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Biomedical subjects

J Ruskin

Publications and source records attributed to J Ruskin.

At least 55 records · Page 3Linked to original sources
PubMed1981

Are the "nonpathogenic" Neisseriae pathogenic?

Neisseriae other than N. meningitidis and N. gonorrhoeae are common upper respiratory commensals, but rarely cause disease. A case of N. sicca bacteremia in an immunocompromised patient is reported, and the literature dealing with infections attributed to these usually nonpathogenic organisms is reviewed. These neisseriae have been shown to cause meningitis, endocarditis, sepsis, and some cases of pneumonia, otitis media, and sinusitis; however, their pathogenicity is doubtful in many of the reported cases of urethritis, cervicitis, and upper respiratory infection. They are not uniformly sensitive to the penicillins, so therapy should be guided by the results of antimicrobial susceptibility testing.

Adult↗
PubMed1978

Therapy of gonorrhea. Comparison of trimethoprim-sulfamethoxazole and ampicillin.

Eighty-nine men with gonococcal urethritis were randomly treated with trimethoprim-sulfamethoxazole, four tablets (trimethoprin, 320 mg, and sulfamethoxazole, 1,600 mg) twice daily for two days, or ampicillin, 3.5 g, plus probenecid, 1 g, in a single dose. Forty-one (95.3%) of 43 patients who received trimethoprin-sulfamethosazole and 41 (97.6%) of 42 given ampicillin were cured. Neither drug caused major side effects. All isolates of Neisseria gonorrhoeae were susceptible in vitro to trimethoprim-sulfame-thoxazole, and all but one were inhibited by ampicillin. The ampicillin-resistant strain (minimum inhibitory concentration, 4 micrograms/ml) produced penicillinase and was reovered from a patient who responded to treatment with trimethoprim-sulfamethoxazole. There was no significant correlation between the minimum inhibitory concentrations of trimethoprim-sulfamethoxazole and ampicillin. It is concluded that trimethoprim-sulfamethoxazole is as efficacious and safe as ampicillin in the therapy of gonococcal urethritis.

Ampicillin↗
PubMed1978

Miconazole for treatment of disseminated coccidioidomycosis. Unfavorable experience.

Miconazole at dosages up to 30 mg/kg/day was given intravenously to seven patients with complicated courses of disseminated coccidioidomycosis. Six had received treatment with amphotericin B previously and five of these patients could be evaluated for the efficacy of the treatment. In three patients the condition failed to respond to therapy, another patient required intratracheal administration of amphotericin B later, and the fifth patient had an equivocal response to treatment. Severe phlebitis, pruritus, nausea, vomiting, hyperlipidemia, and thrombocytosis were frequent side effects. These limited unfavorable results indicate that until controlled studies demonstrate its safety and efficacy, therapy with miconazole should be reserved for highly selected patients with disseminated coccidioidomycosis who cannot receive amphotericin B.

Adult↗
PubMed1977

Empyema due to Streptococcus mutans.

Empyema due to Streptococcus mutans occurred following dental manipulation in two patients with periodontal disease. Isolation of this dental pathogen from pleural fluid localized the site of origin of the empyemas to the oropharynx and precluded the need to search for a remote intra-abdominal source of these pleuropulmonary infections. Although there is controversy regarding the susceptibility of S mutans to penicillin, the isolates from our patients were markedly sensitive to the drug, and both patients were cured with penicillin therapy and surgical drainage.

Adult↗
PubMed1976

Toxoplasmosis in the compromised host.

In 81 cases of toxoplasmosis in patients with neoplasia, collagen-vascular disorders, and organ allografts, the clinical manifestations were highly variable but neurologic syndromes consistent with diffuse encephalopathy, meningoencephalitis, or cerebral mass lesions predominated. Many concomitant infections with DNA viruses were seen. The diagnosis of toxoplasmosis was not made until postmortem examination in most cases. Biopsy of lymph nodes or brain and serologic tests needed for definitive diagnosis were done infrequently. Twenty patients received antitoxoplasma chemotherapy (pyrimethamine and sulfonamide), 16 (80%) showing marked clinical improvement or complete remission. In immunosuppressed hosts disseminated toxoplasmosis appears to result from defects in cellular immunity that permit recrudescence of latent infection. Because cell-mediated immunity to Toxoplasma gondii can be enhanced in animals by administration of adjuvants, immunotherapy may become a useful adjunct to chemotherapy in immunoincompetent humans suffering potentially lethal infection.

