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Biomedical subjects

A L Florman

Publications and source records attributed to A L Florman.

At least 19 recordsLinked to original sources
PubMed1987

Correlation of serum opsonic activity in cystic fibrosis with colonization and disease state: measurement of opsonins to Pseudomonas aeruginosa by neutrophil superoxide anion generation.

Serum from patients with cystic fibrosis and normal controls was used to opsonize mucoid and nonmucoid Pseudomonas aeruginosa particles. Opsonic activity was then determined by measuring the production of superoxide anion (O2-) from normal neutrophils stimulated with the opsonized particles. Without any opsonization, mucoid P. aeruginosa stimulated significantly more O2- than nonmucoid P. aeruginosa. Responses to nonmucoid P. aeruginosa observed with heat-inactivated serum from patients with cystic fibrosis were significantly higher (p = 0.008) than those observed with heat-inactivated control sera. Comparisons made between patients who were colonized with P. aeruginosa and those who were not showed that heat activated serum from colonized patients had significantly higher levels of opsonic activity than heat inactivated serum from patients who were not colonized. These differences were observed with either mucoid or nonmucoid P. aeruginosa. A negative correlation was also observed between opsonic activity and clinical status measured by Schwachman scores of colonized patients. These data indicate that in patients colonized with P. aeruginosa the deterioration of their clinical status correlated with increased opsonic activity reflected in the oxidative burst response of neutrophils.

Adolescent↗
PubMed1987

Rapid noninvasive techniques for determining etiology of bronchitis and pneumonia in infants and children.

Table 2 lists the names, abbreviations, and principle underlying most of the rapid diagnostic techniques we have described. Table 3 lists the pathogens most likely to cause lower respiratory tract infections in pediatric patients, the specimens needed for each rapid diagnostic test now generally available, and the approximate time required for its actual performance. For maximal cost-effectiveness, it is recommended that laboratory diagnosis be pursued in a stepwise manner: 1) The usual patient with acute respiratory illness who is to be managed as an outpatient may need little if any laboratory evaluation. 2) For the child for whom hospital admission is being considered, serum C-reactive protein screen, urine bacterial antigen tests, and a cold agglutinin test (at the appropriate age) will help to classify the etiology of the infection as likely or unlikely to be bacterial. If antibiotic therapy is to be given, a blood culture should be obtained before starting. 3) For the child admitted to the hospital with a possible chlamydial or viral lower respiratory infection for whom specific therapy is considered, nasopharyngeal secretions should be examined for Chlamydia and for antigens of respiratory syncytial, parainfluenza, and influenza viruses to help select the appropriate antimicrobial. Serum for IgM level may be helpful. 4) For the child who has been intubated for respiratory support, a specimen of deep respiratory secretions should be sent for Gram stain, bacterial culture, for Chlamydia, and viral antigens and culture. 5) For patients presenting with atypical symptoms, signs, or clinical course additional diagnostic possibilities should be considered and appropriate tests done even if results may not be available within 48 hours.

Agglutinins↗
PubMed1986

Multiple lung cavities in a 12-year-old girl with bubonic plague, sepsis, and secondary pneumonia.

After one week of nonspecific symptoms, pneumonia and an extremely tender and enlarged cervical lymph node developed in a 12-year-old girl who lived in an area of New Mexico known to have plague-infected rodents. Cultures from an aspirate of the node, her sputum, and blood all showed growth of Yersinia pestis. She was treated successfully with aminoglycosides and tetracycline. As the pneumonia resolved, areas of consolidation were replaced by cavitary lesions.

Child↗
PubMed1985

Evaluation of a skin test for chicken pox.

Results with a VZV skin test as a marker of past infection were compared with histories of chicken pox and specific antibody detected by ELISA in 100 individuals--25 of whom were pediatric patients with malignant diseases. A negative or uncertain history was not reliable, neither were the skin test results among the oncology patients. However, among the normal individuals, the skin test when compared with the ELISA had a sensitivity of 85%, a specificity of 100%, and a positive predictive value of 100%.

Adult↗
PubMed1983

Lung defenses against infection: a clinical correlation.

The current state of knowledge of lung defenses has been reviewed. First, mechanical factors such as aerodynamic filtration and mucociliary transport were considered. Then, in general terms, the contributions of alveolar macrophages, neutrophils, lymphocytes, and immunoglobulins, and the roles of complement, antiproteases, lysozyme, and fibronectin were examined. Interactions between these components may regulate their effect. Finally, the responses to five specific microorganisms were reviewed to illustrate different aspects of the lung's defenses. Streptococcus pneumoniae was selected as a representative extracellular bacterial pathogen, Mycobacterium tuberculosis as an intracellular bacterial pathogen, Mycoplasma pneumoniae because it elicits significant humoral and cell-mediated immunity, respiratory syncytial virus as an example of a local viral pathogen, and measles as a viral pathogen that causes generalized disease. It was shown that these responses may not always be beneficial for the host. For each of the five infections, recommendations for improving the outcome were made.

Cilia↗
PubMed1980

Gentamicin resistant and sensitive strains of S. aureus. Factors affecting colonization and virulence for infants in a special care nursery.

During an eight month period in 1978, a large number of infants in a special care nursery at Bellevue Hospital, New York City, were found to carry a Staphylococcus aureus which was resistant to gentamicin. The records of 43 newborn infants who were admitted during this period of high prevalence were analyzed retrospectively for factors that might favor acquisition of gentamicin sensitive or resistant strains. It was found that neither sex nor administration of gentamicin or kanamycin played a significant role. Duration of stay was a major determinant of colonization, but there was no significant difference between the median stay of infants colonized with gentamicin sensitive or resistant strains. A life table analysis showed no difference in the rate at which gentamicin sensitive or resistant strains were acquired. As a group, staphylococci were acquired at the same rate as Gram negative rods and less rapidly than S. epidermidis. A review of all nosocomial staphylococcal infections recognized in the unit during 1977 and 1978 did not support a concern that there might be greater risk of serious infections during the months when gentamicin resistant strains of S. aureus were prevalent. Both sensitive and resistant strains appeared to be similar in virulence. Indeed, in this infant population, there were no differences in behavior between gentamicin resistant and sensitive strains of S. aureus.

Carrier State↗
PubMed1980

Nosocomial scalded skin syndrome. Ritter's disease caused by phage group 3 Staphylococcus aureus.

Three cases of generalized exfoliative staphylococcal scalded skin syndrome (SSSS) were encountered during a 25-day period in a nursery for premature infants. A single strain of Staphylococcus aureus, phage type 42E/54/75 (group 3), was recovered from each of the three infants and from no others. Two of the three isolates were tested and both produced epidermolytic toxin (ET). Most cases of SSSS have been associated with phage group 2 strains. To our knowledge, this is the first report of a nursery outbreak caused by a phage group 3 staphylococcus. It illustrates that ET production and not phage type distinguishes S aureus strains that are associated with SSSS.

Cross Infection↗
PubMed1975

Nonspecific enhancers of resistance in man.

Nonspecific enhancers of resistance may include (1) viral interference, (2) interferon, (3) interferon inducers, (4) bacterial interference, (5) bacterial products such as Coley's "toxins," endotoxins, or staphylococcal, BCG, and Corynebacterium parvum vaccines, (6) transfer factor, and (7) well-defined chemicals such as dinitrochlorbenzene, levamisole, and vitamin C. These are discussed only as they have been applied to man to learn whether or not they have enhanced his ability to resist infections and growth of tumors. Preliminary studies suggest that a variety of relatively safe and effective nonspecific enhancers may soon be available for clinical use.

Adjuvants, Immunologic↗