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Biomedical subjects

P A Brunell

Publications and source records attributed to P A Brunell.

At least 19 recordsLinked to original sources
PubMed1992

Meningoencephalitis in a neonate congenitally infected with human immunodeficiency virus type 1.

A newborn infant born to a mother infected with human immunodeficiency virus type 1 had acute meningoencephalitis on the second day of life. Human immunodeficiency virus type 1 was isolated from the plasma, cerebrospinal fluid, and peripheral blood mononuclear cells. Specific IgM for human immunodeficiency virus type 1 was detected by an enzyme-linked immunosorbent assay antibody-capture technique in cord blood and in serum obtained 3 weeks later. We believe that the meningoencephalitis was caused by human immunodeficiency virus type 1 acquired in utero.

Adult↗
PubMed1992

Varicella in pregnancy, the fetus, and the newborn: problems in management.

As many as 9000 pregnancies annually may be complicated by varicella, which creates management problems for the woman and her fetus or newborn. Estimates on risk to the fetus and to neonates vary widely, making counseling difficult. Likewise, the efficacy of passive immunization of pregnant women or their exposed newborns is not precisely known. In addition to these problems in clinical management, questions remain about the developmental immunology of varicella-zoster virus infection. For example, why do infants exposed in utero to the virus get zoster at an early age and why does passive immunization of newborns appear to be less effective than immunization of older individuals?

Acyclovir↗
PubMed1991

Virus burden in human immunodeficiency virus type 1-infected children: relationship to disease status and effect of antiviral therapy.

The human immunodeficiency virus type 1 (HIV-1) was isolated from the plasma and peripheral blood mononuclear cells (PBMCs) from each of 21 infected children. The mean titers in plasma were 7 and 165 tissue culture-infective doses per milliliter in 9 children with asymptomatic (P-1) and 12 with symptomatic (P-2) infection, respectively (P = .0013). Significantly higher viral titers were found in PBMCs obtained from P-2 compared with P-1 children: 1920 vs 25 tissue culture-infective doses per 10(6) PBMC (P = .0018). In symptomatic patients at least 1 in 520 circulating mononuclear cells harbored HIV-1. No correlation was found between the viral burden and CD4+ lymphocyte counts. A decrease in the HIV-1 titers was noted both in PBMCs and plasma of symptomatic patients treated with zidovudine for 2 to 7 months. It is concluded that symptomatic children harbor a higher amount of the virus in plasma and PBMCs than asymptomatic children. Zidovudine treatment for 2 months or more decreased the amount of HIV-1 in PBMCs and plasma.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Measles vaccine.

Administration of measles vaccine has sharply reduced the occurrence of measles. However, "mini epidemics" occurring at increasing intervals through 1989 brought about the need for a routine two-dose schedule of measles vaccination. The prevention of preschool cases and school-based cases are two major goals of this new schedule. A two-dose schedule will address the latter goal, however, it will not affect the more difficult problem of measles among preschoolers, a group with lower immunization rates than school-age children. The use of Edmonston-Zagreb measles vaccine in developing countries offers the promise of reducing worldwide disease rates in young infants in the future. However, the major goal in the United States and other developed countries is to increase levels of measles immunity.

Adolescent↗
PubMed1989

Transmission of chickenpox in a school setting prior to the observed exanthem.

An epidemic of chickenpox in a class is described. Four children were able to transmit infection prior to the time their rash was observed by their parents. A fifth child was known to have attended school while he had localized varicelliform lesions that were present for 2 days prior to the appearance of the generalized exanthem. It cannot be ascertained whether some of the other children may have had similar lesions that were not observed at the time they attended school. The first classroom case was observed prospectively so that the time of rash was fairly well established. Although he apparently transmitted infection prior to the onset of rash, virus could not be isolated from the respiratory secretion of this child on the day he presumably infected his classmate. Virus was not found in his respiratory secretions or those obtained from his two siblings before or after the onset of rash, although it was recovered from vesicular fluid.

Chickenpox↗
PubMed1988

Herpes zoster in children with acute lymphocytic leukemia.

Herpes zoster (HZ) occurred in 25% (28/88) of a population of children with acute lymphocytic leukemia (ALL) who were seropositive for varicella zoster virus antibody before its onset; 16.5% (33/199) of the total group of children with ALL developed HZ. There were no deaths and only one significant complication, cutaneous disseminated disease, as a result of HZ. The small number of patients studied may have accounted for the failure to find a significant association between the occurrence of HZ and the type of ALL or chemotherapy protocol employed. Although HZ seemed to be more common in those patients who experience relapses of their leukemia, it did not portend a poor outcome for ALL.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

Establishment by enzyme-linked immunosorbent assay of seronegative range for herpes simplex virus and cytomegalovirus antibodies and evaluation of heterologous responses to live varicella vaccine.

Cord serum samples treated with staphylococcus protein A and an immune affinity column to remove immunoglobulin G were used to establish a seronegative range for herpes simplex virus and cytomegalovirus. No seroconversions or increased heterologous antibody levels to herpes simplex virus or cytomegalovirus were found in live varicella vaccine recipients.

Adult↗
PubMed1988

Combined vaccine against measles, mumps, rubella, and varicella.

A combined measles, mumps, rubella, and varicella vaccine produced seroconversions for all four components similar to that found if measles, mumps, and rubella vaccine or live varicella vaccine were given separately. In addition, those exposed to varicella were completely protected or had only a mild rash. Moreover, the reaction rates were not increased if the vaccines were combined. The somewhat lower and delayed serologic response to live varicella vaccine as compared with the combined measles, mumps, rubella, and varicella may have been due to the small amount of varicella vaccine virus used or to its degree of attenuation. Persistence of antibody was observed 1 year postimmunization.

Antibodies, Viral↗
PubMed1987

Measles outbreak in a fully immunized secondary-school population.

An outbreak of measles occurred among adolescents in Corpus Christi, Texas, in the spring of 1985, even though vaccination requirements for school attendance had been thoroughly enforced. Serum samples from 1806 students at two secondary schools were obtained eight days after the onset of the first case. Only 4.1 percent of these students (74 of 1806) lacked detectable antibody to measles according to enzyme-linked immunosorbent assay, and more than 99 percent had records of vaccination with live measles vaccine. Stratified analysis showed that the number of doses of vaccine received was the most important predictor of antibody response. Ninety-five percent confidence intervals of seronegative rates were 0 to 3.3 percent for students who had received two prior doses of vaccine, as compared with 3.6 to 6.8 percent for students who had received only a single dose. After the survey, none of the 1732 seropositive students contracted measles. Fourteen of 74 seronegative students, all of whom had been vaccinated, contracted measles. In addition, three seronegative students seroconverted without experiencing any symptoms. We conclude that outbreaks of measles can occur in secondary schools, even when more than 99 percent of the students have been vaccinated and more than 95 percent are immune.

Adolescent↗