ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1990.tb01636.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.The influence of high‐dose intravenous immunoglobulins (HD‐IVIG) on the clinical status and T4 cell count of adults with AIDS‐related complex (ARC) and Walter‐Reed 5 (WR5) was evaluated in a randomized double‐blind longitudinal study. Inclusion criteria were: (1) T4 cells<400/μl and (2a) oral thrush or cutaneous anergy or (2b) two clinical ARC criteria (fever, diarrhea, weight loss, fatigue, night sweats). Thirty patients [28 males, 2 females, median age 41 (24–64) years] with ARC (n = 8), WR5 (n = 12) and both (n = 10) were stratified according to their T4 cell count (≥ vs.<300/μl). Fifteen patients received 0.4g/kg body weight IVIG and 15 placebo (albumin 0.03%) every other week for 26 weeks with follow‐up for another 26 weeks. The clinical status was defined as a score consisting of fever, diarrhea, night sweats, fatigue, weight loss, oral candidiasis and mucosal or cutaneous herpes simplex. Clinical examination and routine laboratory assessments were performed before initiation of the study and before each administration, lymphocyte phenotyping every 4 weeks and cutaneous reaction, serology and lymphocyte stimulation every 12 weeks. Both groups were comparable in initial clinical symptoms and laboratory values. Seven patients developed AIDS (treatment group: 3, placebo group: 4), 1 patient died by homicide. After 26 weeks, the clinical score (particularly fatigue and fever) was significantly improved in the treatment group, while the T4 cell count and other clinical and immunological parameters remained unaltered. This limited effect was still evident at termination of the study after 52 weeks. In conclusion, HD‐IVIG can improve the clinical status of patients with advanced HIV‐1 infection without obviously correcting the underlying impaired cellular immunity. The substitution of intact antibodies in the state of functional hypogammaglobulinemia is suggested as possible

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1990.tb01637.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Sixty‐six pre‐term infants of less than 30 weeks gestation consecutively admitted to either of two neonatal intensive care units were randomized to receive routine intensive care only or prophylactic intravenous immunoglobulin, 200 mg/kg body weight at 3‐weekly intervals in addition to routine intensive care. Eleven babies, 6 in the control group and 5 in the treatment group, were withdrawn from the trial due to early death from extreme prematurity (7 babies), early return to the referring hospital (3 babies), and elective treatment with intravenous immunoglobulin for severe congenital septicaemia (1 baby). Of the 55 who remained in the trial, significantly fewer babies in the treatment group had infection, 8 compared to 17 (p = 0.01). This difference was not significant when blood‐culture‐proven septicaemia only was considered, 8 compared to 14 (p = 0.09). Twenty‐seven (84%) of 32 blood‐culture‐positive episodes of infection were caused by coagulase‐negative staphylococci. Serum IgG was significantly higher with treatment and achieved levels comparable to those of normal full‐term babies at the

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1990.tb02105.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.The relationship between in vivo behavior and in vitro characteristics of 59 platelet concentrates (PC) stored for up to 14 days in a synthetic medium or in CPDA‐1 plasma was systematically investigated. 25 paired studies (1 study was incomplete) were performed comparing platelets suspended either in the synthetic medium or CPDA‐1 plasma with 5 days (n = 5); 7 days (n = 10); 10 days (n = 5); and 14 days (n = 5) of storage. In addition, 10 control studies were performed with freshly prepared PC (6–24 h) in CPDA‐1 plasma. Both percent recovery and survival estimations showed decreases with increasing storage duration, irrespective of storage medium used. In both media, with prolonged storage, the platelet survival curves not only became shorter, but also increasingly exponential, suggesting that in vitro storage caused progressive damage to the platelets present in circulation. Survival curves of platelets suspended in synthetic medium remained more linear, indicative of less random damage during storage. Mean population lifespan (MPL) of the stored PC was determined by the area below the survival curve divided by the mean percent recovery for the fresh PC, which was 55%. MPL decreased from 4.5 days (fresh PC) to 0.4 days after 14 days of storage in plasma, with a 50% reduction (t½) estimated at 7.2 days of storage. MPL t½for PC stored in the synthetic medium was estimated to be 8.8 days. The decrease in in vivo viability with prolonged storage was paralleled with loss of energy‐dependent in vitro parameters such as hypotonic shock response, shape change with ADP, and ATP levels, and with increased lactate levels. Although the length of the storage period was shown to be the major factor responsible for the variability in MPL observed in this study, multiple linear‐regression analysis showed also that platelet discoid shape, as measured by the shape change, and lactate production were independent in vitro parameters with significant predictability of the in vivo viability. Combined with days of storage in the regression equation, these parameters were found to ‘explain’ 78% of the variability of the MPL fo

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1990.tb02106.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.In HIV‐infected patientsmajor histocompatibility complex(MHC) class I and II (= HLA‐A, B, C, DR) association has been controversial. Of the MHC class III coded complement components C2, BF, C4A/C4B especially C4 allotypes appear of major immunogenetic relevance for their potential differences in virus neutralizing potency and immune complex formation. In the present study 29 patients with AIDS‐related complex and Walter‐Reed 5 (ARC/WR5), 35 patients with disseminated Kaposi's sarcoma (KS), and 160 HIV‐negative control individuals were compared for MHC class I to III allotypes. Diagnosis of ARC and KS (WR criteria) was done by clinical and laboratory parameters, MHC testing, by standard procedures. Anincreasein frequency (p≤0.05) was observed between ARC/WR5 patients and controls for HLA‐B35/CW4, DRW14, adecreasefor B16, CW6/DR7. However, values were not significant if corrected for the number of tested antigens. No significant differences were seen between KS and ARC patients or controls for class III allotypes, nor for previously reported associations, e.g. for B8, DR2, DR3, and especially DR5, including the DR5 splits DRW11, 12. The results indicate the lack of a strong MHC association with the investigated antigens in West German Caucasoids, and support the hypothesis of ethnic dependence of HIV‐related diseases. The HLA‐B35/CW4 increase, also associated with the duplicated C4 A*3 A*2 and the silent C4B*Q0, was more pronounced in ARC patients with progression to AIDS‐OI. The increased frequency of C4B*Q0 alleles in these patients was thought to be secondary to a hypothetical increase in ‘converted’ and dysregulated C4 genes not seen to be a

