Search PubMed⌕ Search

Biomedical subjects

A M Lerner

Publications and source records attributed to A M Lerner.

At least 19 recordsLinked to original sources
PubMed1993

Repetitively negative changing T waves at 24-h electrocardiographic monitors in patients with the chronic fatigue syndrome. Left ventricular dysfunction in a cohort.

This study surveys the occurrence of repetitively negative to flat T waves, alternating with normal upright T waves in 24-h electrocardiographic recordings from a subspecialty infectious diseases outpatient practice during the years 1982 to 1990. Patients with normal resting electrocardiogram in the assayed leads, but with repetitively inverted to isoelectric abnormal T waves at Holter monitors, were considered to have abnormal readings. A total of 300 patients had undergone a 24-h Holter monitor. This group included 24 individuals with chronic fatigue syndrome (CFS). This population was restricted to individuals 50 years old or younger, and the patients with CFS are compared with the patients without CFS. One of the more striking differences between the two groups was the difference in abnormal Holter readings. The patients with CFS all had abnormal Holter readings, while 22.4 percent patients without CFS had abnormal readings (p < 0.01). We further report the occurrence of mild left ventricular dysfunction in 8 of 60 patients in continuing studies of this population with CFS, younger than 50 years old, and with no risk factors for coronary artery disease. All 60 patients with CFS showed repetitively flat to inverted T waves alternating with normal T waves. Stress multiple gated acquisitions (MUGAs) (labeled erythrocytes with stannous pyrophosphate) were abnormal in eight patients with CFS. Although resting ejection fractions (EFs) were normal (mean, 60 percent), with increasing work loads (Kilopon meters [Kpms]), gross left ventricular dysfunction occurred. The fatigue of patients with CFS may be related to subtle cardiac dysfunction occurring at work loads common to ordinary living.

Adult↗
PubMed1989

Ultrasound imaging of residual limbs: new use for an old technique.

The use of ultrasound for diagnosing problems in the residual limb of an individual with an amputation has not been documented in the literature. We present a case where this modality was particularly useful in the diagnosis of an extensive abscess in the distal stump. Ultrasound imaging of compromised residual limbs is useful in the diagnosis of stump infections with infected muscle tissue and deep fluid collection. This technique can help shorten the course of intravenous antibiotics by clarifying the need for surgical intervention.

Aged↗
PubMed1986

Coxsackievirus-positive cervices in women with febrile illnesses during the third trimester in pregnancy.

Coxsackievirus B5 infection was demonstrated in five of seven third-trimester pregnant women with undifferentiated febrile illnesses or aseptic meningitis. Coxsackievirus B5 was recovered from the cervix and throat in four women and from the rectum in three. No obvious illnesses were evident in the babies. These findings suggest that previously unrecognized cervical enterovirus carriage or infection is common in infected pregnant women in the last trimester and that subsequent neonatal infection at delivery may result.

Antibodies, Viral↗
PubMed1984

Pharmacokinetics and tolerance of intravenous and intramuscular recombinant alpha 2 interferon in patients with malignancies.

Fifteen patients with advanced hematopoietic and other malignancies were treated with recombinant DNA produced Alpha 2 Interferon (IFN) (Schering) by intravenous (IV) and intramuscular (IM) routes at weekly intervals in escalating doses from 1 X 10(6) IU to 100 X 10(6) IU in order to determine the tolerance and pharmacokinetics. The most common side effects included fever, chills, myalgia, and arthralgia. At doses of 60 X 10(6) or above, severe but reversible hypotension was observed in five patients receiving interferon by intravenous route. Patients receiving interferon by intramuscular route had fever, chills, and myalgias but did not develop hypotension at the same dosage. Two patients with non-Hodgkin lymphoma showed objective evidence of regression. Our data suggest a biphasic pattern of elimination with terminal half-life ranging from 1.9 to 2.9 hours and peak titer of 16,000 units and under for IV interferon, and terminal half-life of 6 hours with peak titers of 600 units for intramuscular interferon. However, interpatient variability precludes a definite conclusion. Although the areas under the serum concentration vs time curves were similar, the intravenous route provided higher but unsustained levels of interferon than the intramuscular route.

Adolescent↗
PubMed1984

Studies of in vitro synergy between several beta-lactam and aminoglycoside antibiotics against endocarditis strains of Pseudomonas aeruginosa.

