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Biomedical subjects

T L Meinking

Publications and source records attributed to T L Meinking.

18 recordsLinked to original sources
PubMed1998

Isolation, amplification, and sequencing of human mitochondrial DNA obtained from human crab louse, Pthirus pubis (L.), blood meals.

The ability to identify individual human hosts based on analyses of blood recovered from the digestive tract of hematophagous arthropods has been a long-term pursuit in both medical and forensic entomology. Blood meal individualization techniques can bring important advancements to studies of vector-borne disease epidemiology. Forensically, these analyses may aid in assailant identification in violent crime cases where blood-feeding insects or their excreta are recovered from victims or at crime scenes. Successful isolation, amplification, and sequencing of human mitochondrial DNA obtained from adult human crab lice fed on human volunteers are reported. Adult lice were removed from recruited volunteers frequenting inner city health clinics. Live lice were killed by freezing and subsequently air dried at ambient temperature. A saliva sample was obtained from each volunteer and served as a DNA reference sample. Volunteers were afforded free, approved pediculosis treatment. Individual lice were subsequently processed using procedures developed for the extraction of mitochondrial DNA from human hair, teeth, and bone. The resulting DNA was amplified by the polymerase chain reaction and sequenced. Our results point to valuable avenues for future entomological research.

Animals↗
PubMed1997

Treatment of HIV-related scabies with emphasis on the efficacy of ivermectin.

Since the mid-1980s, worldwide reports confirm that scabies in individuals infected with the human immunodeficiency virus (HIV) result in a wide range of-clinical manifestations which differ from those seen in immunocompetent patients. There is also general agreement that HIV-related scabies is more difficult to treat. Oral ivermectin has been shown in several countries to be a safe and effective therapy. In otherwise healthy persons, one dose of 200 microg/kg is usually curative. In HIV-related scabies, one treatment may be curative but repeated doses may be required. Crusted scabies in these individual requires a combination of oral ivermectin, total body treatments with 5% permethrin cream, and keratolytic agents to hasten removal of crusts.

AIDS-Related Opportunistic Infections↗
PubMed1996

Permethrin.

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Humans↗
PubMed1995

The treatment of scabies with ivermectin.

BACKGROUND: Ivermectin is an anthelmintic agent that has been a safe, effective treatment for onchocerciasis (river blindness) when given in a single oral dose of 150 to 200 micrograms per kilogram of body weight. Anecdotal reports of improvement in patients who suffered from infestation with the mite Sarcoptes scabiei suggest that the ectoparasitic disease scabies might be treated with ivermectin. METHODS: We conducted an open-label study in which ivermectin was administered in a single oral dose of 200 micrograms per kilogram to 11 otherwise healthy patients with scabies and to 11 patients with scabies who were also infected with the human immunodeficiency virus (HIV), 7 of whom had the acquired immunodeficiency syndrome. All patients received a full physical and dermatologic examination; scrapings from the skin of all patients tested positive for scabies. Patients were reexamined two and four weeks after treatment, when the scrapings for scabies were repeated. The patients used no other scabicides during the 30 days before ivermectin treatment or during the 4-week study period. RESULTS: None of the 11 otherwise healthy patients had evidence of scabies four weeks after a single dose of ivermectin. Of the 11 HIV-infected patients, 2 had < or = 10 scabies lesions before treatment, 3 had 11 to 49 lesions, 4 had > or = 50 lesions, and 2 had heavily crusted skin lesions. In eight of the patients the scabies was cured after a single dose of ivermectin. Two patients received a second dose two weeks after the first. Ten of the 11 patients with HIV infection (91 percent) had no evidence of scabies four weeks after their first treatment with ivermectin. CONCLUSIONS: The anthelmintic agent ivermectin, given in a single oral dose, is an effective treatment for scabies in otherwise healthy patients and in many patients with HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Seabather's eruption. Clinical, histologic, and immunologic features.

