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Biomedical subjects

J D Nelson

Publications and source records attributed to J D Nelson.

At least 289 records · Page 16Linked to original sources
PubMedDate not supplied

Oral or intravenous trimethoprim-sulfamethoxazole therapy for shigellosis.

A review of the literature concerning shigellosis treated with trimethoprim-sulfamethoxazole (TMP-SMZ) revealed comparative studies of 149 cases and noncomparative studies of 147 cases. Bacteriologic and clinical success rates were greater than or equal to 90% and TMP-SMZ compared favorably with alternative drug therapy. In the present study TMP-SMZ was given intravenously as initial therapy to 11 children hospitalized for severe shigella colitis. Bacteriologic and clinical responses were comparable to those observed with oral TMP-SMZ therapy. Pharmacokinetic studies revealed substantial differences between the responses of these children and those reported for adult patients; a higher ratio of SMZ to TMP (50:1) was found in children. It is concluded that TMP-SMZ is effective therapy for shigellosis and is the drug of choice in areas where ampicillin resistance is prevalent.

Administration, Oral↗
PubMedDate not supplied

Measurement of benzoylecgonine in whole blood using the Abbott ADx analyzer.

An alternate procedure has been developed for the processing of whole blood for the estimation of benzoylecgonine with the use of the Abbott ADx reagents and analyzer. This procedure allows for handling of relatively large numbers of samples without the need to evaporate extraction solvent. Blood samples were diluted with an equal volume of phosphate buffer-methanol (80:20 v/v), and the proteins were removed by centrifugation through a membrane filter device. A comparison of the proposed method with an acetone solvent extraction procedure has been made, and results were shown to be equivalent. Recoveries of 94-105% benzoylecgonine were obtained for added concentrations of 25-500 ng/mL.

Cocaine↗
PubMedDate not supplied

Measurement of lead in blood by graphite furnace atomic absorption spectrometry.

A simple method of deproteinizing whole blood with an 0.8M (5%, v/v) nitric acid solution containing Triton X-100 (0.1%, v/v) is described. The resulting supernatant is used for the measurement of lead by Zeeman graphite furnace atomic absorption spectrometry using calibration with aqueous standards. Recoveries ranged from 97.7-105.6% when an aqueous lead solution was added to a deproteinized sample supernatant and from 98.5-104.5% when whole blood control material was added to a whole blood sample. At a blood lead concentration of 11.2 micrograms/dL, the within- and between-run coefficients of variation were both approximately 5%. Comparison of the proposed method versus one using a recommended matrix modifier gave a regression equation of Y(proposed) = 0.99x(matrix modifier)-0.36, with a correlation coefficient of r = 0.994 (n = 54).

Graphite↗
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Cefuroxime therapy for pneumonia in infants and children.

Because Streptococcus pneumoniae, Haemophilus influenzae b and Staphylococcus aureus are the major causes of bacterial pneumonia in infancy, we customarily have given a beta-lactam antibiotic and chloramphenicol as initial antibiotic therapy. Cefuroxime (75 mg/kg/day divided every 8 hours iv or im) was evaluated as single drug therapy in an open study of 100 infants and children with suspected bacterial pneumonia. The mean serum concentration of cefuroxime 30 minutes after a 15-minute infusion of 25 mg/kg iv was 29.1 micrograms/ml, and the volume of distribution was 695 ml/kg. Pleural fluid concentrations in 3 specimens were 2.2, 8.5 and 11 micrograms/ml. Median age of patients was 15 months. Bacterial etiology was established in 20 patients: H. influenzae b (8 patients); pneumococcus (8 patients); S. aureus (2 patients); Group A streptococcus (1 patient); Neisseria meningitidis B (1 patient). All organisms were susceptible to 1.25-micrograms/ml doses or less of cefuroxime. The mean number of days was 3.1 until patients became afebrile and 5.1 until respiratory symptoms were gone. Eosinophilia occurred in 10 patients. Cefuroxime is safe and effective single drug therapy for pneumonia in infants and children.

Cefuroxime↗
PubMedDate not supplied

Pharmacologic interactions among chloramphenicol, phenytoin and phenobarbital.

Bioactive chloramphenicol was measured in the sera of 34 infants and children receiving intravenous chloramphenicol succinate (25 mg/kg/dose) as therapy for meningitis, pneumonia, brain abscess or Rocky Mountain spotted fever. In 17 children receiving chloramphenicol succinate alone, mean peak and trough serum concentrations of chloramphenicol were 25.3 and 13.4 micrograms/ml, respectively. Concurrent administration of chloramphenicol succinate and phenobarbital in six patients resulted in reduced peak and trough concentrations of chloramphenicol of 16.6 and 7.5 micrograms/ml, respectively (P less than 0.05). Concurrent administration of chloramphenicol succinate and phenytoin in six patients resulted in an elevated mean peak serum concentration of chloramphenicol of 41.7 micrograms/ml (P less than 0.05). Five other patients treated with phenytoin had indeterminate serum chloramphenicol half-lives with chloramphenicol concentrations of 29 to 90 micrograms/ml. Potentially toxic chloramphenicol concentrations occurred in 9 of 17 controls, 0 of 6 patients who had received phenobarbital (P = 0.001) and 11 of 11 patients who had received phenytoin (P = 0.008). Patients receiving combined chloramphenicol succinate and anticonvulsant therapy require monitoring of serum concentrations of drug and adjustments in the dose of chloramphenicol succinate administered.

