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Biomedical subjects

L T Gutman

Publications and source records attributed to L T Gutman.

At least 37 records · Page 2Linked to original sources
PubMed1985

The epidemiology of cytomegaloviral infection in women attending a sexually transmitted disease clinic.

To test the hypothesis that cytomegalovirus (CMV) is sexually transmitted, we examined the association of CMV infection with indices of sexual activity in 347 women attending a sexually transmitted disease (STD) clinic. Stepwise multivariate logistic regression analysis showed that seropositivity to CMV (complement-fixation antibody titer, greater than or equal to 1:8) was most closely associated with number of sex partners in the subjects' lifetime (P less than .0001), young age at first sexual intercourse (P = .0002), and nonwhite race (P = .0007). Among seropositive women, cervical shedding of CMV was most strongly associated with younger age (P = .0001) and the presence of cervical chlamydial infection (P = .016). Among 84 seronegative women followed up for a mean of 18.4 weeks, 11 (13%) developed primary CMV infections, an annual incidence of 37%. Sexual contact seems to be an important mode of acquisition of CMV in some young women.

Adult↗
PubMed1985

Impact of medical school class ranking systems on applicants' ratings for residency positions.

The systems used by the medical schools for evaluation of 106 applicants for 1984-85 pediatric level 1 (PL-1) residency positions at the Duke University Medical Center were studied by the authors to determine the possible relationship between contents of the applications and the rankings of these applicants for the National Resident Matching Program (NRMP). In the 56 U.S. medical schools studied, the grading systems of 24 medical schools used three passing grades (usually A, B, C), 14 used two passing grades (usually honors and pass), six used one passing grade (pass) and seven used a mixed system or number grades. The grading systems of five schools could not be discerned. Ten schools provided the class distribution of the awarded grades, and 23 identified the relative class standing of the applicant. Twenty-seven schools disclosed the position of the applicant in the class through grade distribution data or class standing; the 29 other schools did not make such information known. Students whose schools had identified their class positions achieved higher rankings from the residency selection committee than did students from schools which did not, in spite of the fact that schools which did not disclose the student's comparative positions were categorized as being more "distinguished."

Educational Measurement↗
PubMed1982

Pathogenicity of acyclovir-resistant herpes simplex virus type 1 from an immunodeficient child.

Sequential isolates of herpes simplex virus type 1 (HSV-1) from a child with severe combined immunodeficiency were examined for sensitivity to acyclovir. Early intravenous courses of acyclovir resulted in dramatic clinical improvement and were associated with the isolation of sensitive strains of HSV-1 (ID50[dose inhibiting 50% of control plaques], 0.010-0.106 microgram/ml), whereas later recurrences following intravenous, oral, and ophthalmic therapy were characterized by low-grade chronic lesions (ID50, 1.04-9.43 microgram/ml) that were unresponsive to acyclovir despite serum levels of up to 10.45 microgram/ml. Diminished sensitivity was associated with reduced viral thymidine kinase activity, and linked resistance with idoxuridine was detected in the isolates from the patient's eye. Intracerebral and cutaneous snout inoculation of a resistant isolate into BALB/c, hairless, and athymic nude mice revealed a 100- to 1,000-fold decrease in virulence as compared with an early sensitive isolate. Acyclovir-resistant HSV-1 can emerge in certain clinical settings but may be associated with diminished virulence.

Acyclovir↗
PubMed1978

Nasal colonization of infants with group B Streptococcus associated with intrauterine pressure transducers.

The rate of nasal colonization with group B Streptococcus in infants cultured at the time of discharge from the nursery rose significantly during a four-month interval. Investigation of this trend resulted in detection of group B streptococci in the domes of two intrauterine pressure transducers (IPTs). Subsequent routine sterilization of IPT domes after each maternal use was associated with a decline in infant group B streptococcal colonization to the usual endemic rate in the nursery. Retrospective evaluation demonstrated that colonization in infants born to IPT-monitored women had increased significantly during the study interval and that no increase in colonization occurred in infants born to non-IPT-monitored women. From epidemiologic evidence it appears that use of contaminated IPTs during labor was a nosocomial source of group B streptococcal colonization.

Cross Infection↗
PubMed1977

Single-dose trials of monovalent A/New Jersey/76 (Hsw1N1) influenza virus vaccine in children in Durham, North Carolina.

Ninety-two children received single doses of one of 13 monovalent vaccines derived from influenza virus strain A/New Jersey/8/76 (A/NJ), and 18 children received placebo. Five influenza virus vaccines were whole-virus vaccines, and eight were split-product vaccines. Samples of sera were taken once three weeks after vaccination. All of the 29 children receiving whole-virus vaccines developed a titer of antibody to A/NJ virus of greater than or equal to 1:20, and the geometric mean titers were 1:14-1:45. One of the 60 children who received split-product vaccines developed a titer of antibody to A/NJ of greater than or equal to 1:20, and geometric mean titers were all less than 1:10. There was a trend toward correlation between titers of hemagglutination-inhibiting (HAI) antibody to A/NJ and titers of HAI antibody to A/Victoria/3/75 viruses, with a correlation coefficient of 0.40 for children who received whole-virus vaccines. Three of 60 recipients of split-product vaccines and two of 20 recipients of whole virus developed a fever of greater than or equal to 38 C. One of the two febrile children who had received whole-virus vaccine had otitis media. Therefore, reactogenicity of whole-virus vaccines and split-product vaccines appeared to be similar in these children.

Antibodies, Viral↗
PubMed1975

Pharmacokinetics of trimethoprim-sulfamethoxazole in children.

The present report extends experience with the use of trimethoprim-sulfamethoxazole (TMP-SMX) in children aged 3 months to 10 years. The regimen was TMP (200 mg)--SMX (1000 mg)/m-2d given in two equal doses. The drug was easily administered, well tolerated and efficacious in the treatment of a variety of infections in 12 children. A steady state had been achieved by the third dose of medication and accumulation of either component during days 1 through 4 did not occur. Serum concentrations of TMP were slightly lower in children aged less than 3 years compared with those aged 3 to 6 years but the differences were small and these results are preliminary. Peak mean serum TMP concentration was highest at day 3 when it reached 1.63 mug/ml. It is concluded that this regimen may be suboptimal for some major parenchymal infections even though the therapeutic result was excellent in most children.

Administration, Oral↗
PubMed1975

Recurrence of skin disease in a nursery: ineffectuality of hexachlorophene bathing.

An outbreak of streptococcal and staphylococcal skin disease was discovered in a full-term nursery after the discontinuation of bathing infants with hexachlorophene. The epidemic was only temporarily controlled by conventional means and recurred despite reinstitution of hexachlorophene bathing. Measures that decreased infants' exposure to visitors and hospital personnel and enforced aseptic techniques in the nursery were more important than use of hexachlorophene soap in achieving and maintaining control.

Anti-Bacterial Agents↗