BACKGROUND: Seabather's eruption (SE) is a highly pruritic eruption under swimwear that occurs after bathing in the ocean. Its cause has been unknown. Few data have been collected since the classic description by Sams in 1949. OBJECTIVE: Our purpose was to describe the clinical and histopathologic findings in SE and to confirm the cause. METHODS: Patients with a pruritic eruption that developed after swimming were seen within 1 week of onset. Skin biopsy specimens and sera were obtained in selected cases. Water samples taken from areas of active SE outbreaks were examined for a causative organism. Sera were tested by enzyme-linked immunosorbent assay for reactivity to this organism. RESULTS: In southeast Florida, during a 4-month period, 70 patients with SE were seen. Inflammatory papules and pruritus were noted within hours of exposure. Eruptions were maximal in areas covered by a bathing suit. Children were more likely than adults to have systemic symptoms. The average duration of the eruption and pruritus was 12.5 days, with recurrences in 4.3% of patients. Histopathologic examination revealed a superficial and deep perivascular and interstitial infiltrate consisting of lymphocytes, neutrophils, and eosinophils. Water samples contained many cnidarian larvae, later grown to maturity and identified as Linuche unguiculata (thimble jellyfish). Enzyme-linked immunosorbent assay demonstrated in patients' sera high IgG levels specific for L. unguiculata. CONCLUSION: SE is a severely pruritic marine dermatosis that resolves spontaneously within 2 weeks. Therapy is symptomatic but often ineffective. Sera from affected persons showed specific reactivity to L. unguiculata.

Adolescent↗
PubMed1994

Identification of host DNA by amplified fragment length polymorphism analysis: preliminary analysis of human crab louse (Anoplura: Pediculidae) excreta.

The ability to identify individual hosts of hematophagous arthropods via bloodmeal analyses is a continuing pursuit in both medical and forensic entomology. Characterization of human DNA from blood-feeding arthropods has been advanced substantially by preparation techniques, such as the polymerase chain reaction (PCR). Successful application of amplified fragment length polymorphism (AMP-FLP) analysis to excreta obtained from adult crab lice, Pthirus pubis (L.), fed on human volunteers is reported herein. Human DNA derived from crab louse excreta was typed successfully for two human DNA genetic markers, D1S80 and HUMTH01. Although preliminary, these results illustrate the ability of AMP-FLP analyses to provide individual human locus characterizations from desiccated arthropod excrement.

Animals↗
PubMed1991

Community control of scabies: a model based on use of permethrin cream.

For 18 years treatment with lindane or crotamiton products has failed to stem the epidemic of scabies among the Kuna Indians in the San Blas islands of the Republic of Panama. Permethrin 5% cream was introduced as the only treatment in a programme to control scabies on an island of 756 inhabitants and involving workers recruited locally. Prevalence fell from 33% to less than 1% after every person was treated. As long as continued surveillance and treatment of newly introduced cases was maintained, prevalence of scabies remained below 1.5% for over 3 years. When supply of medication was interrupted for 3 weeks, prevalence rose to 3.6%. When control was lost after the US invasion of Panama, prevalence rose to 12% within 3 months. Bacterial skin infections decreased dramatically when scabies was controlled. Permethrin is safe and effective even in areas where this disease has become resistant to lindane.

Administration, Topical↗
PubMed1990

Comparison of crotamiton 10% cream (Eurax) and permethrin 5% cream (Elimite) for the treatment of scabies in children.

Permethrin 5% cream (Elimite) was approved as a treatment for scabies by the U.S. Food and Drug Administration in September 1989. In a double-blinded, randomized study, it was compared with crotamiton 10% cream (Eurax) for the treatment of scabies in children 2 months to 5 years of age. Two weeks after a single overnight treatment, 14 (30%) of 47 children were cured with permethrin 5% cream, in contrast to only 6 of 47 (13%) of subjects treated with Eurax. Four weeks after treatment the figures were 89% and 60% cured for the two agents, respectively. In 10 of the 19 patients whose treatment failed, the condition became worse after therapy. The difference in efficacy in favor of permethrin was significant (P = 0.002). That agent also demonstrated greater effectiveness in reducing pruritus and secondary bacterial infections. Elimite offers a safe, efficacious, and cosmetically elegant alternative to Eurax in the treatment of scabies in children.

