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Biomedical subjects

N Vetter

Publications and source records attributed to N Vetter.

At least 19 recordsLinked to original sources
PubMed1995

[Idiopathic CD4+ T-lymphocytopenia in 2 patients without indications for HIV infection].

We report on two patients with idiopathic CD4+ T cell depletion. A 26 year-old woman presented to us with acute respiratory failure requiring mechanical ventilation. Despite combined antibiotic therapy parenterally the opacities increased in the chest X-ray. An open lung biopsy was performed and led to the histological diagnosis of bronchiolitis obliterans organizing pneumonia (BOOP). Respiratory function was improved impressively by high dose parenteral cortisone administration. This patient showed a general lymphocytopenia with severe CD4+ T cell depletion (60(37%)/mm3 blood). The CT4+ T cell concentration increased during a follow up period of 14 months, but did not reach normal values. The second patient was a 33 year-old homosexual. He was admitted with a mucocutaneous fungal infection which was successfully treated by antifungal drugs. This patient demonstrated a transient CD4+ T cell depletion (350(32%)/mm3 blood). In both patients HIV type 1 and 2 infections were excluded by antibody- and p 24-antigen testing, polymerase chain reaction and virus culture. CONCLUSION. Idiopathic CD4+ T lymphocytopenia differs from HIV infection in immunological profile, in the tendency to reversal of the CD4+ T cell depletion over time and in its better prognosis. It is unclear if this is a new syndrome and whether a transmissible agent, or possibly a genetically-determined reaction to noxious agents is responsible.

Adult↗
PubMed1994

[Home care of AIDS patients from the medical and nursing viewpoint--a project in Vienna].

Based on the longer survival time of HIV-infected patients the spectrum of HIV associated complications changed. The frequency of neurological diseases, as AIDS dementia complex, is increasing. Therefore there is more need for nursing of AIDS patients. Aim of the study was to evaluate the cost-effectiveness, the practicability and the influence of home care on the outcome of the patients. During a 1-year period 7 AIDS patients were treated by 4 nurses and 1 doctor in a home care setting. Three of these patients were immobile and needed nursing; the four other received their parenteral therapy at home. Nursing took 2 to 7 hours, the administration of parenteral therapy one and a half hour per day and patient. 226,520 Austrian Schillings were spent for the care of the 7 patients during 1 year. By minimizing the duration and the number of hospital stays the quality of life of the patient was improved. Home care did not influence the outcome of the patients negatively.

Acquired Immunodeficiency Syndrome↗
PubMed1992

[Differential diagnosis of ascites and abscess forming hepatitis in AIDS patients with reference to the first patient with microsporidia infection in Austria].

We report on a 30 years-old female AIDS patient suffering from generalized pneumocystosis and intestinal microsporidiosis. The chest X-ray showed a right-sided pleural effusion; the lungs showed no areas of consolidation and the heart and the vessels were normal in size. Sonography revealed multiple cystic lesions of the liver measuring 1-3 cm in diameter, as well as ascites. Pneumocystis carinii was detected on cytological examination of the bronchoalveolar lavage fluid, the pleural effusion and the ascitic fluid. Intestinal microsporidiosis was diagnosed by cytological examination of the stool. Both pneumocystis carinii infection and microsporidiosis may cause hepatitis and ascites. In our patient the organ manifestations of the two infections did not overlap. Since simultaneous organ manifestations are possible the differential diagnosis is discussed. This is the first case of microsporidiosis reported in Austria.

AIDS-Related Opportunistic Infections↗
PubMed1991

Induced sputum and cytological diagnosis of lung cancer.

Diagnosis of lung cancer by examination of induced sputum specimens for malignant cells may be a valuable alternative to diagnosis by bronchoscopy. Patients suspected of having lung cancer were recruited and randomly distributed into two groups, one group (n = 34) having sputum induced by use of an ultrasonic nebuliser before bronchoscopy, and the other (n = 33) undergoing ordinary expectoration before bronchoscopy. 25 patients in the induced-sputum group were diagnosed as having primary lung cancer; induced sputum was positive for malignant cells in 21 of these patients (84%), whereas bronchoscopy was positive in 23 (92%) (not significantly different). In comparison, ordinary sputum was positive in 15 of 29 patients (52%) diagnosed as having primary lung cancer, whereas bronchoscopy was positive in 28 (97%) (p less than 0.001). Induction of sputum by an ultrasonic nebuliser was an effective procedure for diagnosis of primary lung cancer.

Administration, Inhalation↗
PubMed1991

[Differential diagnosis of necrotizing sarcoid angiitis: necrotizing sarcoid angiitis and collagen disease--a case report].

