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Biomedical subjects

M Nelson

Publications and source records attributed to M Nelson.

At least 451 records · Page 25Linked to original sources

Spectinomycin versus tetracycline for the treatment of gonorrhea.

Spectinomycin and tetracycline are alternative drugs to penicillin in the treatment of gonorrhea. To compare the efficacy of these agents and their propensity to select resistant gonococci, we treated 4043 patients randomly with either 2 or 4 g of spectinomycin once or 9 g of oral tetracycline for four days. Minimum cure rate for anogenital gonorrhea was 94 per cent with either drug. Oropharyngeal infection responded poorly to spectinomycin in men, with failure of therapy in six of 11. Postgonococcal urethritis in men was less common after tetracycline than after spectinomycin (P less than 0.005). Spectinomycin failure was not related to drug resistance. Tetracycline failure correlated with resistance (P less than 0.0002); one fifth of the isolates resistant to 1.0 mug per milliter of tetracycline were not eradicated. For several reasons, including the appearance of beta-lactamase-producing gonococci, it is no longer clear that penicillin G is the "drug of choice" for gonorrhea. Spectinomycin and tetracycline are equally acceptable alternatives, each with distinct advantages and disadvantages.

Administration, Oral↗

Evaluation of a serologic test for gonorrhea in a low-risk female population.

This is a report of an evaluation of a new serologic test for gonorrhea--the Gonosticon Dri-Dot Test--as compared to the standard Thayer-Martin culturing technics in a low-risk female population. The Gonosticon Dri-Dot Test detected only 50% of the gonorrhea cases discovered by the conventional culture method. Furthermore, the serologic technic accounted for 17% false-positives, indicating that a reactive Gonosticon test is not necessarily consistent with active gonococcal infection. The efficacy of the Thayer-Martin culture plate diagnostic procedure for uncomplicated gonorrhea in women was reaffirmed by this study.

Cervix Uteri↗

Abnormal cervical cytology in the teen-ager: a continuing problem.

Abnormal cervical cytology is being discovered in an alarming number of sexually active teen-agers. Over an 18 month period, cytology consistent with mild dysplasia or worse was noted in 188 of 2,655 teen-agers screened. This represents a rate of 70.8 per thousand. Colposcopically directed biopsies in 65 patients revealed 15 cases of severe dysplasia-carcinoma in situ. Cryosurgery was the principle method of treatment and, combined with colposcopy, is a safe and effective means of managing these patients.

Adolescent↗

Culture sites in the diagnosis of gonorrhea in women.

To test for the presence of Neisseria gonorrhoeae infection, culture speciments were taken from the endocervical, urethral, and rectal sites in 556 women seen at the Alameda County Venereal Disease Clinic, Oakland, California, U.S.A. There was no significant difference between the number of new cases found with the rectal speciments alone (nine out of a total of 154 cases diagnosed) and those revealed by the urethral site alone (seven). It is suggested, however, that the urethral specimen has importance, since it does yield cases not otherwise identified. The possibility of culturing endocervical, rectal, and urethral specimens from a given patient together on a single Thyayer-Martin plate is discussed. Such a method would afford increased possibilities of isolating N. gonorrhoeae at a markedly reduced cost. It is recommended that studies be undertaken in this connection.

Cervix Uteri↗

Air-rinsing after dialysis. A mode of transmission of hepatitis virus.

During a recent outbreak of hepatitis B among patients receiving dialysis, georgraphic and temporal distribution of cases in the absence of exposure to blood products suggested patient-to-patient transmission. The patients who contracted hepatitis used Kiil dialyzers with a single-pass dialysate system, while patients who used hollow-fiber dialyzers appeared to be protected. Blood was returned to patients after Kiil dialysis by the air-rinse technique with the use of a nonsterile plastic tube attached to a manometer bulb. Laboratory experiments demonstrated that Staphylococcus aureus and poliovirus became widely distributed throughout the Kiil dialyzer when introduced during the rinse phase by contaminating the air-rinse tubing.

