False-negative cryptococcal antigen test.
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Antigens, Fungal↗
Biomedical subjects
A M Stamm
Publications and source records attributed to A M Stamm.
Long-term intravenous drug therapy.
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Amphotericin B↗
Effect of aerosolized isoproterenol on resting myogenic tone in normals.
The effects of aerosolized isoproterenol on expiratory (exp) and inspiratory (insp) conductance (Gaw), maximal exp and insp flow (VEmax and VImax), and static elastic recoil pressure (Pst) were measured in 12 normals. Both exp and insp Gaw increased throughout the vital capacity (37% at 50% VC; P less than 0.01). VEmax increased only at 50% VC (9%; P less than 0.01). VImax and Pst did not change. Accordingly, a dichotomy existed between the Gaw and Vmax changes during both exp and insp. We do not attribute this dichotomy to loss of driving pressure or to volume-time-dependent behavior of airway tone. We interpret the increased exp and insp Gaw to indicate isoproterenol deposition within and bronchodilatation of larger central airways (trachea, main stem, lobar, segmental). Since insp Gaw increased and VImax did not, we conclude that the caliber of these central airways is not the exclusive deteminant of VImax, that the caliber of some more distal airways (subsegmental and beyond) did not change, and that these airways are important determinants of VImax. We conclude that non-uniform distribution of isoproterenol could account for the Gaw-Vmax dichotomy during inspiration, and that such non-uniform distribution coupled with resultant increased compliance and compressibility of the downstream segment could account for the Faw-Vmax dichotomy during expiration.
Adult↗
Listerial myocarditis in cardiac transplantation.
Clinical signs of heart failure developed in two cardiac transplant recipients and were interpreted initially as graft rejection. Morphologic examination of explanted hearts revealed myocarditis with abscess formation and necrosis consistent with a bacterial process; Listeria monocytogenes was isolated from myocardial tissue in the first case and from blood in both. The first patient also developed signs of meningoencephalitis, but the second had no signs of infection outside the heart. Antimicrobial therapy and retransplantation were successful in eradicating listeriosis. The differential diagnosis of heart failure in cardiac transplant recipients includes infectious myocarditis due to L. monocytogenes.
Adult↗
Group C streptococcal pneumonia: report of a fatal case and review of the literature.
A previously healthy 22-year-old man acquired tonsillitis due to Streptococcus equisimilis, a group C Streptococcus. He rapidly developed pneumonia, empyema, septicemia, and metastatic arthritis, and despite appropriate therapy with antibiotics and drainage of abscesses, he experienced progressive respiratory insufficiency and died. The four species of group C streptococci are described in terms of their biochemical properties, the infections they cause in animals, and their tendency to produce disease in humans. Pharyngeal carriage of these organisms is not rare, and outbreaks of pharyngitis and tonsillitis occur. Group C streptococcal pneumonia, like group A pneumonia, is often a severe disease with a prolonged febrile course and frequently is complicated by empyema. Appropriate management includes isolation of the patient, penicillin G therapy, drainage, and respiratory support.
Adult↗
Listeriosis in renal transplant recipients: report of an outbreak and review of 102 cases.
We observed six renal transplant recipients with listeriosis during a 10-week period in the autumn of 1979. Investigation of this outbreak established that the first four cases wer close contacts, all infected by Listeria monocytogenes serotype 1b. The source of infection and route of spread were not identified. A total of 102 renal transplant recipients with listeriosis have now been reported. The major manifestation of disease was meningitis in 50% of the patients, parenchymal disease of the central nervous system in 10%, both meningitis and parenchymal disease of the central nervous system in 9%, and primary bacteremia in 30%. The overall mortality rate was 26%. Pneumonia due to L. monocytogenes, a previously neglected finding, was present in seven patients (7%); five of the seven died. The route of transmission may sometimes be respiratory. Special techniques for isolation of L. monocytogenes from sputum are usually required but not complicated. We recommend that individual renal transplant patients with listeriosis be cared for with secretion and excretion precautions and that they be treated with ampicillin and gentamicin. We advocate the serotyping of all isolates and a careful case-control analysis of all epidemics, but we do not support the use of serologic testing or surveillance cultures.
Adult↗
[Urinary tract infection associated with indwelling bladder catheter: incidence and risk factors].
BACKGROUND: To determine the incidence and risk factors associated with urinary tract infection (UTI) in patients submitted to long-term urinary (bladder) catheterization. One hundred and thirty-six patients who had urinary catheterization during the period of may to december 1993 at an University Hospital in Brazil. MATERIAL AND METHOD: Observational prospective cohort non-controlled study. Patients receiving bladder catheter were followed from insertion to removal of the catheter, looking for the development of a positive culture. Urine cultures were done using conventional media for aerobic organisms and biochemical tests for identification. Material from a urethral meatus swab was also examined for bacteria. Statistical analysis using parametric tests for cathegorical and continuous variables, and multivariate analysis for determination of risk factors for UTI were performed. RESULTS: Incidence of UTI associated with urinary catheter was 11.0%. Univariate analysis showed 3 factos as predictors: the nature of his disease (clinical or surgical) (p = 0.01), stayed during hospitalization in one clinic (p = 0.02) and duration of catheterization (p = 0.00003). In the multivariate analysis only the duration of catheterization was statistically significant. (p = 0.03). CONCLUSIONS: Incidence of UTI associated with urinary catheters in the analysed sample was 11.0%, because in the University Hospital there is a control of the alterable risk. Catheterization duration is an important risk factor for this problem. It is recommended to limit to the minimum the time of catheterization in hospitalized patients.
Adolescent↗