Post-varicella streptococcal pyomyositis.
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Abscess↗
Biomedical subjects
M C Fisher
Publications and source records attributed to M C Fisher.
Potentiation of IL-1-induced BALB/3T3 fibroblast proliferation by neuropeptides.
The interactions between IL-1 and several neuropeptides associated with pain and inflammation were examined in the context of fibroblast proliferation as a paradigm for the synovial hyperplasia associated with chronic rheumatoid arthritis. The BALB/3T3 fibroblast cell line, which proliferates in response to increasing doses of IL-1, demonstrated enhanced proliferation after a 72-h culture period when various neuropeptides were included with IL-1 in serum-free medium. Thus, bradykinin, at concentrations between 10(-8) and 10(-5) M, moderately promoted [3H]TdR incorporation in vitro in the BALB/3T3 cells, and substance P at approximately 3 x 10(-9) to 3 x 10(-7) M demonstrated minor proliferative activity. However, when the cells were cultured with IL-1 plus substance P or IL-1 plus BK, the ensuing proliferative responses, as measured by [3H]TdR incorporation, were consistently magnified greater than or equal to twofold above the anticipated additive response caused by IL-1 in combination with either of those neuropeptides. Combinations of IL-1 and SP, or IL-1 and BK, also provoked increases in cell numbers that did not occur when the mediators were tested individually. In other experiments, we tested neurokinin-A, Neurokinin-B, histamine, and serotonin. These results are discussed with respect to neurogenic contributions to the immunopathology of IL-1-mediated inflammation.
Adjuvants, Immunologic↗
Potentiation of Balb/3T3 fibroblast proliferative response by interleukin-1 and epidermal growth factor.
Balb/3T3 fibroblasts respond to interleukin-1 (IL-1) by proliferating in a dose-dependent fashion. Increasing proliferative responses were observed with increasing IL-1 concentration in serum-free medium when the medium was supplemented with insulin, transferrin, and selenium. This response was evident only if the cell culture medium also contained the cyclooxygenase inhibitor indomethacin. When another fibroblast mitogen, epidermal growth factor (EGF) was cocultured with either purified monocyte-derived IL-1 beta or recombinant IL-1 beta, there was a potentiation of proliferation above the expected additive response. Unexpectedly, the response to recombinant IL-1 alpha was only additive with EGF. This suggests that IL-1-mediated activation of synovial fibroblasts in rheumatoid arthritis may be compounded by EGF as well as by other fibroblast mitogens secreted by cells found in the joint. The results further suggest that IL-1 and EGF interactions may play a significant role in wound healing, scarring, and bone resorption. In addition, these results imply that there may be different cellular activation pathways brought to bear in vivo which may depend, in part, on the IL-1 isotype available.
Animals↗
Atypical radionuclide scan appearance in cellulitis due to group A streptococcus.
The scintigraphic manifestations of cellulitis consist of a diffuse increase in activity in the affected soft tissues without a focal increase in activity in the bone. The radionuclide images in two children with Group A streptococcal cellulitis were atypical, as no increased activity was noted in the soft tissues. The false-negative radionuclide images in these children is attributed to the marked amount of edema present at the sites of infection.
Bone and Bones↗
Potentiation of IL-1-induced BALB/3T3 fibroblast proliferation by substance P.
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Animals↗
Effect of tolmetin glycine amide (McN-4366), a prodrug of tolmetin sodium, on adjuvant arthritis in the rat.
The glycine amide of tolmetin sodium (TGA) functions as a prodrug and was demonstrated to be more potent than the parent compound as an inhibitor of developing and established adjuvant arthritis in the female Lewis rat. In contrast, the glycine amide of indomethacin was less potent than indomethacin. The superiority of TGA relative to tolmetin sodium in alleviating this condition was demonstrated by inhibition of paw swelling and reduction of the degenerative bone changes that are associated with the progression of this chronic animal model of rheumatoid arthritis in humans. These properties were not evident when equimolar mixtures of tolmetin sodium and glycine were administered concurrently. Pharmacokinetic analyses revealed that TGA was absorbed completely and hydrolyzed to tolmetin in the female adjuvant arthritic rat. The combined effects of absorption, distribution and hydrolysis of TGA produced lower peak plasma tolmetin levels than an equivalent dose of tolmetin sodium, but plasma concentrations were sustained for a longer period of time contributing to an apparent increase in potency. Furthermore, TGA displayed a decreased propensity to cause gastrointestinal irritation compared to tolmetin sodium. Several additional amino acid amides of tolmetin were similar to the glycine amide in exhibiting increased potency and reduced gastrointestinal toxicity in comparison to equivalent doses of tolmetin sodium.
