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Biomedical subjects

M A Menegus

Publications and source records attributed to M A Menegus.

At least 55 records · Page 3Linked to original sources
PubMed1987

Free light chains in multiple sclerosis and infections of the CNS.

The intrathecal humoral immune response was analyzed in 83 patients with MS and 35 patients with acute CNS infections. CSF free kappa chains and CSF free lambda chains were quantified by radioimmunoassay; CSF IgG and albumin were measured by electroimmunodiffusion. The MS patients were characterized by higher levels of free kappa chains; free kappa:free lambda chain ratio; free kappa chain:albumin ratio; and IgG:albumin ratio. There were no differences in the level of free lambda chains or absolute concentration of IgG. A significant correlation was observed between free kappa chains and total IgG in MS and between free lambda chains and total IgG in infections, suggesting that the immune response was predominantly IgG-kappa in MS and IgG-lambda in infections.

Adolescent↗
PubMed1987

Percutaneous central venous catheter colonization with Malassezia furfur: incidence and clinical significance.

Malassezia furfur colonization of central venous catheters has been implicated in the pathogenesis of systemic infections with this lipid-dependent yeast. To determine the incidence of catheter colonization in our neonatal intensive care unit (NICU), 25 consecutively removed percutaneous central venous catheters were examined by rinsing the lumen with saline and plating the rinse fluid on Sabouraud dextrose agar overlaid with olive oil. M furfur grew from the lumina of eight catheters (32%). Surveillance skin cultures were performed in the NICU on two occasions to determine the prevalence of skin colonization with M furfur. M furfur was found on the skin of 64% of the infants. In contrast, only 3% (1/33) of healthy, nonhospitalized infants 2 to 8 weeks of age had skin colonized with M furfur. During the 5-month study period, two NICU infants had evidence of systemic infection with M furfur. We conclude that M furfur frequently colonizes both the skin and percutaneous central venous catheters in NICU infants. Further studies are needed to determine the relationship between skin colonization and catheter colonization, and the factors contributing to systemic disease with this organism.

Age Factors↗
PubMed1986

A combination of four cell types for rapid detection of enteroviruses in clinical specimens.

Isolation in cell culture is currently the most sensitive and reliable way to demonstrate enterovirus (EV) in clinical specimens. During July-October 1982 and 1983, we studied the impact of adding two new cell lines, Buffalo green monkey kidney (BGM) and human rhabdomyosarcoma (RD), to the more traditional cell combination used for EV isolation, human embryonic lung (HEL) and primary cynomolgus monkey kidney (CMK) cells; 2,558 specimens were studied: 632 fecal, 677 respiratory, 537 CSF, and 712 blood. An EV was isolated from 417 (16%); of these, 77 (18%) were positive only in BGM or RD; 35% (146/417) of the specimens were positive in BGM, RD, or both, at least one day earlier than in the traditional cells. BGM cells were helpful in isolation of group B coxsackieviruses (CB): 99% of 121 positive specimens were detected in BGM vs 73% in CMK and 23% in HEL; 72% of the CB isolates were detected by day 2 in BGM vs 48% in CMK and 0% in HEL. RD cells were helpful in the isolation of echoviruses: 59% of the 189 positive specimens were detected in RD vs 67% in HEL and 58% in CMK. RD was the only positive cell type in 28/189 (15%) positive specimens; 31% of the echovirus isolates were detected by day 2 in RD, vs 20% in HEL and 19% in CMK. Using the cell types described, we provided the clinician with results in 42% of the EV-positive specimens by day 2 after inoculation and in 61% by day 4.

Animals↗
PubMed1985

Detection of conserved and nonconserved epitopes on Coxsackievirus B4: frequency of antigenic change.

