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Biomedical subjects

G P Bodey

Publications and source records attributed to G P Bodey.

At least 163 records · Page 9Linked to original sources
PubMed1989

Necrotizing gas-forming infections in cancer patients.

Necrotizing gas-forming infections in cancer patients present some unique characteristics, such as nontraumatic, spontaneous clostridial gangrene and gangrene involving an ischemic tumor mass. These infections can be rapidly progressive and uniformly fatal without surgical debridement. We review ten cases of gas gangrene seen during an 18-year period. Four were caused by Clostridium species and six by other organisms. Neutropenia was present in seven patients. During the last nine years, Clostridium septicemia occurred in 54 patients; in only two of those patients did gas gangrene ensue.

Adolescent↗
PubMed1989

Antifungal susceptibility of 44 clinical isolates of Fusarium species determined by using a broth microdilution method.

The MICs and minimum fungicidal concentrations of amphotericin B, natamycin, miconazole, itraconazole, and flucytosine against 17 isolates of Fusarium solani, 14 isolates of Fusarium moniliforme, 10 isolates of Fusarium oxysporum, and 3 isolates of Fusarium semitectum were determined by a broth microdilution method. Amphotericin B and natamycin were the most active agents tested and failed to show any inoculum size effect. In contrast, miconazole and itraconazole showed poor inhibitory and fungicidal activities, and the inoculum size had a major effect on the results. Flucytosine had no activity against any of the isolates tested.

Antifungal Agents↗
PubMed1989

Serological classification of Xanthomonas maltophilia (Pseudomonas maltophilia) based on heat-stable O antigens.

Twenty-six serotypes of Xanthomonas maltophilia were defined by using 15 antisera described by Hugh and Ryschenkow (R. Hugh and E. Ryschenkow, J. Gen. Microbiol. 26:123-132, 1961) and 11 new antisera. The antisera were prepared by immunizing rabbits with bacterial strains heated at 100 degrees C for 2 h. Twelve antisera required adsorptions with cross-reacting heterologous immunizing strains. We tested 275 clinical and environmental strains of X. maltophilia with 26 antisera by the slide agglutination technique. A total of 259 (94.2%) strains were typeable, with 137 (49.8%) strains agglutinating in three antisera.

Agglutination Tests↗
PubMed1989

Intestinal crytosporidiosis treated with eflornithine: a prospective study among patients with AIDS.

Twenty-two patients with the acquired immune deficiency syndrome (AIDS) and severe debilitating diarrhea caused by Cryptosporidium received eflornithine as therapy. Of 17 evaluable patients, 5 had complete resolution of diarrhea and negative follow-up stool examinations for Cryptosporidium. One patient responded but relapsed after cessation of therapy. Four patients had resolution of diarrhea and symptomatic improvement, but continued to excrete the organisms in feces. Seven patients did not respond to eflornithine therapy. Eflornithine may induce complete responses or palliation of diarrhea in some AIDS patients with intestinal cryptosporidiosis.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Cutaneous Rhizopus and Aspergillus infections in five patients with cancer.

Primary cutaneous infection with Aspergillus species and Rhizopus species was observed in five patients between October 1986 and January 1988. All patients had an underlying hematological malignancy and were neutropenic. Four patients developed skin lesions with eschars at and around the site of intravenous catheter insertion. One patient had two lesions along the course of the intravenous line. The fifth patient developed the lesion on the left side of the lower part of the back subsequent to the appearance of a rash due to excessive perspiration. A diagnosis was made in each case by histopathological studies and cultures of skin biopsy specimens. The fungal organisms cultured were Aspergillus species in three patients and Rhizopus species in two patients. All patients were treated with amphotericin B. Three patients responded to antifungal therapy and local care without surgical débridgement. Two patients died of disseminated fungal infection. The development of cutaneous lesions due to opportunistic fungal pathogens seemed to have been related to the moist and humid conditions created by occlusive dressings or excessive perspiration.

