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Biomedical subjects

P Bernhard

Publications and source records attributed to P Bernhard.

15 recordsLinked to original sources
PubMed1999

[Cerebellar syndrome after varicella infection without virus identification in cerebrospinal fluid--an important differential ataxia diagnosis].

We report on a 35 year old female with a 26 day history of an intermittent cerebellar syndrome (dysarthria, ataxia of extremities, gait and trunk, nystagmus), mild meningism, cephalgia, recurrent emesis and nausea. Symptoms developed after typically chickenpox exanthema. Examination of the liquor showed mild pleocytosis, elevated protein and increased albumin quotient. Virus was not found by EIA or PCR. There were elevated levels of IgM- and IgG-antibodies to VZV. The EEG showed mild general changes, compatible with an encephalitis. Neuroradiological examinations were unremarkful. The neurological deficits partly regressed in the follow-up of two months. To the best of our knowledge we are the first that describe the paradox of an intermittent cerebellar syndrome after infection with chickenpox without detection of the virus in the liquor. This phenomenon can be related to the unusual combination of cerebellar ataxia and the later occurrence of mild encephalitis.

Adult↗
PubMed1998

Bilateral optic neuritis in acute human immunodeficiency virus infection.

PURPOSE: To report a case of acute viral disease accompanied by bilateral optic neuritis with substantial paraclinical evidence that human immunodeficiency virus was the causative agent. METHODS: Clinical and paraclinical examination. Magnetic resonance imaging. RESULTS: Virus and antibody titers as well as reverse lymphocytosis were consistent with acute infection by the human immunodeficiency virus-1. CONCLUSIONS: Human immunodeficiency virus infection should be considered in the differential diagnosis of acute optic neuritis.

Acute Disease↗
PubMed1995

Chronic ulcerating acyclovir-resistant varicella zoster lesions in an AIDS patient.

We describe a 28-year-old HIV-infected woman with AIDS, defined by cerebral toxoplasmosis and a CD4-count of less than 10 x 10(6) cells/I, who, after several eruptions of genital herpes and typical dermatomal herpes zoster, all successfully treated with acyclovir, developed chronic cutaneous ulcerating lesions on a finger and on the tibia. The lesions were found to contain varicella zoster virus antigen but repeated treatment courses with acyclovir were unsuccessful. After a course of intravenous foscarnet the lesions resolved. They recurred after discontinuation of foscarnet but finally responded to a second course of treatment.

AIDS-Related Opportunistic Infections↗
PubMed1992

[Ergotism of the locomotor apparatus--a sometimes forgotten diagnosis?].

The alcaloids from rye-ergot are known and used for their vasoconstrictive properties, which can induce secondary ergotism. The extremities will be particularly involved. Vasoconstriction will also concern the gastrointestinal tract as well as the peripheric and the central nervous system, possibly with neuro-psychiatry symptoms. Cardiac and renal involvement has been described. Migraine, thrombosis prophylaxis and obstetrical situations are the most frequent therapeutic indications. Precise patient history, clinical and the typical angiological findings are necessary for diagnosis. The importance of an early diagnosis is emphasized. The responsible agent can then be stopped with thorough in-time vasodilatating treatment, and restitution will occur. Three cases are reported. The patients were referred to the rheumato-orthopedic clinic because of limbs claims. They suffered from different grades of ergotism, and one had to be amputated at the right hand. The following discussion is based on a review of the literature.

Adult↗
PubMed1992

Inappropriate vasopressin secretion in severe alcohol withdrawal.

Forty-one male alcoholics suffering from alcohol withdrawal syndrome were investigated to assess the relationship between vasopressin (ADH), water homeostasis and alcohol withdrawal. During 10 d, we found a significant decrease in serum vasopressin, from 3.08 +/- 0.61 to 1.71 +/- 0.22 pg/nl. There were no concomitant changes in osmolality, so that a general dysregulatory state of vasopressin secretion during alcohol withdrawal cannot be assumed. Only patients with delirium tremens (8/41) had higher vasopressin levels despite lowered serum osmolalities. These findings support the hypothesis of an inappropriate rebound secretion of vasopressin in severe alcohol withdrawal. Furthermore, they may contribute to the pathogenesis of focal alcoholic brain damage, because rapid and/or profound changes in osmolality are suspected to cause circumscribed cerebral demyelinization.

Adult↗
PubMedDate not supplied

Genital manifestations and reproductive health in female residents of a Wuchereria bancrofti-endemic area in Tanzania.

To assess the significance of lymphatic filariasis for the development of chronic genital manifestations and for reproductive health in women, we conducted a cross-sectional study of 2 villages in north-eastern Tanzania including interview and gynaecological examination of adult women, focusing primarily on reproductive history and genital health. In a population of 2165 residents, prevalence of Wuchereria bancrofti microfilaraemia was 28%, and geometric mean intensity of microfilariae (mf) was 722 mf/mL. Leg lymphoedema (elephantiasis) was present in 4.2% of adults aged > or = 15 years, and hydrocoele in 26.5% of adult males. Five hundred and thirty women completed an interview, and 404 of these completed a gynaecological examination. Most women were Muslims (72%), polygamy was common (29%), and 49% of women had undergone circumcision (clitoridectomy). Presence of microfilaraemia did not influence fertility or fertility-related variables including age at menarche, parity, spontaneous abortion, stillbirth, Caesarean section and premature labour, nor presence of primary or secondary infertility. Mf status was strongly correlated with abnormal menstruation pattern in the 30+ years age-group (P = 0.001), but not in the < 30 years age-group. Cervical, vaginal and vulval pathology was unrelated to mf status. Two women, aged 46 and 77 years, had vulval oedema of probable filarial origin, both were mf negative. Overall, microfilaraemia appeared to have no influence on genital disease or reproductive health, and chronic manifestations of lymphatic filariasis of the genitals does not appear to be a substantial problem in women.

Adolescent↗
PubMedDate not supplied

A randomized, double-blind, placebo-controlled study with diethylcarbamazine for the treatment of hydrocoele in an area of Tanzania endemic for lymphatic filariasis.

Hydrocoele is common in men in Wuchereria bancrofti-endemic areas, the treatment for which is currently surgical intervention. Two community studies have recently suggested that the antifilarial drug diethylcarbamazine (DEC) may have a beneficial effect of reducing the size of hydrocoeles of filarial origin. To test this hypothesis, a double-blind, placebo-controlled study was carried out in 1998 and 1999 in an area of north-eastern Tanzania where microfilaria (mf) carrier rates and hydrocoele prevalence rates were known to be high. Ninety-eight adult male volunteers (aged > or = 15 years) with chronic hydrocoele received DEC 300 mg per day for 12 days (49 patients), or placebo (49 patients). Circumferential and ultrasonographic measurements of the scrotum, and a serum sample for measuring W. bancrofti antigen, were obtained at the onset and after 3, 6 and 12 months. Scrotal size and hydrocoele fluid volume indices were calculated. No statistically significant differences in volumetric measurements between the DEC and placebo groups were found at any of the follow-ups. Separate analyses dividing patients by antigen status, hydrocoele size or presence of thickening of the scrotal skins gave similar results. Geometric mean intensity of W. bancrofti antigen was significantly lower in the DEC group than in the placebo group (P = 0.008), indicating that lack of compliance was not a significant factor. Two months into the treatment trial, mass treatment with monthly low-dose DEC was given to the rest of the community. We conclude that DEC is not effective in reducing the size of hydrocoele of filarial origin. Interventions to replace or supplement hydrocoelectomy should be investigated.

Adolescent↗