Search PubMed⌕ Search

Biomedical subjects

C G Wlodaver

Publications and source records attributed to C G Wlodaver.

14 recordsLinked to original sources
PubMed2005

Infectious-appearing diseases, and infections that present in disquises.

Several disorders can appear to be infections when actually they are not. Conversely, certain infectious diseases can manifest themselves as something other than infection. These unwittingly mistaken diagnoses segue into misguided therapy-misuse of antibiotics in particular-and consequently fail to improve. These disorders have been described separately. Grouping them together draws attention to their importance in an infectious disease differential diagnosis. This article systematically assembles and briefly discusses some of these infectious-appearing diseases.

Diagnosis, Differential↗
PubMed1996

The merits of varicella vaccination for varicella non-immune health care workers.

Immunity against varicella can be reliably established by history and, if negative, confirmed or refuted by serology. If non-immune, the merits of varicella vaccine for a health care worker (HCW) can be stated clearly: Protection from a disease which may be particularly severe in an adult, and evading the inconvenience (investigation time and possible work restriction) and cost of managing an exposure. This paper discusses implementation of a varicella immunity program for HCWs at Columbia Presbyterian Hospital in Oklahoma City.

Adult↗
PubMed1991

Twice daily intramuscular imipenem/cilastatin in the treatment of skin and soft tissue infections.

One hundred and two patients were enrolled in an open-label evaluation of intramuscular imipenem/cilastatin using doses of either 500 or 750 mg every 12 h in the treatment of mild to moderately severe skin and soft tissue infections. Seventy-four of 102 patients were clinically evaluable. Thirty-one patients had abscesses, 20 had cellulitis and 23 had wound infections. One hundred seventy-eight isolates were recovered from these 74 patients (average 2.4 isolates/patient). Sixty of 74 evaluable patients (82%) were cured; 12 of 74 (16%) were improved. Two patients failed to improve. Therapy was well tolerated. Adverse effects occurred in 8 patients. All of these effects were minor, and none required discontinuation of therapy. Eighty-two percent of patients reported no pain with injections. Therapy did not need to be interrupted or discontinued in the remaining 18% of patients reporting moderate local pain with injections. Peak and trough serum imipenem levels were measured in 15 patients receiving a 500-mg intramuscular dose of imipenem/cilastatin. The mean peak imipenem concentration in 15 patients was 10.7 micrograms/ml (range 3.3-17.8); the mean trough concentration was 2.1 micrograms/ml (range 0.8-4.9). The trough levels were higher than those found in healthy volunteers and may reflect the age and mild renal dysfunction in this group of treated patients. Imipenem/cilastatin used for mild or moderate skin and soft tissue infections was both efficacious and well tolerated. Intramuscular therapy with this agent offers advantages over intravenous therapy because of its long apparent half-life and pharmacokinetics.

Abscess↗
PubMed1990

Unusual skin sites of herpes simplex eruptions: delay in diagnosis.

Whereas Herpes simplex labialis and genitalis are common and simple to diagnose, herpetic eruptions in other areas are relatively rare and often misdiagnosed. We report five cases of Herpes simplex eruption at unusual sites. Diagnosis was delayed up to 20 years and resulted in unnecessary antibiotic treatment. The recurrent nature of this eruption is the key to diagnosis.

Acyclovir↗
PubMed1986

Ethanol inhibition of granulocyte adherence.

Ethanol inhibits granulocyte adherence (GA) in whole blood. To determine the mechanism, GA was measured by the nylon fiber assay. In vitro addition of 300 mg/dl ethanol to whole blood caused a 28.1% decrease of GA compared with the control value (p less than 0.009) but did not affect GA of pure PMNs suspended in plasma or in HBSS. Similarly, GA measured in whole blood from intoxicated rabbits fell 48.8% from preintoxication values, but adherence of isolated postintoxication PMNs suspended in postintoxication plasma was not inhibited. Therefore, inhibition of GA by ethanol requires the presence of other cellular components of whole blood. To determine which cell(s) mediate the inhibition, PMNs were suspended with isolated blood components: platelet-rich and platelet-poor plasma, with and without the addition of mononuclear leukocytes and RBCs. Although the reconstitution of whole blood from its components allowed alcohol-induced inhibition of GA (decrease of 32.9%), none of the incomplete blood component mixtures demonstrated this effect. It was concluded that inhibition of GA by ethanol is mediated by an interaction between the components of whole blood.

Adult↗
PubMed1985

The role of pretransplant immunity in protection from cytomegalovirus disease following renal transplantation.

To determine the extent to which pretransplant immunity resulting from natural infection protects against cytomegalovirus (CMV) disease, we analyzed CMV serology on 153 kidney donor and recipient pairs and followed transplant patients to determine incidence and severity of CMV disease. The overall incidence of CMV disease was 22%. Significant differences occurred in CMV disease incidence and severity, depending on the immune status of the kidney donor and recipient. Among recipients of kidneys from seropositive donors, immunity offered significant protection from CMV disease, reducing its incidence from 61% in nonimmune to 24% in immune patients (P less than 0.01). Pretransplant immune patients also had fever CMV-related complications. Among recipients of kidneys from seronegative donors, pretransplant immunity conferred a significant risk of CMV disease; immune patients had a 20% incidence of CMV disease compared with 2% in nonimmune patients (P less than 0.02). Disease was generally mild in all patients receiving kidneys from CMV infection had a 3-fold higher incidence of CMV disease than patients with reactivation infection (P less than 0.01). The incidence of CMV disease was similar in immune patients, whether they received a kidney from a seropositive or a seronegative donor. However, an important observation was that disease was significantly more severe in immune patients receiving a kidney from a seropositive donor (P less than 0.05). This indicates that if kidneys from seropositive donors are selected for use only in seropositive recipients, this places the immune patient at a higher risk for severe CMV disease. We conclude that pretransplant immunity offers a significant advantage to patients receiving kidneys from seropositive donors.

Adolescent↗
PubMedDate not supplied

Ganciclovir treatment of systemic cytomegalovirus in an immunocompetent host.

Cytomegalovirus (CMV) infects a significant number of otherwise healthy individuals. Although most cases are subclinical and therefore not diagnosed, some patients present with a mononucleosis-type illness. Ganciclovir, an agent effective against CMV, has primarily been studied for use in immunocompromised patients. No formal studies have been done in immunocompetent individuals. We report a case of an otherwise healthy adult female with severe heterophile negative infectious mononucleosis. Her symptoms included high fever, malaise, myalgias, cough, and abdominal pain. Work-up revealed an acute CMV infection. Intravenous ganciclovir was given with dramatic clinical and laboratory improvement.

Acute Disease↗