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Article: Complications of asplenia and hyposplenism--persistent uncertainties.

Styrt, B

1992 Volume 157, Issue 4, Page(s) 461–463

MeSH term(s)	Bacterial Infections/diagnosis ; Bacterial Infections/etiology ; Bacterial Infections/microbiology ; Bacterial Infections/prevention & control ; Humans ; Splenectomy/adverse effects
Language	English
Publishing date	1992-10
Publishing country	United States
Document type	Comment ; Editorial
ZDB-ID	189235-6
ISSN	1476-2978 ; 0093-0415 ; 0008-1264
ISSN (online)	1476-2978
ISSN	0093-0415 ; 0008-1264
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Infection associated with asplenia: risks, mechanisms, and prevention.

Styrt, B

The American journal of medicine

1990 Volume 88, Issue 5N, Page(s) 33N–42N

Abstract: The risk of overwhelming sepsis in asplenic patients has been recognized increasingly over the past several decades, but the underlying mechanisms are not fully understood, and there is controversy over the true magnitude of risk and the value of ... ...

Abstract	The risk of overwhelming sepsis in asplenic patients has been recognized increasingly over the past several decades, but the underlying mechanisms are not fully understood, and there is controversy over the true magnitude of risk and the value of specific interventions. Review of recent series indicates that postsplenectomy sepsis is more likely after splenectomy in childhood than after splenectomy in adulthood but may occur after splenectomy at any age. In some cases, sepsis has been documented many years after surgery. The pneumococcus remains the predominant organism, and the characteristic course is rapid progression to multisystem involvement with high morbidity and mortality. Predisposition to pneumococcal sepsis and to other infections reflects the role of the spleen in mechanical filtration of particulate material in the bloodstream, generation of opsonins and other soluble mediators of phagocytosis, and anatomic juxtaposition of different elements of the immune system. Whereas pneumococcal vaccine is indicated in asplenic patients, the value of other interventions requires further evaluation.
MeSH term(s)	Bacterial Infections/etiology ; Bacterial Infections/prevention & control ; Humans ; Infection/etiology ; Infection Control ; Risk Factors ; Spleen/immunology ; Splenectomy/adverse effects
Language	English
Publishing date	1990-05
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	80015-6
ISSN	1555-7162 ; 1873-2178 ; 0002-9343 ; 1548-2766
ISSN (online)	1555-7162 ; 1873-2178
ISSN	0002-9343 ; 1548-2766
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Article: Species variation in neutrophil biochemistry and function.

Styrt, B

Journal of leukocyte biology

1989 Volume 46, Issue 1, Page(s) 63–74

MeSH term(s)	Animals ; Chemotaxis, Leukocyte ; Cytoplasmic Granules ; Humans ; Ion Exchange ; Mammals/blood ; Neutrophils/physiology ; Oxidation-Reduction ; Phagocytosis ; Receptors, Cell Surface ; Species Specificity
Chemical Substances	Receptors, Cell Surface
Language	English
Publishing date	1989-07
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	605722-6
ISSN	1938-3673 ; 0741-5400
ISSN (online)	1938-3673
ISSN	0741-5400
DOI	10.1002/jlb.46.1.63
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Article: History and implications of the neutrophil glycoprotein deficiencies.

Styrt, B

American journal of hematology

1989 Volume 31, Issue 4, Page(s) 288–297

Abstract: This review focuses on the initial clinical descriptions and subsequent investigation of the syndrome of recurrent infections associated with neutrophil membrane glycoprotein deficiencies. Characterization of the missing group of three glycoprotein ... ...

Abstract	This review focuses on the initial clinical descriptions and subsequent investigation of the syndrome of recurrent infections associated with neutrophil membrane glycoprotein deficiencies. Characterization of the missing group of three glycoprotein heterodimers and their role in adhesion-related neutrophil function is summarized. Study of the clinical consequences of these genetically determined membrane glycoprotein defects has also contributed to the understanding of the role of normal neutrophils in both host defense and host tissue damage.
MeSH term(s)	Glycoproteins/blood ; Glycoproteins/deficiency ; Glycoproteins/genetics ; Humans ; Neutrophils/pathology ; Phagocyte Bactericidal Dysfunction/blood ; Phagocyte Bactericidal Dysfunction/genetics
Chemical Substances	Glycoproteins
Language	English
Publishing date	1989-08
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	196767-8
ISSN	1096-8652 ; 0361-8609
ISSN (online)	1096-8652
ISSN	0361-8609
DOI	10.1002/ajh.2830310416
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Zs.A 1251: Show issues

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Article: FDA perspective on antivirals against biothreats: communicate early and often.

