Search PubMed⌕ Search

Biomedical subjects

C Singer

Publications and source records attributed to C Singer.

At least 109 records · Page 6Linked to original sources
PubMed1981

Prophylactic trimethoprim-sulfamethoxazole during consolidation chemotherapy for acute leukemia: a controlled trial.

We conducted a prospective, controlled, randomized trial of oral trimethoprim-sulfamethoxazole treatment in patients with acute leukemia receiving consolidation chemotherapy. We followed 14 treatment patients during 33 episodes and 15 control patients during 34 episodes of granulocytopenia (less than 1000 granulocytes/mm3). We found no significant difference in the incidence of febrile episodes (13 in treatment group versus 14 in control group), hospitalizations to treat fever or infection (10 versus 12), number of documented infections (eight versus 10), number of septicemias (one versus two), or mean duration of hospital stay to treat fever or infection (8.9 versus 9.2 days) in the two groups. There was little colonization with organisms resistant to trimethoprim-sulfamethoxazole, including Candida, in either group. Prophylactic trimethoprim-sulfamethoxazole did not significantly reduce the incidence of fever, hospitalization, or infection in granulocytopenic patients during consolidation chemotherapy.

Acute Disease↗
PubMed1979

Rickettsialpox. Case report and epidemiologic review.

In recent years, rickettsialpox was infrequently reported: one case per year was recorded by the Public Health Service during the past 15 years. We observed a case of rickettsialpox in New York City and reviewed the clinical, diagnostic, and epidemiologic features. Records of the New York City Health Department showed that serum samples from only six patients were submitted for serological testing for rickettsialpox during the past ten years, suggesting that although the disease is uncommon now, clinicians may be failing to recognize and diagnose rickettsialpox, as it may occur more frequently than is presently recognized.

Adolescent↗
PubMed1979

Diffuse pulmonary infiltrates in immunosuppressed patients. Prospective study of 80 cases.

Over a two year period, we studied prospectively 80 cases of diffuse pneumonia at Memorial Sloan-Kettering Cancer Center. In 72 per cent of these, the patient had leukemia or lymphoma. Diagnostic procedures consisted of extensive serologic testing for antibody to known respiratory pathogens, including the agent of Legionnaire's disease, and culturing of biopsy specimens for bacteria, viruses, mycoplasmas and fungi. Of 44 cases in which open lung biopsy was performed, a specific cause was found in 61.4 per cent: Pneumocystis carinii in 38.6 per cent, other infections in 9.1 per cent and tumor involvement in 13.7 per cent. There were nonspecific pulmonary changes in 38.6 per cent. Of the 56 cases in which biopsy, autopsy or both were performed, a specific diagnosis was made in 69.7 per cent: P. carinii infection in 37.5 per cent and other infections in 12.5 per cent. In cases in which neither biopsy nor autopsy was performed, a specific infection was diagnosed in 33 per cent; no specific diagnosis was made in the remainder. One patient in the entire group had a significant antibody titer for Legionnaire's disease. Although diagnostic in some cases, extensive serologic testing proved relatively unfruitful. Pneumocystosis was the most frequent diagnosis in this study. The cause of some cases remained obscure, even after lung biopsy.

Adolescent↗
PubMed1977

Bacteremia and fungemia complicating neoplastic disease. A study of 364 cases.

During a 14 month period there were 364 episodes of bacteremia and fungemia at Memorial Sloan-Kettering Cancer Center. The first nine months of the study were retrospective, and the next five prospective. In patients with leukemia or lymphoma (group 1), Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Staphylococcus aureus were the most frequently isolated organisms. The mortality in this group was 40.5 per cent. In the patients with solid tumor (group 2), Esch. coli, Staph. aureus, Bacteroides sp. and Candida sp. were most frequent. Mortality was 27.8 per cent. The source of infection in both groups was often indeterminate. High mortality was associated with pulmonary and intraabdominal infection and with Ps. aeruginosa, K. pneumoniae or polymicrobic sepsis. Factors of prognostic significance were the causative microorganism, source of infection and shock. Although mortality was higher in patients with leukopenia than in those with normal leukocyte counts, the differences were not significant. The mortality in this series was low considering the severity of the underlying diseases and the immunosuppressed state of many of the patients. In a prospective, randomly controlled study, mortality was further diminished by infectious disease consultation at the time the positive blood culture was reported. Severe fungal superinfection, predominantly aspergillosis and candidiasis, was found in 52 per cent of the autopsy patients with leukemia or lymphoma (group 1), but in only 8 per cent of those with solid tumors (group 2).

Adolescent↗
PubMed1977

Infectious syphilis mimicking neoplastic disease.

Five patients who were initially evaluated for malignant neoplasm actually had infectious syphillis (one primary, two secondaries, two secondaries with persistence of primary). Two patients were considered for radical surgery and one for extensive radiation and/or chemotherapy. In four patients an elevated routine admission VDRL was the first indication of the correct diagnosis. Dark-field examination is the most important laboratory test in the diagnosis of primary syphillis; VDRL and FTA-ABS are most important in confirming secondary syphillis. Penicillin remains the drug of choice for therapy. At a time when the incidence of sexually transmitted diseases is increasing, it is extremely important to develop adequate educational programs for medical students and physicians.

Adult↗
PubMed1975

Imported mucocutaneous leishmaniasis in New York City. Report of a patient treated with amphotericin B.

A case of mococutaneous leishmaniasis in a patient referred to Memorial Sloan-Kettering Cancer Center, New York, with a presumptive diagnosis of lethal mid-line granuloma is described. The patient had lived in Bolivia and had been treated with antimony during and after which his mucosal lesions progressed. These lesions completely healed with 971 mg of amphotericin B. Mucocutaneous leishmaniasis is endemic in many areas of Central and South America and may occur in patients in the United States who have lived in or traveled to these areas. Organisms may be difficult to identify, and multiple biopsies and cultures may be necessary. The use of amphotericin B for the treatment of leishmaniasis is reviewed. It is an effective alternative to antimony therapy, and in some cases resistant to antimony, it may be the drug of choice.

Adult↗
PubMed1975

Pneumocystis carinii pneumonia: a cluster of eleven cases.

An unusual cluster of 11 patients with Pneumocystis carinii pneumonia occurred in a 3-month period at Memorial Hospital, New York. Ten of the 11 patients had lymphoma or leukemia. In 7 patients, corticosteroid therapy was decreased or stopped shortly before pneumocystis pneumonia was diagnosed. The pediatric patients had extensive contact in the outpatient department, and three of them had roomed together, suggesting the possibility of man to man transmission. Tree of 4 adult patients with Hodgkin's disease and pneumocystis pneumonia had the same physician. This physician had an indirect immunofluorescent titer of 1:16, as did an infectious disease resident involved in the care of 6 patients. Three of 9 patients tested showed indirect immunofluorescent titers of 1:16 or above, with rising or falling titers on serial specimens. Although definitive evidence of communicability was not established, patients with suspected or proved pneumocystis pneumonia are now isolated in this hospital.

Adolescent↗