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Biomedical subjects

W Meigel

Publications and source records attributed to W Meigel.

At least 19 recordsLinked to original sources
PubMed1998

[Acanthosis nigricans maligna. Case report and review of the literature].

More than 400 cases of acanthosis nigricans maligna (ANM) and 23 cases of "florid cutaneous papillomatosis" (FCP) were published. ANM is an obligatory paraneoplastic symptom. A 28-year old female patient with an adenocarcinoma of the stomach presented with ANM. We review the number and types of associated cancer with ANM. In most cases and adenocarcinoma of the gastrointestinal tract has been present. We feel that FCP is not an entity of its own but a variant of ANM; the literature supports this view.

Acanthosis Nigricans↗
PubMed1997

[Systemic treatment of acne with isotretinoin: current status].

Introduced in 1979, isotretinoin remains a major advance in acne therapy. Both hospital- and community-based dermatologists have experience with this valuable drug, which, owing to its causal principle of action, offers a large proportion of patients the prospect of a cure. Isotretinoin is now in use in more than 80 countries and has been prescribed for some six million patients. Based on accumulated clinical findings with the drug, more comprehensive recommendations can now be made with respect to indications, dosing and duration of treatment than was possible when the drug was launched. Experience with the drug also provides a basis for reevaluating its safety profile. Finally, at a time when healthcare resources are limited, it is important to examine the cost-benefit ratio of this acne treatment versus other options. This paper is accordingly intended to provide a critical status report as well as a detailed and balanced set of recommendations for clinical practice.

Acne Vulgaris↗
PubMed1997

Increased risk for opportunistic infections during chemotherapy in HIV-infected patients with Kaposi's sarcoma.

BACKGROUND: Kaposi's sarcoma (KS) is the most frequent neoplasm in patients with AIDS, responsible for death in about 20-30% of the affected patients. OBJECTIVE: To determine the frequency of opportunistic infections (OI) and change of CD4+ cell counts in patients with KS treated with chemotherapy compared to a group of matched-pair patients without chemotherapy. METHODS: In a prospective study, the clinical courses of 35 HIV-infected patients with KS treated with chemotherapy were compared with 35 matched-pair patients without chemotherapy. RESULTS: During the observation period of 6 months, 11 OI occurred in 10 patients of the chemotherapy group and 5 OI in 5 patients of the control group. With respect to the changes of CD4+ cell counts, no significant differences could be observed. CONCLUSION: The risk for OI in HIV-infected patients with KS is increased while receiving chemotherapy. This should be reflected upon when chemotherapy is taken into consideration.

AIDS-Related Opportunistic Infections↗
PubMed1995

[Bacillary angiomatosis].

Bacillary angiomatosis (BA) is a rare infectious disease usually associated with HIV infection. Recent molecular biologic investigations confirm that both Rochalimaea henselae and Rochalimaea quintana can cause BA. The bacteria can be identified by Warthin-Starry staining and electron microscopy. The typical clinical signs are solitary or multiple dermal or subcutaneous nodules. Bone, liver, spleen and other organs may also be involved. We describe the clinical and histological features of a 39-year-old HIV-infected patient with cutaneous and bony lesions of BA. All manifestations of BA disappeared during therapy with erythromycin.

AIDS-Related Opportunistic Infections↗
PubMed1995

[HIV-associated mycoses].

Candidosis, cryptococcosis, and histoplasmosis often occur as HIV-associated mycoses. However, aspergillosis can be observed quite recently. The morphology of the pathogen of HIV-associated mycoses in vivo and in vitro is demonstrated and discussed.

AIDS-Related Opportunistic Infections↗
PubMed1994

[Primary and secondary prevention of Pneumocystis carinii pneumonia with pentamidine aerosol. Effectiveness, side effects and incidence of extrapulmonary Pneumocystis carinii manifestations].