Roberts, Rosemary / Styrt, Barbara / McCune, Susan

Antiviral research

2008 Volume 78, Issue 1, Page(s) 60–63

Abstract: Development of antiviral products for certain highly pathogenic viruses with limited available treatments, such as viruses that may have biothreat potential, is critically important and challenging. The mission of the FDA is to protect the public health ... ...

Abstract	Development of antiviral products for certain highly pathogenic viruses with limited available treatments, such as viruses that may have biothreat potential, is critically important and challenging. The mission of the FDA is to protect the public health by assuring the safety, efficacy and quality of such products. Human clinical trials are critically important whenever relevant naturally occurring diseases can appropriately be studied. In selected situations when clinical studies are not ethical and field efficacy studies are not feasible, the Animal Rule (67 FR 37988, 2002) introduces the possibility of drug/biologic approval/licensure based on efficacy studies in animals, and appropriate human safety and pharmacokinetic information. This approach necessitates the development of well-delineated animal models predictive of human disease and treatment responses, and plans for adding human information if suitable circumstances arise. Efficient development of therapeutics against these agents requires collaborative efforts among industry, academia and federal agencies.
MeSH term(s)	Animals ; Antiviral Agents/therapeutic use ; Bioterrorism ; Disease Models, Animal ; Drug Approval/legislation & jurisprudence ; Drug Industry ; Government Regulation ; Humans ; Interdisciplinary Communication ; Private Sector ; Public Sector ; Therapies, Investigational ; United States ; United States Food and Drug Administration ; Virus Diseases/drug therapy
Chemical Substances	Antiviral Agents
Language	English
Publishing date	2008-04
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	306628-9
ISSN	1872-9096 ; 0166-3542
ISSN (online)	1872-9096
ISSN	0166-3542
DOI	10.1016/j.antiviral.2007.10.001
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Zs.A 1627: Show issues

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Article: Prevention of recurrent staphylococcal skin infections with low-dose oral clindamycin therapy

Styrt, B.

JAMA. J. American Medical Association

1988 Volume 260, Issue 18, Page(s) 2682–2685

Abstract: The authors conducted a double-blind, controlled trial of low-dose (150mg/d) oral clindamycin hydrochloride vs placebo to prevent recurrent staphylococcal skin infections. Twenty-two patients (11 in both the placebo and clindamycin treatment groups) ... ...

Institution	750 Washington St, USA Boston, MA 02111 Division of Geographic Medicine/Infectious diseases, New England Medical Center
Abstract	The authors conducted a double-blind, controlled trial of low-dose (150mg/d) oral clindamycin hydrochloride vs placebo to prevent recurrent staphylococcal skin infections. Twenty-two patients (11 in both the placebo and clindamycin treatment groups) completed the trial and were assessable. The two groups did not differ as to age, sex, race, or the number of recurrent abscesses preceding the trial. In pretrial evaluations, no patient had hypogammaglobulinemia or abnormal neutrophil function. Sixty-four percent (7/11) of the placebo-treated patients had a recurrent abscess within three months of enrollment whereas 82% (9/11) of the patients treated with clindamycin were free of any infection during the three-month treatment period. Of the nine patients who responded to clindamycin treatment, six did not have a recurrent infection for at least nine months after discontinuing antibiotic therapy. All patients tolerated the regimen without side effects. The authors conclude that a three-month course of low-dose oral clindamycin is an effective, convenient, well-tolerated, and often durable approach to prevention of recurrent staphylococcal skin infections.
Keywords	Haut ; Staphylokokkeninfektion ; Praeventivmedizin ; Laboruntersuchung ; Arzneimitteltherapie ; Oral
Language	English
Document type	Article
ZDB-ID	2958-0
ISSN	1538-3598 ; 0002-9955 ; 0098-7484 ; 0254-9077
ISSN (online)	1538-3598
ISSN	0002-9955 ; 0098-7484 ; 0254-9077
Database	Social Medicine (SOMED)

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Article: Necrotizing soft tissue infections reported with nonsteroidal antiinflammatory drugs.