Animals↗
Conjunctivitis in children.
Conjunctivitis is a common, usually mild, self-limited problem. Pathogens vary at different ages. Conjunctivitis occurs alone or as a manifestation of a systemic infection or a systemic disease. Diagnosis can usually be established by the combination of clinical and laboratory findings. Topical, systemic or combination therapy is used, depending on the agent and extent of infection.
Bacterial Infections↗
Transfusion-associated acquired immunodeficiency syndrome--what is the risk?
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Acquired Immunodeficiency Syndrome↗
Pseudomonas cepacia in the hospital setting: lack of transmission between cystic fibrosis patients.
Possible mechanisms of transmission of Pseudomonas cepacia in hospitalized patients with cystic fibrosis were examined. Twelve patients were colonized with P. cepacia prior to admission (group 1), and 15 patients were not (group 2). Daily contact occurred between both groups. Sputum cultures were obtained from all patients at admission and discharge, and 3 and 6 months after discharge in group 2 patients. Environmental cultures included cough plates, settle plates, spirometry tubing, stethoscopes, sinks, wall outlets, and hands of patients, physicians, nurses, and respiratory therapists. Specimens were plated on a P. cepacia-selective medium. All group 1 patients remained colonized with P. cepacia at discharge. None of the group 2 patients acquired P. cepacia during hospitalization or follow-up. P. cepacia was recovered from three of 151 environmental cultures; two of these were presumably patient related. P. cepacia contamination of pulmonary function equipment, wall outlets, hands, and stethoscopes was not documented. We conclude that transient aerosol environmental contamination is uncommon and restricted to the immediate patient environment.
Adolescent↗
Idiopathic pulmonary fibrosis. Another cause of ventilation/perfusion mismatch.
A case of idiopathic pulmonary fibrosis, presenting as a single segmental perfusion defect without a corresponding ventilatory abnormality in a patient suspected of having a pulmonary embolus is reported. This has not been reported previously in the literature.
Diagnosis, Differential↗
Nosocomial pulmonary infections in children.
Nosocomial infections prolong hospitalization and increase morbidity, mortality, and costs. Unfortunately only 50% of hospital-acquired infections are preventable. Factors that increase the risk for infection include use of monitoring devices, performance of invasive diagnostic and therapeutic procedures, prolonged duration of hospitalization, and impairment of host defense. Diagnosing nosocomial pulmonary infections is challenging. Radiographic studies must be combined with other diagnostic techniques to confirm diagnoses. Aggressive pursuit of a definitive diagnosis is important in evaluation of the compromised host. Specific therapy is preferred over empiric therapy. Outcome is related to the infecting agent and the patient's underlying condition. Preventive measures include hand-washing, isolation of infected patients, and careful attention to aseptic technique when inserting and manipulating catheters. In general, antibiotic therapy will not prevent infection but will alter the patient's flora and increase the likelihood of infection by resistant pathogens.
Child↗
Sneakers as a source of Pseudomonas aeruginosa in children with osteomyelitis following puncture wounds.
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Adolescent↗
Nutrition evaluation of published weight-reducing diets.
The objective of this study was to determine the nutritional adequacy of some of the popular published diet plans. Diet analyses were made using the University of Massachusetts Nutrient Data Bank. Not one of the 11 diets evaluated provided 100% of the U.S. Recommended Daily Allowances for the 13 vitamins and minerals studied. The nutrients most often below recommended levels were thiamin, vitamin B-6, vitamin B-12, calcium, iron, zinc, and magnesium. Vitamin and mineral supplementation may be warranted for individuals following some diet plans.
Chemical Phenomena↗
Importance of culture in laboratory diagnosis of Bordetella pertussis infections.
