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Biomedical subjects

J McCarty

Publications and source records attributed to J McCarty.

32 records · Page 2Linked to original sources
PubMed1992

Loracarbef (LY163892) versus cefaclor in the treatment of bacterial skin and skin-structure infections in an adult population.

Loracarbef (LY163892), a member of the class of beta-lactam antibiotics known as carbacephems, is characterized by a high level of chemical stability and a broad spectrum of antibacterial activity that persists in the presence of beta-lactamase. The efficacy and safety of loracarbef, 200 mg (twice daily), and cefaclor, 250 mg (three times daily) (one patient received 178 mg of cefaclor suspension, three times daily), were compared in a randomized, double-blind, multicenter trial conducted in adults with skin and skin-structure infections due predominantly to Staphylococcus aureus. Examination within 72 hours after the completion of therapy indicated a favorable clinical response in 84 (93.3%) of the 90 loracarbef-treated patients evaluable for efficacy and in 79 (95.2%) of the 83 evaluable patients treated with cefaclor. Pathogens were eradicated in 83 (92.2%) of the patients in the loracarbef group and 74 (89.2%) of those in the cefaclor group. Only four adverse events--headache/migraine, diarrhea, abdominal pain, and nausea--occurred in greater than 2% of the total study population. The overall incidence of adverse events in the 201 loracarbef-treated and 192 cefaclor-treated patients evaluated for safety was 19.9% and 24.5%, respectively. Adverse events that required hospitalization or discontinuation of treatment occurred in four patients in the cefaclor group but in none of those treated with loracarbef. There were no statistically significant differences in the clinical or bacteriologic response or the incidence of side effects between the two treatment groups. These findings indicate that loracarbef given twice daily is comparable in safety and efficacy to cefaclor given three times daily in the treatment of adults with skin and skin-structure infections.

Adolescent↗
PubMed1991

Congenital optic tract syndrome.

We describe two patients with complete homonymous hemianopia who were unaware of their visual field defects. The clinical impression of an optic tract syndrome was confirmed by magnetic resonance imaging, which showed absence of the corresponding tract in each case. The pathogenesis of congenital absence of the optic tract is unclear but it could represent either a primary failure of development or secondary atrophy due to focal injury during the perinatal period.

Adult↗
PubMed1986

Pathogenicity of a rifampin-resistant cerebrospinal fluid isolate of Haemophilus influenzae type b.

Two children in a day care facility developed Haemophilus influenzae type b meningitis. The second child was enrolled in the facility after rifampin had been administered to the other attendees. The isolate from the first child was susceptible to rifampin, but the isolate from the second was resistant. Both isolates had identical outer membrane protein PAGE profiles. To investigate the virulence of these isolates, we inoculated infant rats intranasally with either the rifampin-resistant or rifampin-susceptible CSF isolate. The rates of nasal colonization (14 of 20 and eight of eight animals inoculated with the rifampin-resistant and rifampin-susceptible isolates, respectively) did not differ significantly. However, bacteremia occurred less frequently in pups inoculated with the rifampin-resistant strain than in animals inoculated with the susceptible strain (four of 20 vs eight of eight, P less than 0.0001). Nasal washings, blood, and CSF obtained from animals inoculated with the rifampin-resistant isolate were divided and plated on media containing rifampin (1 microgram/ml) or without rifampin. Except for those from one animal, organisms isolated from blood and CSF grew only on medium lacking rifampin, whereas H. influenzae type b growing from nasal washings was frequently found on both media. We conclude that mutation of H. influenzae to rifampin resistance is a hazard of rifampin chemoprophylaxis. Rifampin-resistant isolates have the potential to cause disease in patients and experimental animals, although they may be relatively less pathogenic than the parent, susceptible organism.

Animals↗
PubMed1983

Aspartylglucosaminuria in the United States.

Aspartylglucosaminuria (AGU) was diagnosed in two unrelated males with progressive mental retardation, coarse facies and skeletal abnormalities. Until now, this disorder has been described in predominantly Finnish populations with only one previous case reported in the U.S. We conclude that AGU may be more common in non-Finnish populations than the number of reported cases would indicate and should be included in the differential diagnosis in patients with suspected lysosomal storage disorders regardless of their geographical or ethnic backgrounds.

