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1.
Tijdschr Psychiatr ; 48(9): 745-8, 2006.
Article in Dutch | MEDLINE | ID: mdl-17007481

ABSTRACT

Epileptic disorders can manifest themselves with symptoms of anxiety and panic. In clinical practice it is not always easy to achieve a correct diagnosis. The subject of this case study is an adult with symptoms of anxiety and panic who was referred to the mental health care service but who was diagnosed as having epilepsy when subjected to a supplementary examination. Psychological and in particular anxiety symptoms in epilepsy are discussed. The psychiatrist needs to consider the possibility of epilepsy in a patient presenting with anxiety symptoms.


Subject(s)
Anxiety Disorders/diagnosis , Epilepsy/diagnosis , Epilepsy/psychology , Adult , Anxiety Disorders/etiology , Diagnosis, Differential , Epilepsy/complications , Humans , Male , Panic Disorder/diagnosis , Panic Disorder/etiology
3.
J Clin Microbiol ; 34(1): 25-8, 1996 Jan.
Article in English | MEDLINE | ID: mdl-8748265

ABSTRACT

When a diagnosis of invasive candidiasis has been made, treatment with toxic fungicidal agents is inevitable. The crucial decision of when to stop such treatment is difficult to make, because cultures are often negative despite ongoing invasive candidiasis and can therefore not be used as a reliable parameter of effective therapy. In the present study, the use of PCR in monitoring the therapeutic efficacy of antifungal treatment with liposomal amphotericin B was evaluated by using neutropenic mice with systemic candidiasis. Blood cultures of infected mice treated with different doses of liposomal amphotericin B were only positive at the early onset of the infection process and became sterile within 3 days; this was true even with mice treated with 1 mg of liposomal amphotericin B per kg of body weight that experienced a relapse of infection 14 days later. A significant correlation between presence of Candida albicans in the kidneys and PCR results obtained with blood was demonstrated. Thus, PCR results obtained with blood samples correlated well with the therapeutic efficacy of antifungal treatment.


Subject(s)
Amphotericin B/administration & dosage , Antifungal Agents/administration & dosage , Candidiasis/drug therapy , Candidiasis/microbiology , Polymerase Chain Reaction/methods , Animals , Base Sequence , Candida albicans/genetics , Candida albicans/isolation & purification , Candidiasis/complications , DNA Primers/genetics , DNA, Fungal/genetics , Evaluation Studies as Topic , Female , Fungemia/complications , Fungemia/drug therapy , Fungemia/microbiology , Liposomes , Mice , Mice, Inbred BALB C , Molecular Sequence Data , Mycology/methods , Neutropenia/complications , Time Factors
4.
J Clin Microbiol ; 33(3): 625-8, 1995 Mar.
Article in English | MEDLINE | ID: mdl-7751367

ABSTRACT

A PCR using primers aimed at the multicopy gene coding for the small subunit rRNA and resulting in the synthesis of a 180-bp fragment was evaluated for its use in diagnosing invasive candidiasis in comparison with blood culture. With the use of a C. albicans-specific probe, +/- 10 to 15 C. albicans cells are detected in 100 microliters of whole blood by Southern analysis. A DNase pretreatment was critical in the purification process of yeast DNA from whole blood. Omission of the DNase pretreatment decreased assay sensitivity 10-fold. PCR analysis of blood specimens collected from mice with invasive candidiasis is more sensitive than blood culture (100 versus 67%, respectively) at 72 h after intravenous (i.v.) inoculation with C. albicans. Furthermore, the intensity of the hybridization signals increased with the progression of infection. In contrast, multiple blood samples from gastrointestinally colonized mice were all negative by PCR, indicating that the PCR assay is also specific and may, therefore, make a positive contribution to the detection and follow-up of invasive candidiasis.


Subject(s)
Candida albicans/isolation & purification , Candidiasis/microbiology , Animals , Base Sequence , Blood/microbiology , Blotting, Southern , Candida albicans/genetics , Candida albicans/growth & development , Colony Count, Microbial , Culture Media , DNA, Fungal/analysis , Digestive System/microbiology , Female , Mice , Mice, Inbred BALB C , Molecular Sequence Data , Neutropenia/microbiology , Polymerase Chain Reaction/methods , Sensitivity and Specificity
5.
J Clin Microbiol ; 32(1): 17-23, 1994 Jan.
Article in English | MEDLINE | ID: mdl-8126174

ABSTRACT

An immunodominant antigen with enolase enzyme activity was purified and used for the development of an assay to detect antibodies directed against this antigen in sera from patients with either invasive candidiasis or Candida colonization. The Au enzyme-linked immunosorbent assay established with the Candida enolase antigen was able to discriminate significantly between invasive candidiasis and colonization in both immunocompetent and immunodeficient groups of patients. The test had a sensitivity of 50% and a specificity of 86% in the immunocompetent patient group. In the immunodeficient patient group, a sensitivity of 53% and a specificity of 78% were established. Antibody levels determined by a counterimmunoelectrophoresis assay with the same set of sera resulted in a better sensitivity for sera from the immunocompetent patient group but a lower specificity, i.e., 80 and 29%, respectively. The counterimmunoelectrophoresis assay of sera from the immunodeficient patient group was not able to discriminate significantly between invasive candidiasis and colonization. With the use of more serum from each patient, the sensitivity of the antibody detection assays increased, while the specificity was maintained. The increase, however, was not statistically significant. Combining the results of the antibody assays with antigen titers obtained by the Cand-Tec assay did not improve the predictive value with respect to invasive candidiasis, as determined by multivariance regression analysis. Furthermore, it was demonstrated by performance of Western blots (immunoblots) that sera from patients as well as a rabbit antiserum cross-reacted with the Candida enolase and baker's yeast enolase enzyme. However, by tandem crossed immunoelectrophoresis it was demonstrated that the antibodies were directed toward different epitopes of the antigen.