A sensitive microneutralization assay was used to detect antigenic variants of Coxsackievirus B4. Analysis of 47 clinical isolates with 16 monoclonal neutralizing antibodies revealed highly conserved, moderately conserved, and poorly conserved epitopes. Upon passage of Coxsackievirus B4 in tissue culture, certain epitopes disappeared and others appeared in the apparent absence of selective pressure. Changes in epitopes often exceeded a frequency of 10(-2). Despite considerable variation in individual epitopes, the overall antigenic composition of Coxsackievirus B4, as measured by the capacity of hyperimmune serum to neutralize clinical isolates, remains fairly constant.

Antibodies, Monoclonal↗
PubMed1985

Serological diagnosis of influenza A/USSR/77 H1N1 infection: value of ELISA compared to other antibody techniques.

Serologic diagnosis of influenza is an important but imperfect tool. During an outbreak of natural H1N1 A/USSR/77 infection, volunteers who received either amantadine, rimantadine, or placebo were tested to determine serologic response to infection by four different antibody techniques. Hemagglutination inhibition (HAI) and complement fixation (CF) were least sensitive, detecting only about half of the virus-positive subjects, whereas neutralization detected 81% and enzyme-linked immune peroxidase (ELISA) detected 95%. Failure to detect significant antibody response was associated with a higher titer of antibody in acute serum specimens and with a history of receipt of A/New Jersey/76 Hsw1N1 vaccine. Although antibody response measured by ELISA was of lower magnitude in vaccinees, it still was sufficient to be diagnostic. Thus, in situations where there is no access to viral isolation facilities, ELISA antibody techniques appear to be an excellent measure of assessing the rate of influenza infection.

Adolescent↗
PubMed1985

Identification of infants unlikely to have serious bacterial infection although hospitalized for suspected sepsis.

During a 2-year period, 233 infants younger than 3 months were prospectively studied to determine whether physical examination, white blood cell and band count, and urinalysis could identify infants unlikely to have serious bacterial infections. Only previously healthy infants (born at term, no perinatal complications, no previous or underlying diseases, no previous antibiotic therapy) were studied. One hundred forty-four (62%) of the 233 infants were considered unlikely to have serious bacterial infections, because they did not have physical findings consistent with ear, soft tissue, or skeletal infection, had between 5000 and 15,000 white blood cells/mm3, had less than 1500 bands/mm3, and urinalysis yielded normal findings. Eighty-nine (38%) infants did not meet one or more of these criteria and were classified as being at high risk for serious bacterial infection. Only one (0.7%) of the 144 infants in the low-risk group had a serious infection, compared with 22 (25%) of the 89 infants in the high risk group (P less than 0.0001). None of the infants in the low-risk group had bacteremia, compared with nine (10%) of the 89 infants in the high-risk group (P less than 0.0005). Neither traditional risk factors, such as age, sex, and temperature, nor other signs, symptoms, or laboratory findings were adequate predictors of serious bacterial infection. We conclude that previously healthy infants younger than 3 months with an acute illness are unlikely to have serious bacterial infection if they have no findings consistent with ear, soft tissue, or skeletal infections and have normal white blood cell and band form counts and normal urine findings.

Age Factors↗
PubMed1985

Viremia in hospitalized children with enterovirus infections.

In a prospective study during the summer and fall of 1982, enterovirus was isolated from 48 hospitalized children; in 29 (60%) enterovirus was isolated from CSF or blood, and in 19 (40%) only a presumptive diagnosis was established. Blood was positive in 21 (44%) and was the only positive specimen in two children. A presumptive diagnosis was provided within 4 days of admission in 38 (80%) and within 48 hours in 19 (40%) of the children from whom enterovirus was isolated. Viremia was most often detected in febrile infants younger than 3 months of age with a clinical picture simulating bacterial sepsis. The presence of viremia was inversely related to the presence of CSF pleocytosis and to virus isolation from CSF. The diagnosis of diseases caused by enterovirus is more accurate when blood culture is added to CSF stool and throat cultures.

Adolescent↗
PubMed1985

Atypical bacterial infections explained by a concomitant virus infection.

