PubMed Health⌕ Search

Biomedical subjects

M G Michaels

Publications and source records attributed to M G Michaels.

27 records · Page 2Linked to original sources
PubMed1994

Pseudomonas cepacia empyema necessitatis after lung transplantation in two patients with cystic fibrosis.

Lung transplantation is an accepted modality for patients with cystic fibrosis (CF) who have end-stage respiratory failure. The postoperative course of these patients is often complicated by serious infections with organisms such as Pseudomonas aeruginosa and Pseudomonas cepacia that may be multiply resistant to conventional antimicrobial agents. We describe two patients with CF who, after double lung transplantation, developed the unusual complication of empyema and empyema necessitatis due to P cepacia that was resistant to all tested antibiotics.

Adolescent↗
PubMed1992

Toxoplasmosis in pediatric recipients of heart transplants.

Toxoplasma gondii has long been recognized as a potential cause of severe disease in the congenitally infected infant and the immunocompromised host. This report describes three children with toxoplasmosis after heart transplantation and reviews the cases of 18 adult recipients of cardiac transplants (reported in the English-language literature) who developed toxoplasmosis postoperatively. Onset of disease was within the first 6 1/2 months following transplantation. Severity ranged from asymptomatic seroconversion to myocardial infiltration or disseminated neurological disease and death. Only one patient was known to be seropositive for antibody to T. gondii prior to transplantation. Transmission was most likely via the donor organ. Seronegative patients who receive organs from seropositive donors are at high risk for serious disease; prophylactic strategies need to be developed.

Adolescent↗
PubMed1992

Adenovirus infection in pediatric liver transplant recipients.

A retrospective review of adenoviral infection in pediatric liver transplant recipients was done at Children's Hospital of Pittsburgh to define its epidemiology and clinical importance. Medical records of patients with adenovirus were reviewed and data collected regarding clinical course, microbiologic studies, biopsy results, immunosuppression, concurrent infections, and outcome. Of 484 liver transplant recipients, 49 had 53 episodes of adenoviral infection. The most common sites of adenoviral infection were the liver, lung, and gastrointestinal tract. Serotypes 1, 2, and 5 were recovered most often; type 5 was commonly associated with hepatitis. Invasive adenoviral infection occurred in 20 children, leading to death in 9. Median time from transplantation until isolation of adenovirus was 25.5 days. This timing suggests either reactivation or donor-associated transmission. Prospective studies using molecular epidemiologic techniques will be helpful in evaluating transmission patterns of adenovirus in this population.

Adenovirus Infections, Human↗
PubMed1992

Respiratory syncytial virus: a comparison of diagnostic modalities.

This study compared prospectively viral culture for respiratory syncytial virus (RSV) with three rapid RSV antigen detection tests: RSV EIA and TestPack RSV (TP), and Directigen RSV (DIR). Additionally two methods of specimen collection were compared: nasopharyngeal rub (RUB) and nasopharyngeal wash (WASH). True positives were defined as positive RSV viral culture or at least two positive antigen tests. One hundred ninety-eight WASH specimens obtained from children 3 years of age or younger during the 1991 RSV winter epidemic were tested for RSV antigen. Sensitivity and specificity of WASH specimens were 59.5 and 100% (culture), 86.2 and 98.2% (RSV EIA), 91 and 96.3% (TP) and 83.5 and 94.3% (DIR). Concurrently obtained RUB samples from 124 children were tested by TP and/or DIR. Sensitivity of RUB specimens was significantly lower than that of WASH specimens; 64.9% (TP) and 43.6 (DIR). These easy to perform, rapid RSV antigen tests for WASH specimens provide timely diagnosis thereby facilitating management decisions and isolation efforts.

Child, Preschool↗
PubMed1989

A case of bilateral nursemaid's elbow.

Although the case presented was easily treated, it caused anguish and expense that might have been avoided had the diagnosis been entertained initially. Considering the high frequency of occurrence, radial head subluxation should be thought of in young children with upper extremity injuries, typical posturing, and no other evidence of trauma or deformity. A suggestive history should be sought, and an attempt to reduce the subluxation should be made. Parents and caretakers should be advised about the potential for recurrence of this injury, as well as the dangers of sudden traction on a child's arm.

Child, Preschool↗
PubMedDate not supplied

Infectious concerns of cross-species transplantation: xenozoonoses.

Xenotransplantation is a potential solution to the current donor shortage for allotransplantation. Likewise it is being investigated for a number of other disease states such as Parkinson's disease, diabetes, and acquired immunodeficiency disease. Infections are a concern with the use of any biologic agent and as such have proved to be a substantial cause of morbidity and mortality after allotransplantation. Similarly, infections will likely cause disease after xenotransplantation. Public debate on the ethics of whether the field of xenotransplantation should move forward has focused on the concern of novel infections, xenozoonoses. Accordingly, the role of animal microbes must be critically examined. This article reviews mechanisms for xenogeneic infections and details what is known and what still needs to be learned as the field of xenotransplantation progresses. Emphasis is placed on microbial agents of baboons and swine, as they are currently the most common species considered as donor sources for xenotransplantation.

Animals↗