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Biomedical subjects

H A Kessler

Publications and source records attributed to H A Kessler.

At least 91 records · Page 5Linked to original sources
PubMed1987

The office approach to the sexually transmitted diseases: Part I.

Sexually transmitted diseases (STDs) are diagnosed in 10 million patients per year in the United States. The infected individuals come from all walks of life and all age groups. They may present with either genital or nongenital signs and symptoms. Most individuals are treated as outpatients, but more than a quarter of a million hospital admissions for STDs are necessary each year. These numbers will rise precipitously as the number of AIDS cases increases. More than 10,000 deaths per year are caused by STDs, primarily because of AIDS, cervical carcinoma, and hepatitis B induced cirrhosis and hepatoma. Physicians must become highly skilled in the diagnosis and treatment of the common STDs caused by herpes simplex virus, Neisseria gonorrhoeae, and Chlamydia trachomatis. Simple office microscopic skills are needed for the diagnosis of vaginitis, cervicitis, and urethritis, and all physicians should be encouraged to develop these skills. Physicians will need to keep abreast of the rapidly evolving changes in the diagnosis and treatment of STDs.

Epididymitis↗
PubMed1987

The office approach to the sexually transmitted diseases: Part II.

All physicians share a responsibility for educating the public in the expanding risks of sexually transmitted diseases, and in the vital importance of safe sexual practices. Both the public health implications of undiagnosed STDs and the adverse social consequences of an incorrect diagnosis emphasize the need to comprehensively and precisely diagnose these diseases, despite the problems encountered in obtaining material for culture. Current interest in AIDS should not obscure the facts that genital herpes continues to increase in prevalence, and that syphilis no longer is declining. The many extragenital syndromes associated with STDs, such as perihepatitis, polyarthritis, and acute septic states make it necessary to evaluate all sexual contacts.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Sensitivity and specificity of an HIV antibody assay.

We have evaluated a new enzyme immunoassay (EIA) to measure IgG antibodies (Abs) to HIV in patients with AIDS, AIDS-related complex (ARC), AIDS contacts (AC), and low risk controls. Twenty-nine (94%) of 31 AIDS, 27 (96%) of 26 ARC, 12 (54%) of 22 AC, and 1 (2%) of 60 control patients were anti-HIV Ab positive by this assay. Positive results were confirmed by Western blot analysis. The EIA for anti-HIV evaluated in this study is sensitive and specific in identifying individuals who have been infected by this retrovirus.

Antibodies, Viral↗
PubMed1986

Effects of suramin on in vitro HBsAg production by PLC/PRF/5 cells and hepatitis B virus DNA polymerase activity.

The effects of suramin, an antiparasitic agent, upon in vitro hepatitis B surface antigen production by the human hepatoma cell line PLC/PRF/5 and hepatitis B virus associated DNA polymerase activity in the serum of a chronically infected patient were examined. Treatment with suramin resulted in decreases in hepatitis B surface antigen production and hepatitis B-virus associated DNA polymerase activity. The decrease in hepatitis B surface antigen production was paralleled by a general decrease in hepatoma cell viability and cellular protein synthesis. Although the inhibitory effects of suramin for hepatitis B virus appear to be nonspecific as demonstrated in these two in vitro systems, the recently announced trial of suramin for the treatment of the acquired immunodeficiency syndrome should afford an unusual opportunity to evaluate the effectiveness of suramin in the treatment of chronic hepatitis B virus infection.

Carcinoma, Hepatocellular↗
PubMed1986

In vitro activity of ketoconazole against herpes simplex virus.

The effects of ketoconazole alone and in combination with acyclovir and adenine arabinoside upon the replication of herpes simplex virus types 1 and 2 (HSV-1 and -2) were investigated by using a yield reduction assay. Ketoconazole demonstrated antiviral activity against HSV-1 and -2 and synergistic antiviral activity when it was combined with acyclovir. Combinations of ketoconazole with adenine arabinoside resulted in either interference or indifference. The effects of ketoconazole upon the protein synthesis of HSV-2-infected cells were also determined in an effort to define the mechanism of action for the antiviral activity of ketoconazole. There was no reduction of HSV proteins when compared with acyclovir. These findings suggest that further investigations of the use of ketoconazole for the treatment of HSV infections are warranted.

Acyclovir↗
PubMed1985

Inhibition of in vitro HBsAg production by amphotericin B and ketoconazole.

The effects of amphotericin B, ketoconazole, and adenine arabinoside on production of hepatitis B surface antigen (HBsAg) particles by the human hepatoma cell line PLC/PRF/5 were examined. In addition, the effects of these drugs on cellular protein synthesis were determined. These drugs caused a dose-dependent decrease in HBsAg production that was paralleled by a decrease in cellular protein synthesis. Ketoconazole was the most active of these drugs and the most specific, causing a 72% reduction in HBsAg production with only a 38% reduction in protein synthesis. These data suggest that further studies evaluating ketoconazole for the treatment of chronic hepatitis B virus infection in animals are warranted.

Amphotericin B↗
PubMed1985

Antibodies to hepatitis B surface antigen as the sole hepatitis B marker in hospital personnel.

The epidemiologic and serologic differences between hospital employees with antibodies to hepatitis B surface antigen (anti-HBs) alone or in combination with antibodies to hepatitis B core antigen (anti-HBc) were evaluated. Of 105 employees with anti-HBs, 38 (36%) did not have anti-HBc. Sera from employees with anti-HBs alone had significantly lower mean sample ratio units of anti-HBs than sera with both antibodies (15.9 +/- 43.2 as compared to 110.3 +/- 73.9, p less than 0.0005) and more commonly had less than 10 sample ratio units of anti-HBs (32 [84%] of 38 as compared to 9 [13%] of 67, p = 0.0001). The anti-HBs in sera with anti-HBs alone was predominantly IgM as shown by inactivation with 2-mercaptoethanol and the presence of anti-HBs activity in serum IgM fractions. Failure of protection from hepatitis B virus infection in persons with anti-HBs alone and the presence of nonprotective IgM anti-HBs in chimpanzees has been reported. Our data suggest the use of anti-HBs as a single serologic screening test for hepatitis B virus immunization programs may not be reliable in identifying employees with protective antibodies.

Chicago↗
PubMed1983

A hospital-based influenza immunization program, 1977-78.

An influenza immunization program on General Medicine inpatient and outpatient units immunized a greater proportion of patients than did physicians on medical subspecialty units. Many patients hospitalized with influenza and other respiratory conditions had been discharged earlier in the year or seen in outpatient clinics. Previous hospital care may be a useful marker for identifying many high-risk patients who could receive influenza vaccine in organized programs for hospital-based immunization. (Am J Public Health 1983; 73:442-445.)

Disease Susceptibility↗
PubMed1983

Elevated creatine phosphokinase levels associated with influenza A/Texas/1/77 infection.

24 patients admitted to hospital between December 1, 1977 and March 3, 1978 with cultural or serological evidence of influenza A infection were retrospectively analyzed for evidence of elevated creatine phosphokinase (CPK) levels. 14 patients had elevated CPK levels not attributable to usual causes. Muscle biopsies from 2 patients showed focal necrosis and myopathic changes. Influenza A/Texas/1/77 was isolated from the biopsy specimen of 1 patient. Patients with elevated CPK levels tended to have greater per day hospital costs and more complications than patients with normal CPK levels. Elevated CPK levels are relatively common in hospitalized patients with influenza and may be due to influenza virus involvement of skeletal muscle.

Biopsy↗
PubMed1981

Effects of amphotericin B on hepatitis B virus.

We investigated the effects of amphotericin B (AmB) on the ultrastructure and biochemistry of hepatitis B virus (HBV) and hepatitis B surface antigen (HBsAg) particles. These effects were compared with those reported for AmB and other polyene antibiotics on other lipid-enveloped viruses and artificial membranes. Treatment of HBV particles with concentrations of AmB ranging from 5 to 250 microgram/ml resulted in (i) an increase in HBV deoxyribonucleic acid polymerase activity as the concentration of Amb increased; (ii) changes in the electron microscopic appearance of HBV ranging from increased penetration of negative stain into the lipid envelope to disruption of the virus; and (iii) an increase in density form 1.165 to 1.225 g/ml. In addition, AmB treatment of HBsAg particles resulted in disruption into a nonparticulate HBsAg-reactive fraction and an HBsAg-AmB complex fraction with no HBsAg immunoreactivity.

Amphotericin B↗
PubMed1980

Acute myopathy associated with influenza A/Texas/1/77 infection. Isolation of virus from a muscle biopsy specimen.

Influenza A/Texas/1/77 was isolated from a muscle biopsy specimen from a patient with muscle weakness and increased serum creatine phosphokinase level. The patient was seen during an outbreak of influenza A/Texas/1/77 that was associated with myopathy. Isolation of this virus from this patient's muscle specimen suggests that the myopathy associated with influenza may be due to direct infection of skeletal muscle.

Aged↗
PubMed1980

Acute pneumococcal epiglottitis in immunocompromised adults.

3 cases of acute bacterial epiglottitis in immunocompromised adults are reported. All were due to Streptococcus pneumoniae, an unusual pathogen in this disease. Only 1 other case of acute bacterial epiglottitis also due to S. pneumoniae has been reported in an immunocompromised adult. The occurrence of this disease in 4 immunocompromised adults suggest that an Arthus reaction may not be important in the pathogenesis of acute epiglottitis due to S. pneumoniae.

Acute Disease↗
PubMed1975

Acute myocardial infarction diagnosed by myoglobinuria.

Myoglobin can be found in excess in the urines of some patients with acute myocardial infarction. To test the specificity of this finding, urine specimens were analyzed from 39 patients with provisional diagnosis of myocardial infarction by means of a hemagglutination-inhibition technique with prepared antisera to monkey myoglobin. Of 24 patients with subsequently documented myocardial infarction, 15 had at least one positive determination. None of the 15 patients without infarction had positive tests. Ten of 13 patients with infarction studied within 24 hours of the initial event had positive reactions. The percentage of positive reactions in the infarct group decreased sharply after the first 24 hours. This technique may be of value in rapid screening of patients with possible acute myocardial infarction during early stage of symptoms.

Aspartate Aminotransferases↗