Adult↗
PubMed1989

Nosocomial fungal infections. Old problems and new challenges.

The frequency of nosocomial mycoses has substantially increased in recent years, primarily because of the use of intensive therapeutic regimens in patients with cancer and organ transplantation. Furthermore, newer fungi previously considered as contaminants or harmless colonizers have now emerged as significant human pathogens, particularly in the immunocompromised host. Only through the collaboration between clinicians, pathologists, microbiologists, and infection control officers can these fungal infections be recognized and treated early. It is hoped that the proper implementation of infection control policies, the advent of newer antifungals and biological response modifiers, and the advances in immunosuppressive regimens for organ transplant recipients will result in a significant improvement in the prevention and treatment of these life-threatening opportunistic mycoses.

Aspergillosis↗
PubMed1989

Haemophilus species bacteremia in patients with cancer. A 13-year experience.

We reviewed the clinical and laboratory presentation of Haemophilus species bacteremia at our institution, with special attention to predisposing and prognostic factors. Of 36 cases, 18 presented with pneumonia, 1 with cellulitis, and another with sinusitis. No cases of meningitis or endocarditis were detected. Most episodes were caused by Haemophilus influenzae, and the overall response rate to treatment was 72%. Factors including chronic obstructive pulmonary disease, alcoholism, prior splenectomy, and neutropenia did not play an important role in these patients' infections. Most of the isolates serotyped were found to be nontypable. The occurrence of ampicillin resistance was 6% throughout the study. Ampicillin, chloramphenicol, and second-generation cephalosporins were all effective therapeutic regimens. Bacteremia due to Haemophilus species remains an uncommon infection in patients with cancer, despite the predominance of traditional predisposing factors.

Adolescent↗
PubMed1989

Treatment of systemic fungal infections with liposomal amphotericin B.

Forty-six patients with systemic fungal infections were treated with liposomal amphotericin B. Twenty-one patients had disseminated candidiasis, 19 had aspergillosis, and the rest had a variety of other fungal infections. Forty patients failed to respond to conventional amphotericin B therapy, and 6 patients were given liposomal amphotericin B because conventional amphotericin B caused severe side effects. Twenty-four patients had a complete response, and 22 patients failed to respond. No short- or long-term toxic reactions were observed. The acute side effects such as fever, chills, and potassium loss were infrequent and milder than those commonly observed with conventional amphotericin B. No chronic renal, hematologic, or central nervous system side effects were observed. Liposomal amphotericin B therapy was effective and less toxic than conventional amphotericin B therapy.

Adolescent↗
PubMed1988

Cefoperazone plus mezlocillin for empiric therapy of febrile cancer patients.

Two dosing regimens of cefoperazone plus mezlocillin were compared in a prospective, randomized trial for therapy of febrile cancer patients. The two regimens were 5 g mezlocillin plus 2 g cefoperazone intravenously every four hours (higher dose) or 3 g mezlocillin plus 1 g cefoperazone intravenously every four hours (lower dose). Although the overall response rate was higher with the higher dose regimen (78 percent versus 66 percent, p = 0.04), the two regimens were comparable in patients with documented infections (72 percent versus 68 percent). Likewise, the two regimens were equally effective against those infections in which the pathogen could be determined (82 percent versus 82 percent). Serum bactericidal titers of at least 1:32 against a known pathogen were associated with a higher response rate than were titers of less than 1:32, but the higher dose regimen did not result in higher serum bactericidal titers. Hypoprothrombinemia was a side effect, especially with the higher dose regimen, before prophylactic vitamin K was routinely administered to patients. Since there were no major benefits with the use of the higher dose regimen of mezlocillin plus cefoperazone, the lower dose regimen is more appropriate for routine usage.

Adolescent↗
PubMed1988

Survey of antibiotic susceptibility among gram-negative bacilli at a cancer hospital.

