Robert Siegel

All Publications

• Fatal H1N1-Related Acute Necrotizing Encephalopathy in an Adult. Case reports in critical care Lee, Y., Smith, D. S., Rao, V. A., Siegel, R. D., Kosek, J., Glaser, C. A., Flint, A. C. 2011; 2011: 562516-?

  Abstract

  Acute necrotizing encephalopathy (ANE) is a severe neurological complication of influenza infection, including H1N1 influenza. Many cases of ANE have been reported in the pediatric literature, but very few cases have been described in adults. The cause of ANE remains unknown-the influenza virus is not known to be neurotropic, and evidence of direct viral involvement of the central nervous system (CNS) has not been demonstrated in the limited cases of ANE in which pathological specimens have been obtained. Here we report a fatal case of ANE from H1N1 influenza infection in an adult. Neuroimaging and postmortem analysis both showed widespread brain edema, necrosis, and hemorrhage, but molecular studies and postmortem pathology revealed no evidence of direct viral involvement of the CNS. This case of fatal ANE in an adult is consistent with the hypothesis generated from pediatric cases that the host immune response, and not direct viral invasion of the CNS, is responsible for pathogenesis of ANE.

  View details for DOI 10.1155/2011/562516

  View details for PubMedID 24826323

  View details for PubMedCentralID PMC4010007

• Fatal H1N1-Related Acute Necrotizing Encephalopathy in an Adult Case Reports in Critical Care Lee, Y., Smith, D. S., Rao, V. A., Siegel, R. D., Kosek, J., Glaser, C. A., Flint, A. C. 2011; 2011: 4

  View details for DOI 10.1155/2011/562516

• Amantadine in treatment of chronic hepatitis C virus infection? JOURNAL OF VIRAL HEPATITIS Lim, J. K., Wooten, D., Siegel, R., Cheung, R. C. 2005; 12 (5): 445-455

  Abstract

  Treatment of chronic hepatitis C (CHC) continues to be an important and growing challenge. As the response rate to FDA-approved treatment improved over the past decade, we are facing increasing number of difficult-to-treat patients such as those who have failed prior anti-viral therapy. The role of amantadine in the treatment of CHC remains unclear. Studies thus far have produced conflicting results, and type II error could not be excluded. This review summarized results published in the literature from 1997 to 2003, and reviewed the existing questions and controversies regarding the use of amantadine. Current literature suggests that amantadine is ineffective as monotherapy. Amantadine increased the sustained virologic response of certain treatment naïve patients when used in combination with interferon, and may be effective as an adjunct to interferon-based combination therapy in some patients who have failed or relapsed on prior therapy. Factors such as small sample size, patient characteristics, and differences in treatment protocols including amantadine preparation and duration of therapy might explain the conflicting observations of various studies. Further investigations are needed to define optimal dosing and formulation of amantadine, and its appropriate role in management of CHC infection.

  View details for DOI 10.1111/j.1365-2893.2005.00622.x

  View details for Web of Science ID 000231223400001

  View details for PubMedID 16108758