The chest x-ray showed a bilateral micronodular pattern and hilar lymph nodes. Lung function test revealed a diminished VC, TLC and a reduced compliance and CO diffusion capacity. The histological examination of the lung biopsy showed sarcoid-like necrotising granulomatous formations of the vessel walls and destruction of these. Unusual was the coincidence of a sarcoidal necrotizing angiitis and a connective tissue disease which presented as Raynaud's disease. Antinuclear antibodies and antibodies against SSA-RO and Scleroderma 70 were identified. The histological examination of the skin biopsy showed changes pertaining to scleroderma. In accordance with the definition by Laevitt (4, 5), this disease is a polyarteritis overlap syndrome.

Adult↗
PubMed1991

[Wegener's granulomatosis with splenic involvement and Hashimoto's lymphomatous thyroiditis].

A case of a 37-year old female patient suffering from Wegener's granulomatosis is reported. The chest x-ray showed a tumorous consolidation of the right upper lobe and of the apical segment of the right lower lobe. The histological examination of the lung, the kidney and the spleen revealed necrotising granulomas typical of Wegener's granulomatosis. Additionally, a thyroiditis lymphomatosa Hashimoto was diagnosed. So far, coincidence of thyroiditis Hashimoto and Wegener's granulomatosis has not been reported in the literature. The involvement of the spleen was a rare manifestation of Wegener's granulomatosis.

Adult↗
PubMed1990

[Comparison of an oxygen-conserving module "Oxytron" and the reservoir cannula "Oxymizer Pendant" with continuous oxygen administration via nasal prong in hypoxemic patients].

High costs involved in administering continuous long-term oxygen therapy to patients with chronic lung diseases and limited portability of oxygen sources stimulated research into and development of oxygen conserving devices. Oxytron (Weinmann, Hamburg) is a new electronic demand oxygen delivery system which limits oxygen flow to the early phase of inspiration. The reservoir cannula Oxymizer Pendant (Chad-Therapeutics Inc.) is a nasal prong system incorporating a pendant reservoir which stores oxygen during expiration and delivers it as a bolus at the onset of inspiration. Ten patients with significant hypoxaemia at rest received oxygen delivered at various breath interval settings with the Oxytron method and at flow rates of 2, 3 and 41/min with the reservoir cannula Oxymizer Pendant and with continuous flow. The results indicate that significantly less oxygen was required to provide equivalent oxygen saturation with Oxytron as compared with steady flow delivery: an oxygen flow reduction of greater than 75% was achieved at all Oxytron settings tested. With the reservoir cannula oxygen saving was most evident at low oxygen flows: 29.3, 19.4 and 4.7% less oxygen was required than with continuous flow at 2, 3 and 41/min. Individual patient acceptance of various drug delivery systems and response to therapy should be considered when prescribing home oxygen therapy. The use of oxygen saving techniques could result in a substantial cost saving and greater mobility may help to improve compliance in patients requiring continuous oxygen therapy.

Adult↗
PubMed1990

Serum neuron-specific enolase is a useful tumor marker for small cell lung cancer.

Small cell lung cancer (SCLC) may be potentially curable. A correct diagnosis of cancer cell type is important and serum markers are of great value. Although several markers have been suggested, they have been of limited value because of insufficient specificity. To assess the value of serum neuron-specific enolase (S-NSE) as a possible marker of SCLC, the serum levels of 81 patients with SCLC (59 patients with extensive disease and 22 patients with limited disease) were compared with the serum levels of patients with non-small cell lung cancer (N-SCLC) and 93 patients with nonmalignant lung diseases. The S-NSE level also was measured in 104 patients with extensive disease of various other malignancies, including 71 solid tumors and 33 malignant hematologic disorders. From 105 healthy control subjects, the upper limit of the normal range (x + 2 standard deviations [SD]) was determined as 12.3 ng/ml. The S-NSE level was elevated in 78% of patients with SCLC, including 11 of 22 (50%) with limited disease and 52 of 59 (88%) with extensive disease. In contrast, the S-NSE level was raised only in 18% of patients with advanced N-SCLC (nine of 50) and 6% of patients with nonmalignant lung diseases (six of 93). Twelve patients (17%) with other solid malignant tumors and two patients (6%) with malignant hematologic disorders had raised S-NSE levels. Serial N-NSE levels were obtained in 13 patients with SCLC. S-NSE levels fell in all patients responding to chemotherapy and increased again with progression of disease. Our results indicate that S-NSE seems to be specific for SCLC (85%), whereas sensitivity seems to be dependent on the stage of disease. Further, S-NSE may be a useful marker for monitoring treatment and predicting relapse in patients with SCLC.

