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Biomedical subjects

K Shannon

Publications and source records attributed to K Shannon.

118 records · Page 7Linked to original sources
PubMed1977

Antibacterial activity of netilmicin, a new aminoglycoside antibiotic, compared with that of gentamicin.

The antibacterial activity of netilmicin (Sch 20569), a new semisynthetic aminoglycoside, was compared with that of gentamicin against a variety of gram-negative bacteria, staphylococci, and streptococci. Both antibiotics had similar activity against most organisms, but netilmicin had appreciably greater activity against gram-negative organisms that were resistant to gentamicin because these species synthesized aminoglycoside 3-N-acetyltransferase I or aminoglycoside 2''-O-nucleotidyltransferase. Netilmicin was also more active than gentamicin against gentamicin-resistant strains of Staphylococcus aureus that produced two enzymes-aminoglycoside-2''-O-phosphotransferase and aminoglycoside-6'-N-acetyltransferase.

Anti-Bacterial Agents↗
PubMedDate not supplied

Non-neonatal infection due to Listeria monocytogenes.

In the period from 1969 through 1983, four cases of non-neonatal Listeria monocytogenes meningitis were encountered in Dallas, representing an incidence rate of 0.3%. Three cases occurring in immunocompetent patients are the subject of this report. A review of the literature since 1945 produced 87 cases of Listeria infections in patients who were from 2 months to 20 years of age. Of these, 54% occurred in immunocompetent persons. The case-fatality rate was 15% in the immunocompetent patients, compared with 42% in immunocompromised patients and with 35% in patients with other underlying illnesses. The diagnosis of listeriosis causes concern about the possibility of an underlying occult malignancy or disorder of T cell function, but on the basis of our review these underlying abnormalities are usually clinically apparent at the time of infection. A rational approach to the child with Listeria infection, who is not known to be a compromised host, would be to examine the history and patient carefully to consider documenting normal numbers of T lymphocytes and assessing delayed hypersensitivity by skin testing.

Adolescent↗
PubMedDate not supplied

Congenital leukemia: successful treatment of a newborn with t(5;11)(q31;q23).

A male neonate presented with a high white cell count, an 11q23 translocation, and M5b leukemia. He was treated at 3 days of age with intensive combination chemotherapy after progressing despite exchange transfusions. The patient achieved complete remission at 28 days of age. Therapy was completed at the age of 6 months. At the time of this report, the patient is 17 months old and remains in remission. Twenty-nine patients with congenital acute myeloid leukemia were also reviewed. Twenty of these patients received varying therapies. Ten of the treated patients achieved complete remission; two died of toxicity; and eight died of progressive disease. Two patients had a translocation affecting 11q23. Congenital leukemia is a rare and usually fatal condition in patients without Down syndrome. The patient reported here shows that survival may be achieved with very intensive chemotherapy plus supportive care, despite extremely high white blood cell counts and unfavorable translocation.

Adult↗
PubMedDate not supplied

Porcine xenografts in Parkinson's disease and Huntington's disease patients: preliminary results.

The observation that fetal neurons are able to survive and function when transplanted into the adult brain fostered the development of cellular therapy as a promising approach to achieve neuronal replacement for treatment of diseases of the adult central nervous system. This approach has been demonstrated to be efficacious in patients with Parkinson's disease after transplantation of human fetal neurons. The use of human fetal tissue is limited by ethical, infectious, regulatory, and practical concerns. Other mammalian fetal neural tissue could serve as an alternative cell source. Pigs are a reasonable source of fetal neuronal tissue because of their brain size, large litters, and the extensive experience in rearing them in captivity under controlled conditions. In Phase I studies porcine fetal neural cells grafted unilaterally into Parkinson's disease (PD) and Huntington's disease (HD) patients are being evaluated for safety and efficacy. Clinical improvement of 19% has been observed in the Unified Parkinson's Disease Rating Scale "off" state scores in 10 PD patients assessed 12 months after unilateral striatal transplantation of 12 million fetal porcine ventral mesencephalic (VM) cells. Several patients have improved more than 30%. In a single autopsied PD patient some porcine fetal VM cells were observed to survive 7 months after transplantation. Twelve HD patients have shown a favorable safety profile and no change in total functional capacity score 1 year after unilateral striatal placement of up to 24 million fetal porcine striatal cells. Xenotransplantation of fetal porcine neurons is a promising approach to delivery of healthy neurons to the CNS. The major challenges to the successful use of xenogeneic fetal neuronal cells in neurodegenerative diseases appear to be minimizing immune-mediated rejection, management of the risk of xenotic (cross-species) infections, and the accurate assessment of clinical outcome of diseases that are slowly progressive.

Adult↗
PubMedDate not supplied

PACE (Program of All-Inclusive Care for the Elderly): innovative care for the frail elderly. Comprehensive services enable most participants to remain at home.

PACE--the Program of All Inclusive Care for the Elderly--provides integrated comprehensive healthcare services to the frail elderly on a capitated basis. Begun in the early 1970s in San Francisco's Chinatown, PACE today comprises many individual programs across the nation. PACE's goal is to provide participants with the healthcare services they need for the highest possible level of functioning and autonomy. A typical PACE program is divided into sites, each of which serves 120 to 150 participants. Most participants come several times a week to the site's adult day care center, where they see members of an interdisciplinary team that includes physicians, nurses, social workers, therapists, and others. Home care is provided to participants unable to attend the center. PACE is financed by capitated payments from Medicare and Medicaid, which put providers at full risk for the services used by participants. The flexibility provided by this funding enables PACE to offer a wide variety of services, including supportive housing, which help keep participants out of institutions. Estimates of Medicare savings attributed to PACE are 12 percent and higher.

Activities of Daily Living↗
PubMedDate not supplied

Lymphocyte subpopulations in Kawasaki disease.

The relative percentages of subpopulations of peripheral T lymphocytes in children with Kawasaki Disease (KD) was investigated using matched antibodies directed against the T3, T4 and T8 antigens. The percentage of B cells was determined with antibodies against human surface immunoglobulins. Subjects were six children with acute KD who were compared to normal, age matched controls. The percentage of peripheral lymphocytes positive for OKT3 was 61% for KD children and 64% for controls; for OKT4 they were 41% and 44% respectively and for OKT8 both were 19%. The B cell percentages were 13% in KD and 11% in controls. Thus no abnormalities in the distribution of lymphocyte subtypes in children with KD was found. Previous studies of immune function in KD are reviewed.

Acute Disease↗
PubMedDate not supplied

The accuracy of patient encounter logbooks used by family medicine clerkship students.

BACKGROUND: Family medicine predoctoral programs frequently have medical students record patient diagnoses in logbooks. Little is known about the accuracy of such logbooks. No studies have compared patient records dictated by students with cases recorded in logbooks. METHODS: Over 2 years, all patient encounters dictated by 79 medical students during their 8-week family medicine rotations were recorded and compared with information in the students' logbooks. RESULTS: Students dictated 2,520 patient encounters but only recorded 2,085 (82.7%) of them in their logbooks. Still, this rate of inclusion is higher than other studies where students did not dictate patient encounters. On the average, each student saw and dictated 32 patient encounters but omitted five to six from their logs. There were no significant differences between the 10 honors and 69 non-honors students in the proportion of patients omitted from logbooks. CONCLUSIONS: Medical students underreport patient encounters in clerkship logbooks. Keeping a record of the patients dictated by medical students was helpful in determining the accuracy of students' logbooks.

Clinical Clerkship↗