BACKGROUND: We report on a retrospective study in 544 HIV-positive patients, (42 women, 502 men, mean age 35 years) showing CD4 lymphocyte counts below 200 c/mcl or after their cure of Pneumocystis carinii pneumonia, who received 300 mg pentamidine aerosol as prophylaxis against Pneumocystis carinii pneumonia every four week. PATIENTS AND METHODS: 277 patients were asymptomatic, 120 in the AIDS related complex stage (ARC) and 147 in the full stage of AIDS. The mean follow-up was 14.4 months. RESULTS: A total of 25 cases of Pneumocystis carinii pneumonia was observed (3.83/year): in the primary prophylaxis group 18 (3.25%/year), in the secondary prophylaxis group seven (6.8%/year). By introducing the loading dose (one inhalation per day for five consecutive days for patients with CD4 cell counts below 150 c/mcl) we reduced the percentage of early manifestations within the first three months from 61% to 14%. No extrapulmonary Pneumocystis carinii manifestation was observed. CONCLUSION: This study supports the efficacy of pentamidine aerosol prophylaxis of primary and secondary Pneumocystis carinii pneumonia.

AIDS-Related Opportunistic Infections↗
PubMed1993

A preparation from bovine colostrum in the treatment of HIV-positive patients with chronic diarrhea.

In a prospective, open, uncontrolled study 25 patients infected with the human immunodeficiency virus with chronic refractory diarrhea and either confirmed cryptosporidiosis (n = 7) or absence of demonstrable pathogenic organisms (n = 18) were treated with a daily oral dose of 10 g of an immunoglobulin preparation from bovine colostrum over a period of 10 days. Among the 7 patients with cryptosporidiosis, this treatment led to complete remission in 3 and partial remission in 2. Among the 18 patients with diarrhea and negative stool culture, complete remission of diarrhea was obtained in 7 and partial remission in 4. In the remaining 2 patients with cryptosporidiosis and the 7 patients with diarrhea but no demonstrable pathogens treatment produced no significant improvement of the diarrhea. Subsequent doubling of the Lactobin dose (2 x 10 g daily) in 8 of the nonresponders led to complete remission in one case and at least partial remission in a further 4 patients. Treatment of refractory diarrhea with 10 g immunoglobulins from bovine colostrum per day constitutes an important therapeutic approach and led to complete (40%) or partial (24%) remission of diarrhea in 64% of the patients described here.

Animals↗
PubMed1993

[Antifungal activity of sulfonated shale oils].

Bituminous shale, developed from marine sediments during the Jura era, is the raw substance for the production of shale oil. The shale oil undergoes heating, distillation, fractionated refining and sulfonation (according to a patented method) resulting in water-soluble sulfonated shale oils (Ichthyol) for medical purposes. The antifungal effect of sulfonated shale oils have been described earlier. In this study an in vitro method is applied which is based upon the CO2 detection as a measure for the sensitivity of fungi to sulfonated shale oils. In addition to the minimal inhibitory concentration values (MIC values), sub-inhibitory concentrations are also determined. The actual efficacy of these antifungal agents is demonstrated via dose-effect curves. Our results show that the fractions of sulfonated shale oils refined at 150 to 210 degrees C (Ichthyol, dark) are fungicidal in concentrations between 0.2 and 16.8% for yeasts, dermatophytes and other hyphomycetes. The fractions of sulfonated shale oils refined at 85 to 150 degrees C (Ichthyol, light), on the other hand, showed a clearly higher antifungal activity (concentrations between 0.1 and 5.9%) for all fungi tested. An extended exposition (24 to 168 h) of Candida albicans to these fractions resulted in a further increase of fungicidal activity. Due to the complex nature of sulfonated shale oils the chemically defined antifungal substance(s) have not yet been identified.

Antifungal Agents↗
PubMed1992

[Scabies norvegica sive crustosa in a patient with AIDS].

We report the case of a 20-year-old homosexual man with HIV-1 infection presenting with AIDS. An erythemato-squamous, papulo-crustous, non-itching dermatosis of 4 months duration was finally diagnosed as Norwegian scabies in the immunosuppressed. For clinical and epidemiological reasons the high contagiosity of this rare entity requires an appropriate therapy without delay.

AIDS-Related Opportunistic Infections↗
PubMed1991

[Effect of alfa-2b interferon on prognostic parameters and clinical events in HIV positive patients in the LAS/ARC stage].

