PubMed Health⌕ Search

Biomedical subjects

J L Shenep

Publications and source records attributed to J L Shenep.

At least 37 records · Page 2Linked to original sources
PubMed1997

Pulmonary fungal infections in immunocompromised children.

Pulmonary mycoses are increasingly encountered in children with underlying diseases associated with immunosuppression, including children with cancer or HIV infection. Knowledge of the epidemiology and pathogenesis of pulmonary mycoses can be applied to prevent infection in many cases and to promptly diagnose infections that do occur. Treatment is usually successful if initiated early, although pulmonary aspergillosis and zygomycosis are portentous ailments unless surgical resection or prompt immunologic recovery ensue.

Antibiotic Prophylaxis↗
PubMed1996

Lipoteichoic acid from viridans streptococci induces the production of tumor necrosis factor and nitric oxide by murine macrophages.

Bacterial endotoxin or lipopolysaccharide is the major proinflammatory component of gram-negative bacteria, but the components of gram-positive bacteria that trigger the inflammatory cascade are poorly understood. Lipoteichoic acid (LTA) purified from 2 strains of viridans streptococci induced the accumulation of tumor necrosis factor (TNF) mRNA and protein by the murine macrophage cell line RAW 264.7 in a dose- and time-dependent manner. Furthermore, in the presence of recombinant interferon-gamma, LTA from both strains of viridans streptococci provoked the accumulation of inducible nitric oxide (NO) synthase mRNA and the production of NO. Together these observations indicate that LTA can trigger macrophage activation and the production of TNF and NO and suggest that LTA may be an important determinant of the host inflammatory response to gram-positive infection.

Animals↗
PubMed1996

Septic shock.

Explore the source record for details and available documents.

Anti-Bacterial Agents↗
PubMed1995

Use of abdominal computed tomography for identifying disseminated fungal infection in pediatric cancer patients.

Disseminated fungal infection (DFI) is an important cause of morbidity and mortality among immunosuppressed patients with cancer. To determine the role of abdominal computed tomography (CT) in the diagnosis and management of DFI, we studied the records of patients treated in a pediatric oncology center over an 11-year period. A total of 35 children had CT findings compatible with fungal abscesses in the liver, spleen, and/or kidneys and had fungal infection confirmed by culture, biopsy, or at autopsy. Patients were treated with antifungal agents (median duration of treatment, 57 days) until fever resolved and repeated CT scans demonstrated that the lesions had disappeared, regressed, or stabilized. The 3-month survival rate was 86%. An additional 29 patients with similar characteristics and risk factors had characteristic CT findings, but DFI was not documented with other procedures. These patients were empirically treated for presumed DFI; their courses and outcomes were similar to those for patients with documented DFI. These results suggest that it is reasonable to make a presumptive diagnosis of DFI for patients with characteristic CT findings and clinical features. With appropriate therapy, the prognosis for pediatric patients with cancer and documented or presumed DFI is good.

Abdomen↗
PubMed1994

Decreased counts of blood neutrophils, monocytes, and platelets in human immunodeficiency virus-infected children and young adults treated with diethyldithiocarbamate.

Nineteen young human immunodeficiency virus-infected patients were randomized to receive 400 mg of oral diethyldithiocarbamate (DTC) per m2 or placebo weekly for 12 weeks. Changes in blood CD4+ lymphocytes were not significantly different between groups. However, neutrophil, monocyte, and platelet counts consistently decreased during DTC treatment, suggesting DTC-mediated myelosuppression.

Adolescent↗
PubMed1994

Diffuse alveolar hemorrhage associated with Mycoplasma hominis respiratory tract infection in a bone marrow transplant recipient.

An 18-year-old woman developed respiratory distress and diffuse pulmonary infiltrates after allogeneic bone marrow transplantation. Bronchoalveolar lavage findings indicated diffuse alveolar hemorrhage. Cultures of the lavage fluid and the pharynx grew Mycoplasma species; the pharyngeal isolate was identified as Mycoplasma hominis. Mycoplasma hominis infection may have an etiologic role in diffuse alveolar hemorrhage.

Adolescent↗
PubMed1994

Influence of needle gauge in Mantoux skin testing.

STUDY OBJECTIVE: To determine the influence of needle gauge in Mantoux skin testing for tuberculosis. DESIGN: Randomized selection of either a 27- or 30-gauge needle for Mantoux skin test placement; observer-blinded. SETTING: Annual hospital employee screening. PARTICIPANTS: Six hundred twenty-five employees working in clinical and laboratory research environments. RESULTS: Blinded observers found that the use of 27-gauge needles caused increased bleeding and bruising compared with 30-gauge needles (p < or = 0.007 for each). However, the 27-gauge needle produced larger blebs and less leakage of tuberculin solution (p < or = 0.0003). CONCLUSION: Smaller gauge needles could potentially cause false-negative screening results because of decreased antigen delivery. Use of needle gauges smaller than 27 gauge should be avoided until their reliability is validated.

Evaluation Studies as Topic↗
PubMed1993

Azithromycin for treatment of severe Cryptosporidium diarrhea in two children with cancer.

Two children with cancer received azithromycin for Cryptosporidium-associated diarrhea that was unresponsive to supportive care. One child had choleriform diarrhea requiring daily fluid replacement of up to 65% of his total body weight; the other had protracted diarrhea and wasting. In both cases, administration of azithromycin was followed by prompt clinical improvement.

