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Biomedical subjects

M Shapiro

Publications and source records attributed to M Shapiro.

At least 55 records · Page 3Linked to original sources
PubMed2001

Skin disease presenting as an outbreak of pseudobacteremia in a laboratory worker.

An outbreak of pseudobacteremia due to Streptococcus pyogenes (group A streptococci [GAS]) and methicillin-susceptible Staphylococcus aureus (MSSA) was traced to the venting procedure for aerobic bottles prior to their loading into the incubator of the BacT/Alert analyzer (Organon Teknika). Bacteria shed by a laboratory worker suffering from impetigo and cellulitis contaminated the aerobic bottles of 10 patients. All blood culture isolates, in addition to the isolates from the laboratory worker, were of the same GAS M and T types. All MSSA isolates from blood cultures and the index case's hands had the same lytic phage profile. Procedural breakdowns were identified in the laboratory. Bottles were vented outside the biological safety cabinet, gloves were not worn, and unprotected needles were used for the venting procedure. The source of the aspirated bacteria that contaminated the bottles was identified and the index case was treated promptly.

Bacteremia↗
PubMed2001

Multidrug-resistant Trichosporon asahii infection of nongranulocytopenic patients in three intensive care units.

Trichosporon asahii (Trichosporon beigelii) infections are rare but have been associated with a wide spectrum of clinical manifestations, ranging from superficial involvement in immunocompetent individuals to severe systemic disease in immunocompromised patients. We report on the recent recovery of T. asahii isolates with reduced susceptibility in vitro to amphotericin B (AMB), flucytosine, and azoles from six nongranulocytopenic patients who exhibited risk factors and who developed either superficial infections (four individuals) or invasive infections (two individuals) while in intensive care units. The latter two patients responded clinically and microbiologically to AMB treatment. All six isolates were closely related according to random amplified polymorphic DNA studies and showed 71% similarity by amplified fragment length polymorphism analysis, suggesting a common nosocomial origin. We also review the literature pertaining to T. asahii infections and discuss the salient characteristics of this fungus and recent taxonomic proposals for the genus.

Aged↗
PubMed2001

Ultrasound features of spermatic cord hydrocele in children.

The aim was to evaluate the value of ultrasound diagnosis of spermatic cord hydrocele as a cause of inguinal swelling or mass in children. Clinical and ultrasound (US) findings and surgical procedures of 27 children with spermatic cord hydrocele were reviewed. All children, except one, were referred for US because of suspected inguinal hernia, hydrocele or inguinal mass. In one child, the US examination was performed to confirm the diagnosis of a spermatic cord hydrocele. An encysted hydrocele was diagnosed in 24 out of 27 cases, whereas a funicular type of spermatic cord hydrocele was found in the remaining 3 cases. Internal septa were seen within the fluid mass in four patients. 23 children underwent surgical exploration that confirmed the US diagnosis. Three children with encysted-type hydrocele were only followed clinically and by US, and one was lost from follow-up. US examination is a very sensitive and accurate method for diagnosis of this entity and for exclusion of other lesions in this region.

Adolescent↗
PubMed2001

The effects of cations on the activity of the gypsy moth (Lepidoptera: Lymantriidae) nuclear polyhedrosis virus.

Fourteen cations were tested at a 1% concentration (wt:wt), as chlorides, for their effects on the biological activity of the gypsy moth, Lymantria dispar (L.), nuclear polyhedrosis virus (LdMNPV). Cupric chloride was toxic to gypsy moth larvae. Ferrous and ferric chloride were inhibitory to larval growth and development as well as to virus activity. Strontium chloride was inhibitory to virus activity but had no apparent effects on gypsy moth larvae. Six cations had little or no effect on virus activity (i.e., calcium, lanthanum, magnesium, nickel, potassium, sodium), whereas four cations (i.e., cobalt, manganese, ruthenium, zinc) acted as viral enhancers, as indicated by reductions in LC50s.