A number of in vivo and in vitro results suggest that interferons have an antiretroviral effect on HIV. To check this, 15 HIV-positive patients who had no full-blown AIDS, were treated with recombinant interferon alpha 2b (5 mill. IU s. c. three times a week) over a period of six months. Twelve to 16 weeks after the initiation of treatment, an increase in CD 4 lymphocytes (+16%), NK cells (+16%), lymphocytes stimulation by con A (+ 176%), neopterin (+66%), and beta-2-microglobulin (+19%) was observed. By the end of the study, all these parameters had slightly decreased again. In all patients with CD4 lymphocytes greater than 0.2 c/nl, we observed a decrease in p24 antigen levels, but in patients with CD4 lymphocytes less than 0.2 c/nl, an increase. It would thus seem that any antiretroviral effect of IFN (as shown by the p24 antigen parameter) is more pronounced in patients with superior immune parameters.

AIDS-Related Complex↗
PubMed1991

[Clinical and serological findings of syphilis in HIV-infected patients].

To identify the characteristic features of lues in patients infected with HIV, 402 HIV-positive patients were examined for serological and clinical signs of lues. 141 patients (133 male, 8 female, mean age 36 [18-69] years) had a positive lues serology. Treatment for lues was required in 20 of the 141 cases (14%). In ten patients (one case of lues I, nine cases of lues II) dermatological signs were predominant, macular exanthemas (n = 4) and palmo-plantar syphilides (n = 3) being most frequent. Three patients had seropositive latent lues. Eight patients presented with signs of an active neurolues (lues II: n = 1; lues III: n = 6; lues IV: n = 1). In three of the eight cases the serum FTA-ABS-IgM findings were negative. In these three patients the need for a specific treatment was realized only on the basis of cerebrospinal fluid (CSF) examination in conjunction with the clinical findings and the anamnesis. This result makes it very clear that indication for CSF puncture should be more liberal in some HIV infected patients. The markedly high proportion of cases of neurolues (40% of the luetic patients requiring treatment) is possibly due to reactivation of old lues infections.

AIDS-Related Complex↗
PubMed1991

[Local therapy measures in HIV-associated Kaposi's sarcoma with special reference to fractionation radiotherapy].

In 23 patients with HIV-associated Kaposi's sarcoma 53 tumor lesions were treated with fractioned radiotherapy. Indication for the radiotherapy were mostly cosmetic reasons in stigmatizing tumors, but also in several cases pain, oedema or functional deficits as a result of the tumor lesions. 21 patients received orthovoltage irradiation, the remaining four patients were treated with telecobalt therapy. A complete response was observed in 17%, a partial response in 76% and unchanged lesions in 4%. In two cases (4%), both were treated with telecobalt-therapy by large tumor masses, there occurred a further tumor progression inspite of the radiotherapy. In ten lesions, all with partial remission, we later observed a repeated tumor progression. Important side effects were signs of inflammation as mucositis and edema or hyperpigmentation. The occurrence of acute side effects can be reduced by fractionating of the radiotherapy.

Adult↗
PubMed1990

[Recombinant interferon alpha-2A in the treatment of HIV-associated Kaposi sarcoma. Long-term results].

47 HIV-positive male patients with cutaneous Kaposi's sarcoma (KS) were treated with recombinant interferon alpha-2A (IFN) in an open, prospective study. 45 patients received 18 million I.U. IFN s.c. daily for the first three months. From the fourth month, the patients received 18 million I.U. IFN s.c. three times weekly. Four of the 45 patients withdrew from therapy because of side effects during the first weeks (weeks 2 to 6) of treatment. The remaining 41 patients were treated for a minimum period of two years or until their death. Two further patients received 36 million I.U. IFN daily for three months. After three months of IFN therapy we observed complete remission (CR) in five of the 41 patients (12%), partial remission (PR) in seven patients (17%), stable disease in seven patients (17%) and progressive disease (PD) in 22 patients (54%). The mean survival time from the beginning of IFN therapy to date is 26 months for the 19 responders (patients with CR, PR or SD; six are still alive) and nine months for the 22 non-responders (patients with PD; all died). Recurrence of tumor progression occurred in 15 of the 19 responders after an average of ten months of continuous IFN therapy. The longest time of survival in this group is 54 months up to now. Of the four remaining patients, all in the CR group, two died after 24 and 26 months of IFN therapy, without any recurrence of KS growth (causes of death: Burkitt's lymphoma and unknown). The two other patients, both still alive, have not suffered any recurrence of tumor progression after 40 and 41 months, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