Kahn, L H / Styrt, B A

The Annals of pharmacotherapy

1997 Volume 31, Issue 9, Page(s) 1034–1039

Abstract: Background: Recent reports of necrotizing fasciitis in children with varicella who received a nonsteroidal antiinflammatory drug (NSAID) recall earlier concerns regarding the possibility of relationships between infections and NSAIDs. We searched the ... ...

Abstract	Background: Recent reports of necrotizing fasciitis in children with varicella who received a nonsteroidal antiinflammatory drug (NSAID) recall earlier concerns regarding the possibility of relationships between infections and NSAIDs. We searched the Food and Drug Administration's Spontaneous Reporting System (SRS) for necrotizing soft tissue infections reported in conjunction with the use of NSAIDs, to identify common features. Methods: A computer search of NSAID listings in the adverse event database recovered reports with codes for selected infection and necrosis-related diagnostic categories. From review of individual reports classified under these codes, cases were selected if the terms "necrotizing fasciitis," "necrotic," or "gangrenous" appeared in the adverse drug reaction description. Demographic, drug use, and disease course information were gathered. Findings: Thirty-three cases were identified, of which 10 were fatal. Over two-thirds of the patients were younger than 40 years. Thirty (91%) had a possible portal of entry for infection. Most received NSAIDs for acute conditions including varicella, trauma, and postoperative or postpartum pain; 7 received an NSAID by intramuscular injection. Specific NSAIDs accounting for most reports were also among those likely to be most heavily used in the relevant populations. Interpretation: Common features of these rare case reports of necrotizing soft tissue infections with NSAID use include characteristics such as age, portal of infection entry, indication for NSAID use, route of administration, and individual NSAIDs. The total number of SRS cases does not suggest that necrotizing infection is frequent with NSAIDs or likely without other risk factors. Controlled observational studies would help to define any causal contribution of these factors to the evolution of severe infection.
MeSH term(s)	Adverse Drug Reaction Reporting Systems ; Anti-Inflammatory Agents, Non-Steroidal/adverse effects ; Fasciitis, Necrotizing/chemically induced ; Fasciitis, Necrotizing/epidemiology ; Fasciitis, Necrotizing/mortality ; Fasciitis, Necrotizing/therapy ; Humans
Chemical Substances	Anti-Inflammatory Agents, Non-Steroidal
Language	English
Publishing date	1997-09
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1101370-9
ISSN	1542-6270 ; 1060-0280
ISSN (online)	1542-6270
ISSN	1060-0280
DOI	10.1177/106002809703100914
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Article: Hepatotoxicity of antiviral agents.

Styrt, B / Freiman, J P

Gastroenterology clinics of North America

1995 Volume 24, Issue 4, Page(s) 839–852

Abstract: Because most therapeutic agents used for viral infections are relatively new, experience with their adverse effects is still evolving. Hepatic toxicity has not been among the most important concerns with this class of drugs so far. Liver damage has been ... ...

Abstract	Because most therapeutic agents used for viral infections are relatively new, experience with their adverse effects is still evolving. Hepatic toxicity has not been among the most important concerns with this class of drugs so far. Liver damage has been increasingly noted with accumulating experience, especially with antiretroviral drugs and those used to treat chronic hepatitis (e.g., fialuridine), but it is often difficult to distinguish between effects of therapy and of the underlying disease. It is important for clinicians to be aware of the possibility of hepatotoxicity in such situations, and further reporting of adverse experiences should contribute to more definitive evaluation of the potential influence of antivirals on liver function.
MeSH term(s)	Animals ; Antiviral Agents/adverse effects ; Humans ; Liver/drug effects ; Liver/metabolism
Chemical Substances	Antiviral Agents
Language	English
Publishing date	1995-12
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	92114-2
ISSN	1558-1942 ; 0889-8553
ISSN (online)	1558-1942
ISSN	0889-8553
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Article: Estrogens and infection.