Animals↗
PubMed2001

Relative effectiveness of selected stilbene optical brighteners as enhancers of the beet armyworm (Lepidoptera: Noctuidae) nuclear polyhedrosis virus.

The addition of a stilbene optical brightener, Tinopal LPW, at 1% concentration (wt:wt) significantly reduced the LC50 of the beet armyworm nuclear polyhedrosis virus (SeMNPV) from 2.9 PIB/mm2 to 0.02 PIB/mm2. Moreover, the LT50 of SeMNPV was reduced by 34% by the addition of Tinopal LPW. Seven other structurally related stilbene brighteners were also tested as viral enhancers. Five of these brighteners (Tinopal LPW, Blankophor BBH, Blankophor HRS, Blankophor P167, and Blankophor RKH) reduced LD50, whereas three brighteners (Blankophor BSU, Blankophor DML, and Blankophor LPG) had little effect. Among the active brighteners, LC50s were reduced by 10.5-fold (Blankophor P167), 52.4-fold (Blankophor RKH), 87.3-fold Tinopal LPW), 131-fold (Blankophor BBH), and >400-fold (Blankophor HRS). LT50s were also decreased by the addition of Blankophor BBH, Blankophor P167, and Blankophor RKH, but were increased by the addition of Blankophor BSU, Blankophor DMLO, and Blankophor LPG to SeMNPV suspensions.

Animals↗
PubMed2001

Therapeutic advances in biological response modifiers in the treatment of cutaneous T-cell lymphoma.

Cutaneous T-cell lymphoma (CTCL) is most often a skin-infiltrating malignancy of clonal CD4+ T-cells. Therapy is based on staging and the likelihood of progression. Biological response modifiers and chemotherapeutic agents are used to preserve the integrity of the host antitumour response while selectively targeting the malignant cells. The biological response-modifying treatment options currently used to treat CTCL are bexarotene, denileukin diftitox, interferon-alpha, interferon-gamma and interleukin-12, as well as extracorporeal photopheresis and phototherapy. A combination therapy approach maximises response in patients with advanced CTCL. Biological response modifiers in combination with photopheresis are used for patients with the leukaemic phase of the disease. Among the majority of patients with advanced stage disease so treated, immune response augmentation appears to prolong survival. Future areas of research should assess not only survival and optimal treatment combinations, but also quality of life during the treatment period.

Bexarotene↗
PubMed2001

A near-fatal hypersensitivity reaction to abacavir: case report and literature review.

A near-fatal hypersensitivity reaction to abacavir developed in a 62-year-old HIV-seropositive man who had been sensitized 17 months before presentation. Six days after he was rechallenged, acute respiratory distress developed, requiring mechanical ventilation for 2 weeks. Four days after extubation, he was again rechallenged. Hours later, the patient experienced anaphylactic shock, requiring mechanical ventilation for 3 weeks, aggressive volume resuscitation, and vasopressor support. Recovery was complicated by acute tubular necrosis, digital necrosis, and a GI bleed. This report reviews the mechanisms of action, efficacy, and adverse reactions of abacavir and illustrates the danger of serially rechallenging patients with this agent.

Anaphylaxis↗
PubMed2000

Coherently controlled nanoscale molecular deposition.

Quantum interference effects are shown to provide a means of controlling and enhancing the focusing of a collimated neutral molecular beam onto a surface. The nature of the aperiodic pattern formed can be altered by varying laser field characteristics and the system geometry.

Journal Article↗
PubMed2000

High rate of candidemia in patients sustaining injuries in a bomb blast at a marketplace: a possible environmental source.

In this study, a cluster of candidemia among patients sustaining injuries in a bomb blast at a marketplace was investigated by means of a multivariate analysis, a case-control study, and quantitative air sampling. Candidemia occurred in 7 (30%) of 21 patients (58% of those admitted to the intensive care unit [ICU]) between 4 and 16 days (mean, 12 days) after the injury and was the single most frequent cause of bloodstream infections. Inhalation injury was the strongest predictor for candidemia by multivariate analysis. Candidemia among the case patients occurred at a significantly higher rate than among comparable trauma patients injured in different urban settings, including a pedestrian mall (2 of 29; P=. 02), and among contemporary ICU control patients (1 of 40; P=.001). Air sampling revealed exclusive detection of Candida species and increased mold concentration in the market in comparison with the mall environment. These findings suggest a role for an exogenous, environmental source in the development of candidemia in some trauma patients.

