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Biomedical subjects

F K Murphy

Publications and source records attributed to F K Murphy.

8 recordsLinked to original sources
PubMed1996

Pancreatitis associated with human immunodeficiency virus infection: a matched case-control study.

To determine the frequency of pancreatitis and to define risk factors for pancreatitis in patients with AIDS, we compared patients with pancreatitis to patients without pancreatitis in an urban infectious disease practice. Pancreatitis was defined as at least one clinical sign or symptom (nausea, vomiting, abdominal pain, or tenderness) accompanied by elevation of serum amylase or lipase. Twenty-four (22%) of 105 patients with AIDS, 2 (4%) of 46 patients with AIDS-related complex, 1 (3%) of 39 asymptomatic patients infected with HIV-1, and none of 9 uninfected patients at risk for HIV-1 developed pancreatitis as defined above. Fourteen patients experienced multiple episodes and three were symptomatic for more than 2 months. Pancreatitis was more likely to have occurred in patients with AIDS (P < .001), biliary tract disease (P = .013), and hypertriglyceridemia (P = .032). After matching for these factors and duration of current HIV disease, cryptosporidiosis, intravenous pentamidine, and isoniazid were each associated independently with pancreatitis (P < .05). Before didanosine (ddl) became available, 22% of the patients with AIDS in this practice had pancreatitis. Cryptosporidiosis, isoniazid, and intravenous pentamidine should be considered among the potential etiologies.

AIDS-Related Opportunistic Infections↗
PubMed1991

Differential diagnosis of bacterial myositis in AIDS: evaluation with MR imaging.

Magnetic resonance (MR) imaging was used to assess for the presence of bacterial myositis, rare outside the tropics, in 13 patients with either the acquired immunodeficiency syndrome (AIDS) (n = 11) or positive results of serologic tests for the human immunodeficiency virus but without other evidence of AIDS (n = 2). Bacterial myositis was diagnosed in six patients: in five it was caused by pyogenic bacteria, and in the other, by Mycobacterium tuberculosis; in each patient, little or no subcutaneous tissue alteration occurred. On T1-weighted images in three patients, muscle abscesses showed a rim of increased signal intensity corresponding to margins between drainable pus and edematous muscle. Subcutaneous tissues appeared normal in patients with bacterial myositis but was not in the others, in whom muscle abnormalities tended to be less prominent. The latter group included patients with lymphoma (n = 1), Kaposi sarcoma (n = 2), and carbunculosis (n = 1), and three patients in whom no diagnosis was made; lymphedema was presumed to account for imaging abnormalities in four of the latter group.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Progressive multifocal leukoencephalopathy in a renal transplant recipient. Increased diagnostic sensitivity of computed tomographic scanning by double-dose contrast with delayed films.

A progressive, deteriorating neurologic disorder developed in a 28-year-old white man 10 years after he successfully received a living related donor kidney transplant. An extensive neurologic evaluation was unrevealing, including normal results of computed tomographic scanning of the brain with and without contrast medium. Repeated computed tomographic scanning after a double dose of radiocontrast medium in conjunction with delayed imaging revealed multiple areas of abnormal enhancement. This technique helped to direct brain biopsy, which led to the early diagnosis of progressive multifocal leukoencephalopathy and the institution of specific therapy.

Adult↗
PubMed1983

Transfusion-associated cytomegalovirus infection and acquired immune deficiency syndrome in an infant.

An infant who received multiple blood transfusions in the neonatal intensive care unit developed a transfusion-associated CMV infection at age 11 weeks and thereafter was noted to have hepatosplenomegaly, mitogen hyporesponsiveness, persistent viruria, an abnormal distribution of T-lymphocyte subpopulations, and poor growth. He has had recurrent opportunistic infections, including Pneumocystis carinii pneumonia. Six donors of blood products received by this infant were investigated; one was found to have chronic lymphadenopathy, weight loss, intermittent diarrhea, lymphopenia, and a profound depression of lymphocytes with a helper/inducer surface phenotype (T4 positive). Family members have an abnormal distribution of T cell subpopulations similar to those reported in asymptomatic homosexuals. The course of disease in our patient suggests that acquired immune deficiency syndrome may be transmitted to young infants via blood products.

Acquired Immunodeficiency Syndrome↗
PubMed1980

Infections of hairy cell leukemia. Clinical evidence of a pronounced defect in cell-mediated immunity.

We compared infection rates in 12 patients with hairy cell leukemia (a malignant neoplasm for which the cell of origin remains controversial) with rates in 15 patients with chronic lymphocytic leukemia (a known B-lymphocyte neoplasm) recently treated at four Dallas hospitals. We found a significantly higher over-all rate of infections in the patients with hairy cell leukemia (P = 0.004 BY Gehan's variation on the generalized Wilcoxon test). This increased rate was primarily due to a significantly higher rate of infections normally controlled by the cell-mediated immune system (P = 0.005). Despite these findings, five of six patients with hairy cell leukemia who were skin-tested exhibited intact delayed type hypersensitivity, and each of the three patients examined serologically produced antibodies normally in response to recent infections. A review of the case records of 173 previously described patients with hairy cell leukemia, demonstrated a similar predilection of patients with this disease for infections normally controlled by cell-mediated immunity. In this regard, they were similar to previously described patients with Hodgkin's disease. Both over-all infection rates and rates of fatal infection were highest in patients with hairy cell leukemia who received chemotherapy as their sole form of treatment and lowest in those who underwent splenectomy as their only form of antitumor therapy.

Adult↗
PubMed1980

Antigenuria in St. Louis encephalitis.

Patients with St. Louis encephalitis may have urinary tract symptoms when they develop manifestations related to involvement of the central nervous system. During 1976, 12 patients with St. Louis encephalitis were studied for the presence of antigenuria, and compared to controls. Although virus isolation attempts were negative indirect immunofluorescence, electron microscopy, and immune electron microscopy demonstrated the presence of viral antigen in urine. Further study of antigenuria in St. Louis encephalitis is needed to delineate the pathophysiology of the lower urinary tract symptoms and to determine whether this phenomenon might furnish the basis for a rapid diagnostic test for the disease.

Antibodies, Viral↗
PubMed1979

Epidemic gastritis with hypochlorhydria.

Seventeen of 37 healthy volunteers participating in studies of acid secretion and 1 patient with Zollinger-Ellison syndrome became rapidly and profoundly hypochlorhydric. A mild illness with epigastric pain occurred in 9 subjects, usually several days before detection of hypochlorhydria. Gastric mucosal biopsy specimens taken from subjects during hypochlorhydria revealed severe fundal and antral gastritis; however, even when acid secretion was severely depressed, parietal cells were abundant and appeared normal histologically. During hypochlorhydria, gastric permeability to hydrogen, sodium, and lithium was normal in 4 subjects. Serum gastrin concentrations were usually normal, whereas serum pepsinogen concentrations were invariably elevated. Serum parietal cell antibodies were not present. Acid secretion returned to near baseline levels in 14 of 17 subjects after a mean of 126 days (range 53--235); severity of gastritis diminished concurrently in 7 of 10 subjects on whom biopsies were serially performed. An infectious etiology is suspected, although serologic studies and bacterial and conventional viral cultures of stool and gastric juice have not identified a candidate agent.

Achlorhydria↗