Adolescent↗
PubMed1979

Mesial temporal sclerosis detected by computed tomography.

We report a case of an epileptic patient in whom unilateral mesial temperal sclerosis was detected by computed tomography in the form of an arcuate, nonenhancing calcification. Temporal lobectomy was followed by relief of the seizures.

Adult↗
PubMedDate not supplied

Outpatient management of the uncomplicated postdate pregnancy with intravaginal prostaglandin E2 gel and membrane stripping.

The purpose of the study was to determine the safety and efficacy of outpatient intravaginal prostaglandin E2 (PGE2) and membrane stripping in promoting labor in the uncomplicated postdate pregnancy. In a double-blind placebo-controlled study, 150 enrollees were randomized to one of four treatment groups; group I, no membrane stripping and placebo gel; group II, no membrane stripping and PGE2 gel; group III, membrane stripping and placebo gel; and group IV, membrane stripping and PGE2 gel. The treatments were administered at 287 days (41 weeks) and 294 days (42 weeks) of gestation, then every 3-4 days until 307 days (43 completed weeks) of gestation. The patients in group IV had the shortest interval to delivery with a median of 1 day, P = .001, and the fewest antenatal surveillance visits with only 21% requiring more than one visit, P = .02. Group I patients in comparison, had a 7-day median to delivery, and 61% required more than one visit. The time spent in labor and delivery and the need for oxytocin augmentation was not significantly reduced in groups II, III, and IV. No adverse side effects to either mother or neonate could be directly attributed to this outpatient treatment combination. We conclude that intravaginal PGE2 gel combined with membrane stripping reduces postterm pregnancies and antenatal visits in our patients.

Administration, Intravaginal↗
PubMedDate not supplied

Clarithromycin suspension vs penicillin V suspension in children with streptococcal pharyngitis.

Clarithromycin, an advanced-generation macrolide antibiotic, has demonstrated excellent in vitro activity against group A beta-hemolytic streptococcus (GABHS). Potent activity against Streptococcus pyogenes and a favorable pharmacokinetic profile have made it a reasonable alternative for treatment of patients with streptococcal pharyngitis. The safety and efficacy of clarithromycin and penicillin V were compared in a randomized, investigator-blind study. Children 6 months to 12 years of age received 5 days of clarithromycin suspension 7.5 mg/kg twice daily (n = 268) or 10 days of penicillin V suspension 13.3 mg/kg three times daily (n = 260). Patients were evaluated for signs and symptoms of pharyngitis, and throat swabs for culture were obtained prior to therapy, at the end of therapy, and at follow-up. Clarithromycin and penicillin V produced comparable rates of clinical success (cure + improvement) at the posttreatment (97% and 94%) and follow-up (81% and 82%) evaluations. The GABHS eradication rate, however, was significantly higher with clarithromycin (94% vs 78%, P < .001). Both drugs were well tolerated; gastrointestinal complaints were similar and mild. Resistance did not occur with the short course of clarithromycin or the standard regimen of penicillin V. Five days' treatment with clarithromycin was superior to 10 days of penicillin in eradicating S. pyogenes.

Analysis of Variance↗
PubMedDate not supplied

The regulation of GM-CSF is dependent on a complex interplay of multiple nuclear proteins.

GM-CSF is an important mediator of hematopoiesis and its dysregulation may play a role in neoplastic and inflammatory conditions. Previous studies have demonstrated that GM-CSF production depends upon the accumulation of specific mRNA, which occurs by transcriptional and post-transcriptional mechanisms. In order to dissect the cis-acting sequences responsible for its regulation, we performed an extensive mutagenesis study spanning 54 nucleotides 5' of the GM-CSF coding region. Our analysis suggests that the previously-described functional elements of the GM-CSF promoter, kappa B and a repetitive CATTT/A motif, the former co-exists with an overlapping 9 nucleotide site which silences promoter activity, and the CATTT/A complex binds multiple polypeptides which differentially contribute to basal and inducible promoter activity. These two sites interact to provide tissue-appropriate and stimulus-specific promoter function. Using DNA-protein cross-linking and co-transfection studies, we demonstrate that the c-rel-related proteins p65 and p50 bind to the GM-CSF promoter and that p65 binding is primarily responsible for the enhancing effects at this site. In addition, we show that the GM-CSF kappa B decanucleotide is inadequate to provide full binding affinity; mutation of nucleotides flanking this site affect promoter function by altering NF-kappa B binding affinity. Together these results suggest that the transcriptional response of GM-CSF is dependent on a complex interplay of multiple DNA binding proteins.