Biomarkers, Tumor↗
PubMed1990

[Effectiveness and tolerance of disodium cromoglycate capsules in pellet form].

The efficacy of, and tolerance to lactose-free sodium cromoglycate capsules was investigated in a multicentre trial. Data of 154 patients with asthma treated at 41 centres were evaluated over an observation period of 5 weeks. During treatment there was a significant reduction in the required dosage of concomitant medication, a marked improvement with regard to the severity of symptoms and a significant increase in peak flow rates. Assessment of treatment was "good" or "very good" in 86% of patients. Mild side effects such as cough or throat irritation were seen in only 2.6% of patients.

Adolescent↗
PubMed1990

A comparative study of ofloxacin and amoxycillin/clavulanate in hospitalized patients with lower respiratory tract infections.

We conducted an open randomized trial to compare the efficacy of parenteral and oral ofloxacin with that of amoxycillin/clavulanate. A total of 121 patients was studied; 92 were clinically evaluable. Of these, 59 patients were treated with ofloxacin and 33 with the comparator drug. Patients were given the drugs intravenously for a minimum of three days followed by oral preparations for the next seven to ten days. Ofloxacin was usually administered as a 200 mg dose bd. In the ofloxacin treated group all patients showed clinical improvement. In the comparator group 94% improved clinically (either a complete or partial response), while 6% were clinical failures. Of the bacteriologically evaluable patients 19 of 20 showed a satisfactory bacteriological response in the ofloxacin treated group, while in the comparator group the bacteriological response was judged satisfactory in 14 of 17 patients. A small proportion of patients (7%) treated with ofloxacin suffered mild adverse effects (nausea, vomiting, headache, hypotension and rash). On the whole, ofloxacin was well tolerated by our patients. The two deaths that occurred were in the comparator group. We conclude that ofloxacin in both oral and parenteral forms is an effective and safe drug in the treatment of lower respiratory tract infections.

Administration, Oral↗
PubMed1990

[Prevalence of malignancy in preoperatively undetermined solid round lesions].

We report on 20 patients submitted to surgery, with an average age of 53.9 years (+/- 8.8), in whom solitary pulmonary nodules were not amenable to preoperative diagnosis on the basis of biopsy material. It was shown that 35 per cent of the unclear solitary lesions were malignant. Provided that the medical risks of surgery can be justified, surgical clarification via a thoracotomy in patients in this age group is indicated.

Diagnosis, Differential↗
PubMed1990

[Results of preventive screening of chimney sweeps].

In a prospective study, 18 chimney sweeps aged between 21 and 57 years were examined with the aim of detecting the presence of heavy metals in the blood and urine, and identifying cardiopulmonary diseases. Elevated concentrations of cadmium were found in three cases, and of lead in two cases, the concentrations being such that damage to health could not be excluded. None of the chimney sweeps showed any signs of bronchial hyper-reactivity or coronary heart disease. With respect to risk factors for coronary heart disease, elevated cholesterol and/or triglyceride levels were observed in 7/16 patients. These figures are compatible with the average figures for the Austrian population at large.

Adult↗
PubMed1989

[The significance of nonspecific bronchial hyperreactivity].

The bronchial hyperreactivity is the cause of dyspnea in asthmatic subjects. The bronchial hyperreactivity is caused by the allergic "late-reaction". Inhalative bronchial challenge tests by metacholine prove bronchial hyperreactivity. The therapy of the bronchial hyperreactivity consists in systemic and local corticosteroids and dinatriumcromoglycate. One of these substances should be part of the basic therapy of every asthmatic patient.

Asthma↗
PubMed1989

[Immunocytochemical studies in the diagnosis of pulmonary histiocytosis X].

The diagnostic value of immunocytochemical tests was analysed for 19 cases of pulmonary histiocytosis X (PHX) and eight of other types of fibrosing pulmonary disease (sarcoidosis, 3; exogenous allergic alveolitis, 3; chronic pneumonia, 1; fibrosing alveolitis, 1). The cellular, proliferative-fibroblastic and fibrocystic stages in the course of pulmonary changes were differentiated. PHX cells reacted with anti-S 100 protein in all stages. In three cases for which unfixed tissue was available, all PHX cells reacted with antibody Leu-6, and 35% of these cells also reacted with the proliferation marker Ki-67. The few S-100 positive cells from the eight controls were limited to peribronchial tissue. Thus the antibodies Leu-6 and S-100 are useful aids in the diagnosis of PHX.

Antibodies↗