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Biomedical subjects

P T Harrington

Publications and source records attributed to P T Harrington.

11 recordsLinked to original sources
PubMed1992

Successful medical therapy of Rhodococcus equi pneumonia in a patient with HIV infection.

A 34-year-old HIV-infected man was successfully treated with antimicrobial therapy alone for Rhodococcus equi pneumonia and has survived longer than six months. In the current literature, only two of seven HIV-infected patients so treated have survived as long as six months. Based on our experience and the available literature, it seems reasonable to treat HIV-infected patients with R equi pneumonia who do not require surgical intervention with prolonged intravenous therapy followed by long-term oral therapy with at least two effective antibiotics. The optimal choice and duration of antibiotic therapy need to be determined.

AIDS-Related Opportunistic Infections↗
PubMed1991

Management of HIV infection in adults.

The natural history of HIV infection continues to change with improved diagnostic and therapeutic modalities available to manage opportunistic infections and malignancies. Antiretroviral therapy with zidovudine and other investigational agents has improved the median survival of AIDS patients from 11 months in 1985 to 18-25 months at present. Most importantly, early intervention with zidovudine can delay onset of clinical illness in asymptomatic patients and progression to AIDS in symptomatic patients. A 500 mg/d dose has been found as effective as previously recommended doses of 1200-1500 mg/day. Lower doses decrease the incidence and severity of adverse effects and therapeutic benefit appears to be greatest in asymptomatic patients with CD4 lymphocyte counts less than 500/ul. Indications for zidovudine, therefore, have been expanded to include asymptomatic adults with CD4 lymphocyte counts less than 500/ul. Concerning early intervention with zidovudine, studies were not designed to measure survival or define the optimal timing of intervention based on immunologic status. In addition, long-term benefits are not clearly defined, particularly since the drug seems to lose clinical effectiveness after approximately two years, probably due to emergence of resistant HIV strains. Adverse effects continue to occur even at low doses including headaches, nausea, anemia and neutropenia, myopathy and possible hepatitis. Nevertheless, the overall clinical benefit seems to be greatest, albeit temporary, in asymptomatic patients. The optimal dosage appears to be 500-600 mg/d; however, this may not be sufficient for infection in the central nervous system.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Adrenal insufficiency in the acquired immunodeficiency syndrome.

Patients with the acquired immunodeficiency syndrome (AIDS) often have signs and symptoms suggestive of adrenal insufficiency. Reports in the literature suggest that adrenal insufficiency may be relatively common in patients with AIDS based on the finding of destructive adrenal lesions in a large number of the patients studied. In no series, however, has standard testing for adrenal reserve been done in an unselected population of patients with AIDS. We found a normal response to a standard, short adrenocorticotropic hormone test in 11 consecutive patients with AIDS (P less than .0005). Thus, although adrenal involvement by various destructive lesions may be common in patients with AIDS, clinically significant adrenal insufficiency does not appear to be common.

Acquired Immunodeficiency Syndrome↗
PubMed1982

Activity of N-formimidoyl thienamycin and cephalosporins against isolates from nosocomially acquired bacteremia.

The in vitro activity of N-formimidoyl thienamycin was compared with that of seven beta-lactam agents against bacteremic clinical isolates, including gentamicin-resistant, gram-negative bacilli, Staphylococcus aureus, Staphylococcus epidermidis, streptococci, and enterococci. N-formimidoyl thienamycin was the most active antibiotic against all of the gram-positive cocci studied, with the exception of Staphylococcus epidermidis, and the only agent active against the enterococci. N-formimidoyl thienamycin was less active than some of the other agents against Enterobacteriaceae, except for the strains of Serratia and Citrobacter studied. For Pseudomonas aeruginosa, N-formimidoyl thienamycin was the most active agent (4 micrograms/ml was the lowest concentration that inhibited 90% of the strains tested).

Anti-Bacterial Agents↗
PubMedDate not supplied

Granulomatous hepatitis.

According to the literature on the subject, hepatic granulomas are present in 2.4%-10% of the liver tissue specimens examined in general hospitals. The pathogenesis and pathological importance of these lesions remain unclear in many cases. Hepatic granulomas have been associated with a wide variety of diseases, among which sarcoidosis, followed by tuberculosis, figure most prominently. The etiology remains undetermined in less than or equal to 36% of reported cases. In some instances the lesions are found by chance, and in other cases they are associated with a prolonged course of fever of undetermined origin, which may or may not resolve spontaneously. In the present article, the histopathogenesis and appearance of these lesions are described; the associated diseases are reviewed with detailed emphasis on the clinical manifestations, pathology, and diagnosis of those diseases most commonly responsible for the lesions; and, finally, some comments are offered on the diagnostic work-up and controversial management of undiagnosed cases.

Bacterial Infections↗