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Biomedical subjects

M J Wiselka

Publications and source records attributed to M J Wiselka.

36 records · Page 2Linked to original sources
PubMed1993

Schistosomiasis in Leicester.

Twenty-two cases of schistosomiasis were diagnosed in the Infectious Diseases Unit in Leicester during a 5-year period. There were 11 cases of Schistosoma haematobium infection and three of S. mansoni infection. The schistosoma type in the remaining eight cases was uncertain. Fourteen asymptomatic family members of patients with proven schistosomiasis were screened and 6 (43%) had evidence of schistosomal infection. Seventeen (77%) of the patients were thought to have been infected in Malawi and all but one of these had swum in Lake Malawi. The study highlights the large proportion of cases who acquired infection in Malawi and emphasises the importance of family screening.

Adolescent↗
PubMed1993

Impact of respiratory virus infection in patients with chronic chest disease.

This study investigated the morbidity associated with respiratory virus infections in patients with well-documented chest disease, and the risk of transmission between close contacts. Patients informed the study team if they were exposed to a family member or colleague with a cold. Patients and symptomatic index cases recorded respiratory symptoms during the study period. Acute nasopharyngeal swabs and paired sera were obtained for viral diagnosis. Twenty-five (43%) of 58 recorded exposures resulted in a symptomatic illness and 16 (28%) patients developed lower respiratory tract symptoms. Sixteen (64%) of the 25 symptomatic patients contacted their general practitioner, 14 (56%) received antibiotics and 4 (16%) were hospitalized. Mean duration of illness was 10.6 days in symptomatic patients and 5.7 days in their corresponding index cases (P < 0.005). Mean symptom scores were 100.6 in symptomatic patients and 62.2 in index cases (P < 0.01). Respiratory viruses were identified in 19 (33%) episodes. Rhinovirus, coronavirus and respiratory syncytial virus infections were all associated with lower respiratory tract exacerbations. Respiratory tract symptoms following exposure to a cold were comparatively severe in these patients with chronic chest disease. This group of patients might gain particular benefit from the introduction of effective vaccines or antiviral therapy.

Adolescent↗
PubMed1992

Genetic similarity and maintenance of Candida albicans strains from a group of AIDS patients, demonstrated by DNA fingerprinting.

By using the computer-assisted Dendron system to analyze the patterns of Southern blots probed with the repetitive sequence Ca3, we have compared oral isolates of Candida spp. from a group of 11 nonhospitalized patients with AIDS suffering from recurrent episodes of oral thrush in Leicester, England, with oral isolates from a group of control individuals. Genetic diversity among the AIDS strains was significantly reduced compared with that of control strains. In addition, the same strains persisted through recurrent infections in patients with AIDS. Although AIDS strains were genetically less diverse than either control strains or oral commensal strains analyzed in previous studies, the majority did not form a genetically distinct group. The results of this study suggest that in the majority of patients with AIDS in this group from Leicester, original commensal strains were replaced, replacement occurred early in the manifestation of AIDS, and replacement occurred only once.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Prophylactic intranasal alpha 2 interferon and viral exacerbations of chronic respiratory disease.

BACKGROUND As respiratory virus infections often lead to exacerbations of chronic bronchitis and asthma an effective antiviral drug may be helpful in such patients. Alpha 2 interferon has been shown to give protection against rhinovirus infections in field studies. METHODS Patients with chronic respiratory disease exposed to close contacts with symptoms of upper respiratory tract infection were randomly allocated to receive nasal sprays of recombinant alpha 2 interferon (3 x 10(6) IU) or placebo twice daily for five days. Of the 123 patients recruited into the study, 69 took 117 courses of medication; 11 courses were excluded from analysis. RESULTS No important side effects were recorded and the incidence of possible adverse effects was similar in the two groups. Interferon treatment did not reduce the number or severity of symptomatic episodes; 11 of 48 patients given interferon and 16 of 58 given placebo developed lower respiratory symptoms. There were no differences in mean symptom scores (51 interferon and 52 placebo), number of symptomatic days (3.3 interferon and 5.0 placebo), peak flow values, number of general practitioner consultations, or use of antibiotics. CONCLUSION Alpha 2 interferon 3 x 10(6) IU taken twice daily for five days does not protect patients with chronic respiratory disease from exacerbations after they have been in contact with an upper respiratory tract infection.

Administration, Intranasal↗
PubMed1990

Malaria in Leicester 1983-1988: a review of 114 cases.

We have reviewed 114 episodes of malaria in 110 patients who were admitted to the Infectious Diseases Unit in Leicester during the 5 year period from February 1983-January 1988. There were 71 episodes of vivax malaria (62%), 33 episodes of falciparum malaria (29%), four patients with mixed infection and six patients with negative blood films who were diagnosed on clinical suspicion alone. Most patients presented in the summer months, 68% were aged under 40 years, 39% were born in the Indian subcontinent, 23% in East Africa and 23% in Britain. Eighty-two per cent of patients with falciparum malaria had recently returned from Africa whereas 82% with vivax malaria had visited Asia. Thirty six per cent had been given antimalarial chemoprophylaxis but only half of these took medication correctly. Seventy five per cent of episodes of falciparum malaria presented within 2 weeks of arrival in Britain, however vivax malaria could present at any time and 49% of cases occurred over 3 months after exposure. Presenting symptoms and signs were often non-specific. Twenty nine per cent of patients had been treated with antibiotics and 11% received antimalarials prior to admission. Vivax malaria was generally a mild infection but falciparum malaria was often severe with 39% of patients experiencing complications including one death. Although Plasmodium vivax and P. falciparum are morphologically similar the diseases caused by the two species of parasite are quite distinct. Physicians must ensure that malaria is excluded in anyone who has travelled to an endemic area.

