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Biomedical subjects

J Mendelson

Publications and source records attributed to J Mendelson.

At least 37 records · Page 2Linked to original sources
PubMed1992

Growth curves of Staphylococcus aureus, Candida albicans, and Moraxella osloensis in propofol and other media.

Propofol, 2,6 diisopropylphenol, in an emulsion formulation (Diprivan), has been associated with postsurgical infections caused by Staphylococcus aureus, Moraxella osloensis and Candida albicans. These organisms were individually inoculated into each of the following media: (1) the emulsion preparation of propofol, (2) Intralipid 10%, (3) pure 2,6 diisopropylphenol, and (4) trypticase soy broth (TSB). The organisms were incubated and subcultured hourly for eight hours at room temperature. Propofol supported the growth of all three organisms, but for S. aureus and M. osloenis, the growth rate was slower in propofol than in TSB (P less than 0.05). There was no difference between the growth rate of any organism in propofol than in Intralipid 10%. The authors conclude that propofol, in the emulsion formulation, supports bacterial growth and, therefore, must be prepared for administration in an aseptic manner. Also, by administering propofol soon after preparation, the risk of introduction of a significant inoculum to the patient will be reduced.

Candida albicans↗
PubMed1992

Recombinant alpha-2 interferon gel treatment of recurrent herpes genitalis.

Topical recombinant alpha-2 interferon treatment of recurrent genital herpes was studied in a randomized, double-blind, placebo controlled clinical trial. Three hundred and eighty-seven patients were treated at eight study centers with either interferon gel or placebo four times daily for four days. Interferon therapy caused a 26% decrease in the duration of viral shedding. For male patients, there were also significant decreases in the time to crusting (17%) and duration of pain (34%) and itching (21%). For patients with recurrent genital herpes, treatment with topical interferon was found to be effective in decreasing the duration of viral shedding and, for males, pain, itching and time to crusting.

Administration, Cutaneous↗
PubMed1992

A comparison of brain perfusion SPECT in cocaine abuse and AIDS dementia complex.

Intravenous drug use is a major risk factor for HIV-1 infection. Since both AIDS dementia complex (ADC) and cocaine have been associated with abnormal brain perfusion imaging, we compared the scintigraphic patterns of ADC patients and cocaine polydrug users with normal control subjects using 99mTc-HMPAO SPECT. We found a high incidence of cortical defects in both ADC (100%) and cocaine-dependent (90%) subjects. In the cocaine and ADC patients, cortical defects were most frequent in the frontal, temporal and parietal lobes and occurred with similar frequency in the two populations. In both groups, the number of cortical defects per subject was higher than normal subjects (10.0 +/- 5.0 for ADC, 10.1 +/- 5.2 for cocaine and 0.7 +/- 1.5 for normal), background activity was high (a 65% and 60% incidence for ADC and cocaine, respectively), and basal ganglia involvement was frequent (40% and 65% for ADC and cocaine). We conclude that the brain perfusion pattern, while a sensitive indicator of ADC, cannot be distinguished from chronic cocaine polydrug use and caution should therefore be applied before entertaining a specific diagnosis.

AIDS Dementia Complex↗
PubMed1991

Ability of National Committee for Clinical Laboratory Standards-recommended quality control strains from the American Type Culture Collection to detect errors in disk diffusion susceptibility tests.