A survey was conducted of the susceptibility of gram-negative bacilli to selected broad-spectrum antibiotics. The organisms were isolated from all patient specimens submitted to the routine microbiology laboratory during two three-month periods. Overall, the least resistance was observed against imipenem and ciprofloxacin. Considering all of the gram-negative bacilli, differences in susceptibilities to the other antibiotics (aztreonam, cefoperazone, ceftazidime, piperacillin) were minimal. Significant increases in resistance to some antibiotics occurred during the latter period.

Anti-Bacterial Agents↗
PubMed1988

Branhamella catarrhalis septicemia in patients with leukemia.

During a 10-year period, four patients with leukemia were identified who had Branhamella catarrhalis septicemia. Two patients had acute leukemia and the remaining two had chronic myelogenous leukemia with blastic transformation. All patients were febrile and neutropenic at the onset of the septicemia. After appropriate antibiotic therapy, they recovered from their infection despite persistence of neutropenia. Because beta-lactamase-producing bacteria are an increasing cause of nosocomial infections, treatment should be selected to cover them.

Humans↗
PubMed1988

Phase II study of AMSA alone and in combination with DTIC in patients with metastatic melanoma.

A randomized phase II study of AMSA (amsacrine) alone and AMSA combined with DTIC (dacarbazine) was carried out in 31 and 39 patients with metastatic melanoma respectively. AMSA was used at a starting dose of 40 mg/m2/day X 3 days with escalation to 50-60 mg/m2/day X 3 days in 8 pts. For AMSA + DTIC the starting dose was: AMSA 30 mg/m2/day X 3 days; DTIC, 800 mg/m2 X 1 day. Additionally, seven pts received AMSA in a similar dose schedule but DTIC was used in a 5-day schedule of 250 mg/m2/day. Twenty-five patients were evaluable for response in the AMSA group and 36 in the AMSA + DTIC group. The objective response to AMSA included 1(4%) partial response compared with 11 complete or partial responses (30%) with AMSA + DTIC therapy. The median lowest absolute granulocyte count was 1100/microliters in AMSA group compared with 1000/microliters in the AMSA + DTIC group. Severe neutropenia of less than 500 granulocytes/microliter was observed in 5 pts in the AMSA group compared with 13 pts in the AMSA + DTIC group. We concluded that AMSA has no significant activity against melanoma, although the combination of AMSA + DTIC seemed to be more active than DTIC alone.

Adult↗
PubMed1988

Phase I study of weekly-administered iproplatin [cis-dichloro-trans-dihydroxy-bis-isopropylamine platin (chip, JM9)].

Iproplatin [cis-dichlor-trans-dihydroxy-bis-isopropylamine platinum (CHIP, JM9)] is a new antineoplastic platinum analogue with an octahedral conformation. It has more water solubility than does cisplatin and was found to have less neurotoxicity and nephrotoxicity in experimental animals than cisplatin. Like cisplatin, it has been demonstrated to have a broad spectrum of activity in experimental tumor systems. A phase I study of iproplatin was conducted in 28 patients (12 with melanoma, 8 with sarcoma, 6 with breast cancer, and 2 with colon cancer). All patients had failed prior chemotherapy. Four consecutive doses of iproplatin were administered at weekly intervals followed by a rest period of two weeks for hematologic recovery (one course). One hundred forty-two weekly doses were administered with all patients except three receiving at least one full course. The weekly starting dose of 40 mg/m2 was increased to 120 mg/m2 given over 30 minutes without hydration. Myelosuppression predominantly thrombocytopenia, was the dose-limiting toxicity at weekly doses of greater than or equal to 95 mg/m2 per course. With iproplatin doses 75 mg/m2, 95 mg/m2, and 120 mg/m2, the lowest median granulocyte counts were 2.6 x 10(3)/mm3, 2.2 x 10(3)/mm3, and 1.8 x 10(3)/mm3, respectively. Similarly, at iproplatin doses of 75 mg/m2, 95 mg/m2, and 120 mg/m2, the lowest median platelet counts were 144 x 10(3)/mm3, 99 x 10(3)/mm3, and 31 x 10(3)/mm3, respectively. Mild to moderate nausea and vomiting were observed in the majority of patients. No significant neurotoxicity, nephrotoxicity, or ototoxicity was observed. Objective tumor regression was not observed in this study.(ABSTRACT TRUNCATED AT 250 WORDS)

Antineoplastic Agents↗
PubMed1988

Brown Sequard syndrome secondary to soft tissue infection in a patient with acute lymphocyte leukemia.

