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Biomedical subjects

L D Frenkel

Publications and source records attributed to L D Frenkel.

At least 19 recordsLinked to original sources
PubMed1991

Rapid culture confirmation of herpes simplex virus by a monoclonal antibody-based enzyme immunoassay.

Rapid confirmation of herpes simplex virus (HSV) is essential in many clinical settings. Viral isolation in cell culture is the standard method for diagnosing HSV infection, with confirmation by specific immunological staining. The performance of the Rapid Absorbent Matrix Pad (RAMP) HSV culture confirmation test was evaluated with specimens obtained from 71 patients with suspected HSV infection and inoculated into African green monkey kidney cell lines. Forty-one culture-positive specimens were confirmed to be HSV by both the RAMP HSV test and the Bartels HSV immunoperoxidase test. Thirty immunoperoxidase-negative specimens were also negative in the RAMP HSV test. The sensitivity and specificity of the RAMP HSV test were 100%. Twelve specimens positive for cytomegalovirus, adenovirus, or enterovirus tested negative by the RAMP HSV test. Thus, the RAMP HSV test was faster than, easier to perform than, as sensitive as, and as specific as other well-documented confirmation methods.

Antibodies, Monoclonal↗
PubMed1990

Routine immunizations for American children in the 1990s.

It has been suggested that one of the major advances in medicine, and for society at large, has been the development of vaccines and the adoption of routine immunization by the vast majority of responsible health care practitioners in the developed nations. Thankfully, there continue to be rapid advances in our ability to diagnose and treat infectious diseases. However, with these rapid advances come necessary changes in the dogma of medical practice, including changes in the routine immunization procedures recommended by various authoritative bodies in the United States. New immunizing agents will be developed and will achieve routine use. Unexpected adverse reactions and complications of our immunization reagents must constantly be sought and described. Previously unrecognized subgroups of hosts at special susceptibility to adverse and untoward vaccine effects will be recognized; the pathogenesis of their special susceptibility needs to be understood and then will have to be appropriately addressed. Individual health care practitioners will need to keep abreast of routine immunization recommendations and the application of these recommendations in an organized and thorough fashion to infants, children, adolescents, and adults. A crucial link in the chain of optimal preventive health care will continue to involve those who prescribe, order, and administer vaccines.

Child↗
PubMed1989

Can parents do a throat culture?

Throat swabs for Group A beta-hemolytic Streptococcus were obtained from 98 patients, ages 4 to 17 years, both by their parents and by physician investigators. Compared with results obtained by physicians, there was a false negative rate of 32% (P less than 0.001) for the parents. The discrepancy was greater in the youngest age group (38% false negative rate in the 4- to 8-year-olds) compared with older children (P less than 0.001). The overall sensitivity and negative predictive value for the parent-obtained swabs were 68 and 45%, respectively. In the 4- to 8-year-old group, these values were 62 and 37%, respectively. Because there were no false positives the positive predictive value was 100%. We conclude that the false negative rate for untrained parents obtaining throat swabs is too high to warrant the implementation of home testing for Group A streptococci.

Adolescent↗
PubMed1988

Once-daily administration of ceftriaxone for the treatment of selected serious bacterial infections in children.

Ceftriaxone treatment (50 to 80 mg/kg once daily) was given to 201 children between 1 month and 18 years of age. There were 201 serious bacterial infections, including epiglottitis, pneumonia, cellulitis, osteomyelitis, septic arthritis, pyelonephritis, sepsis, and meningitis. The common pathogens responsible for pediatric infections isolated from these patients included Haemophilus influenzae, Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae, and Escherichia coli. The overall clinic cure rate was 94%. Ten patients were clinically improved but not cured. There were two clinical failures. Bacteriologic failure occurred in six patients. The overall bacteriologic cure rate was 97%. Twenty patients (10%) experienced adverse effects; none required discontinuation of therapy. The efficacy, safety, spectrum, and convenience of ceftriaxone monotherapy make this antimicrobial agent a candidate for the treatment of choice of selected serious pediatric infections.

Adolescent↗
PubMed1987

Evaluation of routine lumbar punctures in newborn infants with respiratory distress syndrome.

Infants with respiratory distress syndrome are routinely evaluated for infection which commonly includes a lumbar puncture. In this study cerebrospinal fluid (CSF) examination failed to elicit evidence for meningitis in 238 consecutively admitted infants with respiratory distress syndrome evaluated during the first 24 hours of life. Blood cultures were obtained in all; suprapubic or catheterized urine was obtained in 163 infants; CSF was collected successfully in 203 infants. Seventeen infants demonstrated positive blood cultures: 7 Streptococcus, 5 Staphylococcus, 3 Haemophilus influenzae, 1 Bacillus subtilis and 1 diphtheroid infection. CSF obtained from 14 of those infants had normal examinations and sterile cultures. Factors associated with bacteremia were birth weight (P less than 0.01), gestational age (P less than 0.01), prolonged rupture of membranes (P less than 0.05) and leukopenia below 10 000/mm3 (P less than 0.05). In view of the negative CSF examinations in infants with positive blood cultures and the potential complications of lumbar puncture (hypoxia, trauma, infection, epidermoid tumor), the potential risks of CSF evaluation may exceed the assessed benefit for the infant with respiratory distress syndrome.

