Meningococcal disease continues to be a serious problem, and increasing recognition of sulfadiazine-resistant strains1 2 3 4 renders sulfonamide therapy untenable. For most persons either penicillin G or ampicillin has supplanted sulfonamides as the antimicrobial agents of choice in the treatment of meningococcal disease in man.3 , 5 However, selecting therapy for penicillin-sensitive patients remains a problem. Various cephalosporin derivatives have been suggested as bactericidal alternatives in life-threatening infections, but little experience with these agents has been reported in association with meningococcal disease. Binns and Pankey6 described a patient with meningococcal meningitis treated with cephalothin whose response was equivocal. They expressed the hope that others . . .
This document summarizes recommendations from a state-of-the-art conference convened to evaluate the role of nucleoside analogue reverse transcriptase inhibitors in the treatment of human immunodeficiency virus (HIV) infection. Data from controlled clinical trials of zidovudine, didanosine, and zalcitabine were reviewed by an expert panel, which then formulated guidelines to assist clinicians and HIV-infected patients in the use of these agents. Recommendations were framed in the context of clinical scenarios for patients with asymptomatic HIV infection who have not had prior antiretroviral therapy; those with signs and symptoms of HIV-related disease who have not received prior therapy; clinically stable patients who are tolerating initial zidovudine therapy; patients experiencing clinical progression while on zidovudine therapy; and those who are intolerant of antiretroviral therapy. The panel concluded that physicians need to integrate up-to-date scientific knowledge with other relevant needs to improve the care of HIV-infected patients. (JAMA. 1993;270:2583-2589)
AbstractChanges in the zoonotic infections that affect Americans stem primarily from shifting patterns of animal-human interaction, the crossover of species-specific organisms, and the importation or identification of new organisms. Although Lyme disease is not, strictly speaking, zoonotic, it leads off this review by virtue of its epidemic or near-epidemic prevalence in many areas.
From the Department of Internal Medicine, University of Texas Southwestern Medical School, and the Dallas Veterans Administration Hospital, Dallas, Texas *From the Department of Internal Medicine, University of Texas Medical Branch at Galveston, Galveston, Texas 77550
Letters1 September 1979Legionnaires' Disease PapersJAY P. SANFORD, M.D.JAY P. SANFORD, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-91-3-492_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: My summary of the International Symposium on Legionnaires' Disease, which appeared in the 22 March 1979 issue of The New England Journal of Medicine, was an invited summary and was not intended in any way to suggest attribution of scientific priority to me. There are two aspects of this article I should like to clarify.Brenner, Steigerwalt, and McDade first described the taxonomy of Legionnaires' disease bacterium, for which they proposed the nameLegionella pneumophila. This name was proposed by them at the International Symposium on Legionnaires' Disease on 13 to 15 November 1978, and their paper...Reference1. BRENNERSTEIGERWALTMCDADE DAJ. Classification of the Legionnaires' disease bacterium: Legionella pneumophila, genus novum, species nova, of the family Legionellaceae, familia nova. Ann Intern Med. 1979; 90:656-8. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: School of Medicine Uniformed Services University of the Health Sciences Bethesda, MD 20014 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 September 1979Volume 91, Issue 3Page: 492-492KeywordsLegionella pneumophilaLegionellosis Issue Published: 1 September 1979 PDF DownloadLoading ...
Candiduria has emerged as a common, vexing diagnostic and therapeutic problem over the past 40 years. Treatment by means of bladder irrigation with a solution of amphotericin B has become widely used in clinical practice. However, the specifics of the procedure—concentration of amphotericin B, use of continuous washing vs. instillation with cross-clamping to allow “dwell-times,” and duration of treatment—are based entirely on anecdotal experiences. The published reports and evolution of recommendations are reviewed. A prospective randomized double-blind study is needed to provide answers. In the meantime, administration of 200–300 mL of amphotericin B solution by triple-lumen urethral catheter with cross-clamping for 60–90 minutes seems most appropriate. Irrigation for no longer than 2 days should sufficeif the procedure is to be effective. The optimal concentration of amphotericin B has not been defined; however, 5–10 mg/L appears adequate.
