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Biomedical subjects

M L Clements

Publications and source records attributed to M L Clements.

117 records · Page 7Linked to original sources
PubMed1981

Comparison of simple sugar/salt versus glucose/electrolyte oral rehydration solutions in infant diarrhoea.

In a randomized double-blind trial, infants with mild or moderate diarrhoeal dehydration were rehydrated orally either with a simple solution containing table sugar and salt (without potassium or bicarbonate) or with a complete glucose/electrolyte formula. All 32 given glucose/electrolyte solution and 27 (93%) of 29 infants given sugar/salt were successfully rehydrated with similar improvement in metabolic acidosis and rapidity of rehydration. The drawbacks to oral therapy with simple sugar/salt solution were the frequent development of hypokalaemia and greater volume of vomiting during treatment. Carefully prepared sugar/salt solution, if accompanied by adequate potassium supplementation, may be used as an alternative to the preferred glucose/electrolyte formula when the latter is unavailable.

Acidosis↗
PubMed1981

In vitro production of anti-influenza virus antibody after intranasal inoculation with cold-adapted influenza virus.

We have studied the production of anti-influenza virus antibody in vitro by peripheral blood mononuclear cells (PBMC) obtained from 7 normal volunteers at various times after intranasal inoculation with cold-adapted A/Alaska/6/77 [H3N2] influenza virus. Antibody released into culture supernatants was assayed by a 2-step enzyme-linked immunosorbent assay (ELISA). Cells obtained 6 days after intranasal inoculation spontaneously released both IgG and IgA anti-influenza antibody; this antibody production occurred within 24 hr, was specific for the virus used to inoculate the volunteers, and was inhibitable by cycloheximide. When day 6 cells were cultured in vitro for 12 days with the polyclonal activator pokeweed mitogen (PWM), no increase in the amount of antibody above that released in the absence of PWM was seen. In contrast, cells obtained 27 days after inoculation made no spontaneous antibody. In addition, cultures of these day 27 cells with PWM resulted in the production of large amounts of IgG antibody but relatively little IgA anti-virus antibody. Thus, after a mucosal influenza virus infection, several subpopulations of functionally different cells sequentially appear in the peripheral circulation: an initial population of cells secreting IgG and IgA antibody spontaneously, followed by a 2nd population of cells secreting IgG antibody when stimulated with PWM.

Administration, Intranasal↗
PubMed1981

Proliferation of enteropathogens in oral rehydration solutions prepared with river water from Honduras and Surinam.

Oral rehydration of infants with diarrhoea is an effective therapy that is becoming increasingly available in developing countries. To formulate judicious recommendations for preparation and storage of such solutions, we assessed the capability of recognized bacterial enteropathogens to survive and proliferate in solutions made either with sterile distilled or river water collected in two developing countries. Shigella flexneri, an enteropathogen typically transmitted by faecal/oral contact rather than by water or food, survived very poorly. In contrast, Vibrio cholerae and enterotoxigenic Escherichia coli, pathogens classically associated with transmission by food and water, reached concentrations of 103-104 per ml by 12 h and 104-106 by 24 h after inoculation of solutions made with river water and somewhat lower concentrations in distilled water. This potential exposure to bacteria must be considered in the context of the field situation where children are already ingesting high levels of bacteria in drinking water and food and where the oral rehydration solution would probably add little to their exposure. Although it is probably wise to prepare solutions fresh each day with water as free from faecal pollution as possible, in situations where lack of fuel to boil water or scarce supply of glucose/electrolyte packets preclude compliance with these recommendations prompt administration of oral rehydration solutions to infants with diarrhoea should nevertheless proceed.

Administration, Oral↗
PubMedDate not supplied

Prospects for development of a rotavirus vaccine against rotavirus diarrhea in infants and young children.

Major advances have been made in elucidating the etiologic agents of severe infantile diarrhea, and it is clear that rotaviruses are the single most important etiologic agents. Progress in the development of rotavirus vaccine candidates has also moved swiftly with the "Jennerian" approach, in which a related live, attenuated rotavirus strain from a nonhuman host is used as the immunizing antigen. If this strategy is not effective against all rotavirus serotypes, reassortant rotaviruses hold great promise for the development of a multivalent vaccine. Field trials with the "Jennerian" approach vaccines are under way, and phase 1 trials with the reassortants have been initiated.

Animals↗
PubMedDate not supplied

Treatment of experimentally induced enterotoxigenic Escherichia coli diarrhea with trimethoprim, trimethoprim-sulfamethoxazole, or placebo.

In a double-blind study of the treatment of disease caused by enterotoxigenic Escherichia coli (ETEC), diarrhea was induced in volunteers with a trimethoprim (TMP)- and sulfamethoxazole (SMZ)-susceptible strain of E. coli that produces both heat-stable and heat-labile toxin. III volunteers were then treated with TMP, TMP-SMZ, or placebo. Volunteers treated with both TMP alone and the TMP-SMZ combination showed a substantial decrease in the duration and severity of the illness, as compared with the placebo-treated controls. TMP-resistant (MIC, 3.1-12.5 micrograms/ml) ETEC were isolated from stool cultures of five of 10 TMP-treated volunteers and none of 10 TMP-SMZ-treated volunteers after 48 hr of therapy, and in two volunteers the appearance of resistant organisms was associated with a clinical relapse. These data suggest that the TMP-SMZ combination should be evaluated in field trials to determine its usefulness as an adjunct to replacement of fluid and electrolytes in the therapy of ETEC diarrhea.

Adult↗