Adolescent↗
PubMed2000

Coherently controlled asymmetric synthesis with achiral light

A laser-based method of increasing the enantiomeric excess of a chiral enantiomer in a racemic mixture is described. Neither the initial reagents nor the incident light need be chiral. Both formal and computational results show that enhancement of the enantiomer of choice, controlled by laser parameters, can be extensive.

Journal Article↗
PubMed2000

Autoimmune thyroid disease and antiphospholipid antibodies.

OBJECTIVE: Autoimmune thyroid disease (ATD) is associated with circulating autoantibodies reactive with epitopes on thyroid tissue and that are thought to be pathogenic in the development of these diseases. Antiphospholipid antibodies (APLA) are a family of immunoglobulins that recognize a variety of plasma proteins in association with anionic phospholipids. These antibodies may lead to a number of clinical syndromes including venous and arterial thromboses, thrombocytopaenia, and recurrent fetal loss. We have studied the prevalence of APLA in patients with ATD and have determined the prevalence of the APLA syndrome among APLA-positive patients. DESIGN: The study was a retrospective survey of patients with autoimmune thyroid disease attending the endocrinology clinic of a tertiary care academic hospital. PATIENTS AND MEASUREMENTS: One hundred and thirty patients with autoimmune thyroid disease from the endocrinology clinic at our hospital were studied. 84% had chronic thyroiditis and 16% had Graves' disease. Free T4 and thyroid stimulating hormone (TSH) levels, antimicrosomal and antithyroglobulin antibodies, and an antiphospholipid antibody test were performed on all subjects. RESULTS: 43% of patients with chronic thyroiditis and 43% of patients with Graves' disease were APLA positive, with an overall rate of 43% APLA positivity among patients with ATD. Of the 56 patients that were APLA positive, forty-eight (86%) had APLA of the IgG subtype, four (7%) had IgM antibodies, and nine (16%) had both IgG and IgM antibodies. None of the patients had clinical evidence of the APLA syndrome. CONCLUSIONS: We conclude that the prevalence of APLA in ATD is increased compared to healthy individuals but that this is likely to be an epiphenomenon. However, prolonged follow up is necessary in order to determine the true clinical significance of these antibodies in ATD patients.

Antibodies, Antiphospholipid↗
PubMed2000

Helicoverpa armigera granulovirus interference with progression of H. zea nucleopolyhedrovirus disease in H. zea larvae.

Capsular proteins from Helicoverpa armigera granulovirus (HaGV) have previously been shown to enhance H. armigera nucleopolyhedrovirus (HaSNPV) infection in H. armigera larvae. Yet, HaGV and HaS-NPV, as viable viruses, interfered with one another. In our study, we have examined the effects of co-infection of the slow-killing virus HaGV with the fast-killing virus Helicoverpa zea NPV (HzSNPV) on H. zea larvae. The mortality parameter measured was survival time. Virus stocks had 50% lethal concentrations of 3.2x10(-9) g HaGV-infected cadavers (GVC) (HaGV) and 32 occlusion bodies (HzSNPV) per cup. Average survival times were 16.8 and 5.5 days for larvae treated with HaGV and HzSNPV, respectively; death of HzSNPV-treated larvae was as early as 72 h posttreatment. In co-infection experiments in which larvae were treated concurrently with both viruses, the viruses competed in typical fashion for host resources. However, interference with disease progression in HzSNPV-fed larvae occurred even when HaGV was fed to larvae up to 36 h after the NPV, a time at which NPV infection should have been well established in host larvae. At death, co-infected larvae were observed microscopically to be filled with HaGV granules rather than HzSNPV polyhedra. The time study results imply that HaGV might be outcompeting HzSNPV by inhibiting its replication. We also observed that H. zea larvae treated with high dosages of HaGV (> or =3x10(-5) g GVC) were initially stunted but had survival times similar to those of larvae treated with lower dosages.