Nasopharyngeal secretions from 223 patients were examined for the presence of Bordetella pertussis and B. parapertussis by culturing on Regan-Lowe agar (J. Regan and F. Lowe, J. Clin. Microbiol. 6:303-309, 1977) and by direct fluorescent-antibody testing. B. pertussis was found in 38 patients; B. parapertussis was recovered from 2. Culturing was more sensitive (38 of 38 patients) than direct fluorescent-antibody testing (26 of 38 patients) for the detection of B. pertussis. Overgrowth by other organisms (7 of 223 patients) was uncommon. The patients with B. pertussis infections were generally less than 1 year old, had received no or one immunization, and had coughing spells but infrequently had whooping cough. Accurate diagnosis of B. pertussis infections should include culturing.
Adolescent↗
Clostridium difficile cytotoxin in a pediatric population.
Assays for cytotoxin of Clostridium difficile were performed on stool samples submitted to the laboratory for routine microbiologic study. Cytotoxin was recovered from 8.6% of 208 pediatric patients studied. Cytotoxin was identified significantly more often in younger patients (median age, 11 months) and in those with hospital-associated illness (17%) and antibiotic-associated illness (18%). Hospitalization and antibiotic use were significant independent risk factors. Clinical diagnoses in patients with C difficile cytotoxin included classic pseudomembranous colitis, acute self-resolving diarrheal syndrome, chronic diarrhea with failure to thrive, infant botulism, and asymptomatic carriage.
Adolescent↗
Pseudomonas maltophilia bacteremia in children undergoing open heart surgery.
Pseudomonas maltophilia was isolated from intraoperative blood cultures in eight of 13 children undergoing open heart surgery during a five-week period. Antibiograms were identical and included resistance to prophylactic antibiotics. The source of the outbreak was traced to contamination of both the calibration device used on the pressure monitoring system and the sensor surface of transducers used in this system. In a mock system, calibration with a contaminated device resulted in recovery of the organism from transducer dome fluid. Dye studies confirmed the integrity of the transducer membrane but demonstrated reflux of dome fluid into the monitoring line fluid. A case-control study revealed no patient- or surgery-related factors predisposing to P maltophilia bacteremia and no excess of morbidity or mortality in patients as a result of bacteremia. The outbreak was confined to patients undergoing open heart surgery and was terminated abruptly by sterilization of transducers and revision of the calibration device.
Cardiac Surgical Procedures↗
Bacteremia due to Bacteroides fragilis after elective appendectomy in renal transplant recipients.
Bacteremia caused by Bacteroides fragilis occurred in four of 75 children after renal transplantation, and B. fragilis was the most common cause of postoperative bacteremia. Bacteroides bacteremia was significantly associated with performance of elective appendectomy at the time of transplantation (P less than 0.01) and with profound lymphocytopenia (P = 0.01). No patient received antibiotics at the time of surgery or prior to the first positive blood culture, yet B. fragilis was the single organism isolated from blood and abscesses in these patients. A role for lymphocytes in containment of B. fragilis has not been suggested previously, although unexplained occurrence of bacteroides bacteremia in immunocompromised patients has occasionally been reported. Lymphocytes themselves may be important in this host-bacterium interaction, or lymphocytopenia may be the marker for a more generalized deficiency in host defenses.
Adolescent↗
Absence of significant effects by levamisole on circulating neutrophil levels in normal mice treated with 5-FU.
When B6C3F1 mice were given a single intravenous (i.v.) injection of 150 mg/kg 5-fluorouracil (5-FU) their levels of circulating neutrophils plummeted, reaching a nadir at 6 to 7 days postdosing and then gradually increasing to normal and above-normal levels. Neutropenia (actual neutrophil count (ANC) below 100 ANC/microliters) extended until 8.7 +/- 0.2 days after 5-FU injection. When these mice were also given levamisole (2.5 mg/kg, po) on days 0-2 the mean time to ANC recovery greater than 100/microliters was 7.7 +/- 0.3 days, (p < 0.05 vs. controls), while IL-1 (2 micrograms/day, ip) positive controls yielded a mean time to > 100 ANC of 6.5 +/- 0.2 days. Although levamisole-treated mice attained normal neutrophil levels one day faster than controls did and this more rapid recovery led to their neutrophil levels being between 2- and 3-fold greater, these differences were not statistically significant. Effects were only manifested on neutrophil recoveries. There were no differences between levamisole-treated mice and controls when recovery rates for platelets, monocytes or lymphocytes were examined. These results demonstrate that levamisole has, at best, only weak myelopoietic properties against 5-FU-induced myelotoxicity in mice.
Animals↗