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Biomedical subjects

W S Foshee

Publications and source records attributed to W S Foshee.

12 recordsLinked to original sources
PubMed2000

Upper respiratory tract infections in adolescents.

While upper respiratory tract infections (URTIs) cause much infectious morbidity in infants and young children, adolescents are not immune to infections. Adolescents experience two to four episodes of viral nasopharyngitis annually. In addition to group A streptococcus (GAS), pharyngitis may occur with other streptococci, Arcanobacterium haemolyticum, Epstein-Barr virus, Neisseria gonorrhoeae, and other pathogens. Uvulits, typically in association with GAS, occurs occasionally. Peritonsillar abscess is the most common deep neck space infection seen in adolescents, but retropharyngeal and parapharyngeal abscesses also occur, causing major morbidity. Adolescents experience fewer cases of otitis media than younger children. Rhinosinusitis occurs commonly in adolescents, occasionally leading to chronic sinusitis and serious sequelae such as osteomyelitis. This article reviews the major URTIs likely to be encountered by physicians caring for adolescents. For each entity there is a brief description of the epidemiology, morbidity, microbiology, clinical and laboratory features, treatment, and prevention.

Abscess↗
PubMed1992

Loracarbef (LY163892) versus amoxicillin-clavulanate in the treatment of bacterial acute otitis media with effusion.

The efficacy and safety of loracarbef, a new beta-lactam antibiotic, was compared with that of amoxicillin-clavulanate potassium in the treatment of bacterial acute otitis media with effusion. A double-blind format was utilized to administer 10-day, randomized, parallel treatment regimens to patients who were between 6 months and 12 years of age. The most prevalent causative pathogens found in the two treatment groups were Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella (Branhamella) catarrhalis. The percentages of favorable posttherapy clinical responses in evaluable patients were similar for both drugs: 87.3% (124/142) of the loracarbef group, compared with 91.5% (130/142) of the amoxicillin-clavulanate group, showed favorable responses within 72 hours after treatment. Ten to sixteen days after treatment, 68.1% of the loracarbef group, compared with 76.1% of the amoxicillin-clavulanate group, showed favorable responses. More patients in the amoxicillin-clavulanate group reported treatment-emergent events: 46.1% compared with 35.8% in the loracarbef group (p = 0.023). Diarrhea was the most frequently reported event, occurring in 13.3% of the loracarbef group and in 26.3% of the amoxicillin-clavulanate group (p less than 0.001). Vomiting was reported by 5.8% of the loracarbef group and 10.3% of the amoxicillin-clavulanate group (p = 0.072). Loracarbef is comparable in efficacy to amoxicillin-clavulanate in the treatment of bacterial acute otitis media with effusion and has a more desirable safety profile.

Amoxicillin↗
PubMed1992

Comparative United States and European trials of loracarbef in the treatment of acute otitis media.

Acute otitis media with effusion is one of the most common infectious diseases of childhood. Two multicenter randomized controlled clinical trials were conducted to assess the relative safety and efficacy of loracarbef and either amoxicillin/clavulanate or amoxicillin in the treatment of acute otitis media. Patients were evaluated clinically and bacteriologically at a pretherapy visit (within 48 hours of study drug administration), a posttherapy visit (within 72 hours after completion of therapy), and a late posttherapy visit (10 to 16 days after completion of therapy). In both studies, etiologic agents were assessed by tympanocentesis. In both studies patients had to have a pathogen susceptible to both study drugs to be continued in the study and declared evaluable. The first study, conducted at 24 United States centers, compared loracarbef 30 mg/kg/day in two divided doses and amoxicillin/clavulanate 40 mg/kg/day in three divided doses each for 10 days. At the posttherapy visit 124 (87.3%) of 142 evaluable loracarbef-treated patients and 130 (91.5%) of 142 evaluable amoxicillin/clavulanate-treated patients had favorable (cure or improvement) clinical outcomes (P = 0.247). Loracarbef-treated patients were significantly less likely to experience adverse events, notably diarrhea, than amoxicillin/clavulanate-treated patients (P less than 0.001). The second study, conducted at 12 European sites, compared loracarbef 30 mg/kg/day in two divided doses and amoxicillin 40 mg/kg/day in three divided doses each for 7 days. At the posttherapy visit 120 (81.1%) of 148 evaluable loracarbef-treated patients and 125 (87.4%) of 143 amoxicillin-treated patients had favorable clinical outcomes (P = 0.139). Loracarbef and amoxicillin displayed comparable safety, although vomiting appeared more frequently among patients receiving amoxicillin (P = 0.011).(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1983

An outbreak of gastroenteritis due to a heat-labile enterotoxin-producing strain of Escherichia coli.

