Biomedical subjects

E B Lewin

Publications and source records attributed to E B Lewin.

7 recordsLinked to original sources

PubMed1979

Potential bacteremia in pediatric practice.

The potential consequences of bacteremia are considerable in all infants but particularly in those from 3 to 24 months of age with temperatures of 38.3 degrees C or more. Physicians have been advised to scrutinize these patients carefully with a variety of diagnostic tests and to treat their conditions vigorously if bacteremia is seriously considered or proved. We undertook to determine how often primary care pediatric practitioners encounter such patients "at risk" for bacteremia. Among the practices of nine pediatricians in Monroe County, New York, involving 220 practice days throughout 1977 and 4,151 patient visits, we found 145 instances of potential bacteremia. Depending, then, on the season of the year, practitioners may face this diagnostic and management dilemma as often as once each day. Therefore, laboratory means for determining those infants at highest risk for bacteremia or for rapidly diagnosing bacteremia will need to be readily available to practitioners.

Child, Preschool↗

PubMed1979

Comparative immunogenicity of vaccines prepared from capsular polysaccharides of group C Neisseria meningitidis O-acetyl-positive and O-acetyl-negative variants and Escherichia coli K92 in adult volunteers.

Three structurally and antigenically similar capsular polysaccharides, two derived from group C Neisseria meningitidis (O-acetyl-positive and O-acetyl-negative variants) and one from Escherichia coli K92, which cross-reacts with polysaccharide from group C N. meningitidis, were compared for their ability to induce anticapsular and bactericidal antibodies to group C N. meningitidis in adult volunteers. All three vaccines elicited group C-specific serum antibodies. The vaccine derived from the O-acetyl-negative variant was the most immunogenic of the three vaccines. With use of radiolabeled O-acetyl-positive group C N. meningitidis polysaccharide antigen, the geometric mean titers of antibody in serum were 41.7 microgram/ml to the O-acetyl-negative variant, 22.8 microgram/ml to the O-acetyl-positive variant, and 7.1 microgram/ml to E. coli K92. Antibodies induced by all three vaccines were bactericidal for both of the group C N. meningitidis polysaccharide variants. An inverse relation between the comparative immunogenicity of the O-acetyl-negative polysaccharide and the virulence of group C N. meningitidis was found.

Adult↗

PubMed1978

Teichoic acid serology in staphylococcal infections of infants and children.

Counterimmunoelectrophoresis and gel diffusion were utilized for the detection and titration of antibodies to staphylococcal teichoic acids in various disease states caused by coagulase-positive staphylococcus in infants and children. Serum samples were obtained on admission and serially for 2 to 12 weeks during illness. Teichoic acid antibodies were found by CIE in 12 of 21 patients (57%) with invasive CPS disease with bacteremia (Group A), in two of 17 patients (12%) with CPS infection without bacteremia (Group B), in none of 27 patients with bacteremia and/or invasive infections caused by organisms other than CPS (Group C), and in none of 24 noninfected, hospitalized patients or healthy children (Group D). Gel diffusion was useful for titrating antibodies in seropositive sera. Teichoic acid serology is a useful adjunct in the diagnosis of invasive CPS infections. The presence of these antibodies by CIE and gel diffusion may help to identify patients with endothelial or metastatic infections associated with staphylococcal bacteremia.

Antibodies, Bacterial↗

PubMed1977

The lack of nurse-infant transmission of type B hepatitis in a special care nursery.

Twenty-four infants cared for by a nurse who developed acute B hepatitis with HBsAg present in her serum and saliva were examined for serologic evidence of hepatitis B virus transmission. None of the infants had HBsAg by radioimmunoassay or anti-HBc by complement fixation. One infant had anti-HBs whose transient presence was consistent with passive acquisition. Using sensitive serologic tests, no identifiable risk to newborn infants in a special care nursery could be documented as a result of exposure to a nurse who developed acute type B hepatitis during their period of care.

Cross Infection↗

PubMed1976

Herpesvirus infection in the newborn. Its treatment by exchange transfusion and adenosine arabinoside.

A case is reported of herpesvirus infection in the newborn following maternal genital herpesvirus infection. The rationale for treating a newborn infant with signs of disseminated herpesvirus infection by exchange transfusion in addition to adenosine arabinoside is discussed. Because of the lack of data concerning therapy for a disease with a 50 to 100% mortality rate, it is important to present material such as this in order to provide information about possible new therapeutic modalities.

Adult↗

PubMed1975

Antiviral chemotherapy and neonatal herpes simplex virus infecition: a pilot study--experience with adenine arabinoside (ARA-A).

Among 13 neonates with herpes simplex virus (HSV) infection, eight had disseminated disease, one localized CNS disease, and in four the infection was confined to the skin and eyes. Ara-A, a purine nucleoside with anti-viral activity against DNA-VIRUSES, WAS GIVEN (10 TO 20 MG/MG/DAY) BY A CONTINUOUS 12-HOUR INTRAVENOUS DRIP FOR 10 TO 15 DAYS. In all, ara-A administration was begun within three to eight days after the appearance of skin vesicles which represented the hallmark of the disease. Both diagnosis and ara-A treatment were much delayed in one infant without skin vesicles and four infants whose skin vesicles appeared late, long after the occurrence of CNS damage. In this group of infants with disseminated disease, four died and one infant was left with severe neurological deficits. Eight infants (four with disseminated and four with localized skin disease) with skin vesicles as the earliest sign of infection received ara-A early, within three days after the onset of neurologic signs. All survived with no neurologic deficit at 6 months to 1 year of age. There was no apparent toxicity of ara-A to the bonemarrow, liver, or kidney.

Adolescent↗

PubMed1975

Localization of endovascular infection by selective catheterization with serial cultures.

Pseudomonas infection developed at the suture line of an aortic graft in a patient 13 years after the operation. The site of the infection was localized by quantitative blood cultures taken with the aid of selective arterial catheterization. This technique may be of great help in localizing the source of endovascular infection in difficult cases.

Aorta, Abdominal↗