The National Committee for Clinical Laboratory Standards (NCCLS) recommends, as a quality control for the disk diffusion susceptibility test, the use of three strains from the American Type Culture Collection: Staphylococcus aureus ATCC 25923, Pseudomonas aeruginosa ATCC 27853, and Escherichia coli ATCC 25922. This study assesses the capacity of these strains to detect errors in the overall method. ATCC strains were tested by comparing testing by the standard NCCLS-recommended procedure (ST) with testing under the following conditions: incubation at 25 degrees C, Mueller-Hinton agar depths of 2 mm (AD2) and 8 mm (AD8), agar pHs of 6.5 and 8, inocula with McFarland standards of 0.25 (0.25M) and 4.0 McFarland (4.0M), direct inoculation without preincubation of inoculum (DI), and a 2-h delay between inoculation and disk application (2HR). The frequency of zone measurements outside the NCCLS-recommended control zone limits were as follows: ST, 0%; AD2, 18%; AD8, 9.6%; pH 6.5, 7.9%; pH 8, 5.3%; 0.25M, 3.5%; 4.0M, 24%; DI, 3.4%; 2HR, 1.8%; 25 degrees C (only E. coli and P. aeruginosa were evaluable), 28%. These results suggest that the quality control strains are only partially effective in detecting single extreme laboratory errors and that careful laboratory supervision is necessary even in the setting of properly monitored quality control strains.

Clinical Laboratory Techniques↗
PubMed1991

Brain perfusion is abnormal in cocaine-dependent polydrug users: a study using technetium-99m-HMPAO and ASPECT.

Cocaine abuse is widespread and has been associated with serious neurovascular complications. We studied a group of cocaine-dependent polydrug users with 99mTc-HMPAO and high-resolution SPECT and compared their perfusion pattern to cerebral perfusion in a group of older control subjects. Sixteen of 18 cocaine-dependent polydrug users had abnormal perfusion characterized primarily as small focal defects involving inferoparietal, temporal, and anterofrontal cortex and basal ganglia. Psychometric testing was abnormal in all 18 cocaine-dependent subjects. No relation was found between the severity of SPECT abnormalities and mode of administration or frequency or length of cocaine use. All 15 older normal subjects had normal cerebral perfusion. While the focal perfusion abnormalities to the cortex and basal ganglia could be explained by the profound vasoconstrictor effects of cocaine, the combinational use of multiple substances including cannabis and alcohol may play a contributory role. This study documents the high incidence of functional brain abnormalities in cocaine-dependent chronic polydrug users without corresponding abnormalities on imaging studies of cerebral anatomy and morphology.

Adult↗
PubMed1989

Diagnosis of herpes simplex virus infection in a clinical setting by a direct antigen detection enzyme immunoassay kit.

A commercial 4-h direct herpes simplex virus (HSV) antigen detection enzyme immunoassay (EIA) kit (Du Pont Herpchek) was evaluated by using 273 clinical specimens obtained in a hospital-based infectious disease practice. The EIA was compared with a standard culture method in which WI38 cells were inoculated within 20 min of sample collection. Cultures were observed for 2 weeks, and positive findings were confirmed by fluorescein-labeled monoclonal antibody (FA) staining. The values for the overall HSV detection rate were 40.7% by the standard culture method and 41.4% by EIA. In eight cases, the EIA was positive, while the culture method was negative; however, clinical data and confirmatory blocking EIA suggested that a true HSV infection was present. For six FA-confirmed, culture-positive samples, the direct EIA was negative; however, an EIA performed on the supernatants of these cultures was positive, suggesting that the failure of the EIA to detect these samples was not due to lack of strain specificity of the test. After confirmatory tests of standard culture and EIA discrepant results, the overall sensitivity of the test was 95.0% (113 of 119) and the specificity was 100% (154 of 154).

Acyclovir↗
PubMed1988

Dilated cardiomyopathy in children with acquired immunodeficiency syndrome: a pathologic study of five cases.

Clinicopathologic features with special reference to the heart are presented in five fatal cases of acquired immunodeficiency syndrome (AIDS) in children. Three children showed clinical evidence of cardiovascular compromise or congestive heart failure. Autopsy was performed in all cases. The enlarged heart showed biventricular dilatation with grossly unremarkable valves and coronary arteries and absence of mural thrombi. Microscopic examination of the heart revealed primarily myopathic abnormalities with hypertrophy of the myocardium and only rare foci of sparse inflammatory infiltrate. The pathogenesis of dilated cardiomyopathy in these children with AIDS is not known. Infection, immunologic factors, anemia, deficiency of nutritional factor(s), and longer survival may be related to the pathogenesis. Pediatricians should be alert to the possibility of cardiac involvement in pediatric AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Cefoperazone compared with ampicillin plus tobramycin for severe biliary tract infections.

