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Biomedical subjects

F R Sattler

Publications and source records attributed to F R Sattler.

63 records · Page 4Linked to original sources
PubMed1983

Assessment of antifungal therapy in an 800-gram infant with candidal arthritis and osteomyelitis.

A 720-g premature newborn developed disseminated candidiasis during treatment with systemic antibiotics and total parenteral nutrition through an umbilical arterial catheter. Clinical features were typical for candidal skeletal infection at this age and included warmth and fusiform swelling of the lower extremities together with radiographic evidence of osteolysis and cortical bone erosion. Candida albicans was cultured from blood, urine, joint fluid, and a bone aspirate. The infection was cured with a 44-day course of amphotericin B and flucytosine (5-fluorocytosine). Antifungal therapy was monitored closely with serum drug levels and laboratory tests for bone marrow toxicity and renal dysfunction. Serum levels of both drugs were comparable to those achieved in older patients treated with similar doses. Significant concentrations of amphotericin B were detected in serum four and 17 days after completion of therapy, indicating a slow rate of elimination similar to that which occurs in adults. There was no evidence of drug-induced toxicity other than transient elevation in the fractional urinary excretion of sodium. This suggests that antifungal therapy may be effectively and safely administered to infants in dose schedules similar to those used for older patients.

Amphotericin B↗
PubMed1982

Meningitis caused by Streptococcus bovis.

Streptococcus bovis was isolated from the CSF of a 66-year-old man with meningitis. His clinical appearance was unusual in that he lacked typical signs and symptoms of pyogenic meningitis. Streptococcus bovis was also recovered from his blood, which suggested that bacterial endocarditis was the source of his CNS infection. He was cured after four weeks of therapy with intravenous penicillin G potassium. This is the fourth reported case of meningitis caused by S bovis. The previous three patients also had endocarditis caused by S bovis. Because of the reported propensity of S bovis to infect heart valves and the frequent association of S bovis bacteremia with malignant gastrointestinal (GI) tract tumors, recovery of this organism form CSF should prompt a search for bacterial endocarditis and occult GI cancer.

Aged↗
PubMed1982

A human hepatoma cell line (PCL/PRF/5) produces lung metastases and secretes HBsAg in nude mice.

PLC/PRF/5 is a human liver cancer cell line which synthesizes hepatitis B virus surface antigen (HgsAB). These cells produced tumor in 6 of 8 (75%) congenitally athymic nude mice at 13 of 28 subcutaneous injection sites and in 13 of 14 (93%) mice inoculated intraperitoneally. Tumors were successfully transplanted to 4 of 6 additional nude mice. Tumor growth was rapid. Growth of cephalad tumors was significantly greater than for caudal tumors (0.39 mm/day versus 0.28 mm/day). Microscopic examination of tumors showed moderately well-differentiated hepatocellular carcinoma. Foci of identical cells were present in pulmonary veins in 7 of 14 tumor-bearing animals. Tumor cell karyotype was identical with that of PLC/PRF/5 cells. In addition, HBsAg was detectable in high titer in animals with extensive tumor. Biological features of PLC/PRF/5-induced tumors in nude mice appeared to closely resemble human hepatocellular carcinoma. Moreover, HBsAg may provide a marker of tumor growth.

Animals↗
PubMed1981

Intravenous trimethoprim-sulfamethoxazole therapy for Pneumocystis carinii pneumonia.

Twenty-nine immunocompromised patients were treated with intravenous trimethoprim-sulfamethoxazole for possible Pneumocystis carinii pneumonia. The diagnosis was established in 15 severely hypoxemic patients with lymphoreticular malignancy or cardiac transplants by open lung biopsy or transthoracic needle aspirate. In 13 (87 percent) of the 15, the response to therapy was rapid. They became afebrile in a mean of 2.1 days, showed improved arterial blood oxygenation in 4.7 days and improvements on the chest roentgenogram in 4.3 days. Eight (53 percent) of the 15 survived and were clinically cured. Five other patients with documented P. carinii infection improved clinically but subsequently died of other causes. Postmortem examination in these showed no P. carinii cysts. Two patients with P. carinii pneumonia died soon after therapy was started and had P. carinii cysts in lung tissue at autopsy. The combined clinical and microbiologic response of 87 percent equals or exceeds that of other reported treatment regimens. Intravenous trimethoprim-sulfamethoxazole may, therefore, be the most ideal therapy for severely ill adults with P. carinii pneumonia. Second lung biopsies in 12 patients on therapy showed that P. carinii cysts were rarely found after several days of treatment. This suggests that lung tissue may be falsely negative for P. carinii cysts in persons treated empirically but who later undergo lung biopsy.

