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Biomedical subjects

W J Rodriguez

Publications and source records attributed to W J Rodriguez.

At least 73 records · Page 4Linked to original sources
PubMed1985

Erythromycin-sulfisoxazole vs amoxicillin in the treatment of acute otitis media in children. A double-blind, multiple-dose comparative study.

A fixed combination of erythromycin ethylsuccinate and sulfisoxazole acetyl (erythromycin-sulfa) was compared with amoxicillin for the treatment of acute otitis media (AOM) in children. Of 145 patients studied, 76 boys and 69 girls were compliant and were evaluated for drug efficacy (72 amoxicillin, 73 erythromycin-sulfa). Based on otoscopic and tympanometric results, cure rates at ten to 14 days for AOM due to all organisms were 83% (63/72) for amoxicillin and 89% (65/73) for erythromycin-sulfa; for Haemophilus species (including mixed infections), they were 84% for amoxicillin (26/31) and 83% for erythromycin-sulfa (20/14). Cure rates for ampicillin-resistant Haemophilus were 1/1 for amoxicillin and 7/8 (88%) for erythromycin-sulfa; one patient (12%) had persistent AOM at day 10. Of the patients with AOM due to Streptococcus pneumoniae, 82% (29/35) in the amoxicillin-treated group and 98% (39/40) in the erythromycin-sulfa-treated group were cured. Patients with S pneumoniae as the initial infecting organism who were treated with amoxicillin had significantly more clinical recurrences then their erythromycin-sulfa-treated counterparts, 66% (8/12) vs 33% (3/9). There was no difference between treatment groups in recurrence rates for patients with Haemophilus as the initial infecting organism. On the treatment day indicated, the following number of patients had middle ear effusion: by days 10 to 14, 38% (27/72) amoxicillin-treated patients and 48% (35/73) erythromycin-sulfa-treated patients; by day 28, 10% (7/71) amoxicillin-treated patients and 16% (11/70) erythromycin-sulfa-treated patients. There were no significant differences in adverse reactions. The erythromycin-sulfa combination is safe and effective treatment for AOM, including ampicillin-resistant Haemophilus.

Acute Disease↗
PubMed1985

Fecal adenoviruses from a longitudinal study of families in metropolitan Washington, D.C.: laboratory, clinical, and epidemiologic observations.

During a 29-month period, we studied enteric infection in 70 families from a pediatric practice in suburban Washington, D.C. Fecal adenoviruses were detected in stools of 18 patients by tissue culture and electron microscopic procedures. From 6 through 11 months of age, the incidence of fecal adenoviruses associated with enteritis was seven per 100, and of confirmed enteric adenoviruses (EAds), three per 100 individuals per year. All EAds belonged to subgenus G (type 41). All three patients with EAds had diarrhea; two had vomiting and one had fever, but none required hospitalization. Ten of the 15 patients with non-EAds were younger than 2 years, and 60% had diarrhea, 40% had vomiting, and 20% had fever. Combined gastrointestinal and respiratory symptoms occurred more often in those who shed non-EAds (three of 11) than in matched controls (two of 48, P = 0.04). An adenovirus was detected in approximately 6% of gastroenteritis episodes, and confirmed EAds were present in approximately 2% of episodes of gastroenteritis in children younger than 2 years of age. None of the contacts of patients with non-EAds shed such virus in their stools. None of nine family contacts of those with EAd appeared to shed adenovirus in stool. In contrast, rotavirus spread readily to exposed adults (25% of 65) and children (56% of 62) when a child in similar families had rotavirus infection.

Adenoviridae↗
PubMed1985

Adenoviruses and pediatric gastroenteritis.

Adenoviruses were found in 8.6% of 900 pediatric inpatients with diarrhea who were tested by electron microscopy of a fecal specimen and cell culture inoculation of a throat swab and an anal swab specimen. In 5.1% of these patients, including 13.5% of patients who were four through five months of age, adenovirus particles were visualized in the fecal specimen. Controlled study demonstrated that visualized adenoviruses, especially those that did not grow readily in conventional Hep-2 cell cultures, were significantly associated with diarrhea. About 80% of the visualized adenoviruses from patients with diarrhea or vomiting or both, including 94% of the viruses that grew in the 293 cell line but that did not grow readily in Hep-2 cultures, proved to be enteral adenoviruses--adenoviruses from either group F (type 40) or group G (type 41). Inpatients with gastroenteritis and confirmed enteral adenoviruses ranged in age from one through 16 months, with a median age of seven months. Enteral adenoviruses apparently are endemic in this locale, as one or more of these viruses have been found in every calendar month for nine successive years.

Adenoviridae Infections↗
PubMed1984

Hemophilus species in the pharynx. Comparison of sampling sites.