Subject(s)
Antibodies, Viral/blood , Candida albicans/enzymology , Candidiasis/diagnosis , Phosphopyruvate Hydratase/immunology , Antigens, Viral/immunology , Antigens, Viral/isolation & purification , Candida albicans/immunology , Enzyme-Linked Immunosorbent Assay , Humans , Immunocompetence , Immunocompromised Host , Immunodominant Epitopes/immunology , Immunodominant Epitopes/isolation & purification , Immunoelectrophoresis, Two-Dimensional , Phosphopyruvate Hydratase/isolation & purification , Sensitivity and Specificity
6.
J Clin Microbiol ; 31(4): 994-7, 1993 Apr.
Article in English | MEDLINE | ID: mdl-8463408

ABSTRACT

In this study, it was shown that the diagnostic accuracy of antibody detection by a counterimmunoelectrophoresis technique could be improved by using cytoplasmic antigens depleted of mannan residues. The specificity of the counterimmunoelectrophoresis increased from 28.6 to 78.6% when cytoplasmic antigens depleted of mannan were used, while the sensitivity slightly decreased from 80 to 70%.


Subject(s)
Antibodies, Fungal/blood , Antigens, Fungal/immunology , Candida albicans/immunology , Candidiasis/diagnosis , Counterimmunoelectrophoresis , Antigens, Fungal/chemistry , Cytoplasm/immunology , Humans , Mannans/immunology , Sensitivity and Specificity
7.
Eur J Clin Microbiol Infect Dis ; 9(5): 352-5, 1990 May.
Article in English | MEDLINE | ID: mdl-2373089

ABSTRACT

Tests to detect circulating antibodies to Candida albicans antigens were performed in sera from 27 immunocompetent patients, 15 of whom had deep-seated candidiasis and 12 of whom were colonised by Candida albicans. For the diagnosis of deep-seated candidiasis in patients with either deep-seated candidiasis or Candida albicans colonisation, counterimmunoelectrophoresis had a sensitivity of 87% and a specificity of 75%. Using immunoblotting it could be shown that antibodies to 35K, 47K, 68K and 88K antigens of Candida albicans occurred more frequently in patients with deep-seated candidiasis than in colonised patients. The presence of dense bands in immunoblots representing antibodies against the 47K and/or 68K antigen served to discriminate significantly between deep-seated and superficial candidiasis (p less than 0.05).


Subject(s)
Antibodies, Fungal/blood , Candidiasis/immunology , Immunocompetence/immunology , Candidiasis/diagnosis , Colony Count, Microbial , Counterimmunoelectrophoresis , Hemagglutination Tests , Humans , Immunoblotting , Immunoglobulin G/analysis , Predictive Value of Tests
8.
Antimicrob Agents Chemother ; 31(4): 535-8, 1987 Apr.
Article in English | MEDLINE | ID: mdl-3111354

ABSTRACT

In a double-blind randomized study, 155 male patients with uncomplicated urethral gonorrhea were given 200 mg (one capsule with 200 mg and one capsule with placebo; n = 77) or 400 mg (two capsules with 200 mg; n = 78) of enoxacin orally. The cure rates in the 200- and 400-mg treatment groups were 90 and 92%, respectively. The enoxacin MIC for the isolated Neisseria gonorrhoeae strains ranged from 0.015 to 0.12 microgram/ml. Postgonococcal urethritis was diagnosed in 29 (42%) patients in the 200-mg treatment group and 19 (26%) patients in the 400-mg treatment group. Side effects (nausea, headache, and vomiting) occurred in 2 (3%) of the 77 patients in the 200-mg treatment group and in 3 (4%) of the 78 patients in the 400-mg treatment group.


Subject(s)
Gonorrhea/drug therapy , Naphthyridines/administration & dosage , Acute Disease , Administration, Oral , Double-Blind Method , Drug Resistance, Microbial , Enoxacin , Gonorrhea/microbiology , Humans , Male , Naphthyridines/pharmacology , Naphthyridines/therapeutic use , Neisseria gonorrhoeae/drug effects , Neisseria gonorrhoeae/isolation & purification , Random Allocation
10.
Eur J Clin Microbiol ; 5(4): 395-8, 1986 Aug.
Article in English | MEDLINE | ID: mdl-3093221

ABSTRACT

One hundred and twenty-three female patients suffering from uncomplicated urogenital gonorrhoea were treated in a double blind randomised trial with either 200 mg enoxacin (one capsule of 200 mg, one of placebo) or 400 mg enoxacin (two capsules of 200 mg). The cure rate in the 46 evaluable patients in the 400 mg group was 100%, and in the 40 evaluable patients in the 200 mg group 98.7%. Minor side effects such as nausea, headache and skin rash occurred in three of 109 evaluable patients (2.8%). The minimum inhibitory concentration of enoxacin for the Neisseria gonorrhoeae strains isolated varied between 0.03 and 0.12 mcg/ml. Enoxacin would seem to be a very effective drug in the treatment of uncomplicated urogenital gonorrhoea in female patients.


Subject(s)
Gonorrhea/drug therapy , Naphthyridines/therapeutic use , Neisseria gonorrhoeae/drug effects , Administration, Oral , Adolescent , Adult , Aged , Chlamydia trachomatis/isolation & purification , Clinical Trials as Topic , Double-Blind Method , Drug Administration Schedule , Enoxacin , Enzyme-Linked Immunosorbent Assay , Female , Humans , Microbial Sensitivity Tests , Middle Aged , Naphthyridines/administration & dosage , Naphthyridines/pharmacology , Neisseria gonorrhoeae/isolation & purification , Random Allocation
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