Humans↗
PubMed1985

Avian antigen.

Explore the source record for details and available documents.

Adult↗
PubMed1977

Characteristic early electroencephalographic changes in herpes simplex encephalitis.

We review electroencephalograms taken from 17 patients with severe meningoencephalitis within seven days of onset of CNS symptoms and prior to cortical brain biopsies. All patients had CNS disease clinically compatible with the diagnosis of herpes simplex encephalitis (HSE). The diagnosis was demonstrated by the isolation of virus from the brain in five patients (group 1) but considered highly unlikely in the other 12 patients (group 2) by negative immunofluorescent studies and failure of viral isolation from the brain tissue. Abnormal but nonspecific EEGs with diffuse or focal slowing were found in all patients. Distinctive high-voltage, 1-cycle-per-2-to-3 seconds periodic sharp waves from unilateral temporal lobes were seen only in three of the five patients with virologically proved HSE but in none of the 12 patients without viral isolation. This EEG pattern is strikingly similar in all three patients, regardless of their age, and may be specific for the early diagnosis of HSE prior to brain biopsy. The EEGs of the other two patients with proved HSE did not contain such abnormalities. Athough periodic EEGs with some resemblance to those previously described may occur in other CNS disorders, their presence strongly suggests the diagnosis of HSE when recorded from patients with viral meningoencephalitis. Moreover, EEGs may help locate the best site for cerebral biopsy since maximal yield of the virus in this study was from unilateral temperoal lobes corresponding with the site of local EEG changes.

Adolescent↗
PubMed1977

Specific impairment of cell-mediated immunity in mothers of infants with congenital infection due to cytomegalovirus.

Specific lymphocyte-mediated cytotoxicity to cytomegalovirus (CMV) in eight infants (six to 27 months old) with congenital CMV infection and in the mothers of six of these infants was evaluated with use of a 51chromium (51Cr)-release microassay. The control population consisted of 25 normal newborns, children, and adults. The titers of indirect hemagglutinating (IHA) antibody to CMV in the infected infants ranged from 1:16 to 1:1,024. All of these infants had detectable specific immune release of 51Cr that ranged from 3.3% to 48.9% (mean +/-SE, 21.0%+/-5.6%). The mothers of these infants demonstrated significantly elevated titers of IHA antibody to CMV (geometric mean titer, 1:410) as compared with a mean titer of 1:22 in controls (t = 5.71; P less than 0.001) but showed significantly depressed specific immune release (9.2% +/- 3.2%) compared with that of normal seropositive controls (24.8% +/- 2.8%; t = 3.31; P less than 0.001). In addition, two adult nulliparous women with persistent CMV viruria were also found to have depressed specific immune release to CMV (10.8% and 16.2%). These data suggest that a specific impairment in cell-mediated immunity to CMV occurs in mothers of infants with congenital CMV infection and in some persons who persistently excrete CMV.

Adult↗
PubMed1975

Ascorbic acid for the common cold. A prophylactic and therapeutic trial.

Three hundred eleven employees of the National Institutes of Health volunteered to take 1 gm of ascorbic acid or lactose placebo in capsules three times a day for nine months. At the onset of a cold, the volunteers were given an additional 3 gm daily of either a placebo or ascorbic acid. One hundred ninety volunteers completed the study. Dropouts were defined as those who missed at least one month of drug ingestion. They represented 44% of the placebo group and 34% of those taking ascorbic acid. Analysis of these data showed that ascorbic acid had at best only a minor influence on the duration and severity of colds, and that the effects demonstrated might be explained equally well by a break in the double blind.

Adult↗
PubMed1975

Antiviral chemotherapy and neonatal herpes simplex virus infecition: a pilot study--experience with adenine arabinoside (ARA-A).

Among 13 neonates with herpes simplex virus (HSV) infection, eight had disseminated disease, one localized CNS disease, and in four the infection was confined to the skin and eyes. Ara-A, a purine nucleoside with anti-viral activity against DNA-VIRUSES, WAS GIVEN (10 TO 20 MG/MG/DAY) BY A CONTINUOUS 12-HOUR INTRAVENOUS DRIP FOR 10 TO 15 DAYS. In all, ara-A administration was begun within three to eight days after the appearance of skin vesicles which represented the hallmark of the disease. Both diagnosis and ara-A treatment were much delayed in one infant without skin vesicles and four infants whose skin vesicles appeared late, long after the occurrence of CNS damage. In this group of infants with disseminated disease, four died and one infant was left with severe neurological deficits. Eight infants (four with disseminated and four with localized skin disease) with skin vesicles as the earliest sign of infection received ara-A early, within three days after the onset of neurologic signs. All survived with no neurologic deficit at 6 months to 1 year of age. There was no apparent toxicity of ara-A to the bonemarrow, liver, or kidney.

Adolescent↗