In a study of 170 young children, we compared the number and serotype of ampicillin-sensitive and ampicillin-resistant Hemophilus species recovered from throat cultures with those recovered from nasopharyngeal cultures obtained simultaneously. Hemophilus species were recovered from 107 (63%) of the 170 throat cultures and from 79 (46%) of the 170 nasopharyngeal cultures (chi 2 = 12.6). In only five of the pairs of cultures did the nasopharyngeal culture contain Hemophilus species without simultaneous recovery of this organism from the throat culture. Ampicillin-resistant Hemophilus species were recovered from 29 throat swabs and from ten nasopharyngeal swabs.

Ampicillin↗
PubMed1984

Rapid presumptive recognition of diarrhea-associated adenoviruses.

The quantity of adenoviruses in a diarrhea stool provided a strong presumptive indication of the presence or absence of an adenovirus from subgenus F or G (proposed species 40 or 41). These adenoviruses were found in the stools of 91% of 56 acutely ill diarrhea patients with one or more than one adenovirus particle per min of direct electron microscopic viewing, as compared with 40% of 20 acutely ill diarrhea patients with less than one detected adenovirus particle per min of viewing.

Adenoviruses, Human↗
PubMed1983

Cerumen removal. How necessary is it to diagnose acute otitis media?

We evaluated the consistency and appearance of aural cerumen and the degree to which such cerumen obscured the view of the eardrum in 279 children with unilateral acute otitis media with effusion (AOME). Mechanical removal of cerumen was necessary overall in 29% of the patients. Cerumen removal was inversely proportional to age, and we found it necessary to remove such cerumen to visualize most of the eardrum in 35 (57%) of 61 infants with AOME. Some physicians believe that the heat generated from an intensely inflamed middle ear will invariably cause sticky, honey-colored cerumen to liquefy. Only 29 children (11%) in this study had aural cerumen with a soft cheesy or semiliquefied consistency.

Cerumen↗
PubMed1983

Use of electrophoresis of RNA from human rotavirus to establish the identity of strains involved in outbreaks in a tertiary care nursery.

During two nosocomial outbreaks in a tertiary care nursery, 22 of 102 infants had infections due to human rotavirus (HRV). The time sequence and proximity of the infected infants in the nursery rooms had suggested infant-to-infant spread of a single HRV strain in each outbreak. Polyacrylamide gel electrophoresis of virus permitted demonstration of four different HRV electropherotypes (strains) during the first outbreak period and seven during the second. One of the strains was detected during both outbreaks. All strains had fast-migrating RNA segments 10 and 11. Infant-to-infant spread of at least two different viruses apparently occurred in each outbreak period. Thus, electrophoretic analysis showed that infants in a tertiary care center can be infected with at least 10 different HRV strains within two months, that multiple HRV strains can spread independently and in parallel to different infants as part of a "single" outbreak, and that secondary spread of individual strains can be traced with considerable accuracy.

Cross Infection↗
PubMed1983

Pediatric viral gastroenteritis during eight years of study.

During the period January 1974 through July 1982, fecal samples from 1,537 pediatric inpatients with gastroenteritis were tested for enteric viruses by electron microscopic and rotavirus enzyme-linked immunosorbent assay techniques. Rotaviruses were detected in 34.5% of these patients, enteric adenoviruses were detected in 4.7%, approximately 27-nm viruses were detected in 1.6%, and at least one of these agents was found in 40.1% of the study subjects. Three infections were by an apparently new agent which morphologically is a rotavirus, but which failed to react in the rotavirus enzyme-linked immunosorbent assay. During the first 8 calendar years of study, rotaviruses were detected in 39.0% of 577 patients in the even-numbered years and 30.3% of 702 patients in the odd-numbered years. Adenoviruses were found in all calendar months. Rotaviruses were found in inpatients in November through July, whereas approximately 27-nm viruses were found in October through June. The percentage of patients who had a demonstrated viral infection rose steadily from 7.4% in September to 72.0% in January and then steadily declined to 2.9% in August. Viral infection was especially common in study subjects who were 7 through 24 months of age; 61% of such children had one or more enteric viruses. Rotavirus-infected patients tended to be younger during the months of greatest rotavirus activity than at the beginning and end of the rotavirus season, presumably because of a greater exposure to virus at the height of the rotavirus outbreak.

Adenoviridae Infections↗
PubMed1983

Ampicillin-resistant Haemophilus in the oropharynx: prevalence in three groups of young, middle-class children.

Infections caused by ampicillin-resistant Haemophilus influenzae type b are prevalent in Fairfax County, VA. In order to gain information on pharyngeal carriage of ampicillin-resistant H influenzae, oropharyngeal cultures were obtained from 249 young children. The study population comprised three groups: 90 healthy children (group A), 79 children who had finished a ten-day course of amoxicillin treatment for acute otitis media (group B), and 80 children who were brought to our office for treatment of purulent nasopharyngitis (group C). Approximately 60% of the children in each group carried Haemophilus in the oropharynx. H parainfluenzae was the predominant oropharyngeal species in group 1. H influenzae was predominant in the other two groups. Ampicillin-resistant Haemophilus sp organisms were recovered from 16% of children in group A, 25% of those in group B, and 17% of patients in group C. Recent exposure to ampicillin was associated with an increase in the recovery of ampicillin-resistant strains of Haemophilus.

