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Biomedical subjects

P C McNabb

Publications and source records attributed to P C McNabb.

8 recordsLinked to original sources

A surgeon with AIDS. Lack of evidence of transmission to patients.

In January 1989 [corrected], the media reported the identity of a surgeon who was recently diagnosed with the acquired immunodeficiency syndrome (AIDS). Concern about surgeon-to-patient transmission of human immunodeficiency virus (HIV) persisted despite reassurances from health authorities. Therefore, HIV antibody testing was offered to the surgeon's patients. We identified 2160 patients operated on since 1982; none had been reported to Tennessee's AIDS registry. A total of 264 had already died; none were reported to have died of AIDS or other HIV-related diseases. Of the 1896 patients remaining, we contacted 1652; 616 (37%) were tested. Only one (an intravenous drug user) was HIV antibody positive, and his medical history suggested that he may already have had AIDS at the time of his surgery. These results support the concept that the risks to patients operated on by HIV-infected surgeons are most likely quite low and support recommendations for the individualized assessment of HIV-infected health care workers.

AIDS Serodiagnosis↗

Pseudomonas cepacia.

P. cepacia is reported to be an increasing cause of infection and colonization of patients in hospitals. Historically it is an important contaminant in the pharmaceutical industry. Its nutritional versatility, ability to survive and multiply in water, high intrinsic resistance to antibiotics, and ability to multiply in the majority of traditional disinfectants make it a superb agent for causing nosocomial infection. Recognition of its differences from P. aeruginosa and its ability to contaminate agents used in hospitals is important in proper treatment and infection control.

Anti-Bacterial Agents↗

Macrophage-related fibrinolysis in experimental disseminated histoplasmosis.

A model of disseminated histoplasmosis in CBA/J mice was developed. Cultures of Histoplasma capsulatum from the spleens of infected mice suggested almost complete clearance of fungi by week 3. The adherent spleen cells from infected mice showed a 2- to 20-fold increase in fibrinolysis. The increase in activity was maximal around 1 to 2 weeks and disappeared after week 3 of infection, and this paralleled the progressively decreasing number of culturable fungi from the spleen. In vitro coculture of infected spleen cells or nylon wool-purified immune T cells and proteose peptone-induced macrophages resulted in increased fibrinolysis. Peritoneal exudate cells from infected mice also showed increased fibrinolysis. The addition of soluble antigen to an in vitro culture system resulted not only in an increase in fibrinolytic activity of peritoneal exudate cells derived from infected mice but also of proteose peptone-induced macrophages. These observations suggest that spleen and peritoneal macrophages from H. capsulatum-infected mice exhibit increased fibrinolysis which in turn is indicative of macrophage activation. The mechanism of activation occurs as a result of immunologically specific T cell-macrophage interaction and by the action of histoplasma products on the macrophages. The significance of these findings and the role of the plasminogen activator assay in studies of disseminated fungal infection are discussed.

Animals↗

Transmural eosinophilic gastroenteritis with ascites.

An atopic patient with recurrent abdominal pain, diarrhea, and ascites was shown to have eosinophilic gastroenteritis. Transmural involvement was inferred from the findings of dense eosinophilic infiltrates in the jejunal mucosa and eosinophilia in the ascitic fluid. An impressive response to steroid treatment occurred. The reported cases of eosinophilic gastroenteritis with ascites are reviewed.

Adult↗

Efficacy of trimethoprim and sulfamethoxazole in the prevention and treatment of Pneumocystis carinii pneumonitis.

A combination of trimethoprim and sulfamethoxazole was effective in the prevention and treatment of Pneumocystis carinii pneumonitis in cortisonetreated rats. Although all of 15 untreated rats died with P. carinii pneumonitis, none of 15 given trimethoprim-sulfamethoxazole prophylactically acquired the infection. After P. carinii pneumonitis was established, 9 of 14 rats recovered after treatment with trimethoprim-sulfamethoxazole compared with only 2 of 14 treated with pentamidine isethionate. Rifampin and clindamycin, separately or in combination with pentamidine, were ineffective in the prevention and treatment of P. carinii infection.

Alkanesulfonates↗