Biological Availability↗
PubMedDate not supplied

The effect of penicillin therapy on the symptoms and signs of streptococcal pharyngitis.

The effect of antibiotic therapy on the rate of resolution of signs and symptoms of streptococcal pharyngitis in children has not been previously evaluated in a placebo-controlled study. Patients were randomly assigned to penicillin or placebo therapy and reevaluated after 48 hours, at which time benzathine penicillin G was given to all patients. Rates of improvement in treated (17 patients) or control (18 patients) cases significantly favored treatment with regard to resolution of pharyngeal injection, tender cervical lymph node and total duration of fever. Symptoms of sore throat and the parents' assessment of the well-being of their children also significantly favored treatment. This study confirmed the clinical impression of physicians that specific antibiotic therapy promptly alleviates symptoms in most children with streptococcal pharyngitis.

Child↗
PubMedDate not supplied

Relatively penicillin-resistant pneumococcal infections in pediatric patients.

Two hundred fifty-eight isolates of Streptococcus pneumoniae obtained from 232 infants and children at Children's Medical Center, Dallas, from November 1, 1981, to March 31, 1983, were screened for susceptibility to penicillin. On 1-microgram oxacillin disks 21 strains (8%) had zones of inhibition of 17 mm or less, and the tube-dilution minimal inhibitory concentrations of penicillin were from 0.125 to 0.5 micrograms/ml. These strains were designated as relatively resistant S. pneumoniae (RRSP). Prior therapy with a beta-lactam agent had occurred in 56% of patients with RRSP disease compared with 14% of randomly selected children with infections due to susceptible strains of S. pneumoniae (P = 0.009). Fifteen children (6%) had diseases due to RRSP ranging from sepsis or meningitis to otitis media or conjunctivitis. Four children, including the two patients with meningitis, had unsatisfactory responses to therapy with a beta-lactam antibiotic. Vancomycin or chloramphenicol is preferred for therapy of disease due to RRSP.

Anti-Bacterial Agents↗
PubMedDate not supplied

Detection of teichoic acid antibodies in children with staphylococcal infections.

The presence of serum antibodies to teichoic acid was evaluated by gel diffusion and enzyme-linked immunosorbent assay in 14 patients with deep-seated staphylococcal infection, in 5 patients with superficial staphylococcal infections, in 10 patients with Gram-positive infections other than staphylococcal and in 12 age-matched, uninfected patients. Serum samples were obtained on admission and serially each week during hospitalization. Teichoic acid antibodies were detected by gel diffusion in only 5 of 14 patients with deep-seated staphylococcal infections, in 1 of 10 patients with other Gram-positive infections and in none of the other patients. With the enzyme-linked immunosorbent assay method all patients with deep-seated staphylococcal infections had concentrations of teichoic acid antibodies of 1:1600 or greater, and these titers were significantly larger than those in the other groups of patients. Using a titer of 1:3200 or greater as a diagnostic level in children with deep-seated Staphylococcus aureus infections, the sensitivity was 93% and the specificity was 89%. For all staphylococcal infections the sensitivity was 79% and the specificity was 96%.

Adolescent↗
PubMedDate not supplied

Fever during treatment for bacterial meningitis.

The records of 476 infants and children with bacterial meningitis treated between 1979 and 1982 were reviewed. By the sixth hospital day 90% or more of children with pneumococcal or meningococcal infection compared with 72% of children with Haemophilus infection (P less than 0.001) were afebrile. The rates of prolonged fever for 10 days or more, persistent fever for 5 to 9 days and secondary fever were 13, 13 and 16%, respectively. The conditions associated with prolonged fever for 10 days or more were subdural effusion (27%), drug fever (23%) and concomitant arthritis or pneumonia (20%); 15% were of indeterminable cause. The principal conditions associated with persistent fever for 5 to 9 days were other foci of disease (17%), nosocomial infections (16%) and subdural effusion (14%); in 42% the cause was unknown. The conditions associated with secondary fever were nosocomial infections (27%) and subdural effusion (23%); 39% were of indeterminable cause. Neither the duration nor the patterns of fever correlated with neurologic abnormalities at discharge, including hearing deficit.

Child↗