In April 1981, an outbreak of gastroenteritis, characterized by diarrhea and abdominal cramps, occurred in 282 of approximately 3,000 personnel at a large metropolitan hospital in San Antonio, Tex. There was a significant association between illness and eating at the hospital cafeteria (P = 0.0008), but no specific food could be incriminated. Stools or rectal swabs from 54 ill individuals produced almost pure cultures of Escherichia coli. Cultures from 51 of these subjects had identical antibiotic sensitivity patterns, and 38 had the same biotype. Isolates from 45 persons were tested for production of heat-stable and heat-labile enterotoxins, using the suckling mouse and Y-1 adrenal cell assays, respectively. Of 45 isolates, 41 produced heat-labile enterotoxins, while 0 of 45 produced heat-stabile enterotoxins. Two isolates were rough, and 34 of the remaining 43 were serotype O25:H-. Two strains were O25:H+. None of the 45 strains possessed hemagglutination patterns typical of colonization factor antigens I or II. Six of seven O25:H- heat-labile enterotoxin-positive strains selected at random were piliated as seen by electron microscopy but did not agglutinate with anti-colonization factor antigens I or II antisera.

Diarrhea↗
PubMed1983

Sulfisoxazole chemoprophylaxis for frequent otitis media.

Sulfisoxazole, 75 mg/kg/d in two divided doses for 3 months, was administered in a double-blind placebo crossover study to 35 children aged 6 months to 5 years who had frequent recurring episodes of otitis media. There was a 40% reduction in the rate of otitis media among patients receiving sulfisoxazole compared with those receiving placebo (0.25 v 0.42 episode per patient-month) which did not depend on age, sex, season, or several other factors. Using a randomized order, among patients who received placebo first, there was a 64% reduction on sulfisoxazole therapy compared with placebo (0.20 v 0.56 episode per patient-month). In this subgroup, there was significant improvement in eustachian tube function according to serial tympanograms. In the patients who received sulfisoxazole first, the rate of acute otitis remained low on placebo (0.28 v 0.30 episode per patient-month), and tympanogram patterns continued to improve after discontinuation of the active drug. These differences suggest a carry-over effect from the benefits of chemoprophylaxis. There was no significant difference in the species or sensitivity patterns of bacteria isolated from patients receiving sulisoxazole or placebo. Sulfisoxazole chemoprophylaxis appears to be safe and effective in significantly reducing episodes of otitis media and improving tympanogram patterns.

Acoustic Impedance Tests↗
PubMed1982

Invasive disease due to nontypable Haemophilus influenzae in children.

Its virulence factors, immune responses, and sites of isolation characterize nontypable Haemophilus influenzae as a pathogen of mucosal surfaces which rarely causes invasive disease. We isolated nontypable H influenzae in pure culture from thoracentesis fluid in a child with pneumonia. An extensive review of the literature in which serotyping of H influenzae was reported revealed that nontypable strains have accounted for only six other cases of pneumonia diagnosed by blood culture, lung puncture, or thoracentesis fluid. The only isolate reported to cause disease outside the neonatal age group may have been a typable strain. Because this organism rarely causes invasive disease, its isolation from sputum is of questionable significance and other causes should be sought.

Biopsy, Needle↗
PubMed1977

Visceral leishmaniasis acquired in Greece: diagnosis and treatment in an American child.

Reported is a case of visceral leishmaniasis acquired in Greece by a 3-year-old American child. Untreated, this protozoan infection causes a high mortality. Specific treatment is available, making early recognition of the illness important. This child's infection responded dramatically to a course of sodium antimony gluconate. Repeat bone marrow cultures demonstrated persistent organisms and a second course of treatment was required. Monitoring of his response to therapy suggested that serial bone marrow cultures and the neutrophil response may be sensitive means for following the course of this infection.

Antimony Sodium Gluconate↗
PubMedDate not supplied

The bacteriology of recurrent otitis media and the effect of sulfisoxazole chemoprophylaxis.

Middle ear effusion specimens were obtained from 31 children with recurrent episodes of acute otitis media. Of 75 total specimens 28 were obtained from children during chemoprophylaxis with sulfisoxazole. A single organism was isolated in 65 of 70 instances. Beta-lactamase was produced from Gram-negative organisms in 11 instances, and penicillin resistance from Streptococcus pneumoniae occurred in one instance. Haemophilus influenzae predominated during prophylaxis; S. pneumoniae predominated without it. Serotyping and biotyping were performed on 28 isolates from 8 children with consecutive episodes. In 17 instances the infecting organism was the same species but seven of these strains differed in serotype or biotype. The average number of weeks between onset of recurrence in children with homologous strains was shorter (2.6 weeks) than in the children from whom heterologous strains were found (5.7 weeks). Three media were evaluated for efficacy in 32 episodes, and direct plating resulted in the highest rate of recovery.

Acute Disease↗