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Biomedical subjects

J L Carpenter

Publications and source records attributed to J L Carpenter.

At least 91 records · Page 5Linked to original sources
PubMed1984

Endobronchial tuberculosis simulating lung cancer.

Endobronchial tuberculosis, while relatively common before the advent of effective antituberculosis chemotherapy, is seldom recognized now. Four patients with what appeared to be primary tuberculosis complicated by endobronchial spread were recently seen by us. Three of the four patients presented with anterior segment upper lobe disease with partial segmental collapse. Clinically and roentgenographically, all four patients were felt to have primary bronchogenic carcinoma. Definitive diagnosis was established via the fiberoptic bronchoscope. The declining incidence of tuberculosis in the United States has altered the clinical and roentgenographic presentation. The diagnosis of tuberculosis should be considered even when the clinical features are atypical.

Adult↗
PubMed1983

Anticoagulation in prosthetic valve endocarditis.

We reviewed the experience with infective endocarditis at some major US Army Medical Centers. One hundred patients were studied, comparing 82 patients who had native valve endocarditis (NVE) with 18 patients who had prosthetic valve endocarditis (PVE). Among patients with PVE, four had porcine valves and 14 had synthetic. None of the patients with NVE had received anticoagulants; 14 of 18 patients with PVE had received anticoagulants. The major causes of death were central nervous system hemorrhage, congestive heart failure, uncontrolled infection, and embolic phenomena. The principal cause of death in patients with PVE was CNS hemorrhage. Of the patients with PVE, 36% had symptomatic cerebral hemorrhage while receiving anticoagulants and 80% of them died.

Anti-Bacterial Agents↗
PubMed1983

Antituberculosis drug resistance in south Texas.

The incidence of antituberculosis drug resistance in South Texas has been tabulated. Age, sex, and ethnic group were not found to significantly influence the incidence of resistance. The incidence of resistance to isoniazid (NH) was 16.4%, ethambutol, 3.9%, rifampin, 10.6%, and streptomycin, 7.8%. There was a 7.3% rate of resistance to INH and/or ethambutol or rifampin for any individual organism (i.e., to 2 of the 3 most commonly used antituberculosis drugs). We conclude that the incidence of single and multiple antituberculosis drug resistance in South Texas is higher than previously reported.

Adolescent↗
PubMed1982

Thymoma in 11 cats.

Eleven thymomas, 10 benign and 1 malignant, were diagnosed in cats at the Angell Memorial Animal Hospital. Six cats were dyspneic, owing either to the pressure of the tumor or the associated effusion. The effusion in 1 instance contained chyle, and in another, malignant epithelial cells associated with satellite lesions. Three cats had polymyositis, as evidenced clinically by muscle weakness and confirmed by microscopic examination. Two of these also had myocarditis and difficulty in swallowing. In 1 cat, the primary disorder was an atypical, progressive, moist dermatitis that was unresponsive to treatment and that became so severely generalized that the cat had to be destroyed. The thymoma was discovered only at necropsy.U

Animals↗
PubMed1982

Peritoneal dialysis complicated by Aspergillus flavus peritonitis: a role for fungal antigen serodiagnosis.

A patient is described with aspergillus peritonitis associated with peritoneal dialysis. Although the diagnosis was established by exploratory laparotomy, aspergillus antigenemia was detected retrospectively in sera obtained 15 days prior to the surgical procedure. An approach to the evaluation of a patient with culture negative peritonitis and the potential clinical usefulness of the detection of fungal antigen in serum and peritoneal fluid of patients undergoing peritoneal dialysis is discussed.

Antigens, Fungal↗
PubMed1982

Aspergillus terreus, a pathogen capable of causing infective endocarditis, Pulmonary mycetoma, and allergic bronchopulmonary aspergillosis.

Aspergillus terreus is a rarely reported pathogen in humans, Recovery of this organism from the sputum may therefore be discounted as representing contamination this report describes 3 patients--1 with allergic bronchopulmonary aspergillosis (ABPA), 1 with aspergilloma, and 1 with infective endocarditis-- in whom A. terreus was proved to be the etiologic organism. Together, these 3 cases span the spectrum of disease usually associated with A. fumigatus. Detection of serum precipitins against Aspergillus is essential to a diagnosis of both ABPA and aspergilloma. In our 2 patients with these syndromes, serum precipitins were specific for A. terreus ane did not cross-react with A. fumigatus or mixed Aspergillus antigens. This finding suggests that screening of serum for precipitins were specific for A. terreus and did not cross-react with A. fumigatus or mixed Aspergillus antigens. This finding suggests that screening of serum for precipitins should be carried out with A. terreus antigen in patients suspected of harboring this organism.

Adolescent↗
PubMed1982

Drug-resistant Mycobacterium tuberculosis in Korean isolates.

Tuberculosis is a common disease in developing countries. An increasing incidence of resistance to isoniazid (INH) and streptomycin in organisms isolated from patients who contracted their disease in these countries, particularly in the Far East, is well recognized. This drug resistance has led to the recommendation of empirically beginning a regimen in patients with tuberculosis from the Far East of INH, ethambutol, and rifampin. This report documents the increasing incidence of resistance in isolates from Korea to ethambutol and rifampin in addition to INH and streptomycin. It suggests that the empiric use of INH, ethambutol, and rifampin in this group of patients could potentially lead to resistance to all of these drugs because of a significant amount of multidrug resistance. A regimen of INH, rifampin, pyrazinamide, and capreomycin is suggested as appropriate initial therapy in these patients based on the in vitro sensitivity data presented and initial clinical experience.

Adult↗
PubMed1982

Frequency of clinical isolation and winter prevalence of different Aspergillus species at a large southwestern army medical center.

