PubMed Health⌕ Search

Biomedical subjects

S T Shulman

Publications and source records attributed to S T Shulman.

At least 163 records · Page 9Linked to original sources
PubMed1983

Ceftriaxone therapy of group B streptococcal bacteraemia and meningitis in infant rats.

The efficacy of ceftriaxone against group B streptococci was studied in vitro and in vivo with an infant rat model of group B streptococci bacteraemia and meningitis. Twenty-four strains demonstrated minimal inhibitory concentrations of ceftriaxone of 0 . 05-0 . 1 mg/l and minimal bactericidal concentrations of 0 . 1-0 . 4 mg/l. Four strains were selected to induce bacteraemia and meningitis in infant rats by intraperitoneal inoculation. All 45 bacteraemic animals with or without meningitis that were treated with ceftriaxone 2 mg/kg/dose every eight hours for five doses survived, while all 12 control animals died (P less than 0 . 001). When recultured 54 h after the last dose of ceftriaxone, both CSF and blood remained sterile in all treated animals. These results indicate group B streptococci to be sensitive to ceftriazone in vitro and that, in the low dosage used, ceftriaxone effectively eradicates group B streptococcal bacteraemia and meningitis in infant rats.

Animals↗
PubMed1983

Fatal hepatitis B in early infancy: the importance of identifying HBsAg-positive pregnant women and providing immunoprophylaxis to their newborns.

Infants born to women who are asymptomatic hepatitis B surface antigen (HBsAg) carriers frequently acquire hepatitis B virus infection in infancy. The spectrum of disease in such affected infants includes mild transient acute hepatitis B, chronic active hepatitis with or without cirrhosis, chronic persistent hepatitis, chronic asymptomatic HBsAg carriage, and, rarely, fulminant fatal hepatitis B. Recently, the administration of hepatitis B immunoglobulin has been demonstrated to reduce the risk of infantile acquisition of hepatitis B virus; hepatitis B vaccine may also be preventive in this setting. Three young infants, aged 8 to 16 weeks, who died of acute fulminant hepatitis were studied. In each instance, the mother was found, retrospectively, to be asymptomatic but HBsAg positive. One of these mothers was hepatitis B e-antigen-negative but hepatitis B e-antibody positive. All three babies were HBsAg positive; two who were tested for hepatitis B core antibody were positive. These three fatalities serve to dramatize both the importance of HBsAg screening of pregnant women, particularly those with demographic factors that place them at increased risk for HBsAg carriage, as well as the significance of effective immunoprophylaxis for hepatitis B in all offspring of women with HBsAg seropositivity.

Carrier State↗
PubMed1982

Moxalactam in the treatment of pediatric infections.

The clinical efficacy and safety of the new oxacephalosporin moxalactam disodium were evaluated in 54 children with a variety of pediatric infections. Except for a terminally ill neutropenic leukemic patient with pneumonia and sepsis due to Pseudomonas aeruginosa who died shortly after initiation of therapy, moxalactam treatment was effective in all patients. No recurrent infections were observed. The rate of clinical response to moxalactam appeared to be at least comparable to that of patients treated with traditional antibiotics. In vitro sensitivity testing demonstrated that all bacteria isolated except P aeruginosa were sensitive to moxalactam while Haemophilus influenzae was exquisitely sensitive. Side effects included thrombocytosis (five patients), transient SGPT elevations and eosinophilia (three each), fever with rash (one), and neutropenia (one). In one patient, superinfection with Streptococcus faecalis developed. We conclude that moxalactam may be a useful antibiotic in pediatrics, particularly for the treatment of infections due to H. influenzae and Enterobacteriaceae. Its role in infections caused by group B streptococcus and Pseudomonas awaits further studies.

Adolescent↗
PubMed1982

Complications of mastoiditis with special emphasis on venous sinus thrombosis.

Two children with intracranial venous sinus thrombosis complicating mastoiditis prompted review of the experience with these disorders at the The Children's Memorial Hospital in Chicago over the past decade. Fifteen patients, 1.5 to 14 years of age, with mastoiditis were identified, including nine cases categorized as acute and six as chronic, the latter without fever but with chronic otorrhea. All six patients with chronic, but none with acute, mastoiditis were found to have cholesteatomas. Venous sinus thrombosis developed in four children and intracerebellar abscess in one child. Contrast-enhanced computerized tomography has proved valuable in the diagnosis of these rare, serious complications of mastoiditis in recent patients. Arteriography is still desired to confirm venous patency or occlusion prior to surgery because of well-documented developmental variations in venous drainage patterns. Optimal therapy of mastoiditis and its complications generally requires surgical drainage in addition to administration of antibiotics.

Adolescent↗
PubMed1982

Pulmonary paragonimiasis in Laotian refugee children.