Animals↗
PubMed2000

Proposed association between ileoanal j-pouch perforation and rapid consumption of a high-calorie, high-fiber meal: report of two cases.

PURPOSE: We report two cases of ileoanal J-pouch rupture after rapid consumption of high-fiber, high-calorie meals. METHOD: We review the food intake, presentation, laboratory and radiographic data, and course of two patients who developed ileoanal J-pouch perforation after rapid consumption of meals rich in fiber or calories or both. The potential association between food consumption and rupture is explored. RESULTS: The authors propose that the rapid ingestion of a high-fiber, high-calorie meal may lead to an acute intraluminal pressure elevation or a closed-loop obstruction. These effects may be the basis for an association between food ingestion patterns and perforation at the distal transection site in an ileoanal J-pouch. CONCLUSION: The authors hypothesize that the rapid ingestion of a high-fiber, high-calorie meal may be associated with J-pouch perforation. Further investigative efforts are needed to confirm this association and to evaluate whether a causal relationship is present. If causality is established, physicians may develop a higher index of suspicion for pouch rupture in patients who present with abdominal disturbances after the rapid ingestion of a high-fiber, high-calorie meal.

Adult↗
PubMed2000

Progressive liver calcifications in neonatal coxsackievirus infection.

Coxsackievirus group B can cause a severe systemic disease in the perinatal period. Severe manifestations like meningitis, encephalitis, hepatitis, and myocarditis have been previously reported. A case of a twin neonate infected by coxsackievirus group B is described, who developed progressive extensive hepatic calcifications demonstrated by ultrasound and computed tomography with follow-up. Hepatic calcifications in coxsackievirus infection have not been previously reported.

Calcinosis↗
PubMed2000

Factors associated with nosocomial diarrhea and Clostridium difficile-associated disease on the adult wards of an urban tertiary care hospital.

A prospective survey of the adult inpatient population of an urban tertiary care hospital was conducted to determine factors associated with the development of nosocomial diarrhea and the acquisition of Clostridium difficile-associated disease. During the 3-month survey, 98 patients with nosocomial diarrhea were enrolled, and 38 controls were recruited. The controls were patients without diarrhea lying in beds adjacent to the affected patients. Factors significantly associated with nosocomial diarrhea were the administration of a special diet (P=0.02) and receipt of a greater number of different antibiotics (P=0.02). Among the 98 patients with diarrhea, Clostridium difficile toxin B was identified in the stool of 13. Factors found to be associated with the presence of toxin B as compared to other causes of nosocomial diarrhea were a greater number of individual antibiotics used during hospitalization (P=0.02) and receipt of a cephalosporin (P=0.03) or, more specifically, a third-generation cephalosporin (P=0.02). Among patients with nosocomial diarrhea, those who had toxin in their stool had a significantly higher total antibiotic burden (expressed as antibiotic days) than those with diarrhea due to other causes (P=0.01).

Adult↗
PubMed2000

Planning impairments in frontal lobe dementia and frontal lobe lesion patients.

Patients with frontal lobe brain damage are reportedly impaired on tasks that require plan development and execution. In this study, we examined the performance of 15 patients diagnosed with frontal lobe dementia and 14 patients with focal frontal lobe lesions on the Tower of London planning task. Patients with frontal lobe dementia committed a significantly higher number of rule violations, made more moves, and demonstrated longer solution time latencies compared to their matched controls. Patients with frontal lobe lesions demonstrated significantly delayed solution times and also made more moves compared to their matched controls. Frontal lobe lesion patient performance suggests an impairment in execution-related processes, while frontal lobe dementia patients appear to be impaired in both plan development and execution. Despite these findings, the identification of a specific cognitive impairment that induces these planning problems remains elusive.

Adult↗