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Biomedical subjects

R Hemmer

Publications and source records attributed to R Hemmer.

At least 19 recordsLinked to original sources
PubMed1995

Changes in survival over time after a first episode of Pneumocystis carinii pneumonia for European patients with acquired immunodeficiency syndrome. Multicentre Study Group on AIDS in Europe.

BACKGROUND: Factors associated with improved survival over time for patients with the acquired immunodeficiency syndrome (AIDS) who have Pneumocystis carinii pneumonia at diagnosis are not clearly defined. METHODS: An inception cohort of 2533 patients with AIDS, diagnosed from 1979 to 1989, from 52 centers in 17 European countries was studied. Survival 3 months and 3 years after diagnosis was estimated by Kaplan-Meier life tables. Independent predictors of survival were analyzed by construction of Cox proportional hazards models. RESULTS: Patients in whom AIDS and P carinii pneumonia had been diagnosed before 1988 had a poorer 3-month (ie, short-term) survival, whereas the survival 1 and 2 years after P carinii pneumonia was lower only for patients whose disease was diagnosed before 1987 compared with those with more recent diagnoses. Other variables associated with poorer outcome were greater age, infection via blood transfusion, diagnosis made in south Europe, and coexisting illnesses. After controlling for these prognostic markers in multivariate analysis, improvement in survival over time was still evident. For patients who survived the P carinii pneumonia episode, both zidovudine and secondary prophylaxis for P carinii pneumonia initiated around the time of diagnosis were associated with improved survival, and, after controlling for these treatment variables, no statistically significant improvement in survival over time was observed. CONCLUSIONS: Survival after an episode of P carinii pneumonia has improved within recent years. Increased awareness of early symptoms of P carinii pneumonia and better treatment of the pneumonia may have led to improvement in short-term survival over time, whereas the introduction of zidovudine and increased use of secondary P carinii pneumonia prophylaxis may have resulted in the recent increase in survival 1 and 2 years after the diagnosis. However, 3-year survival remained unchanged over time, implying that the underlying human immunodeficiency virus infection and other complications are not effectively controlled.

AIDS-Related Opportunistic Infections↗
PubMed1992

Prolonged clinically asymptomatic evolution after HIV-1 infection is marked by the absence of complement C4 null alleles at the MHC.

The length of time after which persons infected with HIV-1 progress to AIDS is variable. Certain alleles at the MHC have been shown to influence negatively the clinical outcome of HIV-1-infected persons and to be associated with special clinical manifestations. We investigated the MHC class I, class II and class III antigens in 54 Caucasian HIV-1-infected persons. The MHC profile of individuals with a prolonged period before AIDS is marked by a lower frequency of C4 null alleles.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Redirected targeting of LDL to human monocyte Fc gamma receptors with bispecific antibodies.

Recent studies indicate that low density lipoprotein (LDL)-immune complexes consisting of anti-LDL antibodies bound to LDL may contribute to macrophage foam cell development by uptake through immunoglobulin G (IgG) Fc receptors. As human mononuclear phagocytes possess three structurally and functionally distinct classes of IgG Fc receptors, we developed a system whereby the effects of LDL-immune complexes could be studied with respect to each type of IgG Fc receptor. Novel bispecific antibodies consisting of anti-Fc gamma receptor antibodies linked to anti-LDL antibodies were used to prepare bispecific LDL-immune complexes for targeting to specific Fc gamma receptors. In this report, the effects of bispecific LDL-immune complexes directed to Fc gamma receptor types I, II, and III were studied primarily with monocytes and were compared with the effects of similarly prepared bispecific complexes that targeted LDL to human leukocyte antigen (HLA) class I antigens. Each type of bispecific antibody was effective in targeting 125I-LDL to its respective site on the cell surface. Using fluorophore-labeled LDL and flow cytometry, bispecific complexes directed to Fc gamma receptor types I or II but not to HLA class I antigens caused a two- to sevenfold increase in cell-associated fluorescence relative to control cells treated with LDL in the absence of bispecific antibody. Uptake occurred in the presence of excess unlabeled LDL, acetylated LDL, and antioxidants. That the bispecific complexes triggered metabolic uptake was supported by studies of kinetics and temperature dependence. Using 125I-labeled complexes, metabolic degradation of LDL was demonstrated in association with each of the three types of Fc gamma receptors.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies↗
PubMed1991

Liquid chromatography-mass spectrometry in metabolic research. I. Metabolites of benzbromarone in human plasma and urine.