Administration, Topical↗
PubMed1989

Scabies, lice, and fungal infections.

Scabies and pediculosis capitis are frequent and often unrecognized causes of multiple streptococcal and staphylococcal pyodermas. Permethrin 1 per cent creme rinse (NIX) for head lice, and permethrin 5 per cent topical cream for scabies are new, highly effective, safe, and cosmetically elegant treatments which have shown superiority over older remedies. In populations in which pediculosis and scabies have resisted traditional lindane therapy, patients promptly responded to these permethrin products. Scabies in nursing homes is a persistent and expanding problem which demands a high level of diagnostic suspicion and an integrated approach to management. For fungal infections, several new broad-spectrum oral and topical agents have been introduced. Their successful use is enhanced by appropriate diagnostic tests which can be performed in the office setting. Recommendations and references are given to assist the physician in diagnosis and choice of therapy.

Antifungal Agents↗
PubMed1986

Permethrin 5% dermal cream: a new treatment for scabies.

Permethrin 5% dermal cream (Burroughs Wellcome Co.) was compared in an investigator-blinded, randomized study against lindane 1% lotion (Kwell) for the treatment of microscopically confirmed scabies. Eleven of twenty-three patients treated with permethrin cream were cured in 2 weeks (48%). Only two patients had scabies 1 month following a single treatment with this product, giving a cure rate of 91%. One of these two patients was considered to have a reinfestation. Only three of twenty-three (13%) patients treated with 1% lindane lotion (Kwell) were free of scabies 2 weeks after a single treatment and fifteen of twenty-three (65%) were cured at 1 month. The unusually high percentage of treatment failures (35%) following lindane therapy may have been related to extensive use of this agent for head lice and scabies in this village during the preceding 5 years. The higher cure rate at 1 month seen with permethrin cream was significant (p less than 0.025). Permethrin 5% dermal cream offers a new, cosmetically elegant alternative to lindane therapy and was effective in a community in which lindane demonstrated an unacceptable level of treatment failures.

Administration, Topical↗
PubMed1986

Permethrin 1% creme rinse for the treatment of Pediculus humanus var capitis infestation.

Permethrin 1% creme rinse (NIX) was tested as a treatment for Pediculus humanus var capitis (head lice) in a placebo-controlled, double-blinded, randomized study. As a positive control, a third arm of the study included nonrandomized, but investigator-blinded, treatment with 1% lindane shampoo (Kwell). At 14 days after treatment, 97% of patients treated with permethrin were free of lice compared to 6% of placebo-treated patients (P less than 0.001) and 43% of the lindane-treated group. Permethrin was 70% ovicidal compared to 14% for placebo (P less than 0.001) and 45% for lindane. No adverse experiences were noted during this study. Permethrin 1% demonstrated high pediculicidal and ovicidal activities, which in combination with its low mammalian toxicity, residual activity, and cosmetic properties, make it an excellent treatment for pediculosis capitis.

Adolescent↗
PubMed1986

Comparative efficacy of treatments for pediculosis capitis infestations.

Ovicidal activity and killing times were evaluated for six pediculicides, using viable eggs and recently fed head lice from infested children. Lice were continuously exposed to the products until death, and elapsed time was recorded. Eggs were immersed for ten minutes, rinsed, and dried. Four synergized pyrethrin products (RID, R&C Shampoo, A-200 Pyrinate Shampoo, A-200 Pyrinate Liquid) killed all lice in ten to 23 minutes, and 23% to 32% of treated eggs hatched; 0.5% malathion lotion (Prioderm Lotion) killed lice within five minutes and was highly ovicidal, with only 5% of eggs hatching. One percent lindane shampoo (Kwell Shampoo) was the slowest-acting pediculicide, requiring approximately three hours to kill all lice; 30% of the eggs hatched after treatment. The in vitro results for RID, Prioderm Lotion, and K well Shampoo were validated by clinical trials.

Child↗