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Biomedical subjects

B M Greene

Publications and source records attributed to B M Greene.

At least 73 records · Page 4Linked to original sources
PubMed1984

The statistical analysis of microfilarial skin snip counts: stabilization of the variance of microfilarial counts.

Microfilarial skin snip counts from savannah and rain forest areas of West Africa and from Central America were analyzed. Before parametric statistical tests, such as the comparison of means, can be properly performed, the variance must be independent of the mean. The best transformation of the skin snip counts to make the variance independent of the mean was determined. Frequency distributions of skin snip counts are shown for several different transformations. In three out of four sets of data that were examined, the best transformation was found to be the fourth root of the counts, not the logarithm of the count as has been customarily used.

Animals↗
PubMed1983

Comparison of flubendazole and diethylcarbamazine in treatment of onchocerciasis.

Flubendazole, an injectable benzimidazole drug, was compared with diethylcarbamazine (DEC) in a prospective double-blind study of the treatment of onchocerciasis. Nineteen Mexican men were randomly assigned to receive either flubendazole 750 mg intramuscularly once a week for 5 doses, or DEC 100 mg twice daily for 14 days, and they were then followed up for 12 months. Major systemic side-effects during the first 3 weeks were common in the DEC group but not in the flubendazole group in which there was considerable inflammation at the injection site instead. Ocular complications (limbitis, punctate keratitis, and uveitis) were also common in the DEC group, whereas in the flubendazole group they consisted only of one new punctate opacity at day 4 in one subject. One DEC patient also had several new areas of chorioretinal changes on day 2 but these had disappeared by 2 months. Skin microfilaria counts fell rapidly in the DEC group, but returned to the pretreatment levels. In contrast, skin microfilaria counts in the flubendazole group fell slowly, but by 6 and 12 months were lower than in the DEC group (at 12 months 0.2 vs 7.3 mf/mg, p less than 0.001). In addition, by 6 months none of the flubendazole subjects had intracorneal microfilariae, and only one had microfilariae in the anterior chamber, whereas the numbers of intraocular microfilariae in the DEC group had returned to pretreatment levels. The results suggest that flubendazole is safer and more effective than DEC in the treatment of onchocerciasis.

Adolescent↗
PubMed1983

Ocular and systemic complications of diethylcarbamazine therapy for onchocerciasis: association with circulating immune complexes.

Diethylcarbamazine (DEC) therapy for Onchocerca volvulus infection results in frequent ocular and systemic complications, but the pathogenesis of these complications is unclear. Twenty men with O. volvulus infection were treated over a period of six months with DEC given daily for one week and weekly thereafter. Major systemic and ocular complications included proteinuria, severe pruritus, visual field constriction, optic nerve pallor, chorioretinitis, anterior uveitis, and punctate keratitis. Levels of circulating immune complexes (CICs) were increased (greater than 11% [125I]C1q binding) in 14 of the 20 men prior to treatment. Persons with pretreatment C1q binding activity of greater than 30% were at increased risk to develop constriction of visual fields (P less than 0.05) and proteinuria (P less than 0.015). Linear regression analysis revealed a striking correlation between pretreatment levels of CICs and the total number of both systemic and ocular complications (P less than 0.001) and ocular complications alone (P less than 0.005). These results suggest that CICs may be important in the pathogenesis of the delayed systemic and ocular complications following DEC therapy for O. volvulus infection.

Antigen-Antibody Complex↗
PubMed1983

Chemotaxis of human granulocytes toward microfilariae of Onchocerca volvulus.

Migration of human peripheral blood granulocytes in response to microfilariae of O. volvulus was demonstrated using modified Boyden chambers. Granulocyte migration was significantly enhanced when microfilariae were preincubated with heat-inactivated immune serum (delta IS), then added to a fresh serum source (P less than 0.025). This effect was not seen when microfilariae were incubated in medium alone, in delta IS alone, in delta IS plus C4-deficient guinea-pig serum, or in fresh serum alone. There was no significant difference between the response of cells from O. volvulus-infected donors and that of cells from normal volunteers. Likewise, there was no significant difference between the migratory response seen toward nodule- versus skin-derived microfilariae. These results suggest that the host inflammatory response to O. volvulus microfilariae is mediated in part by chemotactic factors generated by antibody and complement interaction with the organism and, furthermore, that these factors are product(s) of classical complement pathway activation.

Animals↗
PubMed1983

Diethylcarbamazine citrate, an antifilarial drug, stimulates human granulocyte adherence.

