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Biomedical subjects

J Portnoy

Publications and source records attributed to J Portnoy.

At least 55 records · Page 3Linked to original sources

Continuous terbutaline nebulization for the treatment of severe exacerbations of asthma in children.

Twelve children with severe asthma were treated in an intensive care unit with continuously nebulized terbutaline at doses between 1.0 and 12.0 mg/hour. All patients showed improvement in blood gases, pulse, and respiratory rates. None experience significant side effects. The duration of therapy ranged from 1 to 24 hours (mean = 8.3 hours), and all were able to leave the intensive care unit within one day. The use of continuously nebulized terbutaline appears to be safe and effective for the treatment of severe asthma in children in this limited experience.

Administration, Inhalation↗

Clinical course of recurrent genital herpes and treatment with foscarnet cream: results of a Canadian multicenter trial.

Clinic-initiated topical treatment of recurrent genital herpes with foscarnet cream (concentration, 0.3% in men and 1% in women) was compared with a placebo in a Canadian multicenter trial involving 309 patients. Culture-positive episodes of herpes took significantly longer to heal than did the others. Lesions in men were larger and lasted longer but were less symptomatic than those in women. Foscarnet did not statistically improve the times to healing or the loss of symptoms overall but did result in a higher proportion of symptom-free individuals after one day of treatment. Foscarnet-treated patients had a reduced duration of shedding of virus, and this was significant for men. These clinical benefits do not, however, warrant general use of this agent for established lesions. Earlier, prodromal treatment might have been more effective, but patient-initiated studies include a greater proportion of culture-negative (shorter) episodes that often make results difficult to interpret.

Administration, Topical↗

Specific stimulation of lymphocytes from patients with AIDS by herpes simplex virus antigens.

Peripheral blood lymphocytes of patients with AIDS are generally anergic to stimulation by lectins or by alloantigens. We have succeeded in demonstrating that the lymphocytes of six AIDS patients, with histories of herpes simplex virus (HSV)-induced genital, anal and/or oral lesions, retained functional specificity with regard to HSV antigens. This was accomplished by treating patient lymphocytes with OKT8 monoclonal antibodies, in the presence of complement, to yield a cell population that was partially responsive to phytohaemagglutinin (PHA). Enhanced proliferation was obtained in the presence of exogenous interleukin-2, which was also employed to foster the growth of these cells over several generations. Lymphocytes derived from these AIDS patients, and maintained in vitro as described, were specifically stimulated in proliferation assays by a HSV antigen preparation in six of the ten cases studied.

Acquired Immunodeficiency Syndrome↗

Epicoccum allergy: skin reaction patterns and spore/mycelium disparities recognized by IgG and IgE ELISA inhibition.

Comparable degrees of skin reactivity were observed towards spore and mycelium extracts from two isolates of Epicoccum and to one preparation of Alternaria in 35 rural and 120 university patients. The best experimental extracts detected Epicoccum sensitivity in 70% of the group tested while the commercial extract detected sensitivity in only 6%. Skin reaction correlations were greatest within isolates (eg, spore-A/mycelium-A), then for specific fungus parts (eg, spore-A/spore-B), then between isolates and parts (spore-A/mycelium-B). High correlations were found between individual IgG and IgE ELISA values for all antigens using serum from Epicoccum skin-reactive patients. ELISA inhibition results suggested that significant cross-reactivity exists between Epicoccum and Alternaria antigens recognized by IgG but not by IgE. ELISA inhibition cross-reaction patterns among Epicoccum antigens were comparable to skin reactions while IgG patterns showed little variability. Further characterization of spore/mycelium and interstrain recognition patterns among different immunoglobulin isotypes will be necessary before complete standardization of extracts from different parts of fungi will be possible. The use of spore material for skin testing and treatment of Epicoccum sensitivity appears to be both premature and unnecessary at this time.

Enzyme-Linked Immunosorbent Assay↗

Prophylactic antibiotics in elective colorectal surgery.

In an effort to determine whether or not the addition of parenteral antibiotics to orally administered erythromycin and neomycin would diminish postoperative septic complications in elective colorectal operations, a randomized, double-blind, controlled trial was conducted comparing three groups. All patients received vigorous preoperative mechanical bowel preparation, 3 g erythromycin and 3 g neomycin orally, the day prior to operation. Patients in Group O received three doses of saline intravenously as placebo, patients in Group C received cefazolin, 1 g, immediately preoperatively and 1 g every 6 hours postoperatively, intravenously, for two doses, and patients in Group T received a single immediate preoperative dose of 6 g of ticarcillin intravenously and two saline placebo doses intravenously, postoperatively. The patients' progress was followed in the hospital and for one month postoperatively. Septic complications occurred in 35 per cent of patients in Group O, 7 per cent of patients in Group C, and 5 per cent of patients in Group T. Wound infections comprised most of these complications, occurring in 29 per cent of Group O, 4.7 per cent of Group C, and 2.3 per cent of Group T patients. Thus, the addition of either parenteral cefazolin or ticarcillin in this study significantly reduced wound infections in elective colorectal surgery.

Aged↗

A search for congenital rubella in psychiatric day treatment, language and learning centres.

A search for previously undiagnosed congenital rubella (CR) was made on 672 children who had attended psychiatric day treatment, learning, and speech and language centres. This was done by observing the seroresponse of seronegative children to rubella vaccine, since 90% of patients with known CR who are seronegative fail to seroconvert to the vaccine. Of the 225 seronegative children 23 did not seroconvert after a single vaccination. Five of these failed to respond on revaccination. These five children had a high frequency of severe language and learning disability as well as frequent diagnoses of major CNS disorders. It is likely that a far greater number of children in the population studied had CR, since our methods identify only about 20% of those affected. Clinically, a specific diagnosis of CR is helpful in facilitating genetic counselling and in allowing the clinician to offer a more hopeful prognosis.

Adolescent↗

Superoxol(catalase)test for identification of Neisseria gonorrhoeae.

The Superoxol (Merck & Co., Inc., Rahway, N.J.) test (catalase test using 30% H2O2) was used to differentiate Neisseria gonorrhoeae from other Neisseria species. A positive test was defined as immediate, brisk bubbling upon dropping 30% H2O2 onto a bacterial colony. One hundred percent of the gonococci were Superoxol positive. Only 1% of Superoxol-positive isolates on Thayer-Martin agar were organisms other than gonococci (99% specificity). The test was more reliable than the coagglutination test. Individual strains of a wide variety of Neisseria and Branhamella species were Superoxol positive. They could usually be differentiated from N. gonorrhoeae by their poor growth on selective media, colonial morphology on nonselective media, and simple biochemical tests. The Superoxol test is an excellent screening test for N. gonorrhoeae. A positive result on a clinical isolate growing on Thayer-Martin agar is strongly suggestive of the presence of gonococci.

Catalase↗