Base Sequence↗
PubMedDate not supplied

Prehospital care of agricultural injuries.

In the United States, farming has become one of the most dangerous occupations. There are unique challenges for the providers of prehospital care to victims of agricultural trauma. The machinery and the work environment associated with agricultural trauma are different from those encountered in other occupations. The unique features of the machinery and risks are discussed. In addition, solutions unique to the problems of agricultural prehospital care are discussed. Effective care of the victims of agricultural trauma has a potential to reduce morbidity.

Accidents, Occupational↗
PubMedDate not supplied

Videoteleconferencing: solving mobility and recruitment problems.

Many nurses and nursing students live far from the closest campus or health care agency that can provide basic or continuing education. Videoteleconferencing is one way to bridge this distance. As videoteleconferencing technologies become available and cost effective, nurse educators must be knowledgeable about their use. The authors explain telecommunications technologies of videoteleconferencing, identify advantages and disadvantages, and discuss planning, implementation, and evaluation for offering a program by videoteleconference.

Budgets↗
PubMedDate not supplied

Loracarbef versus penicillin VK in the treatment of streptococcal pharyngitis and tonsillitis in adults.

Loracarbef, a member of a unique class of beta-lactam compounds (carbacephems), has excellent chemical and beta-lactamase stability, as well as documented clinical effectiveness against a broad spectrum of bacteria. Ten-day treatment regimens of loracarbef (200-mg capsule BID or 15 mg/kg/day suspension) and penicillin VK (250-mg capsule QID or 20 mg/kg/day suspension) were compared in the treatment of group A beta-hemolytic streptococcal (GABHS) pharyngitis and tonsillitis. Adults (greater than or equal to 12 years of age) were administered loracarbef (n = 58) or penicillin (n = 58) in a double-blind, randomized, parallel study of clinical and bacteriologic response to treatment. Favorable clinical responses among qualified (evaluable) patients in the loracarbef-treated group (46/47; 97.9%) were similar to those for evaluable patients in the penicillin-treated group (43/43; 100%). Forty-one of 47 (87.2%) of the evaluable loracarbef-treated patients and 100% (43/43) of the evaluable penicillin-treated patients had negative posttherapy throat cultures for GABHS. Thirty-nine evaluable patients in each treatment group were assessed 28 to 35 days after completion of therapy: 2.6% of patients in each group experienced relapse of symptoms; and 7.7% of loracarbef-treated patients had positive cultures, compared to 12.8% of penicillin-treated patients. Two (1.9%) loracarbef-treated patients with rashes and one (0.9%) penicillin-treated patient with diarrhea withdrew from the study due to these adverse events. Diarrhea, the most frequently occurring adverse event during therapy in the loracarbef group, was reported by 8.6% of the loracarbef group and by 5.2% of the penicillin group. These data support the conclusion that loracarbef is comparable in safety and efficacy to penicillin VK for the treatment of streptococcal pharyngitis and tonsillitis in adults.

Adolescent↗
PubMedDate not supplied

Three-dimensional computerized tomography: a quantum leap in diagnostic imaging?

Ever since the discovery of radium by Madame Curie, men and women of vision and science have labored to improve radiation technology. Over a period of approximately 85 years, we have gone from this initial discovery to three-dimensional computerized transmission tomography; one of the latest techniques in modern day x-ray imaging. Its uses are vast and unparalleled in many facets of medicine and surgery, outlining pathology as never before seen, and possibly, never before completely understood. Three-dimensional computerized tomography is rapidly gaining popularity in cross-sectional imaging of the foot and ankle. It has proven invaluable in elucidating osseous and soft tissue pathology. Abnormalities of the musculoskeletal system that exhibit complex anatomy are often difficult to interpret using standard radiographic techniques. Overall, three-dimensional computerized tomography has established itself as a means by which clinicians may appreciate the three-dimensional disposition of anatomy and disease.

Ankle↗