31 research outputs found
FĂŒr den Ernstfall gerĂŒstet : tropenmedizinische Isoliereinheit des UniversitĂ€tsklinikums fertig gestellt
Weltweiter SARS-Alarm : eine neue Seuche auf dem Vormarsch?
Mitte MĂ€rz 2003 löste die WHO einen weltweiten Alarm aus, nachdem sich eine neuartige, schwere und unter bestimmten UmstĂ€nden hochansteckende Atemwegserkrankung scheinbar unaufhaltsam ĂŒber weite Teile der Welt auszubreiten schien. Am 15. MĂ€rz desselben Jahres landeten die ersten Patienten mit Verdacht auf Schweres Akutes Respiratorisches Syndrom (SARS) in Frankfurt und wurden auf die Isolierstation des UniversitĂ€tsklinikums aufgenommen. Auslöser war ein zuvor nicht bekanntes Coronavirus, das heute als SARS-CoV bezeichnet wird. Derzeit laufen Untersuchungen zur Biologie und Epidemiologie des neuen Erregers, zu antiviralen Hemmstoffen sowie zu Desinfektions- und Inaktivierungsmöglichkeiten und neuen Therapieoptionen. Daneben wird analysiert, wie sich das öffentliche Gesundheitswesen auf eine mögliche Wiederkehr vorbereiten muss. SARS ist ein Beispiel dafĂŒr, wie schnell sich eine Infektionskrankheit in der modernen Welt international ausbreiten kann und wie wichtig in einem solchen Falle eine gut koordinierte internationale Kooperation ist. Frankfurter Forscher berichten
Virological and immunological response to three boosted protease inhibitor regimens
Poster presentation: Purpose of the study To compare the virological, immunological and clinical response to three boosted double protease inhibitor (PI) regimens of saquinavir and ritonavir in combination with lopinavir (LOPSAQ), atazanavir (ATSAQ) or fosamprenavir (FOSAQ) without reverse transcriptase inhibitors (RTI) in HIV-positive patients with limited RTI treatment options. ..
Isolation facilities for highly infectious diseases in Europe - A cross-sectional analysis in 16 countries
BACKGROUND: Highly Infectious Diseases (HIDs) are (i) easily
transmissible form person to person; (ii) cause a
life-threatening illness with no or few treatment options; and
(iii) pose a threat for both personnel and the public. Hence,
even suspected HID cases should be managed in specialised
facilities minimizing infection risks but allowing
state-of-the-art critical care. Consensus statements on the
operational management of isolation facilities have been
published recently. The study presented was set up to compare
the operational management, resources, and technical equipment
among European isolation facilities. Due to differences in
geography, population density, and national response plans it
was hypothesized that adherence to recommendations will vary.
METHODS AND FINDINGS: Until mid of 2010 the European Network for
Highly Infectious Diseases conducted a cross-sectional analysis
of isolation facilities in Europe, recruiting 48 isolation
facilities in 16 countries. Three checklists were disseminated,
assessing 44 items and 148 specific questions. The median
feedback rate for specific questions was 97.9% (n = 47/48)
(range: n = 7/48 (14.6%) to n = 48/48 (100%). Although all
facilities enrolled were nominated specialised facilities'
serving countries or regions, their design, equipment and
personnel management varied. Eighteen facilities fulfilled the
definition of a High Level Isolation Unit'. In contrast, 24
facilities could not operate independently from their co-located
hospital, and five could not ensure access to equipment
essential for infection control. Data presented are not
representative for the EU in general, as only 16/27 (59.3%) of
all Member States agreed to participate. Another limitation of
this study is the time elapsed between data collection and
publication; e.g. in Germany one additional facility opened in
the meantime. CONCLUSION: There are disparities both within and
between European countries regarding the design and equipment of
isolation facilities. With regard to the International Health
Regulations, terminology, capacities and equipment should be
standardised
Infection control management of patients with suspected highly infectious diseases in emergency departments: data from a survey in 41 facilities in 14 European countries
Heli SiikamÀki on työryhmÀn EuroNHID Working Group jÀsen.Peer reviewe
Cohort Profile: Antiretroviral Therapy Cohort Collaboration (ART-CC)
The advent of effective combination antiretroviral therapy (ART) in 1996 resulted in fewer patients experiencing clinical events, so that some prognostic analyses of individual cohort studies of human immunodeficiency virus-infected individuals had low statistical power. Because of this, the Antiretroviral Therapy Cohort Collaboration (ART-CC) of HIV cohort studies in Europe and North America was established in 2000, with the aim of studying the prognosis for clinical events in acquired immune deficiency syndrome (AIDS) and the mortality of adult patients treated for HIV-1 infection. In 2002, the ART-CC collected data on more than 12,000 patients in 13 cohorts who had begun combination ART between 1995 and 2001. Subsequent updates took place in 2004, 2006, 2008, and 2010. The ART-CC data base now includes data on more than 70 000 patients participating in 19 cohorts who began treatment before the end of 2009. Data are collected on patient demographics (e.g. sex, age, assumed transmission group, race/ethnicity, geographical origin), HIV biomarkers (e.g. CD4 cell count, plasma viral load of HIV-1), ART regimen, dates and types of AIDS events, and dates and causes of death. In recent years, additional data on co-infections such as hepatitis C; risk factors such as smoking, alcohol and drug use; non-HIV biomarkers such as haemoglobin and liver enzymes; and adherence to ART have been collected whenever available. The data remain the property of the contributing cohorts, whose representatives manage the ART-CC via the steering committee of the Collaboration. External collaboration is welcomed. Details of contacts are given on the ART-CC website (www.art-cohort-collaboration.org
Cohort profile: Antiretroviral Therapy Cohort Collaboration (ART-CC).
