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Biomedical subjects

F N Judson

Publications and source records attributed to F N Judson.

At least 91 records · Page 5Linked to original sources
PubMed1986

Altered excretion of modified nucleosides and beta-aminoisobutyric acid in subjects with acquired immunodeficiency syndrome or at risk for acquired immunodeficiency syndrome.

Urinary excretion of modified nucleosides and beta-aminoisobutyric acid, subsequently referred to as markers, was determined in populations of patients with acquired immunodeficiency syndrome (AIDS) or at risk for development of AIDS. Our results show that asymptomatic adult male homosexuals excreted elevated amounts of markers as compared to male heterosexuals. This aberrant excretion was more pronounced in asymptomatic adult male homosexuals with antibodies to HTLV-III. Significantly greater excretion of 1-methylinosine, N4-acetylcytidine, and N2-methylguanosine was observed in asymptomatic adult male homosexuals with antibodies to HTLV-III than in asymptomatic male homosexuals without antibodies to HTLV-III. Increased amounts of markers were also excreted by subjects with the generalized or chronic lymphadenopathy syndrome, AIDS related complex (ARC), or AIDS. In these subjects, the most pronounced differences between groups were between subjects with chronic lymphadenopathy syndrome and those with ARC; subjects with ARC excreted greater amounts of seven of the ten urinary markers. There were few differences between subjects with ARC and those with AIDS, Kaposi's sarcoma, or AIDS with opportunistic infections. This observation may be useful for identifying subjects who are at risk of developing AIDS. A prospective study to test this hypothesis is under way.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Comparative study of ceftriaxone and spectinomycin for treatment of pharyngeal and anorectal gonorrhea.

Of the currently recommended regimens for treatment of uncomplicated gonorrhea, only aqueous penicillin G procaine is effective against infections at all sites. However, procaine penicillin is not effective against penicillinase-producing Neisseria gonorrhoeae and suffers from poor patient acceptability owing to the 10-mL volume of injection and allergic and toxic procaine reactions. Ceftriaxone is a new extended-spectrum cephalosporin with a long serum half-life and is many times more active than penicillin G against both beta-lactamase-positive or -negative strains of N gonorrhoeae. Ceftriaxone was compared as a single, 125-mg, 0.5-mL injection with a single 2-g injection of spectinomycin in difficult to treat pharyngeal gonorrhea in men and women and anorectal gonorrhea of men. Ceftriaxone cured 30/32 (94%) pharyngeal and 52/52 anorectal infections, compared with 6/14 (43%) and 9/9, respectively, for spectinomycin. Both regimens were well tolerated. Ceftriaxone may prove to be a drug of choice for uncomplicated gonorrhea, particularly where homosexual men are treated and/or penicillinase-producing N gonorrhoeae is prevalent.

Adult↗
PubMed1985

Interleukin-2 production by persons with the generalized lymphadenopathy syndrome or the acquired immune deficiency syndrome.

We measured production of interleukin-2 (IL-2) by phytohemagglutinin-stimulated peripheral blood mononuclear cells from 27 heterosexual persons, 43 asymptomatic homosexual men, 34 homosexual men with generalized lymphadenopathy syndrome (GLS), and 21 patients with acquired immune deficiency syndrome (AIDS). Asymptomatic heterosexual and homosexual subjects produced comparable amounts of IL-2, but 8 of 11 AIDS patients with opportunistic infections and two of three AIDS patients with both opportunistic infections and Kaposi's sarcoma failed to produce detectable amounts of IL-2; all seven AIDS patients with only Kaposi's sarcoma produced IL-2. The titer of IL-2 produced by the AIDS patients correlated with the percentage of helper T lymphocytes (Leu 3a+ cells) but not with the percentage of suppressor T lymphocytes (Leu 2a+ cells). This observation is interpreted as indicating that failure to produce IL-2 by AIDS patients is most likely due to depletion of IL-2-producing cells, although an abnormality of T-cell function has not been excluded. In addition, three of eight AIDS patients who did not produce IL-2 produced supernatants that inhibited growth of IL-2-dependent cells in the presence of IL-2. These observations suggest that measurement of endogenous IL-2 production may be important in selecting patients for therapy with IL-2.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Lack of utility of a Limulus amoebocyte lysate assay in the diagnosis of urethral discharges in men.

We evaluated a Limulus amoebocyte lysate assay (LALA) test kit for the diagnosis of gonorrhea in 883 unselected men with urethral discharge. Results were compared with those of Gram-stained smears and Martin-Lewis cultures. Of 331 men with gonococcal urethritis and 552 men with nongonoccal urethritis, 125 (37.8%) and 503 (91.1%), respectively, could not be evaluated by LALA owing either to insufficient discharge specimen to perform the test (569 or 64.4%) or to other exclusion criteria (59 or 6.7%). Of 255 LALA-evaluable discharges, LALA correctly diagnosed 252 (98.8%), compared with 244 (95.7%) for the Gram-stained smear. However, the Gram-stained smear also correctly diagnosed 96.5% of 456 men with insufficient discharge for LALA testing. The clinical utility of the LALA test kit is severely limited by performance criteria that exclude the majority of unselected men with urethritis. In addition, it is more technically cumbersome, time consuming, and costly than Gram-stained smears. Further test modifications are unlikely to overcome these inherent disadvantages of LALA.