Ten strains of Pseudomonas aeruginosa isolated from patients with endocarditis (1969-1975) and eight similar strains (1980) were assayed for minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) to several aminoglycosides (gentamicin, tobramycin, amikacin) and beta-lactam antibiotics (ticarcillin, piperacillin, azlocillin, moxalactam and MKO 787). In vitro synergy (1969-1975 series) between beta-lactam and aminoglycoside antibiotics was shown uniformly with azlocillin (100 per cent) followed by moxalactam (80 per cent), piperacillin and ticarcillin (66 per cent) and MKO 787 (13.3 per cent). Results were similar in 1980. Synergy of azlocillin was demonstrated with five strains previously not showing synergy between carbenicillin and an aminoglycoside. In 1980 four of eight patients infected with pseudomonads that were not synergistically affected in vitro were refractory to treatment with the piperacillin-aminoglycoside combination. In vitro synergy of the infecting strain is necessary for successful medical treatment of patients with P. aeruginosa infective endocarditis.

Aminoglycosides↗
PubMed1984

Renal and auditory toxicity of high-dose, prolonged therapy with gentamicin and tobramycin in pseudomonas endocarditis.

The nephrotoxicity and auditory toxicity of high-dose (mean, 28.6 g) and prolonged (mean, 61.6 days) courses of gentamicin and tobramycin were monitored in 15 patients receiving 17 courses of treatment for pseudomonas endocarditis. Doses were adjusted in a manner that maintained peak levels of aminoglycoside in serum at 12-15 micrograms/ml and trough levels at less than 2 micrograms/ml. Drug-related renal dysfunction and auditory toxicity occurred in 63% and 44%, respectively, of gentamicin-treated patients and in 43% and 25%, respectively, of tobramycin-treated patients. Mean maximal rises (+/- SEM) in serum creatinine levels were 0.8 (+/- 0.4) mg/dl in the group given gentamicin and 1.6 (+/- 0.7) mg/dl in the group given tobramycin. Mean maximal decreases in pure-tone hearing threshold levels were greater in gentamicin-treated patients (58.3 dB) than in those given tobramycin (22.5 dB). Both forms of toxicity appeared earlier and at a smaller dose with gentamicin than with tobramycin.

Adult↗
PubMed1984

Comparative activities of selected combinations of acyclovir, vidarabine, arabinosyl hypoxanthine, interferon, and polyriboinosinic acid-polyribocytidylic acid complex against herpes simplex virus type 2 in tissue culture and intravaginally inoculated mice.

The effects of double and triple combinations of acyclovir (ACV), adenine arabinoside (ara-A), arabinosyl hypoxanthine, or interferon on herpes simplex virus type 2 in mouse embryo fibroblasts were measured. These in vitro data were compared with results obtained in mice infected intravaginally with herpes simplex virus type 2 and treated intraperitoneally with low- and high-dose combinations of ACV, ara-A, or polyriboinosinic-polyribocytidylic acid(poly-L-lysine)carboxymethylcellulose complex [poly IC(LC)], an interferon inducer. Although all double combinations and one triple combination evoked synergistic reactions in vitro, results did not necessarily predict in vivo observations. In vivo synergy was observed when combinations of ACV and ara-A and low doses of ara-A-ACV-poly IC(LC) were used. However, toxicity was seen with full-dose nucleoside-poly IC(LC) doublets. The full-dose ACV-ara-A combination completely prevented progression beyond vaginitis, with all animals surviving. The ara-A-ACV results observed in mice, together with in vivo data of others, suggest that this combination might prove clinically useful for certain herpes simplex virus type 2 infections.

Acyclovir↗
PubMed1984

An enterovirus-induced murine model of an acute dilated-type cardiomyopathy.

After coxsackievirus B3 (CB3) infection of mice, migration of transfused sensitized and nonsensitized 51Cr-labelled T lymphocytes was followed. At autopsies on days 5.5, 6, 7, and 9 after infection, T-cell-dependent in situ calcification was assessed by cardiac xeroradiographs. In CB3-infected animals from group 2 that were not forced to swim (Gr. 2, Inf +, Ex -), significant rerouting of sensitized 51Cr-labelled T cells to the heart occurred beginning on the 9th day after infection. This was accompanied by myocardial calcification. When mice with CB3 myocarditis were forced to swim (Gr. 3, Inf +), 4 times the density of sensitized 51Cr-labelled T cells was redirected to the heart. At xeroradiography, severe myocardial calcification was shown to accompany cardiac dilatation.

Animals↗
PubMed1984

Epileptic Kluver-Bucy syndrome: case report.

The Kluver-Bucy syndrome (KBS) consists of prominent oral tendencies, emotional blunting, altered dietary habits, hypersexuality, and visual and auditory agnosia. It was first produced experimentally in monkeys; subsequently, many human cases have been reported. The syndrome results from bilateral temporal lobe damage, and is mainly observed in conditions which tend to produce such damage, such as herpes encephalitis, Pick disease, and head injury. A case of KBS associated with psychomotor status epilepticus is reported.

Agnosia↗