The advent of effective combination antiretroviral therapy (ART) in 1996 resulted in fewer patients experiencing clinical events, so that some prognostic analyses of individual cohort studies of human immunodeficiency virus-infected individuals had low statistical power. Because of this, the Antiretroviral Therapy Cohort Collaboration (ART-CC) of HIV cohort studies in Europe and North America was established in 2000, with the aim of studying the prognosis for clinical events in acquired immune deficiency syndrome (AIDS) and the mortality of adult patients treated for HIV-1 infection. In 2002, the ART-CC collected data on more than 12,000 patients in 13 cohorts who had begun combination ART between 1995 and 2001. Subsequent updates took place in 2004, 2006, 2008, and 2010. The ART-CC data base now includes data on more than 70,000 patients participating in 19 cohorts who began treatment before the end of 2009. Data are collected on patient demographics (e.g. sex, age, assumed transmission group, race/ethnicity, geographical origin), HIV biomarkers (e.g. CD4 cell count, plasma viral load of HIV-1), ART regimen, dates and types of AIDS events, and dates and causes of death. In recent years, additional data on co-infections such as hepatitis C; risk factors such as smoking, alcohol and drug use; non-HIV biomarkers such as haemoglobin and liver enzymes; and adherence to ART have been collected whenever available. The data remain the property of the contributing cohorts, whose representatives manage the ART-CC via the steering committee of the Collaboration. External collaboration is welcomed. Details of contacts are given on the ART-CC website (www.art-cohort-collaboration.org)
Long-term Mortality in HIV-Positive Individuals Virally Suppressed for >3 Years With Incomplete CD4 Recovery
Virally suppressed HIV-positive individuals on combination antiretroviral therapy who do not achieve a CD4 count >200 cells/”L have substantially increased long-term mortality. The increased mortality was seen across different patient groups and for all causes of deat
Antiretrovirale Therapie der HIV-Infektion
Die antiretrovirale Therapie der HIV-Infektion hat sich in den letzten zwei Jahren aufgrund neuer Therapieoptionen und -strategien deutlich gewandelt. Die Empfehlungen zur antiretroviralen Therapie wurden daher in AbhĂ€ngigkeit von klinischen, immunologischen und virologischen Parametern von einem deutsch-österreichischen Expertengremium ĂŒberarbeitet. Eingebrachte Studienergebnisse betreffen insbesondere die Wertung der Kombinationstherapien von zwei nukleosidanalogen reverse Transkriptase-Inhibitoren (NRTI) in Kombination mit einem nichtnukleosidanalogen reverse Transkriptase-Inhibitor (NNRTI) oder einem Proteaseinhibitor und mit drei NRTI. Diese Kombinationen werden hinsichtlich ihrer therapeutischen EffektivitĂ€t und ihres Nebenwirkungsprofils gewichtet. FĂŒr eine effektive Therapie sind eine Resistenztestung und eine Bestimmung von Plasmamedikamentenspiegeln bedeutsame Parameter, die fĂŒr das Monitoring wichtig sind, sowie Faktoren, die einen Wechsel und eine Unterbrechung der Therapie indizieren, werden aufgezeigt.Antiretroviral Therapy in HIV-Infections During the last two years, antiretroviral therapy of HIV infections has changed dramatically. Therefore a board of German and Austrian physicians experienced in antiretroviral research and HIV patient care revised the guidelines for antiretroviral therapy and treatment and have strongly been influenced by data from latest studies on clinical, immunological and viral parameters. These studies mainly investigated combination therapies such as two nucleoside reverse transcritase inhibitor (NRTI) with one protease inhibitor or one non-nucleoside reverse transcriptase inhibitor with three NRTI. These combination therapies are evaluated in regard to their therapeutic effectiveness and their side effects. Resistance testing and drug monitoring are most important during therapy. Parameters which necessitate a change in or interruption of therapy are discussed