Acute Disease↗
PubMed1982

Rotavirus gastroenteritis and weather.

During 5.5 years of a study in Washington, D.C., hospitalizations of children for rotavirus gastroenteritis tended to be more common after a month of cold or dry weather than after a corresponding calendar month of warm or wet weather. Overall, there were 84% more (178 versus 97) inpatients with rotavirus gastroenteritis after a set of relatively colder individual months taken as a group than after an equal number of warmer corresponding calendar months taken as a group. Comparable differences were not seen with nonrotavirus gastroenteritis patients. There also were 45% more rotavirus hospitalizations after the set of months with the least depth of precipitation compared with the set of corresponding calendar months with the greatest depth of precipitation. Rotavirus infection in young infants, the children least likely to be directly exposed to outdoor conditions, showed some of the most marked weather-associated effects. These findings suggest that weather-related low indoor relative humidity and indoor crowding may be key factors in the epidemiology of rotavirus disease.

Adolescent↗
PubMed1982

Sulphamethoxazole prophylaxis in the otitis-prone child.

A bedtime dose of sulphamethoxazole was effective in preventing ear infections in otitis-prone young children. Thirty-three such children were studied by means of a random, double-blind, placebo-controlled, cross-over protocol. Nine (27%) of 33 children treated with sulphamethoxazole experienced 10 episodes of acute suppurative otitis media or otitis media with effusion while 19 (58%) of 33 children given a placebo experienced 27 episodes of acute otitis media or otitis media with effusion. No new episode of otitis media was observed in 11 children in whom serial urine samples uniformly had a positive response to Micrococcus lutea bioinhibition test, the method we chose to monitor compliance. Otitis media with effusion (secretory otitis media) was detected less often in the children who were given sulphamethoxazole; this fact suggests that prophylaxis with sulphamethoxazole may prevent persistent middle ear effusion in otitis-prone young children.

Child, Preschool↗
PubMed1982

Evaluation of cefaclor in acute otitis media caused by ampicillin-resistant H. influenzae.

Cefaclor was used to treat 13 children with acute otitis media caused by ampicillin-resistant strains of Hemophilus influenzae. The children were re-examined on days 4, 10, and 28. Pharmacologic compliance was assessed by means of a bioinhibition assay on a urine specimen obtained on days 4, 7, and 10. Nine of the 13 children had evidence by tympanogram of residual otitis media with effusion (secretory otitis media). Of these, three were noted to have a bulging, yellow or grey eardrum, which suggested an ongoing acute process. A second middle ear culture was obtained from two of the 3 children, but no pathogens were recovered. Two others had recurrence of otitis shortly after cessation of therapy. Cefaclor is an acceptable antibiotic for the treatment of ampicillin-resistant acute otitis media; but, after cefaclor therapy, some children continued to have a bulging eardrum and sterile pus in the middle ear or had recurrences of otitis soon after cessation of therapy.

Acute Disease↗
PubMed1981

Acute otitis media in children eight years old and older: a reappraisal of the role of Hemophilus influenzae.

The bacteriology of acute otitis media in 18 children eight to 17 years of age was investigated through the use of culture of middle ear exudate obtained by tympanic membrane puncture. Equal numbers of children had either Hemophilus influenzae (six) or Streptococcus pneumoniae (six) in the middle ear exudate. Acute otitis media in children through adolescence should be treated with antibiotics known to be effective against H. influenzae.

Acute Disease↗
PubMed1981

Haemophilus influenzae biotype III infections in children and report of three unusual cases.

Three hundred thirty seven Haemophilus influenza isolates from infections in children were studied to determine the relationship between H. influenza, biotype III, and specimen source. Eighteen per cent (60) of the isolates were H. influenza biotype III. Of these, 70% were from the eye, 18% from the respiratory tract, 7% from the ear and 2% from blood. Although conjunctivitis was the most common clinical condition associated with H. influenza biotype III, three cases of systemic infection with this organism are presented: a 10-month-old female with pneumonia, a 17-year-old male with sepsis, and a 7-year-old male with endophthalmitis. This organism may be a significant pathogen depending on the clinical setting. Increased awareness of its importance will lead to more reports of its isolation.

Adolescent↗
PubMed1981

Thrombocytopenia associated with PF3 antiplatelet activity against the sulfa component of trimethoprim-sulfamethoxazole.

A 3-year-old white boy had symptomatic thrombocytopenia after receiving trimethoprim-sulfamethoxazole in recommended doses for one week. The platelet count returned to normal soon after the medication was discontinued. In vitro admixing of donor platelets with a sample of the patient's serum demonstrated antiplatelet activity with the sulfamethoxazole component, but not with the trimethoprim component of the drug.

Blood Coagulation Factors↗