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Biomedical subjects

E L Goodman

Publications and source records attributed to E L Goodman.

6 recordsLinked to original sources
PubMed1987

Acute and chronic desensitization of penicillin-allergic patients using oral penicillin.

The efficacy, safety and mechanisms of penicillin desensitization were studied in 24 adults and two children with serious infections that required therapy with a beta-lactam drug. Indications for desensitization included debilitating as well as life-endangering infections. Increasing oral doses of phenoxymethyl penicillin were administered at 15-minute intervals to a cumulative dose of 1.3 million units. Parenteral therapy with the beta-lactam drug of choice was instituted at that point. Immunologic complications of desensitization or therapy, ranging from pruritus to serum sickness, occurred in 12 patients. The appearance of gradually worsening wheezing led to abandonment of the procedure in one subject with cystic fibrosis and severe pulmonary disease. The remaining 25 patients were successfully desensitized and received full-dose parenteral therapy. Chronic desensitization was maintained in seven individuals with twice daily oral penicillins for 3 weeks to more than 2 years. No allergic complications of chronic desensitization or recurrent full-dose parenteral therapy were detected. Skin test reactions to one or all penicillin determinants became negative in 11 of 15 patients retested after acute desensitization. Two desensitized patients became skin test negative, remained skin test negative after cessation of desensitization, and tolerated subsequent beta-lactam therapy without allergic reactions or resensitization. The results of this study provide new evidence that acute and chronic penicillin desensitization is useful and an acceptably safe approach and suggest that antigen-specific mast cell desensitization contributes to the protection against anaphylaxis.

Administration, Oral↗
PubMed1981

Bone scintigraphy in the diagnosis of mastoiditis.

Bone scintigraphy has proven utility in the early diagnosis of osteomyelitis, but the authors were unable to find any report of its specific application to mastoiditis. Three cases of mastoiditis are presented in which the bone scan findings predicted the histopathologic findings.

Aged↗
PubMed1975

Prospective comparative study of variable dosage and variable frequency regimens for administration of gentamicin.

In patients with impaired renal function, careful adjustment of gentamicin dosage is required to achieve therapeutic yet nontoxic concentrations. Two regimens that differ in pharmacodynamic characteristics have been recommended for this purpose: prolonging the intervals between administration of equal doses (variable frequency regimen [VFR]) or administering a loading dose followed at the usual intervals by reduced maintenance doses (variable dosage regimen [VDR]). These regimens were compared in a prospective, randomized study of 20 seriously ill hospitalized patients, 10 on VFR and 10 on VDR. Wide variability in peak serum levels of gentamicin was observed both between patients and in individual patients after separate injections of the same dosage. As predicted by the design of these regimens, the trough serum levels of gentamicin correlated significantly with the serum creatinine concentrations in patients on the VDR but not in patients on the VFR. A gentamicin trough level of >/=4 mug/ml was the only variable among those tested that correlated significantly with development or progression of renal insufficiency during treatment with gentamicin, but such trough levels were observed frequently on both regimens. Whereas this study does not permit a direct comparison of the therapeutic efficacy of VDR and VFR, no difference in the risk of nephrotoxicity with these regimens was observed.

Clinical Trials as Topic↗
PubMed1975

Prospective double-blind evaluation of topical adenine arabinoside in male herpes progenitalis.

Thirty-four virologically proven episodes of herpes progenitalis in 32 men were treated in a prospective double-blind study with either adenine arabinoside ointment or an identical-appearing placebo for 7 days. Clinical evaluation and quantitative virological studies were done on days 1, 3, and 8. There was a highly significant correlation between clinical response and quantitative virology. There was no difference in clinical or virological response between drug and control groups. Primary attacks tended to have higher viral excretion over the period of observation. The level of complement-fixing antibody to herpes simplex virus type 2(<1:16 versus >/=1:16) in patients with recurrent disease did not appear to alter the course of viral excretion.

Administration, Topical↗