Seven benzbromarone metabolites were identified in human plasma and urine by electron-impact mass spectrometry after semipreparative high-performance liquid chromatographic fractionation and/or by liquid chromatography-mass spectrometry using a thermospray interface. The major metabolite in plasma and urine was a hydroxybenzofuranoyl species; the 1-hydroxyethyl entity was identified as a minor metabolite. Five urinary metabolites occurred in trace amounts, all of them carrying OH and/or C = O groups in different positions. The hydroxybenzofuranoyl metabolite has often been mistaken for benzarone in previous studies.

Benzbromarone↗
PubMed1990

Camembert, Listeria and the immunocompromised patient.

Listeriosis is a rare but well known infectious complication in pregnant women and immunocompromised patients. Epidemiological studies have shown an association between listeriosis and alimentary contamination by listeria of a variety of foodstuff including soft, ripened cheeses. We describe two case-reports of listeria meningitis with high evidence of food-related illness due to the consumption of contaminated camembert. These observations urged our State Department of Health to formulate a communication about alimentary listeriosis at the intent of all health care professionals, including recommendations for patients at risk.

Aged↗
PubMed1986

Acquired C1 esterase-inhibitor deficiency: case report with emphasis on complement and kallikrein activation during two patterns of clinical manifestations.

A case of severe angioedema with several episodes of life-threatening attacks during a follow-up of 7 years is presented. Although the biologic profile is that of an acquired C1 INH deficiency, no lymphoproliferative malignancy or immune-complex disease could be proven until now. However, the patient has had a small monoclonal IgG lambda-gammopathy for 4 years. During the last 4 years, edematous manifestations have stopped. The patient now suffers at regular intervals of about a week from short-lasting attacks with digestive and vasomotor symptoms. This clinical evolution is accompanied by a worsening in the complement abnormalities. The digestive and vasomotor attacks were found to be correlated with sudden prekallikrein and high-molecular-weight kininogen consumption. These findings demonstrate that prekallikrein is activated during acquired C1 INH deficiency and that the products of this pathway such as bradykinin are probably responsible for a part of the clinical manifestations associated with this disorder.

Aged↗
PubMed1986

Cerebrospinal fluid pressure alterations in experimental communicating hydrocephalus. Response of cerebrospinal fluid pressure to increase in arterial carbon dioxide tension.

The response of cerebrospinal fluid (CFS) pressure to increased arterial carbon dioxide tension (PCO2) was evaluated in 5 control animals and 7 animals with experimentally induced communicating hydrocephalus. The CSF pressure in control dogs increased moderately in response to PCO2; in dogs with hydrocephalus, an increase in PCO2 produced a pronounced increase in CSF pressure accompanied by a simultaneous decrease in cerebral perfusion pressure. Progression of hydrocephalus can be explained by increased intracranial pressure, periventricular edema and cerebral ischemia.

Animals↗
PubMed1984

[Autotransplantation of the spleen. Experimental study in rats. Histology and anti-infectious role of infected splenic tissue].

Experimental study on splenic autotransplantation into the retroperitoneum and an epiploic pouch in the rat. Histologic examination of the splenic transplants was performed 5, 8, 14 days, 3, 4, 5, 6, 9, 12 weeks and 7 months after operation. Study of the immunologic efficiency of the transplant after intravenous injection of the bacteria Pneumococcus and Staphylococcus aureus.

Animals↗