A 42-year-old Latin American female with acute lymphocytic leukemia in second relapse developed a small ecthymic lesion around the entrance site of a left subclavian line. This was followed by development of left-sided hemiparesis with contralateral loss of pain and temperature sensation. CT of the neck revealed a diffuse inflammatory process with soft tissue involvement and several bubbles of air in the anterior paraspinal muscles and within the spinal canal in the epidural location.

Adult↗
PubMed1988

Comparative in vitro activity of the two new 4-quinolones S-25930 and S-25932 against gram-positive bacteria isolated from cancer patients.

The in vitro activity of S-25930 and S-25932, two new quinolone antimicrobial agents, against 306 gram-positive organisms representing 12 bacterial species, was evaluated and compared with the activity of ciprofloxacin, difloxacin, enoxacin, amifloxacin and A-56620. Both agents were active against staphylococcal species (including methicillin-resistant and coagulase-negative isolates), Bacillus spp. and group JK diphtheroids. They were less active against streptococcal species and Listeria monocytogenes. Their activity against most isolates was superior to that of amifloxacin, enoxacin and difloxacin and similar to that of ciprofloxacin and A-56620.

Anti-Bacterial Agents↗
PubMed1988

Comparative in vitro activity of the new difluoro-quinolone temafloxacin (A-62254) against bacterial isolates from cancer patients.

The in vitro activity of temafloxacin, a new difluoro quinolone agent, against 725 bacterial isolates representing 32 species was evaluated in comparison with that of ciprofloxacin. Temafloxacin inhibited the majority of Enterobacteriaceae isolates at a concentration of less than or equal to 0.5 microgram/ml. It was also extremely active against Acinetobacter spp. and Aeromonas hydrophila. Its activity was 2-8 fold less than that of ciprofloxacin against most gram-negative isolates. Methicillin-susceptible and methicillin-resistant Staphylococcus aureus, coagulase-negative Staphylococcus spp., Streptococcus spp., Listeria monocytogenes, Bacillus spp. and group JK corynebacteria were inhibited at concentrations equal to that of ciprofloxacin.

Anti-Infective Agents↗
PubMed1988

Randomized trial of beta-lactam regimens in febrile neutropenic cancer patients.

A three-arm prospective randomized trial was designed to compare the efficacies of piperacillin plus vancomycin, ceftazidime plus vancomycin, or all three drugs as initial therapy for fever in neutropenic cancer patients. The objectives were to determine whether a broad-spectrum penicillin was as effective as a broad-spectrum cephalosporin and whether two beta-lactam antibiotics were more effective than one. Four hundred and seventy of the 519 febrile episodes entered in the study could be evaluated for response. Ceftazidime plus vancomycin was significantly more effective than piperacillin plus vancomycin, considering all febrile episodes (79 percent versus 61 percent, p = 0.001), documented infections (79 percent versus 57 percent, p = 0.004), gram-negative infections (88 percent versus 47 percent, p = 0.001), and bacteremias (81 percent versus 51 percent, p = 0.01). The addition of piperacillin to ceftazidime (piperacillin plus ceftazidime and vancomycin versus ceftazidime plus vancomycin) did not improve the response rate and was associated with a significantly higher incidence of skin rash. Vancomycin plus ceftazidime provides adequate antibiotic coverage for initial treatment of fever in neutropenic patients. This combination was equally effective, less expensive, and less toxic than the double beta-lactam combination used in this study.

Adult↗