Adolescent↗
PubMed1985

The effect of ethambutol on tubercle bacilli within cultured human macrophages.

Ethambutol (EMB) generally is believed to be clinically mycobacteriostatic. This concept was reexamined in an in vitro model of human tuberculosis that has direct relevance to in vivo effects in human subjects. Cultured human monocyte-derived macrophages infected with virulent Erdman tubercle bacilli were treated with EMB, and the resulting antimycobacterial consequences were measured by counts of acid-fast bacilli and bacterial colony-forming units. When added immediately after infection of the macrophages, EMB inhibited and killed tubercle bacilli within the cells at the same concentrations as it did in bacteriologic culture medium. When added 2 days after infection, it first appeared to increase the viable bacillary count above control culture levels, then killed intramacrophage bacilli at lower concentrations than in bacteriologic culture medium. We speculate that this occurs because macrophages enhance EMB effectiveness by killing tubercle bacilli, which have defective cell walls due to the effects of the drug. The concentrations of EMB that proved mycobactericidal in human macrophages are readily achieved clinically. The purported lesser antituberculosis effectiveness of EMB when compared to other bactericidal agents may be due to its less direct and efficient mode of killing tubercle bacilli, and the necessity therefore, for stricter maintenance of effective drug concentrations in vivo.

Adult↗
PubMed1985

Assessing the number of genital chlamydial infections in the United States.

The prevalence and incidence of genital infections with Chlamydia trachomatis have not yet been determined for broadly based populations within the United States. Largely on the basis of results of prevalence studies from sexually transmitted disease clinics, it has been estimated that C. trachomatis infections are the most common of all sexually transmitted infections and may number 3-5 million cases annually. C. trachomatis isolation rates range from 50% to 80% in certain diseases known to be caused by Chlamydia and from 10% to 30% in sexually active female adolescents and approximately 5% in college women. Cheaper, more-sensitive and widely available diagnostic tests are necessary to adequately define the epidemiology of genital Chlamydia infections in the U.S.

Adult↗
PubMed1985

Epidemiologic and clinical factors of Chlamydia trachomatis in black, Hispanic and white female adolescents.

Rates of genital infection with Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis were determined prospectively in 396 sexually active female adolescents from three ethnically different urban teen clinics. The organisms were identified respectively in cultures of specimens from 21%, 7% and 6% of all adolescents; 28%, 16% and 20% of blacks; 23%, 4% and 2% of Hispanics, and 14%, 2% and 1% of whites. C trachomatis was identified in specimens from 27% of pregnant adolescents and from 42% of adolescents who had gonorrhea or trichomoniasis. Of 85 Chlamydia-positive adolescents, 47 (55%) were asymptomatic. Physical findings significantly associated (P <.001) with chlamydial infection were vaginal discharge, cervical inflammation and mucopurulent endocervical discharge. Not significantly associated (P >.05) with Chlamydia were the use of oral contraception or symptoms of lower abdominal pain, vaginal discharge or dysuria. Because in sexually active female adolescents C trachomatis is three times more common than N gonorrhoeae, care givers need to consider routine screening or epidemiologic treatment (or both) for both pathogens.

Adolescent↗
PubMed1984

Comparative study of ceftriaxone and spectinomycin in the treatment of uncomplicated gonorrhea in women.

Single-dose ceftriaxone, 125 mg given intramuscularly, was compared with spectinomycin 2.0 g given intramuscularly in the treatment of women with uncomplicated gonorrhea. Cervical or anorectal gonococcal infection was eradicated in 54 (98 percent) of 55 women treated with ceftriaxone and 22 (96 percent) of 23 treated with spectinomycin. Cure rates for pharyngeal gonococcal infections were nine of 10 for ceftriaxone and four of eight for spectinomycin (p = 0.18). Neither agent eradicated concurrent Chlamydia trachomatis infection. The geometric mean minimal inhibitory concentration for ceftriaxone was 0.0038 microgram/ml for 65 pretreatment cervical isolates of beta-lactamase-negative Neisseria gonorrhoeae and all isolates were inhibited by 0.063 microgram/ml. Neither drug caused perceptible toxicity, but patient acceptance was better for ceftriaxone than for spectinomycin. A single 125 mg dose of ceftriaxone is an excellent regimen in the treatment of uncomplicated gonorrhea in women.

Adolescent↗
PubMed1984

Inhibition by streptomycin of tubercle bacilli within cultured human macrophages.