Incubation with diethylcarbamazine citrate caused significant augmentation of human neutrophil and eosinophil adherence to tissue culture plastic. This effect was dose dependent and cell dependent, with eosinophils showing greater sensitivity and a greater adhesive response to the drug than did neutrophils. Eosinophils preincubated with diethylcarbamazine citrate demonstrated decreased adhesive responses to other adherence-augmenting stimuli. Use of Fc-treated plastic augmented diethylcarbamazine citrate-stimulated neutrophil (but not eosinophil) adherence. Direct stimulation of host effector cell adherence may explain, in part, the therapeutic action of diethylcarbamazine citrate in vivo.

Cell Adhesion↗
PubMed1983

Multiple endocrine adenopathy.

Since the original descriptions of the MEA syndrome, wide interest has been evinced for these familial endocrine disorders. Initially, screening investigations with the advent of the automated blood chemical analyses, and thus, the enhanced ease of detection of serum calcium levels have been followed by a flurry of diagnostic and therapeutic advances. Formal recognition of three MEA types, with their characteristics, has occurred over the last 20 years. Certainly in the future, other variants will be recognized and pose new problems. MEA poses fundamental questions of the embryologic origin and derivation of endocrine glands as well as issues of chromosomal operations of specific gene loci which have not yet been fully investigated.

Adenoma, Islet Cell↗
PubMed1983

In vitro immune mechanisms associated with clearance of microfilariae of Dirofilaria immitis.

An in vitro system has been developed to elucidate potential immune mechanisms associated with clearance of microfilariae (Mf) from the bloodstream in canine Dirofilaria immitis infection. Granulocytes as well as mononuclear cells adhere to Mf of Dirofilaria immitis in the presence of immune serum. Only granulocytes, however, were capable of killing Mf, whereas PBMC attach to but do not effectively kill Mf. In the presence of granulocytes 1% +/- 1, 10% +/- 2, and 12% +/- 3 of Mf were killed by heated normal (NDS), patent (PS), and occult serum (OS), respectively, after an 18-hr incubation. With the addition of fresh NDS there was an increase in killing to 5% +/- 1 (p less than 0.025) with heat-inactivated NDS, to 12% +/- 3 in the presence of PS and to 77% +/- 12 (p less than 0.005) in the presence of OS. On further purification of granulocyte cell populations with metrizamide gradients, neutrophils were found to be the predominant effector cells with 73% +/- 18 killing with neutrophils and 18% +/- 6 with eosinophils (p less than 0.0005). Only with neutrophils was a significant increase in killing of Mf observed when fresh NDS was added to delta OS. Fractionation of OS by gel filtration suggested that IgM was the opsonizing antibody in the occult serum. In addition, immunofluorescent studies showed only IgM bound to the surface on Mf on incubation in OS. The involvement of complement in the fresh serum enhancement of killing was supported by the finding, by immunofluorescence, of surface C3 on Mf after incubation in fresh OS.

Animals↗
PubMed1983

Non-specific suppression of antigen-induced lymphocyte blastogenesis in Onchocerca volvulus infection in man.

Lymphocyte blastogenic responses to O. volvulus antigen (Oncho Ag), SKSD, and the mitogen PHA were tested in three groups of persons: light to moderately infected persons (INF); previously exposed but uninfected persons (EXP) and normal controls (NC). The exposed group showed significant responsiveness to Oncho Ag (delta ct/min = 6,002 +/- 1,375), while the infected (delta ct/min = 943 +/- 418) and normal control (delta ct/min = 428 +/- 418) groups did not. The mean blastogenic response to SKSD were EXP, 8,644 +/- 5,249; NC 6,039 +/- 2,880; INF, 2,619 +/- 1,012. The reduced reactivity in the INF group to Oncho Ag showed a significant correlation with reactivity to SKSD (P less than 0.05). To elucidate the mechanism of hyporesponsiveness in the infected group rigorous adherent cell depletion, by adherence to plastic followed by a nylon wool column, was utilized. When 20% plastic adherent cells were added back to the T cells prepared in this fashion, the mean blastogenic response to SKSD was significantly augmented (P less than 0.01). In contrast, the responsiveness to Oncho Ag was not significantly altered. The addition of indomethacin (1 microgram/ml) or autologous plasma had no significant effect on reactivity to either SKSD or Oncho Ag. There were no significant differences in the mean reactivity of the three groups to PHA-M (delta ct/min EXP 78,514 +/- 12,564; INF 62,393 +/- 14,447; NC 61,423 +/- 4,465). These results suggest that O. volvulus infection is associated with decreased lymphocyte reactivity to both parasite related and unrelated antigens, and imply that the mechanism for the two types of hyporesponsiveness may be distinct. While a weakly adherent suppressor cell may account for non-specific hyporesponsiveness, the mechanism of parasite specific decreased reactivity remains unknown.