Animals↗
PubMed1976

Tularemia in a mule deer.

A case of tularemia was confirmed in a 51-year-old man who acquired the disease from a mule deer, Odocoileus hemionus. Francisella tularensis was isolated from bone marrow of the deer carcass.

Animals↗
PubMed1975

Efficacy of 9-beta-D-arabinofuranosylhypoxanthine 5'-monophosphate in therapy of equine abortion virus-induced hepatitis in hamsters.

Equine abortion virus (EAV)-induced hepatitis in hamsters presents an interesting animal model for the evaluation of drugs possessing anti-deoxyribonucleic acid virus activity. These experiments demonstrate that 9-beta-d-arabinofuranosylhypoxanthine 5'-monophosphate (ara-HxMP), a new synthetic, water-soluble, antiviral agent, effectively controls this disease in hamsters with a therapeutic index of approximately 60. Ara-HxMP prevented hepatitis-associated deaths in hamsters, reduced the titer of EAV developing in hamsters, and inhibited the increase of serum glutamic pyruvic transaminase in EAV-infected hamsters.

Alanine Transaminase↗
PubMed1972

Pneumocystis carinii pneumonia. Problems in diagnosis and therapy in 24 cases.

Twenty-four instances of Pneumocystis carinii pneumonia were recognized in 23 patients at the Stanford University Hospitals between 1962 and 1970. The affected persons could be broadly characterized as "compromised" hosts. All but one were receiving immunosuppressive drug therapy for such underlying disease as hematopoietic malignant disease, collagen vascular disorder, and organ transplant rejection. The one patient not receiving immunosuppressant medication had congenital dysgammaglobulinemia and suffered two discrete bouts of pneumocystis pneumonia. Most of the patients were concomitantly infected with other "opportunistic" pathogens. Open lung biopsy remained the most reliable method of antemortem diagnosis of pneumocystis infection during this eight-year period. It resulted in little morbidity. Unfortunately, direct examination of appropriately stained sputum specimens for cysts was almost uniformly nonproductive. The majority of patients received specific antipneumocystis drug treatment (pentamidine isethionate or pyrimethamine and sulfadiazine). "Cure" was achieved when institution of therapy was prompt and duration of therapy approached the empirically recommended two-week course. The fact that pneumocystis pneumonia can be controlled if recognized early is compelling reason to pursue diagnosis of pneumocystosis in an appropriate clinical setting, namely, in patients with impaired host defenses who have pulmonary infection unresponsive to conventional therapy. There is hope that a noninvasive (serological) technique will be developed shortly to simplify identification of this not uncommon cause of diffuse interstitial pneumonitis.

Adolescent↗
PubMed1970

Pressure-flow studies in man: effect of atrial systole on left ventricular function.

In order to evaluate the effects of atrial contraction on left ventricular function, the pressure gradient technique was used to measure instantaneous aortic blood flow and pressure in nine patients, six having complete heart block and three having normal sinus rhythm. From these data both left ventricular stroke volume and stroke work were calculated. Ventricular rate was controlled by transvenous right ventricular pacing over a range of 50-158 beats/min. At each heart rate, beats which were not preceded by a P wave served as controls. The other beats were divided into six groups according to the duration of the preceding PR interval. The results indicated that stroke volume and stroke work were always affected similarly. In one patient the presence of a P wave did not alter the subsequent stroke volume significantly. In the other patients, beats preceded by P waves had stroke volumes greater than the controls. In general, there was no difference in stroke volume for beats preceded by a P wave having a PR interval within the range of 0.05-0.20 sec. As the PR interval lengthened beyond 0.20 sec stroke volume tended to decrease, especially at more rapid heart rates. The absolute increase in stroke volume after a beat preceded by a P wave (PR interval 0.05-0.20 sec) was quite variable among the patients. For a given patient the absolute increase in stroke volume was essentially independent of heart rate. The percentage change in stroke volume, however, was always greater as the heart rate increased. These data indicate that in most patients atrial systole is important in augmenting ventricular stroke volume and stroke work especially at high heart rates, but the magnitude of these effects are quite variable among patients.

Adult↗