In a prospective, randomized, multicenter study, the efficacy and safety of cefoperazone and the combination ampicillin-tobramycin as initial therapy for patients with severe acute biliary tract infections were compared. Of 77 patients initially entered in the study, definite severe biliary tract infection was confirmed in 67. Sixty-four patients completed treatment. At the end of treatment, 35 of 36 (97%) patients given cefoperazone and 23 of 28 (82%) given ampicillin-tobramycin were cured of their infection (P = 0.07). Pathogens were recovered from the bile in 32 patients; microbiological cures were observed in 18 of 19 (94%) patients receiving cefoperazone and 8 of 13 (62%) receiving ampicillin-tobramycin (P = 0.03). Thirteen patients had septicemia. None (0%) of the eight septicemic patients from the cefoperazone group, but two of five (40%) from the ampicillin-tobramycin group, were clinical failures. Of the isolated pathogens, 51% were resistant to ampicillin, while the resistance rate was 4% for tobramycin and 1% for cefoperazone (P less than 0.001). Biliary concentrations of cefoperazone were maintained at high levels--236 +/- 87 micrograms/ml up to 12 h after administration. Even in the presence of severe obstruction, cefoperazone levels in the bile and gallbladder wall were above MICs for most pathogens. Cefoperazone may be considered as an excellent alternative in the therapy of severe biliary tract infections.

Acute Disease↗
PubMed1988

Hyperprolactinemia during cocaine withdrawal.

Plasma prolactin levels were determined for 8 patients (7 males and 1 female) who reported an average of 3.7 years of cocaine abuse. The mean prolactin level for these 8 patients 24 to 72 hours following admission to the hospital was 20.58 (S.E. +/- 3.2) ng/ml. Hyperprolactinemia (greater than 20 ng/ml) was detected in 4 patients and 3 others had high borderline prolactin levels. Only 1 patient had a normal prolactin value at the time of admission to the hospital. The mean prolactin level obtained prior to the patients' discharge from the hospital was 31.7 (S.E. +/- 5.3) ng/ml. Five of the 8 patients had an increase in prolactin levels between time of admission and discharge from the hospital. The mean increment in plasma prolactin levels for these 5 patients was 15.5 (S.E. +/- 4.2) ng/ml (P less than .02). Two patients who had significant hyperprolactinemia (greater than 50 ng/ml) at the time of discharge from the hospital reported self-administering the highest cocaine dose (6-8 gm per week) of the 8 patient cohort. Since cocaine blocks dopamine reuptake and prolactin secretion is regulated, in part, by dopaminergic inhibitory mechanisms, cocaine withdrawal may induce rebound supersensitivity of prolactin secretion. Findings obtained in this study suggest that cocaine-related derangements in prolactin secretion may be a biologic marker of a protracted cocaine abstinence syndrome.

Adult↗
PubMed1987

Cocaine-calcium channel antagonist interactions.

Diltiazem, a benzothiazepine calcium channel antagonist, was given to six healthy men as a single 60 mg oral dose 120 min before IV injection of cocaine (0.2 mg/kg) in a double-blind, placebo-controlled, two-session study. Diltiazem alone produced no significant effects. Cocaine increased blood pressure, heart rate, pupil size and subjective "high" ratings, and decreased skin temperature. Diltiazem pretreatment diminished the cocaine effect on skin temperature, but did not otherwise alter the response to cocaine. Calcium channel antagonists diminish the effects of cocaine in vitro and in animals. Dosage considerations may be critical because of the differential sensitivity of various tissues to calcium channel antagonists.

Adult↗