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1990.tb01638.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Concentrated red cells (CRC) were filtered through a new leukocyte removal filter, the Imugard E, which consists of a polyvinyl alcohol porous sheet. CRC were filtered through the Imugard E with neither priming before filtration nor rinsing after filtration. Leukocyte removal was 99.1 ± 0.6, 99.6 ± 0.3 and 99.6 ± 0.4% on the 1st, 5th and 10th day after blood collection, respectively. Platelet removal was 96 ± 2, 81 ± 6 and 85 ± 3% on the 1st, 5th and 10th day, respectively. Red cell recovery was 86 ± 2,86 ± 1 and 86 ± 1% on the 1st, 5th and 10th day, respectively. Filtration time was 3.9 ± 0.8, 5.8 ± 0.9 and 6.1 ± 0.8 min on the 1st, 5th and 10th day, respectively. Direct filtration of CRC through the Imugard E resulted in no significant changes in the ATP or 2,3‐DPG concentrations, and no hemolysis due to filtration was noticed. It may be concluded that the Imugard E is a good filter that is simple to use and effective in leuk

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1990.tb02107.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.Thirty patients with AIDS‐related complex/Walter‐Reed 5 enrolled in a placebo‐controlled double‐blind study with high‐dose intravenous gammaglobulin administration were tested by quantitating HIV Western blot and other serological tests for viral antibodies. Furthermore, conventional virus isolation attempts were performed. Absence or loss of p24 antibodies during the study period was associated with progression to AIDS (p = 0.01) and thereby was an earlier prognostic parameter of a poor prognosis than T4cell count. Neither changes in antibody patterns against other HIV polypeptides, HIV titers in the immunofluorescence test nor demonstration of HIV antigen were significantly associated with progression to AIDS. Cytomegalovirus (CMV) could be isolated from two duodenal biopsies of a patient who developed AIDS at the same time, but a concomitant serological diagnosis of CMV infection was not successful. Though signs in the serology of human herpesviruses (herpes simplex virus, CMV, Epstein‐Barr virus), possibly indicating a reactivation of latent infections, could be observed in some instances, a correlation with clinical symptoms or the clinical outcome was not feasible, perhaps also because of a poor standardization of some of the test kits used. All patients were positive for IgG antibodies against the three herpesviruses when entering the study. High prevalence of hepatitis B virus (HBV) markers was found (83% anti‐HBc positive), only 1 patient being chronically infected and highly infectious, as shown by HBV‐DNA hybridization. No significant difference between treatment and placebo group was observed with the parameters teste

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1990.tb01639.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.From the 8th of September 1987 to the 31st of July 1988 all patients scheduled for major elective orthopaedic surgery were systematically offered the facility of pre‐deposit autologous blood storage. Of 251 patients, 204 (81%) were eligible to pre‐donate, and of these only 9 declined to do so. 72% of the participants required only autologous blood at operation, 23% required some additional homologous blood. During the study period, autologous blood accounted for 10% of all blood transfused in the district, making a significant contribution to the local blood sup

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1990.tb02108.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.11,117 blood donors from 24 blood transfusion services evenly distributed throughout the various Italian regions were tested for the presence of hepatitis C virus (HCV) antibodies in the serum and serum alanine aminotransferase (ALT) level. The results are as follows: (1) anti‐HCV seroprevalence in Italy was 0.87% with a difference between Northern and Southern regions (0.68 vs. 1.37%) and between younger and older subjects (0.62 vs. 1.21%); (2) prevalence of elevated ALT levels was 4.74% without a North‐South effect (except than for markedly elevated ALT levels); (3) anti‐HCV seroprevalence was higher in subjects with elevated ALT (5.0%), with a North‐South effect (2.2 vs. 9.9%) and particularly high (19.2%) in subjects with markedly elevated ALT; (4) ALT levels were elevated in 26.2% of anti‐HCV positive subjects, with a North‐South effect (14

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1990.tb02109.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract.In a randomized double‐blind longitudinal study with 30 HIV‐1‐positive patients with AIDS‐related complex or stage Walter‐Reed 5 disease, the effectiveness of intravenous immunoglobulin (IVIG) was tested for correcting eventual immune dysregulation. Although the IVIG‐treated patients showed an improvement of their clinical score, no significant changes were observed in lymphocyte phenotypes, activation markers, immunoglobulins and subclasses, lymphocyte turnover or in indicators of acute inflammation. Since severe bacterial infections or autoimmune processes usually leading to IVIG therapy were not prevalent in the patients of the study, such therapy should probably be reserved for later stages of the disease. HIV‐1 antigen expression in blood lymphocytes remained uninfluenced by I

ISSN:0042-9007    

DOI:10.1111/j.1423-0410.1990.tb01640.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY