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Biomedical subjects

J F Fisher

Publications and source records attributed to J F Fisher.

52 records · Page 3Linked to original sources
PubMed1981

Moxalactam (LY127935) in treatment of meningitis due to gram-negative bacilli.

Moxalactam (LY127935; 6059S), a new broad-spectrum beta-lactam antibiotic, was used successfully with an aminoglycoside in a patient with Serratia marcescens meningitis complicating a neurosurgical procedure. With a bioassay method, peak and trough serum and cerebrospinal; fluid concentrations of moxalactam were determined during therapy. Mean peak and trough serum levels were 100.6 and 35.5 micrograms/ml, respectively. Corresponding mean peak and trough cerebrospinal fluid levels were 12.4 and 10.38 micrograms/ml. Cerebrospinal fluid levels of moxalactam exceeded the minimal bactericidal concentration for the infecting organism by more than 30-fold throughout therapy. No untoward effects of moxalactam were observed. Moxalactam may be a useful agent in the treatment of meningitis due to susceptible gram-negative bacilli.

Cephalosporins↗
PubMed1978

Therapeutic failures with miconazole.

A retrospective review of therapeutic failures of miconazole in three patients is presented. Miconazole, a new imidazole derivative, is a broad-spectrum antifungal agent purportedly effective topically, orally, and parenterally against a number of species of fungi. Three patients with the following culturally proven deep fungal infections were treated with miconazole: (i) destructive arthritis (Sporothrix schenckii), (ii) meningoencephalitis (Cryptococcus neoformans), and (iii) disseminated aspergillosis (Aspergillus fumigatus). All the organisms were susceptible in vitro to 1.56 mug or less of miconazole per ml using a broth dilution technique. In each patient, miconazole administered intravenously in dosages of 30 mg/kg per day failed to control or eradicate infection. Miconazole serum levels ranged from <0.5 to 4.35 mug/ml as determined by radial diffusion bioassay. Cerebrospinal fluid levels were virtually undetectable. In one patient (C. neoformans), miconazole was given intraventricularly in doses of 15 mg without response. Therapeutic failures were attributed to suboptimal body fluid levels of miconazole. The reason(s) for such low levels of activity was not clear, but may have been poor penetrance into tissues, in vitro inactivation, and/or unusually rapid excretion. Untoward reactions from miconazole included fever, chills, nausea, vomiting, and phlebitis.

Adult↗
PubMed1977

Bioassay for miconazole.

A radial diffusion bioassay for miconazole, which employs Candida stellatoidea as the indicator organism, is described. Results from three patients treated with the drug are presented.

Biological Assay↗
PubMedDate not supplied

Elevated serum IgE, eosinophilia, and lung function in rubber workers.

We previously reported an outbreak of acute respiratory illness associated with eosinophilia in a group of rubber workers who performed a thermoinjection process in which synthetic rubber was heated and then injected onto metal molds. This study was conducted to determine if persistent respiratory health effects were associated with this work area and to explore the possible allergic etiology of this syndrome. A survey was performed 1 mo after a major improvement in area ventilation and consisted of baseline, cross-shift, and cross-week spirometry; diffusing capacity; serum immunoglobulin E (IgE), total eosinophil count; and skin patch testing. Baseline lung function, cross-shift, and cross-week spirometry were not significantly worse in the exposed group as compared to the control group. However, either eosinophilia (greater than 450/mm3) or elevated serum IgE (greater than 470 ng/ml) were present in 44% of exposed workers vs. 11% of the control group (p = .003). Nine months later, neither eosinophilia nor elevated IgE were associated with employment in this work area. We conclude that employment in the thermoinjection process was associated with eosinophilia and elevated IgE, which suggests sensitization to one of the components of the rubber, although no effect on pulmonary function could be demonstrated.

Adult↗
PubMedDate not supplied

Urinary tract infections due to Candida albicans.

Infection of the urinary tract due to Candida albicans is an uncommon but well-described complication of modern therapeutics. Despite the rarity of this infection, culture of properly collected urine yielding C. albicans requires an explanation. The significance of systemic factors in the defense of the urinary tract against candidal infection is unknown, but secretions from the prostate gland in men and from periurethral glands in women have been reported to be fungistatic. In addition, growth of Candida at sites on mucous membranes may be suppressed by other normal flora. Conditions that predispose to candiduria include diabetes mellitus, antibiotic and corticosteroid therapy, as well as factors such as local physiology and disturbance of urine flow. Lower urinary tract candidiasis is usually the result of a retrograde infection, while renal parenchymal infection most often follows candidemia. In addition to asymptomatic candiduria, recognized clinical forms of candidal urinary tract infections include bladder infection, renal parenchymal infection, and infections associated with fungus ball formation. Unfortunately, clinical criteria alone are insufficient to distinguish reliably among these clinical types. If the urine is found to contain candidal organisms, the condition of the patient should be considered for determination of appropriate therapy. When infection is thought to be confined to the bladder, patients without indwelling bladder catheters should be considered for flucytosine therapy. For patients requiring indwelling bladder catheterization, irrigation with amphotericin B is usually successful. Although flucytosine alone may be useful for renal parenchymal candidal infection, iv amphotericin B alone or the combination of amphotericin B and flucytosine is indicated when systemic candidiasis cannot be excluded.

Adrenal Cortex Hormones↗