Adolescent↗
PubMed1981

Chemotherapy of onchocerciasis: a controlled comparison of mebendazole, levamisole, and diethylcarbamazine.

Four drug regimens for treating onchocerciasis were compared in a double-blind study in persons from an endemic area in southern Mexico. 40 men were randomly assigned to receive either diethylcarbamazine (DEC) (200 mg/day), mebendazole (2 g/day), levamisole (150 mg per week), or mebendazole plus levamisole. DEC produced the most rapid fall in skin microfilaria counts, but by 6 months the two groups receiving mebendazole showed similar or slightly greater reductions. Despite the administration of corticosteroids to persons receiving DEC, more systemic side-effects were seen in this group. Ocular complications were also commoner and more severe in those receiving DEC. The reduction in the number of intraocular microfilariae at 6 months was similar to those receiving DEC and mebendazole, alone or in combination with levamisole. Levamisole alone had no significant effect on microfilaria counts. Examination of adult worms in nodules excised at 2 months showed changes suggestive of an interruption of embryogenesis in those persons receiving the mebendazole-containing regimens only. The findings suggest that mebendazole may be a useful alternative to DEC in the treatment of onchocerciasis.

Adolescent↗
PubMed1981

Toxic shock syndrome: clinicopathologic findings in a fatal case.

A 15 year old girl presented with a painful desquamative rash, fever, and profound hypotension. Despite antimicrobial therapy and intensive supportive measures, she died 80 hours after admission. The premortem skin biopsy and autopsy findings, which included subepidermal edema and blister formation, subacute vasculitis, and striking interstitial edema involving several organs, are consistent with a toxin mediated process. Current knowledge of the pathogenesis of the toxic shock syndrome and its differential diagnosis are discussed in light of the clinicopathologic findings in this case.

Adolescent↗
PubMed1981

Ocular changes with oral and transepidermal diethylcarbamazine therapy of onchocerciasis.

Twenty men with moderate infection of Onchocerca volvulus were studied in a double-masked, controlled clinical trial to compare the safety and efficacy of oral diethylcarbamazine (DEC) with topical DEC lotion. Visual acuity and colour vision did not alter during the 6 months of observation, although 2 patients receiving DEC lotion and 3 patients receiving oral DEC developed either visual field constriction or optic atrophy. Fluffy corneal opacities were common in both groups. Intraocular microfilariae also appeared in both groups but to a greater extent in those receiving DEC lotion. New chorioretinal changes developed in 4 men receiving lotion and in only 1 receiving tablets. It is concluded that DEC lotion offers no advantage over tablets in the treatment of ocular onchocerciasis and in fact may be associated with more ocular complications than the conventional oral treatment.

Administration, Oral↗
PubMed1980

Controlled clinical trial of oral and topical diethylcarbamazine in treatment of onchocerciasis.

In a double-blind controlled clinical trial comparing the safety and efficacy of oral diethylcarbamazine citrate (DEC) with topical DEC for the treatment of onchocerciasis twenty men with moderate skin-snip microfilarial counts received daily therapy for 1 week, then weekly therapy for the rest of 6 months. The number of microfilariae per skin snip dropped quickly to 2% of initial levels and remained at low levels in those receiving oral DEC, and to 20% of initial levels in patients treated with DEC lotion. Side-effects in both groups included lymphadenopathy, fever, pruritus, rash, proteinuria, and chorioretinitis; they were commoner with topical DEC.

Administration, Oral↗
PubMed1980

Failure of penicillin G benzathine in the treatment of neurosyphilis.

Although penicillin remains highly effective in syphilis, important questions exist regarding the optimal regimen for syphilitic involvement of the nervous system. Progression of neurosyphilis despite 7.2 million units of penicillin G benzathine occurred in the case reported here, with subsequent resolution following high-dose intravenous aqueous penicillin therapy. This and other recent reports support the conclusion that neurosyphilis should be treated with higher amounts of penicillin than is provided by the benzathine regimens.

Adult↗
PubMed1979

Complications of percutaneous central venous catheterization: a report of two cases and review of the literature.

Percutaneous catheterization of the central venous system is a valuable and commonly employed procedure, but it is not without risk. Two cases are reported which illustrate complications of both internal jugular and subclavian vein cannulation: a fatal cerebrovascular accident; and hemo- and pneumothorax. Literature review indicates that pneumothorax and air embolus are major complications of both routes of catheter insertion. Additionally each route has untoward effects related to the proximity of easily compromised structures (pleura, lungs, arteries, nerves). Awareness of potential complications and use of precautionary measures may reduce the risk of these procedures.

Adult↗