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S Lautenschlager

Publications and source records attributed to S Lautenschlager.

47 records · Page 3Linked to original sources
PubMed1993

Oral manifestations in HIV-infected patients: diagnosis and management.

Oral lesions have been observed since the beginning of the AIDS epidemic. The number of HIV-infected patients is still increasing, especially in the heterosexual population. Oral diseases in HIV-infected patients are often more difficult to diagnose because the clinical presentations may differ from the same diseases in HIV-negative patients. HIV-associated oral lesions have diagnostic, prognostic, and therapeutic impact. Approximately 10% of the HIV-infected population will have oral manifestations as a first sign of their disease. In HIV-infected men oral hairy leukoplakia and oral candidiasis are useful markers for disease progression. This article summarizes the oral manifestations and the management of oral health in persons with HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Course and outcome of bacteremia due to Staphylococcus aureus: evaluation of different clinical case definitions.

In a retrospective survey of patients hospitalized in the University Hospital of Basel, Switzerland, the course and outcome of 281 cases of true bacteremia due to Staphylococcus aureus over a 7-year period were analyzed. The main purpose was to evaluate different case definitions. In 78% of cases the source of bacteremia was obvious; vascular access sites (27%) and wounds (10%) were the most common sources. Metastasizing foci were more common in cases of primary vs. secondary bacteremia (P < .001). The incidence of endocarditis was higher in cases in which no portal of entry was defined (P < .03). The overall mortality rate was high at 34% partly because of inappropriate initial antibiotic therapy. With the introduction of an infectious disease service at the hospital, the fraction of misjudged results of blood culture diminished 2.5-fold. Among the differently defined cases, the mortality rate was significantly higher for cases of complicated vs. uncomplicated bacteremia (P < .01), for cases of primary vs. secondary bacteremia (P = .05), and for patients with endocarditis or other secondary foci (P < .001). Since only one methicillin-resistant strain was isolated, multiresistant staphylococci were not a problem in the hospital. Different case definitions allowed the detection of patients at increased risk for complications and death. In the treatment of sepsis with no evident focus, initial antimicrobial therapy should include the use of agents with antistaphylococcal activity.

Adolescent↗
PubMed1993

[Schnitzler syndrome].

A 60-year-old man has been suffering from worsening chronic urticaria for 15 years. In recent years the skin changes have been associated with bone pain, intermittent fever and pruritus. X-rays show localized bone condensation. Immunoelectrophoretic analysis documents an IgM kappa monoclonal gammopathy. Bone biopsy and bone marrow aspirate revealed no atypical lymphoid infiltration. This syndrome was first described by Schnitzler et al. Other cases have been reported, most of them by French authors. The pathogenesis of the syndrome remains unclear although anti-interleukin-1-alpha-antibodies have been found in several cases. Symptomatic treatment with ibuprofen seems promising.

Arthritis↗
PubMed1993

[Paragliding accidents--a prospective analysis in Swiss mountain regions].

During the period from 1.1 to 31.12.90, 86 injuries associated with paragliding were analysed in a prospective study in 12 different Swiss hospitals with reference to causes, patterns, and frequencies. Spine injuries (36%) and lesions of the lower extremities (35%) were diagnosed most frequently. Surprisingly no neurological complications occurred, which is possibly explained by the solitary axial trauma. In 15 cases very severe malleolar fractures required surgical intervention. One accident was fatal due to a lung rupture. 60% of all accidents happened during the landing phase, 26% at launching and 14% at flight. Half of the pilots were affected in their primary training course. Most accidents were due to an in-flight error of judgement, such as incorrect estimation of wind conditions and a choice of unfavourable landing sites. In contrast to early reports of hang-gliding injuries, only one accident was due to an equipment failure, namely a ruptured steering line. In more than a third of all accidents, the used paraglider was not in correct correlation with the pilot's weight and experience. Inspired by the desire for a long flight, gliders of too large surface-areas were often used, leading to a more unstable flight. To reduce the frequency of paragliding injuries, an accurate choice of equipment and increased attention to environmental factors is mandatory. Furthermore education-programs should focus more on intensifying the pilot's mental and practical skills.

