolated from suckling mice. The virus had a close resemblance to European bat rabies isolates, which belong to the group of rabies-related viruses. Of particular concern is whether the virus can spread from bats to terrestrial animals and whether the European type of bat rabies constitutes a danger to man.

Adult↗
PubMed1988

Cognitive changes as early signs of HIV infection.

Neuropsychological examination was performed on 13 patients and 10 matched controls to assess the brain involvement of patients with human immunodeficiency virus (HIV) infection. HIV-infected patients showed a significant decline in visuomotor, visuoconstructive and practical abilities as well as in motor-free visuospatial performance and repeating a long sentence. These findings could not be explained by the concomitant mental depression of these patients. Neither were they associated with any particular stage of HIV infection. The results suggest that mild cognitive changes may be detected even in the early stages of HIV infection, when examined by appropriate neuropsychological methods.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[Erythema nodosum].

Explore the source record for details and available documents.

Erythema Nodosum↗