Air Microbiology↗

Comparison of trimethoprim-sulfamethoxazole with penicillin and tetracycline in the treatment of uncomplicated gonorrhea in women.

In a collaborative prospective study 327 women with uncomplicated gonococcal cervicitis or proctitis were randomly assigned to one of four treatment groups: (1) aqueous procaine penicillin G, 4.8 million units IM in one session plus 1.0 g probenecide; (2) tetracycline HCI, 9 g over 4 days; (3) trimethoprim, 80 mg-sulfamethoxazole, 400 mg (TMP-SMX) six tablets once daily for 3 days; (4) TMP-SMX, six tablets wtice on 1 dat at a 6-hour interval. They were re-examined 4 to 8 days and 10 to 15 days after completion of therapy. There was no significant difference between the results of the four regimens in the 4- to 8-day period (P greater than 0.36). However, at the 2-week point the results of TMP-SMX given for 3 days were less effective (P smaller than 0.05) than those obtained by penicillin plus probenecid. There was no significant difference between the results of the other regimens at this latter period.

Administration, Oral↗

Non-hodgkin's lymphoma in children. Correlation of CNS disease with initial presentation.

The clinical and histopathological findings in 26 children with non-Hodgkin's lymphoma without initial marrow involvement are reviewed. A marked male predominance similar to that observed in previous series was noted. Biopsy material was classified according to the recommendations of Rappaport in 22 cases. All have diffuse lymphomas, and 16 of 22 patients had involvement of the mediastinum as part of their initial presentation. Of these 12, 5 developed lymphomatous involvement of the central nervous system prior to the development of leukemic transformation of the bone marrow. This observation suggests that prophylactic therapy against CNS relapse be considered for children with mediastinal non-Hodgkin's lymphoma, even in the absence of initial marrow involvement.

Central Nervous System Diseases↗

Effects on serum complement of normal and pre-eclamptic pregnancy and of oral contraceptives.

The complement system was studied in normal gestation and puerperium, in pre-eclampsia and in women taking oral contraceptives. In 12 normal pregnancies, CH50 titres, C4, C3, C6 and C7 were increased throughout pregnancy; the serum concentration of C1 inhibitor was decreased in the last 2 quarters but greatly raised after delivery. Oral oestrogen-progestogen contraceptives also raised C3 but in contrast to pregnancy lowered CH50, C6 and C7. The different effects of pregnancy and of oral contraceptives may be due to materno-foetal immune reactions. In 9 patients with pre-eclamplsia, complement levels showed a wider scatter and a significantly higher C3 level than in normal pregnancy. Conversion of C3 to C3i was found in 2 of these patients.

Complement C3↗

Depressive effect of serum from patients with leprosy on mixed lymphocyte reactions. Influence of anti-leprosy treatment.

Mixed leucocyte cultures, from two normal donors, were set up in media containing human serum from one of the following sources: (a) a pool of normal group AB donors; (b) Chinese, Malay or Indian patients with untreated leprosy; (c) the same patients after effective anti-leprosy treatment; (d) control Chinese, Malay or Indian subjects. Transformation was estimated by measuring the incorporation of tritiated thymidine in the last 24 hr of a 7-day culture period. Transformation was impaired in sera from treated lepromatous patients, but was less impaired or not impaired at all in sera from treated lepromatous patients. The loss of depressive activity after treatment was more marked in Chinese and Indian than in Malay patients. Transformation was also impaired, though to a lesser extent, in sera from patients with untreated tuberculoid leprosy; it was still impaired in sera from treated tuberculoid patients. There was no evidence of specificity in impairment of mixed lymphocyte reactivity and lymphocytotoxic antibodies appeared to play no role. The incidences of hepatitis B antigen and antibody and of anti-nuclear factor were not notably high.

Adolescent↗