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Biomedical subjects

E Ayoub

Publications and source records attributed to E Ayoub.

6 recordsLinked to original sources

Progress toward analysis of D8/17 binding to B cells in children with obsessive compulsive disorder and/or chronic tic disorder.

BACKGROUND: Previous research has suggested that a subgroup of children with obsessive compulsive disorder (OCD) have neuropsychiatric sequelae of streptococcal pharyngitis, similar to that seen in the neurological manifestation of rheumatic fever (RF). Monoclonal antibody D8/17 demonstrates increased binding to B cells in patients with RF and in patients with neuropsychiatric disorders using immunofluorescent microscopy. OBJECTIVE: The aim of this study was to determine if an earlier immunofluorescent microscopy study of monoclonal antibody D8/17 in childhood-onset OCD and/or chronic tic disorder (CTD) could be replicated using the more objective method of flow cytometric analysis. METHOD: D8/17 binding to B cells was determined in patients with OCD and or CTD (N=32), and healthy controls (N=12) by flow cytometric analysis. RESULTS: Subjects with OCD/CTD showed increased mean cell binding (26.0%) of monoclonal antibody compared with healthy controls (9.1%) (p<0.001). When using the threshold of greater than 19% binding (95% upper confidence interval) as a measure of positivity, 65.6% of patients compared with 8.3% of controls showed increased antibody binding to B cells (p=0.01). CONCLUSIONS: Although this study reports positive results, many methodological issues will need to be addressed before generalized use of assay for diagnostic purposes.

Adolescent↗

Fewer symptoms occur in same-serotype recurrent streptococcal tonsillopharyngitis.

BACKGROUND: Most patients with acute rheumatic fever report no antecedent pharyngitis. OBJECTIVE: To determine the clinical and microbiological characteristics of recurrent group A beta-hemolytic streptococcal (GABHS) tonsillopharyngitis. DESIGN: Prospective randomized trial. SUBJECTS: Symptoms were recorded and throat cultures were obtained at 4 to 6, 18 to 21, and 32 to 35 days following the start of treatment. A subset of 60 patients with subsequent GABHS episodes occurring were evaluated for a 0.2-or greater log rise in either antistreptolysin O or anti-deoxyribonuclease B titer to confirm a bona fide recurrence. RESULTS: Sixteen (27%) of 60 patients had recurrent GABHS tonsillopharyngitis of the same serotype that occurred 21 days or longer following the onset of the initial GABHS infection and was associated with a 0.2- or greater log rise in either antistreptolysin O or anti-deoxyribonuclease B titer, indicating bona fide recurrent infection; these recurrences all occurred within 55 days. Fewer patients with recurrent GABHS pharyngitis of the same serotype had headache (P =.02), sore throat (P =.006), fever (P =. 008), pharyngeal erythema (P<.001), pharyngeal edema (P<.001), pharyngeal exudate (P =.04), and adenitis (P =.03) compared with the initial episode. Chills, stomachache, scarlatina, tonsillar enlargement, and palatal petechiae were similar for both episodes. CONCLUSIONS: Fewer symptoms occur during recurrent GABHS pharyngitis of the same serotype compared with the initial infection. These patients may be less likely to seek physician attention, yet their infections put them at risk for sequelae.

Adolescent↗

Clinical evaluation of mezlocillin in neonates.

Single-dose pharmacokinetic studies were performed in 64 infants, ranging in age from less than 1 day to 6 days, after intravenous infusion or intramuscular injection of approximately 75 mg/kg of mezlocillin. Mean serum concentrations at one hour were 107 micrograms/ml and 82.5 micrograms/ml for neonates less than or equal to 1 day of age and greater than or equal to 6 days of age, respectively. The serum clearance ranged from 3.0 to 6.4 hours. Based on data from the study, it is recommended that mezlocillin be administered to neonates with gram-negative bacterial infections in a single dose of 75 mg/kg, either as an intravenous infusion over 30 minutes or as an intramuscular injection, every 12 hours during the first week of life. Mezlocillin alone or in conjunction with penicillin was used in treating 165 neonates with suspected sepsis. Gram-negative organisms were recovered from 18 of the 27 neonates from whom pathogens were isolated. Three of these 18 strains, a Klebsiella oxytoca, an Acinetobacter anitratum, and a Haemophilus influenzae, were resistant to mezlocillin in vitro. Twenty-four of the 27 patients who satisfied criteria for evaluation achieved a bacteriological and a clinical cure. Cerebrospinal fluid permeation after multiple doses ranged from 18% to 45% of serum levels. No significant local or systemic side effects were seen. The results indicate that mezlocillin is an effective ureidopenicillin for the treatment of gram-negative bacterial infections.

Bacterial Infections↗

Streptococcal skeletal infections: observations in four infants.

The radiographic findings and clinical presentations of four patients with group B beta hemolytic streptococcal osteomyelitis and pyoarthritis are described. Radiographic features, though not specific, are similar in these patients and others reported in the literature. The combination of radiographic patterns and clinical presentations in children of this age group should alert clinicians and radiologists to the possibility of infection with this organism.

Arthritis, Infectious↗