Three Laotian refugee children with chronic pulmonary complaints and findings were found to have pulmonary paragonimiasis during a one-year period in Chicago. These patients ranged from 8 to 11 years of age and the diagnosis was delayed five to six months in two children because of the unfamiliarity of American physicians with signs and symptoms of this disorder. Clinical manifestations included chronic cough for up to two years, apparent hemoptysis in two patients, lack of fever or sweats, and family history negative for tuberculosis. Physical findings included rales and dullness to percussion, clubbing (one patient), and lack of fever or respiratory distress. All three patients showed interstitial infiltrates on chest roentgenogram whereas two had multiple small cystic areas. Moderate eosinophilia was present. Paragonimus westermani ova were found in stools of two patients, in sputum of two patients, and in bronchoscopic specimens in one patient. All patients demonstrated striking clinical and radiologic improvement following treatment with bithionol (50 mg/kg every other day for 15 doses), which was well tolerated. Lung fluke infestation must be considered in Indochinese refugee children with apparent hemoptysis or chronic pulmonary symptoms, and sputum and stool should be examined for P westermani ova.

Child↗
PubMed1981

Primary amoebic meningoencephalitis: a report of two cases and antibiotic and immunologic studies.

In the summer of 1978, two children who had recently been swimming in freshwater lakes in Florida died from primary amoebic meningoencephalitis. Despite early and intensive treatment with amphotericin B, both patients died three to five days after the onset of illness. Amoebae were observed in wet preparations of cerebrospinal fluid and in sections of cerebral tissue and were identified as Naegleria fowleri by the indirect immunofluorescent antibody technique. The amoebae were highly virulent in mice. The isolate of N. fowleri was extremely sensitive in vitro to amphotericin B (minimal inhibitory concentration [MIC], 0.15 microgram/ml), somewhat sensitive to miconazole (MIC, 25 micrograms/ml), and resistant to rifampin (MIC, less than or equal to 100 micrograms/ml). Treatment with amphotericin B (7.5 mg/kg of body weight per day) administered intraperitoneally protected 60% of the mice. Lower doses of amphotericin B alone or in combination with miconazole (100 mg/kg) or rifampin (220 mg/kg) were not protective. These results suggest that amphotericin B remains the single effective agent in treatment of primary amoebic meningoencephalitis.

Adolescent↗
PubMed1981

Systemic lupus erythematosus glomerulonephritis in children.

This paper reviews the four types of systemic lupus erythematosus (SLE) glomerulonephritis in children and presents the clinical and renal histologic findings. A therapeutic program based upon the hypothesis that the nephritis of SLE is the result of the glomerular deposition of pathogenic dsDNA-anti-ds/DNA immune complexes is outlined. The effectiveness of therapy in suppressing disease activity is best estimated by serial determinations of serum complement components, particularly C3, and secondarily by monitoring serum levels of antibody to native DNA.

Animals↗
PubMed1980

Multiple nosocomial infections: a risk of modern intensive care.

Many components of modern medical care greatly predispose subjects to nosocomial infection. These include cancer chemotherapy, organ transplantation, immunosuppression, and intensive supportive care, particularly in conjunction with mechanical ventilatory support, invasive monitoring devices and prolonged central or peripheral intravenous therapy. The hazard of nosocomial infection associated with residence in a modern intensive care unit is dramatized by the case history of a near-drowning victim whose hospital course was complicated by an unusually large number and variety of nosocomial bacterial infections. Sixteen different bacterial organisms were isolated from cultures of blood, purulent thoracostomy tube drainage, or purulent tracheal secretions during the patient's prolonged hospital course. Factors which predisposed this patient to nosocomial infections included prolonged positive pressure mechanical ventilation, long-term broad spectrum antibiotics, indwelling arterial and central venous lines, violation of anatomic barriers by foreign bodies such as multiple thoracostomy tubes, and residence in an intensive care unit. This patient's case demonstrates that effective means to prevent nosocomial colonization and infection are urgently needed.

Acinetobacter↗
PubMed1980

Prepubertal oral pemphigus vulgaris.

Although rare, oral pemphigus vulgaris must be considered in those patients who have a prolonged history of oral lesions. The fact that chronic oral lesions characteristically precede skin changes in pemphigus emphasizes the importance of this disease to the dental profession. Patients with long-term and recurrent vesiculoulcerative oral lesions should undergo biopsy examination to establish the diagnosis. The dentist and the physician must collaborate to establish an appropriate diagnostic and therapeutic plan for the management of these patients.

Blister↗
PubMed1980

Clinical significance of the presence of cryoglobulins in patients with glomerulopathies not associated with systemic disease.

Serial serum samples from 102 children with glomerulopathies not associated with systemic diseases and from 23 normal controls were examined for the presence of cryoglobulins. Sera from controls, from patients with glomerulopathies thought to be mediated by immune complexes, and from those with non-immunologically mediated glomerulopathies demonstrated similar incidence of cryoglobulins. There was no correlation between cryoglobulin concentration or composition and the glomerular immunohistologic findings. Furthermore, persistence of cryoglobulinemia could not be correlated with progression of renal disease. Although cryoglobulins may contain immune complexes, determination of serum cryoglobulin concentration appears to be of little value in the diagnosis of immune complex mediated renal disease, nor in the assessment of disease activity or monitoring therapy in patients with glomerulopathies unassociated with systemic disease.

Cryoglobulins↗