Because both viral and bacterial infections are common during early childhood, dual infections are not unexpected. However, the clinical manifestation of such combined infections may be, difficult to interpret, and they are often misdiagnosed as "atypical bacterial infection." Five patients with concomitant viral-bacterial infections are described. In all five cases, virus detection enabled the physicians to better understand an otherwise puzzling clinical presentation. In view of the recent progress in rapid viral diagnoses and the potential of antiviral drugs, the possibility of dual infection should be investigated more often.

Bacterial Infections↗
PubMed1984

An outbreak of herpes simplex virus type I gingivostomatitis in a dental hygiene practice.

An outbreak of herpes simplex virus (HSV) type I gingivostomatitis occurred in a dental hygiene practice in November 1981. An epidemiologic investigation disclosed that 20 of 46 patients seen by the dental hygienist during a four-day period had this illness, whereas none of 26 patients seen by the dentist alone became ill. One day after the outbreak, the hygienist was found to have a herpetic whitlow. Identical endonuclease restriction enzyme type I HSV was isolated from the left index finger of the hygienist and from nine of 16 patients. The nine patients with positive cultures all had at least a fourfold increase in complement fixing antibody titer. A similar significant increase in titer indicated another seven cases.

Adolescent↗
PubMed1984

The isolation of enteroviruses from blood: a comparison of four processing methods.

Blood from 28 children hospitalized with symptomatic enterovirus infections was processed by four different methods in an effort to define optimum conditions for detecting viremia. Enteroviremia was demonstrated in 11/28 children. Virus was isolated by method 1 (serum) in 7/11 children and by method 2 (mononuclear leukocytes) in 9/11, but in only 3/10 and 3/11 children by methods 3 and 4 (granulocytes and plasma-mixed leukocytes, respectively). In four children, the only blood isolate was from mononuclear leukocytes, and in two, serum was the only positive blood preparation. This suggests that viremia can be often detected in hospitalized children with enterovirus disease and shows that the methods used for processing blood may significantly influence the isolation rate.

Adolescent↗
PubMed1984

The isolation of nonpolio enteroviruses from serum.

Enteroviruses were isolated from 14 of 31 frozen serum specimens obtained from hospitalized patients with enterovirus infection, which had been previously documented by recovery of virus from stool, throat, or cerebrospinal fluid (CSF). Virus was detected in 71% of the positive sera within 3 days of specimen inoculation and serum virus titers ranged from 1.0 X 10(1) to 9.2 X 10(3) plaque-forming units/ml. The data suggest that blood cultures may be useful in the diagnosis of acute enterovirus disease and that use of RD and BGM cells may improve the speed and rate of virus recovery.

Adolescent↗
PubMed1984

Epidemiology of neonatal enterovirus infection.

During a typical enterovirus season in Rochester, New York, none of 666 neonates or 629 mothers were found to be excreting nonpolio enteroviruses within 1 day of delivery. No enteroviruses were isolated from weekly cultures of the 23 infants who died or remained hospitalized during the first month of life. After discharge, culture specimens were obtained in 586 infants at one to four weekly home visits until 1 month of age. The incidence of acquisition of nonpolio enterovirus infection was 12.8%, and the overall prevalence of enterovirus excretion was 5.3%. Risk of virus infection was associated only with lower socioeconomic status (P less than 0.0001) and lack of breast-feeding (P less than 0.0001). Four percent of all infants and 21% of infants in whom cultures for enterovirus were positive were readmitted to the hospital in the first month of life; 79% of infants with positive enterovirus cultures were asymptomatic. We conclude that enterovirus infection during the first month of life is very common in the late summer and early fall. Most infants are asymptomatic, but the risk of hospitalization is high. Breast-feeding may be associated with protection from infection.

Adolescent↗
PubMed1984

Rapid detection of herpes simplex virus in clinical specimens with human embryonic lung fibroblast and primary rabbit kidney cell cultures.