Adult↗
PubMed1992

[Multicenter paragliding accident study 1990].

During the period from 1.1.90 until 31.12.90, 86 injuries associated with paragliding were analyzed in a prospective study in 12 different Swiss hospitals with reference to causes, patterns, and frequencies. The injuries showed a mean score of over 2 and were classified as severe. Most frequent spine injuries (36%) and lesions of the lower extremity (35%) with a high risk of the ankles were diagnosed. One accident was fatal. 60% of the accidents happened during landing, 26% during launching and 14% during flight. Half of the pilots were affected during their primary training course. Most accidents were caused by inflight error of judgement--especially incorrect estimation of wind conditions--and further the choice of unfavourable landing sites. In contrast to previous injury-reports, only one equipment failure could be noted, but often the equipment was not corresponding with the experience and the weight of the pilot. To reduce the frequency of paragliding-injuries an accurate choice of equipment and an increased attention to environmental factors is mandatory. Furthermore an education-program regarding the attitude and intelligence of the pilot should be included in training courses.

Adolescent↗
PubMed1989

[Incidence and treatment of fresh connective tissue injuries of the knee in winter sports].

For the last 18 years 21,808 alpine skiing injuries have been treated at the hospital of Davos. There is a great decline in the incidence of lower leg fractures with a contrary development of knee ligament injuries. Today half of the lower leg injuries are knee injuries. To ameliorate the documentation of all patients with acute injuries of the knee ligaments we are using a detailed questionnaire, including the mechanism of injury, release of the safety binding, skiing ability, pattern of instability and the techniques of treatment. We report of the evaluation of 145 patients with knee ligament injuries. It is the aim of that protocol to follow up all these cases up to 5 years.

Adolescent↗
PubMedDate not supplied

Lower and upper extremity atrophy associated with a giant congenital melanocytic nevus.

Giant congenital melanocytic nevi (GCMN) may be associated with a variety of malformations. Recently, atrophy of the underlying extremity was reported for the first time. We observed two patients with GCMN on the extremities with marked atrophy of the underlying tissue without functional impairment. According to the definition of hamartoma, it seems possible that one component of tissue has decreased. Dermatologists treating patients with such nevi in the first weeks of life with dermabrasion, laser, or curettage need to know that the natural course of GCMN may lead to atrophy and that this does not necessarily result from the treatment regimen.

Aged↗
PubMedDate not supplied

Retrospective analysis of varicella zoster virus (VZV) copy DNA numbers in plasma of immunocompetent patients with herpes zoster, of immunocompromised patients with disseminated VZV disease, and of asymptomatic solid organ transplant recipients.

BACKGROUND: Varicella zoster virus (VZV) causes significant morbidity and mortality in immunocompromised patients. Subclinical reactivation has been described in solid organ recipients and has been associated with graft versus host disease in bone marrow transplantation. Newer studies assessing the prevalence and impact of subclinical VZV reactivation in solid organ transplant (SOT) recipients are lacking. METHODS AND RESULTS: In a first step we developed a highly sensitive quantitative polymerase chain reaction (qPCR) assay for VZV DNA with a detection limit of < or = 20 copies/mL. Using this assay, we retrospectively analyzed plasma samples of different patient groups for VZV DNA. VZV DNA was found in 10/10 plasma samples of immunocompetent patients with herpes zoster (VZV copy numbers/mL: mean+/-SEM 1710+/-1018), in 1/1 sample of a human immunodeficiency virus-infected patient with primary VZV disease (15,192 copies/mL) and in 4/4 plasma samples of immunocompromised patients with visceral VZV disease (mean of first value 214,214+/-178,572). All 108 plasma samples of asymptomatic SOT recipients off any antiviral therapy, randomly sampled over 1 year, were negative for VZV DNA. CONCLUSION: Our qPCR assay proved to be highly sensitive (100%) in symptomatic VZV disease. We did not detect subclinical reactivation in asymptomatic SOT recipients during the first post-transplant year. Thus, subclinical VZV reactivation is either a rare event or does not exist. These data need to be confirmed in larger prospective trials.

Adult↗