The strategy for using streptomycin against tuberculosis assumes that it is not effective intracellularly. But according to animal cell experiments, this is probably incorrect. We retested this assumption with a new experimental model using cultured human macrophages infected with tubercle bacilli so that the results would be directly relevant to human disease. At 5 and 50 micrograms/ml, streptomycin inhibited the bacilli strongly and killed some; at the lowest tested concentration of 0.5 micrograms/ml, it inhibited them weakly. It was acting intracellularly, because it could inhibit even when added 2 days after the macrophages had been infected and washed free of extracellular bacilli, and because in our experimental model the bacilli were shown to be unable to multiply extracellularly. However, as has been reported for animal macrophages, the antibiotic was quantitatively more than 2 orders of magnitude less effective in human macrophages than in simple bacteriologic medium. Probably this is because streptomycin is concentrated within lysosomes where low pH greatly inhibits it. The human macrophage-tubercle bacillus chemotherapeutic bioassay we describe here for the first time could be a superior patient-consonant new method for testing antituberculosis agents and treatment regimens. It retains important in vivo features, the complete host cell-parasite relationship for instance, without giving up the in vitro advantages of rapidity and objectivity.

Cells, Cultured↗
PubMed1984

Sexually transmitted viral hepatitis and enteric pathogens.

Hepatitis viruses, enteric pathogens, and anorectal infections may commonly be transmitted by various sexual practices. Because of their larger numbers of sexual partners and sexual practices such as anilingus and anal intercourse, homosexual men are at particularly high risk of acquiring hepatitis B, giardiasis, amebiasis, shigellosis, campylobacteriosis, and anorectal infections with Neisseria gonorrhoeae, Chlamydia trachomatis, Treponema pallidum, herpes simplex virus, and human papilloma viruses. The evidence for sexual transmission of these infections as well as their diagnosis and treatment are discussed.

Amebiasis↗
PubMed1984

Health status of Southeast Asian refugees.

The rates of several diseases have been reported to be higher among Southeast Asian refugees compared with those of indigenous North Americans. When we prospectively evaluated 991 refugees new to the Denver metropolitan area for their health and immunization status over a 12-month period, 38% were found to be tuberculin-positive, 71% carried one or more enteric parasites, 15% were HBsAg-positive, 13% had anemia and 31% either presented without immunization records or required continuation of vaccination sequences begun in overseas camps. Age and ethnicity were important variables with regard to tuberculosis, hepatitis B and anemia. The rates of specific parasitic infestations varied among the four ethnic groups, though the overall rates of parasitosis remained constant across ethnic lines.

Adolescent↗
PubMed1984

Oral rifampin and trimethoprim/sulfamethoxazole therapy in asymptomatic carriers of methicillin-resistant Staphylococcus aureus infections.

During a hospital outbreak of methicillin-resistant Staphylococcus aureus (MRSA) disease in 30 patients we studied the use of rifampin and trimethoprim/sulfamethoxazole (TMP/SMX) in managing asymptomatic carriers. The outbreak persisted despite control measures including "barrier" precautions, screening cultures, identification of affected persons and rapid hospital discharge of affected patients. The MRSA strain was susceptible to both rifampin and TMP/SMX and in vitro the combination was not antagonistic. Fourteen carriers received a five-day course of rifampin and TMP/SMX given by mouth. Twelve patients were evaluable. Cultures remained persistently positive in four patients, three of whom had foreign bodies that could not be removed. Among the eight with an initial response, two relapsed to the carrier state more than six months after treatment. During the study the outbreak resolved. These data suggest that rifampin and TMP/SMX may decrease the number of MRSA-colonized patients, but may not permanently eradicate the MRSA carrier state.

Adult↗
PubMed1983

Prevalence of congenital or acquired complement deficiency in patients with sporadic meningococcal disease.

We evaluated the complement system in 20 patients presenting with a first episode of meningococcal meningitis, meningococcemia, or meningococcal pericarditis. Assays of total serum complement activity were performed prospectively in 12 patients and retrospectively in 8. Six of the twenty patients had a complement deficiency (CH50 greater than 2 S.D. below the normal mean). Three of these six had a deficiency of a terminal-pathway protein (C6 in two and C8 in one), and the other three had deficiencies of multiple complement proteins associated with underlying systemic lupus erythematosus or multiple myeloma. Patients with decreased amounts of complement were similar to normal patients in terms of sex, age, type of infection, and meningococcal serogroup, but 3 of the 6 patients with a complement deficiency were black, as compared with none of the 14 patients with normal function (P = 0.018). Complement deficiency is common in patients with a first episode of meningococcal disease and may be due to either a deficiency in a single terminal protein or a complement-depleting underlying illness.

Adolescent↗
PubMed1983

Comparative study of ceftriaxone and aqueous procaine penicillin G in the treatment of uncomplicated gonorrhea in women.

Uncomplicated gonorrhea of 122 mucosal sites in 51 women was successfully treated with either a single intramuscular dose of 250 mg of ceftriaxone (23 patients) or two intramuscular doses of 4.8 X 10(6) U of aqueous procaine penicillin G (28 patients). Women treated with ceftriaxone had 22 cervical, 12 urethral, 10 anal canal, and 5 pharyngeal infections. All 122 pretreatment isolates were inhibited by 0.0125 microgram or less of ceftriaxone per ml. The minimal concentration needed to inhibit 90% of isolates was 0.006 microgram/ml for ceftriaxone and 0.2 microgram/ml for penicillin G. Ceftriaxone was very well tolerated and caused no toxicity.

Adolescent↗