The performance of a culture system for isolation of herpes simplex virus, consisting of one tube each of human embryonic lung fibroblasts and primary rabbit kidney cells, was evaluated. Cultures were incubated at 37 degrees C on a roller drum and observed daily for characteristic cytopathic effect for 5 days. During 1982, a positive isolation rate of 28.1% was seen among 3,154 specimens submitted. Cultures from genital sources were positive more frequently from males (43.8%) than from females (25.5%). Oral lesion cultures were positive as often from males (34.6%) as from females (38.4%). Although detection of herpes simplex virus occurred significantly earlier in rabbit kidney cells on days 1 and 2 of incubation, by day 3 the number of positive cultures was nearly the same in both cell types. By day 4 of incubation, 99.5% of the positive cultures were detected. These results demonstrate that cell culture can be a rapid and sensitive method for detecting herpes simplex virus.

Animals↗
PubMed1983

Practical protocol for cytomegalovirus isolation: use of MRC-5 cell monolayers incubated for 2 weeks.

Isolation of cytomegalovirus (CMV) in tissue culture is presently the most reliable means of proving active CMV infection. To improve both the cost-effectiveness and clinical usefulness of procedures for the isolation of CMV from fresh clinical specimens, we analyzed results obtained with standard isolation procedures and compared them with results obtained under different conditions. Cell monolayers from commercial sources were inoculated with fresh specimens and then were observed for a cytopathic effect typical of CMV. Of 1,375 specimens submitted over a 12-month period, 6.4% were CMV positive in WI-38 monolayers within 28 days after inoculation. The mean day of CMV detection for 45 urine, 13 cervical-vaginal, and 5 saliva specimens was 6.7 +/- 3.1 (mean +/- standard deviation), 9.9 +/- 3.3, and 7.7 +/- 3.3 days, respectively, and 92% were positive within 14 days. When 1,058 subsequent specimens were inoculated in parallel onto WI-38 and MRC-5 cell monolayers, 8.7% were positive for CMV. MRC-5 cells were significantly more sensitive than WI-38 cells: 98% of all positive specimens appropriate for comparison were detected in MRC-5 cultures, but only 85% were detected in WI-38 cells. Although 1 specimen was positive in WI-38 cells only, 38% of all isolates were positive earlier (16 specimens) or only (10 specimens) in MRC-5 cultures. Based on these data, we have developed a practical 2-week protocol for CMV isolation from fresh clinical specimens that includes the use of MRC-5 cell monolayers incubated at 36 degrees C.

Cytomegalovirus↗
PubMed1983

Effect of incubation temperature on isolation of cytomegalovirus from fresh clinical specimens.

The sensitivity of WI-38 cell monolayers for the isolation of cytomegalovirus from fresh clinical specimens was reduced by 41% when cultures were incubated at 33 rather than at 36 degrees C. The mean time to initial detection of cytomegalovirus cytopathic effects in cultures incubated at 33 degrees C was 4.3 days later than in cultures incubated at 36 degrees C (4.0 and 5.4 days later for saliva and urine cultures, respectively). Thus, incubation of cultures at 33 degrees C seriously compromises the efficiency with which cytomegalovirus can be isolated from clinical specimens.

Bacteriological Techniques↗
PubMed1983

Febrile neonates.

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Enterovirus Infections↗
PubMed1982

The clinical relevance of 'CSF viral culture'. A two-year experience with aseptic meningitis in Rochester, NY.

The clinical relevance of CSF viral cultures was evaluated by reviewing the records of 390 patients whose CSF was cultured for virus during a two-year period. The diagnoses at hospital discharge were aseptic meningitis, meningoencephalitis, or both in 111 patients, and enterovirus was isolated from the CSF or other test specimens in 46 patients (41%). The diagnosis or management of nearly one half of the patients from whom enterovirus was isolated was directly influenced by this information. Hospitalization and the unnecessary use of antibiotics were shortened by at least 70 days. Enterovirus was the only virus isolated from the CSF during the study period. The CSF was more likely positive for an enterovirus if it was drawn from a young patient with aseptic meningitis during the summer of fall months. The clinical data obtained from this study are discussed and compared with national statistics.

Adolescent↗