Styrt, B / Sugarman, B

Reviews of infectious diseases

1991 Volume 13, Issue 6, Page(s) 1139–1150

Abstract: The multiple effects of estrogens on infectious processes are only beginning to be understood. The existence of such effects is suggested by gender-related differences in the incidence and severity of some infections and by the association of certain ... ...

Abstract	The multiple effects of estrogens on infectious processes are only beginning to be understood. The existence of such effects is suggested by gender-related differences in the incidence and severity of some infections and by the association of certain infections with predictable hormonal changes. Current information indicates that estrogens may depress cell-mediated immunity, impair the activity of natural killer cells, and suppress some aspects of neutrophil function. Estrogens potentiate the production of systemic antibody, but local antibody responses may be impaired. Direct effects of estrogens on microorganisms have thus far been best studied in fungi; these hormones may either stimulate or suppress fungal virulence, depending on the species involved. Recent research also suggests responsiveness to estrogens in a wider variety of microorganisms. Studies in cell culture, animals, and humans indicate that pregnancy, estrogen supplementation, and menstrual stage can affect the acquisition and severity of certain bacterial, parasitic, and viral infections. This interaction depends on multiple attributes of both the microbe and the host in a given setting and thus may lead to disparate outcomes; however, there appears to be a predisposition to increased infectious morbidity in certain high-estrogen states. In view of the widespread use of estrogen supplementation, the clinical impact of estrogens on the incidence and outcome of infection needs to be better defined.
MeSH term(s)	Antibody Formation/physiology ; Estrogens/immunology ; Estrogens/physiology ; Humans ; Immunity, Cellular/physiology ; Infection/etiology ; Infection/immunology
Chemical Substances	Estrogens
Language	English
Publishing date	1991-11
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	441228-x
ISSN	0162-0886
ISSN	0162-0886
DOI	10.1093/clinids/13.6.1139
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Article: Antipyresis and fever.

Styrt, B / Sugarman, B

Archives of internal medicine

1990 Volume 150, Issue 8, Page(s) 1589–1597

Abstract: While understanding of the mechanisms of fever has progressed in recent years, much uncertainty remains as to whether fever in itself (as distinct from its cause) is beneficial or harmful, and what circumstances warrant antipyretic therapy. This review ... ...

Abstract	While understanding of the mechanisms of fever has progressed in recent years, much uncertainty remains as to whether fever in itself (as distinct from its cause) is beneficial or harmful, and what circumstances warrant antipyretic therapy. This review was designed to identify studies providing information on the effects of fever and of pharmacologic and physical therapy. Fever or analogous behavioral thermal upregulation apparently has positive effects on defense against infection in some animal models. Retrospective studies in humans suggest that failure to mount a febrile response is associated with poor outcome in certain infections but do not establish a causal relationship. Induction of fever apparently had therapeutic value in infections such as syphilis before specific antimicrobials were developed. Fever may have deleterious effects in the context of borderline cardiovascular or neurologic function or pregnancy, but data in most instances cannot separate effects of fever per se from that of underlying disease. Antipyretic drugs are effective in diminishing fever, but they have significant side effects and may suppress signs of ongoing infection. Physical cooling is important when physiologic thermoregulatory mechanisms are overwhelmed, but may sometimes increase discomfort and metabolic stress in fever. Antipyretic therapy should not be instituted routinely for every febrile episode but should be based on evaluation of relative risks in the individual case and reassessed if anticipated benefits are not achieved.
MeSH term(s)	Animals ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Fever/complications ; Fever/etiology ; Fever/physiopathology ; Fever/therapy ; Humans ; Physical Therapy Modalities
Chemical Substances	Anti-Inflammatory Agents, Non-Steroidal
Language	English
Publishing date	1990-08
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	211575-x
ISSN	1538-3679 ; 0003-9926 ; 0888-2479 ; 0730-188X
ISSN (online)	1538-3679
ISSN	0003-9926 ; 0888-2479 ; 0730-188X
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