Adolescent↗
PubMed1978

Therapy of gonorrhea. Comparison of trimethoprim-sulfamethoxazole and ampicillin.

Eighty-nine men with gonococcal urethritis were randomly treated with trimethoprim-sulfamethoxazole, four tablets (trimethoprin, 320 mg, and sulfamethoxazole, 1,600 mg) twice daily for two days, or ampicillin, 3.5 g, plus probenecid, 1 g, in a single dose. Forty-one (95.3%) of 43 patients who received trimethoprin-sulfamethosazole and 41 (97.6%) of 42 given ampicillin were cured. Neither drug caused major side effects. All isolates of Neisseria gonorrhoeae were susceptible in vitro to trimethoprim-sulfame-thoxazole, and all but one were inhibited by ampicillin. The ampicillin-resistant strain (minimum inhibitory concentration, 4 micrograms/ml) produced penicillinase and was reovered from a patient who responded to treatment with trimethoprim-sulfamethoxazole. There was no significant correlation between the minimum inhibitory concentrations of trimethoprim-sulfamethoxazole and ampicillin. It is concluded that trimethoprim-sulfamethoxazole is as efficacious and safe as ampicillin in the therapy of gonococcal urethritis.

Ampicillin↗
PubMed1978

Miconazole for treatment of disseminated coccidioidomycosis. Unfavorable experience.

Miconazole at dosages up to 30 mg/kg/day was given intravenously to seven patients with complicated courses of disseminated coccidioidomycosis. Six had received treatment with amphotericin B previously and five of these patients could be evaluated for the efficacy of the treatment. In three patients the condition failed to respond to therapy, another patient required intratracheal administration of amphotericin B later, and the fifth patient had an equivocal response to treatment. Severe phlebitis, pruritus, nausea, vomiting, hyperlipidemia, and thrombocytosis were frequent side effects. These limited unfavorable results indicate that until controlled studies demonstrate its safety and efficacy, therapy with miconazole should be reserved for highly selected patients with disseminated coccidioidomycosis who cannot receive amphotericin B.

Adult↗
PubMed1977

Empyema due to Streptococcus mutans.

Empyema due to Streptococcus mutans occurred following dental manipulation in two patients with periodontal disease. Isolation of this dental pathogen from pleural fluid localized the site of origin of the empyemas to the oropharynx and precluded the need to search for a remote intra-abdominal source of these pleuropulmonary infections. Although there is controversy regarding the susceptibility of S mutans to penicillin, the isolates from our patients were markedly sensitive to the drug, and both patients were cured with penicillin therapy and surgical drainage.

Adult↗
PubMedDate not supplied

Safety of aztreonam and SQ 26,992 in elderly patients with renal insufficiency.

Aztreonam is hydrolyzed (2%-7%) in vivo to a noncyclic compound, SQ 26,992, which has a serum half-life of 26 hr in healthy volunteers. In a study of whether SQ 26,992 accumulates to potentially toxic levels in patients with renal insufficiency, serum concentrations were measured daily in nine elderly patients (average age, 72 years) with diminished renal function and urinary tract infections. The dosage of aztreonam (1.5, 3.0, or 6.0 g per day) was selected according to the creatinine clearance rate (5-49 ml/min) and the severity of infection. Trough levels of aztreonam for eight patients averaged 34.2 micrograms/ml before the third or fourth dose and 32.7 micrograms/ml on the fifth day of therapy (P = .77). Trough levels of SQ 26,992 at the same times averaged 3.2 and 9.1 micrograms/ml, respectively (P = .04). In the one patient who was undergoing hemodialysis, trough levels of aztreonam averaged 55 micrograms/ml for seven days, and trough levels of SQ 26,992 increased progressively from 2.6 to 38.2 micrograms/ml. For all nine patients, the ratio of the SQ 26,992 concentration on day 5 to that on day 1 was inversely related to the creatinine clearance rate (r = -.89). No adverse clinical reactions or laboratory test abnormalities were detected during therapy. Thus, aztreonam should prove to be safe in elderly patients with diminished renal function.

Aged↗