Adolescent↗
PubMed1989

Malaria prophylaxis in travellers from Britain.

A short questionnaire about malarial prophylaxis was completed by 376 travellers departing from Gatwick Airport to destinations in Asia, Africa, Australasia and South or Central America. Only 263 (70%) had sought advice, 80% of them from a general practitioner. Of travellers born in Britain, 81% had sought advice compared to 38% of those born abroad (P less than 0.001). Advice about protective measures to reduce mosquito bites had been given to 52% travellers. Although 264 were travelling to areas where prophylaxis is advised, only 167 (63%) were taking antimalarials, while 22% travelling to malaria-free destinations were taking unnecessary prophylaxis. Many British travellers do not take effective antimalarial chemoprophylaxis. This has undoubtedly contributed to the recent increase in incidence of the disease in the U.K. General practitioners should ensure that they give correct advice and the immigrant population need to understand the risk of malaria when they return home.

Africa↗
PubMed1987

Influenza vaccination of the elderly: perceptions and policies of general practitioners and outcome of the 1985-86 immunization programme in Trent, UK.

The policies, organization and outcome of the influenza vaccination programmes for the elderly were studied in randomly selected general practices in Trent during the winter of 1985-86. Data from 127 practices, covering approximately one-fifth of the 668 800 people in Trent 65 years of age and older, were studied in detail. Altogether 87% of practices offered vaccine to selected elderly patients and 93.5% gave it upon request. However, less than one-fifth of the elderly population covered by the survey were vaccinated against influenza and the number of doses prescribed by individual practitioners and practice immunization rates varied considerably. The higher immunization rates were correlated with certain practice immunization policies and procedures Reasons for non-acceptance of vaccine were also identified. The observations suggest that provision of educational materials about the risks and benefits of influenza vaccine and a re-appraisal of practice strategies relating to the influenza immunization programme may increase the number of elderly people who are immunized.

Aged↗
PubMed1980

Increased sodium appetite in adrenalectomized or hypophysectomized rats after intracranial injections of renin or angiotensin II.

Rats given free access to food, water and 2.7% NaCl and injected with either renin or angiotensin II into the preoptic area showed an immediate increase in water intake followed by an increase in intake of 2.7% NaCl. The rats continued to drink the hypertonic NaCl solution throughout the test session of 18 h. Intracranial injections of the dipsogen, carbachol, caused thirst but no sodium appetite. Bilateral adrenalectomy had no effect on either the initial water intake or the delayed intake of NaCl that was induced by intracranial injections of renin or angiotensin II. However, the increased water intake during the 18 h after the administration of renin was reduced to normal levels in adrenalectomized rats. Similar results were obtained with hypophysectomized rats. These results demonstrated that the delayed sodium appetite induced by renin or angiotensin II is not secondary to the stimulation of release of hormones from the pituitary gland or adrenal cortex.

Adrenalectomy↗
PubMedDate not supplied

Invasive pulmonary aspergillosis complicating chronic obstructive pulmonary disease in an immunocompetent patient.

Immunocompromised individuals are susceptible to pulmonary aspergillus infection, but invasive aspergillus infection is extremely rare in the presence of normal immunity. We report a case of invasive aspergillosis in an immunocompetent 63-year-old male with chronic obstructive pulmonary disease (COPD). Patients with COPD may be at risk for developing pulmonary aspergillus infection, which should be considered as a diagnostic possibility in patients with unresolving pulmonary infection.

Aspergillosis↗
PubMedDate not supplied

Don't forget dengue! Clinical features of dengue fever in returning travellers.

BACKGROUND: Dengue virus infection is an increasingly important cause of imported fever, but many cases remain unrecognised. This study reviews the clinical features of dengue fever in patients seen at a regional department of infection and tropical medicine. SUBJECTS: All patients with dengue fever presenting to the Department of Infection and Tropical Medicine in Leicester over a three year period. RESULTS: The diagnosis of dengue fever was confirmed in 15 patients. The age range of patients was 19-61 years, and 80% were immigrants returning from a visit to their country of origin. In 11 (73%) patients, infection was associated with travel to India; others had gone to South-east Asia, Barbados and Uganda. All patients presented within three weeks of their return to the United Kingdom. The clinical manifestations of infection were often non-specific. They included fever, nausea, headache, cough and diarrhoea; 5 (33%) patients had a macular rash. Thrombocytopenia was seen in 7 (47%) patients, but only one had evidence of dengue haemorrhagic fever. Dengue infection was confirmed by serology in 14 (93%) patients. In one, dengue virus type 1 was identified by polymerase chain reaction, and the virus was subsequently isolated in tissue culture. CONCLUSIONS: Dengue virus infection should be considered in all febrile travellers who have recently returned from areas where the disease is endemic and in whom tests for malaria are negative.

Adult↗