The frequent occurrence of aspergillosis caused by species other than Aspergillus fumigatus at Brooke Army Medical Center prompted the authors to study the prevalence of the different Aspergillus species at Brooke Army Medical Center and at two other hospitals in San Antonio, Texas. Two parameters were analyzed: (1) frequency of isolation from clinical specimens over a five-year period and (2) relative prevalence in the atmosphere during the late fall and early winter using volumetric air-sampling. A fumigatus was infrequently recovered from clinical specimens and was one of the least prevalent species of Aspergillus in the air. A. terreus, a rare species in prevalence studies performed elsewhere, was frequently recovered from patients; it was the second most prevalent organism in the air after A. niger. Climatic conditions in the authors' area probably favor the growth of A. terreus over A. fumigatus. Since A. terreus has been shown to be a potential pathogen, an increased frequency of disease caused by this organism may be expected in this environment.

Air Microbiology↗
PubMed1980

Intestinal and cardiopulmonary forms of parvovirus infection in a litter of pups.

Parvovirus infection caused signs of gastrointestinal illness in all pups in a litter of 12 and death in 6 of them when 12 to 19 days old. The remaining pups recovered from the gastrointestinal infection, but 5 of the 6 died before they were 9 1/2 weeks old, with signs of cardiopulmonary disease. Necropsy findings were cardiomegaly, myocarditis, pulmonary congestion, and interstitial pneumonia. The only surviving pup also had signs of cardiopulmonary disease but was apparently well at 18 months of age.

Animals↗
PubMed1980

Hyperthyroidism in the cat: ten cases.

In ten neutered crossbred cats 10 to 14 years old and of both sexes, hyperthyroidism was evidenced by hyperactivity, weight loss despite increased appetite, frequent defecation with bulky stools, thirst, polyuria, moderately elevated temperature, increased heart rate and size, sometimes with murmurs and arrhythmias, and palpable enlargement of one or both thyroid lobes. The diagnosis of hyperthyroidism was confirmed on the basis of high serum concentrations of thyroxine (T4) and triiodothyronine (T3). In seven cats (6 treated by total thyroidectomy, 1 studied at necropsy), both thyroid lobes were variably enlarged, mottled, cystic, or nodular; in three cats, only one lobe required removal. Adenomatous goiter was diagnosed microscopically in all. In two, there also were foci of adenocarcinoma and in two others, foci suggestive of adenocarcinoma. Three of the nine cats having surgery were treated preoperatively to stabilize cardiac function. Most cats recovered from surgery rapidly and without complications but although every effort was made to spare at least one parathyroid gland in cats having bilateral thyroidectomies, two cats had transient signs of hypoparathyroidism, requiring careful monitoring of serum electrolytes and treatment with calcium and vitamin D2. All having bilateral thyroidectomies were subsequently maintained on treatment with l-thyroxine or, in one case, liothyronine (triiodothyronine).

Animals↗
PubMed1980

Polycystic disease of the kidney and liver in the Cairn Terrier.

Three related puppies with abdominal distention caused by nephromegaly and hepatomegaly had gross and histologic lesions in the kidney and liver similar to polycystic disease of children. Both kidneys were enlarged and reniform, and contained multiple fusiform or cylindrical cysts lined by cuboidal epithelium radiating through the cortex and medulla. Various amounts of connective tissue surrounded the cysts. The glomeruli and renal pelvis were normal. Histologically, the liver was diffusely subdivided by fibrous connective tissue extending from one portal triad to another. Within the connective tissue, there was proliferation of biliary epithelium, giving the gross appearance of multiple cysts within normal hepatic parenchyma.

Animals↗
PubMed1979

Trombiculosis in a cat.

Trombiculosis (dermatitis caused by trombiculid mites) in a Domestic Shorthair cat was characterized by diffuse thickening and crusting of the skin of the abdomen and limbs and by multiple papules on the face, ears, and sides of the trunk. Skin biopsy revealed acanthosis and hyperkeratosis involving the epidermis and hair follicles, mites in epidermal tunnels, and edema of the dermis, with infiltration of eosinophils and mast cells. Mites from skin scrapings were identified as Walchia americana. The cat was treated systemically with a broad-spectrum antibiotic and topically with a carbaryl and pyrethrin powder preparation. The lesions were resolved within 2 months.

Animals↗
PubMed1979

Failure of routine methods in the diagnosis of chronic brucellosis.

A young man who was raised on a farm and developed recurrent subcutaneous abscesses is described. Multiple cultures revealed either no growth or normal skin flora. Routine serologic evaluation for Brucella agglutinins was negative, including serial dilution to greater than 1:1,000 of the patient's sera. Brucella abortus infection was documented by the use of a binding antibody assay to measure the patient's class-specific serologic response and obtaining a positive culture by incorporating methicillin into the culture media to suppress overgrowth of staphylococci. Thus, the potential difficulty in making the diagnosis of brucellosis is demonstrated, and the use of extraordinary means, namely, specific selective media and a binding antibody assay, to make the diagnosis is emphasized.

Adult↗
PubMed1979

Transurethral passage of Aspergillus fungus balls in acute myelocytic leukemia.

A patient with acute myelocytic leukemia who had a chronic febrile illness during the induction of remission of leukemia developed asymptomatic discrete pulmonary infiltrates which rapidly evolved into cavities containing homogeneous opacities. Over the next five weeks, the cavities resolved without specific treatment. The patient subsequently passed large fungus balls in the urine, and the diagnosis of disseminated aspergillosis was made. A course of intravenous amphotericin B therapy was completed without complications. This case demonstrates the importance of culturing urine specifically for fungal organisms in the immunosuppressed host.

Aspergillosis↗