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Biomedical subjects

M A Mufson

Publications and source records attributed to M A Mufson.

At least 73 records · Page 4Linked to original sources

Clinical aspects and importance of pneumococcal infections.

Annualy in the USA, the estimated occurence of pneumococcal disease exceeds 500 000 cases of pneumonia (50 000 deaths), 1 200 000 cases of otitis media and 5 000 cases of meningitis. The pneumococcus remains the single most important pathogen which can cause pneumonia. When bacteremia accompanied pneumococcal pneumonia (one-fifth of these), the case fatality rate is approximately of 25% and exceeds 50% in individuals over 50 years of age. Most of the deaths (60%) occur within the first five days of illnesses, despite prompt antibiotic treatment of these patients. Emergence of pneumococcal strains with diminished sensitivity for penicillin, or resistant to tetracycline and other antibiotics is also a factor which lend increasing support to the concept that high risk patients should be protected from pneumococcal infection by immunoprophylaxis. A change of capsular types associated with bacteriemic disease has occured, in the USA, during the past three decades. The types 1 and 3 are less common than in the pre-antibiotic era, and the types 4, 8, 12, and 14 have become more prevalent. Infections with type 2, an epidemic type, have occured infrequently in the past 20 years. In the USA, at the present time, nearly four-fifths of bacteremic cases are associated with only 14 of the 84 pneumococcal capsular type ; in descending frequency : 8, 4, 1, 14, 3, 51, 12, 6, 56, 9, 19, 23, 5 and 20 (American system of nomenclature). The predominant capsular types of otitis media are : 1, 3, 6, 7, 14, 18 and 23. The polyvalent pneumococcal polysaccharide vaccine newly developed in the USA, is safe, antigenic and effective. Its widespread use can be expected to reduce the number of deaths attribuable to pneumococcal bacteremia.

Adolescent↗

Infections with viruses and Mycoplasma pneumoniae during exacerbations of chronic bronchitis.

The association of viral and Mycoplasma pneumoniae infections with acute exacerbations of chronic bronchitis was studied by serologic or isolation techniques in 46 adult men during the five years from 1964 through 1968. Serologic evidence of viral or M. pneumoniae infection was detected in 25% of 166 episodes of exacerbation and 14% of 138 remission periods (P = 0.02). Influenza A virus, parainfluenza virus type 3, and coronavirus OC43 predominated; infections with other viruses were infrequent. Infection with M. pneumoniae was detected serologically in four patients, but this organism was never isolated from sputum specimens. Rhinoviruses were isolated from frozen-stored sputum specimens in in 2.7% of the episodes of exacerbation and from 0.55% of the remission intervals (P not significant). These data suggest that although exacerbations of chronic bronchitis may be accompanied by viral and M. pneumoniae infections, patients with chronic bronchitis also acquire such infections without a worsening of their respiratory status.

Adult↗

A review of adenoviruses in the etiology of acute hemorrhagic cystitis.

In a comparison of children with acute hemorrhagic cystitis it was noted that 51 per cent of those in Sendai, Japan and 23 per cent of those in Chicago, Illinois had adenoviruria during their illness. These 2 populations are the only ones in which the disease has been studied and reported. In both populations male outnumbered female patients, with a ratio of 3.4 to 1 in Japanese children and 2.3 to 1 in American children. Adenovirus type 11 was isolated exclusively in both studies, with the exception of 2 American children who had adenovirus type 21 in the urine. While the Japanese children experienced their illnesses for approximately 2 weeks American children had symptoms for only 4 to 5 days. Virus shedding continued throughout the illness in both populations. The adenovirus 11 strains from American children were antigenically similar to the prototype adenovirus type 11 strain as measured by cross hemagglutination-inhibition procedures. Adenovirus antigen was identified by immunofluorescence in exfoliated bladder epithelial cells from patients with acute hemorrhagic cystitis. Studies to date indicate that adenovirus type 11 is the etiologic agent in some but not all pediatric cases of acute hemorrhagic cystitis.

Acute Disease↗

Role of maternal antibody in pneumonia and bronchiolitis due to respiratory syncytial virus.

Fifteen infants with pneumonia caused by respiratory syncytial virus (RSV) and 19 infants with bronchiolitis caused by RSV were studied for the influence of homologous, circulating neutralizing antibody on the severity of their illness. All infants were under nine months of age. Although maternal neutralizing antibody did not prevent infection with RSV and illness, the severity of pneumonia caused by RSV was inversely related to the level of neutralizing antibody. The severity of bronchiolitis caused by RSV was unrelated to maternal antibody levels. Chest roentgenograms showed pneumonia to be slightly more severe than bronchiolitis. Neither the severity of illness nor the presence of maternal neutralizing antibody was related to the development of complement-fixing antibody.

Antibodies↗

The sudden infant death syndrome and epidemic viral disease.

A study was done to investigate the relationship between the sudden infant death syndrome (SIDS) and epidemic respiratory viral disease among hospitalized children under 18 months of age. During the 42 month-period of this study, there were 778 sudden infant deaths in Chicago and 3244 hospital admissions of children under 18 months for respiratory disease. Four outbreaks of respiratory syncytial (RS) virus infections, three outbreaks of influenza A virus infections, and several small clusters of parainfluenza virus infections occurred during the course of this study. Influenza A was the only virus infection found to have a statistically significant association with SIDS. Although environmental temperature was also significantly correlated with SIDS, the association with influenza A virus infection was independent of this temperature effect and neither association was strong.

Black People↗