Administration, Oral↗
PubMed1993

Reversal of dopamine-refractory septic shock by diethyldithiocarbamate, an inhibitor of endothelium-derived relaxing factor.

Septic shock occurs when endotoxin and other bacterial substances induce the release of host products that act in concert to alter the circulation. Recently, investigators have speculated that endothelium-derived relaxing factor (EDRF), a potent endotoxin-inducible vasodilator, plays an important role in the pathogenesis of septic shock. Diethyldithiocarbamate (DTC), a copper chelator lacking intrinsic vasoactivity, inactivates EDRF. Intravenous DTC was compared with placebo and dopamine in 12 matched sets of 3 rabbits with induced Escherichia coli sepsis. Median levels of bacteremia and endotoxemia were similar in the 3 treatment groups. DTC-treated animals had higher mean arterial pressure and lower heart rates and blood lactate concentrations than either placebo- or dopamine-treated animals (P = .013, P < .001, and P = .001, respectively). These effects were independent of plasma catecholamine concentrations. DTC can reverse septic shock that is refractory to conventional therapy, and these results suggest that EDRF is an important mediator of septic shock.

Animals↗
PubMed1991

Safety and pharmacokinetics of 566C80, a hydroxynaphthoquinone with anti-Pneumocystis carinii activity: a phase I study in human immunodeficiency virus (HIV)-infected men.

A hydroxynaphthoquinone compound (566C80) has been shown to be effective in the prevention and treatment of murine Pneumocystis carinii pneumonitis. In a phase I study, five cohorts of four human immunodeficiency virus-infected men received 100, 250, 750, 1500, and 3000 mg of the compound orally once daily for 12 days. A sixth cohort received 750 mg three times daily for 5 days, then twice daily for 16 days. Evaluation included clinical, hematologic, and biochemical studies and the pharmacokinetics of 566C80. The only drug-related adverse effect was a maculopapular rash in one patient that resolved without discontinuation of the drug. With the largest dosage tested (3000 mg) the following pharmacokinetic measures were achieved: maximum plasma concentration, 39 micrograms/ml; time to maximum plasma concentration, 8.0 h; area under plasma concentration-time curve at steady state, 1088 h.micrograms/ml; plasma half-life, 51 h; and total plasma clearance, 4.09 l/h. Compound 566C80 offers promise as a new drug class for P. carinii pneumonia.

Adult↗
PubMed1991

Infrared, thermistor, and glass-mercury thermometry for measurement of body temperature in children with cancer.

Body temperature is often the sole determinant of whether or not the neutropenic cancer patient is admitted to the hospital for empiric antibiotic therapy. Recently developed infrared tympanic thermometers offer rapid readings, but their accuracy has not been established. We studied two infrared thermometers (FirstTemp and Thermoscan) and a thermistor (IVAC) in children with cancer. Mean infrared measurements did not differ significantly between right and left ear canals, and the mean IVAC temperature did not differ significantly from the left to the right axilla (P greater than 0.05, paired t test). IVAC predictive mode mean temperature was 0.2 degrees C lower than monitor mode mean temperature in the axilla (P less than 0.0001), but 0.1 degree C higher than monitor mode orally (P less than 0.0001). Aiming the infrared instrument at the tympanic membrane using an ear tug resulted in a 0.2 degree C higher mean temperature than casual placement in the ear canal (P less than 0.0001). After compensation for the mean difference in reference oral glass-mercury versus test instrument temperatures, the FirstTemp, Thermoscan, and oral and axillary predictive mode IVAC measurements yielded sensitivities for the detection of fever of 84%, 84%, 82%, and 86%; specificities of 100%, 99%, 100%, and 100%; positive predictive values of 100%, 93%, 100%, and 100%; and negative predictive values of 95%, 98%, 98%, and 98%, respectively. We conclude that each of these instruments detects fever with comparable reliability. Infrared instruments are especially attractive alternatives due to their time efficiency.

Age Factors↗
PubMed1990

Risk of Haemophilus influenzae type b disease in children with cancer and response of immunocompromised leukemic children to a conjugate vaccine.

From 1969 to 1988, 8 cases of systemic Haemophilus influenzae type b (Hib) disease occurred among 5288 patients with cancer. For the first 4 years of life, systemic Hib disease was significantly greater in leukemic children than in the general population (606/100,000 vs. 90/100,000, respectively). Fifty children aged 2-6 years with acute leukemia were vaccinated with a Hib conjugate vaccine, ProHibit. The overall response rate was 50%; however, 75% of children receiving leukemic therapy for less than 12 months responded versus 18% of those treated longer. After vaccination, the geometric mean antibody concentration was 7.2 micrograms/ml, appreciably lower than for normal children of similar ages. After 12 months, the geometric mean antibody concentration had declined to 0.35 micrograms/ml, and 75% of subjects had antibody levels greater than or equal to 0.15 micrograms/ml. A booster dose for unsuccessfully vaccinated subjects was of minimal benefit. Children with acute leukemia in remission who were treated according to the leukemia therapy protocol of St. Jude Children's Research Hospital had a good likelihood of responding to the conjugate Hib vaccine if administered within a year of initiation of chemotherapy.

Adolescent↗