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Biomedical subjects

B A Dudding

Publications and source records attributed to B A Dudding.

At least 19 recordsLinked to original sources

Cephalexin and penicillin in the treatment of group A beta-hemolytic streptococcal throat infections.

OBJECTIVE: To determine whether cephalexin or penicillin is more effective in the treatment of group A beta-hemolytic streptococcal tonsillopharyngitis in children. DESIGN: Randomized, double-blind, crossover study conducted from 1981 to 1984. SETTING: Seven pediatric practices in the United States, including private offices and pediatric clinics. PARTICIPANTS: Of the 654 patients, 525 children and adolescents with clinical evidence of tonsillitis or pharyngitis and throat cultures positive for group A beta-hemolytic streptococcal infection were evaluable. Eighty percent of patients completed the study; none were withdrawn because of adverse reaction. SELECTION CRITERIA: Children and adolescents who had acute illness suggestive of group A beta-hemolytic streptococcal infection were enrolled in the study. Treatment was continued if the throat culture was positive for group A beta-hemolytic streptococcal infection. INTERVENTIONS: Four doses of cephalexin and penicillin (27 mg/kg per day) were prescribed to be taken on an empty stomach for 10 days. MEASUREMENTS/MAIN RESULTS: Symptomatic clinical failure occurred in 8% of penicillin-treated patients and in 3% of cephalexin-treated patients. Bacteriologic failure rates were 11% in the penicillin treatment group and 7% in the cephalexin treatment group. The combined treatment failure rate of clinical relapse plus asymptomatic bacteriologic failure was 19% in the penicillin treatment group and 10% in the cephalexin treatment group. Paired antistreptolysin-O titer increased significantly in 62.3% of penicillin-treated patients and in 64.2% of cephalexin-treated patients. Similarly, anti-DNase B titers rose 52.2% in penicillin-treated patients and 52.4% in cephalexin-treated patients. CONCLUSION: Cephalexin is a more effective drug than penicillin in the treatment of group A beta-hemolytic streptococcal throat infection in children.

Adolescent↗

Gonococcal infections in young children. Studies on the social, familial, and clinical aspects of 11 instances.

Of 43 youngsters with gonorrhea, 11 were under 10 years of age. These 11 had in common atypical clinical presentation, marital disharmony of the parents, crowded living conditions; some had been abused sexually. Management of gonorrhea in such young children may require a concerted effort by a team of medical, social, and legal personnel to meet the needs of this unique entity.

Adolescent↗

Temperature-dependent variation in the synthesis of group-specific carbohydrate by streptococcal variant strains. I. Immunochemical studies.

A temperature-dependent alteration in the synthesis of the group-specific polysaccharide was found to occur in two "variant" streptococcal strains, A-486-Var and C 121/46/4. These strains synthesize a polysaccharide with variant immunochemical characteristics when grown at 37 degrees C. However, when these organisms are grown at lower temperatures, 22 degrees C, an enhanced synthesis of Group A carbohydrate occurs. Other variant strains show no appreciable alteration of the cell wall carbohydrate composition when grown at lower temperatures. Studies on an intermediate strain show that this organism has a propensity for the synthesis of a polysaccharide with higher glucosamine content and enhanced Group A serological reactivity when grown at 22 degrees C. Immunochemical studies performed on the carbohydrates produced by the A-486-Var at various temperatures revealed that the appearance of Group A serological reactivity at lower temperatures is due to the additional synthesis of a polysaccharide with Group A specificity along with the continued synthesis of a variant carbohydrate. This finding contrasts with data obtained on the carbohydrate produced by the intermediate organisms that appears to consist predominently of one molecule bearing dual A and variant antigenic determinants.

Animals↗

Enteric immunization with live adenovirus type 21 vaccine. I. Tests for safety, infectivity, immunogenicity, and potency in volunteers.

Studies were undertaken in volunteers to determine whether living adenovirus type 21 (ADV-21) vaccine could be safely administered orally to susceptible young adults. In the first study, ten volunteers were fed 10(6.4) tissue culture infectious dose(50) (TCID(50)) of ADV-21 vaccine virus, and five received placebo tablets. Nine of ten infected volunteers shed ADV-21 in stools (mean duration, 10.1 days; range, 4 to 17 days). No pharyngeal excretion of ADV-21 was observed in any of these volunteers. Each of the nine developed type-specific neutralizing (N) antibodies to ADV-21. No evidence for person-to-person transmission of vaccine was observed. In a second study, volunteers were immunized with ADV-21 vaccines containing 10(6.8), 10(4.6), and 10(2.4) TCID(50). ADV-21 N antibody responses were detected in nine of eleven who received the highest dose, six of twelve who received the middle dose, and two of twelve who were fed the lowest dose. None of twelve susceptible volunteers receiving the placebo capsule developed ADV-21 N antibodies postimmunization. This study established that the human infectious dose(50) for these lots of ADV-21 vaccine was approximately 10(4.6) TCID(50) and that the dose response to ADV-21 vaccine was lower than those previously reported for live ADV-4 and ADV-7 enteric vaccines.

Adenoviridae↗

Enteric immunization with live adenovirus type 21 vaccine. II. Systemic and local immune responses following immunization.

Studies of the immunologic responses following administration of a live, enteric-coated adenovirus (ADV) type 21 vaccine showed that nine of ten vaccinees and none of five controls developed neutralizing antibody. Antibody activity of serum and secretory immunoglobulins was assayed by using a (14)C-labeled ADV-21 antigen in a radioimmunodiffusion system. Increases in immunoglobulin M, A and G (IgM, IgA, IgG) activity were detected in sera from vaccinees but not in those from controls. IgA copro antibody activity was also shown in vaccinees but not in controls. Nasal secretions showed no detectable IgA antibody responses by this method. These studies show marked differences in serum and local IgA antibody activity in induced enteric ADV infection compared to previously reported responses after natural infection. The protective role of secretory IgA in adenovirus infections is obscure. However, absence of nasal IgA responses may indicate that protection against disease with enteric ADV vaccines depends primarily upon humoral antibody.

Adenoviridae↗