Michael H. Grieco

Impairment of rosette-forming T lymphocytes in chronic marihuana smokers.

Abstract Rosettes formed by circulating T and B lymphocytes obtained from 23 healthy, chronic marihuana smokers were compared with those in 23 normal control subjects who denied marihuana use. The ...

Results of comparative skin tests with penicilloyl-polylysine and penicillin in patients with penicillin allergy

Abstract Intracutaneous tests in 120 patients with a previous history of penicillin allergy yielded positive results with penicilloyl-polylysine in 37 per cent and penicillin G in 15 per cent of patients tested up to twenty years after their reactions. There was an inverse relationship between the incidence of positive skin reactions with either reagent and the time interval at which the tests were performed following an allergic reaction. A higher incidence of positive responses resulted with penicilloyl-polylysine at all time periods, and this difference was highly significant for the period of three months to three years. Of patients with allergic reactions to penicillin tested during the initial three month period, 78 per cent demonstrated skin sensitivity to penicilloyl-polylysine. Since a significant number of patients have negative reactions during this early period, this reagent cannot be used to exclude penicillin as the etiologic agent in an allergic reaction. Marked skin responses to penicillin G, which occurred exclusively following immediate systemic reactions, may not be entirely due to the penicilloyl-determinant group. Alternative possibilities are discussed. It appears that skin test responses to penicillin G may be a more specific index of anaphylactic sensitivity than are cutaneous responses to penicilloyl-polylysine. Evidence is presented to substantiate the immunologic pathogenesis of large local reactions to intramuscularly administered penicillin.

Cerebral mucormycosis and renal aspergillosis in heroin addicts without endocarditis.

Abstract:The medical complications of narcotic addiction include fungal infections. Although Candida endocarditis is most commonly recognized, it is important to be aware of the occurence of focal infections resulting from transient fungemia with other ubiquitous organisms. A 23-year-old man is repo

Hyperimmunoglobulinemia associated with narcotic addiction: Effects of methadone maintenance treatment☆

Abstract Increased serum immunoglobulins were common in narcotic addicts. Immunoglobulin M (IgM) levels were high in 75 per cent of 46 adult addicts and in 65 per cent of 63 adolescent addicts seeking methadone maintenance or detoxification. Isolated hypermacroglobulinemia was found in 56 per cent. During methadone maintenance or abstinence high IgM levels were much less frequent. History of overt hepatitis, manifest liver disease, serum glutamic oxaloacetic transaminase (SGOT) or alkaline phosphatase levels did not correlate with the presence of high serum IgM levels. Serum immunoglobulin G (IgG) was more variably and less frequently increased than IgM in the untreated addicts, but was commonly increased in the patients maintained on methadone. Prospective studies of 21 patients starting methadone maintenance showed a decrease in mean serum IgM during treatment. The incidence of normal IgM levels in these patients rose to 48 per cent after one year compared to 24 per cent before treatment. The pattern of immunoglobulin changes in narcotic addiction is significantly altered during methadone maintenance treatment, perhaps as a result in the reduction of drug abuse.

Comparison of the circulatory and metabolic effects of isoproterenol, epinephrine and methoxamine in normal and asthmatic subjects

Abstract The circulatory responses of eleven asthmatic patients and six normal subjects were studied during infusion of isoproterenol, epinephrine and methoxamine. Blood pressure, heart rate, cardiac index, stroke volume index and peripheral resistance index were measured. The finding of increased myocardial chronotropic and inotropic stimulation with isoproterenol in asthmatic patients does not support the view that circulatory beta-adrenergic blockade is present. Responses of asthmatic patients and normal subjects to epinephrine infusion were sharply divergent. The difference observed between the two groups is not readily explained in terms of alpha- and beta-adrenergic sensitivity. The metabolic responses of the four normal subjects and the four asthmatic patients studied here were not significantly different.

Elevated β2-microglobulin and lysozyme levels in patients with acquired immune deficiency syndrome

beta 2-Microglobulin (beta 2-M) levels in sera and urines, and lysozyme levels in sera, were quantitated in healthy heterosexual men and several groups of homosexual males. The mean beta 2-M levels in sera and urines and lysozyme levels in sera of healthy heterosexual and homosexual men were not significantly different. However, beta 2-M levels in patients with lymphadenopathy syndrome and AIDS were elevated. The mean beta 2-M level in sera of 11 patients with the lymphadenopathy syndrome was 4016 +/- 473 micrograms/l (SEM) (P less than 0.001) and 5409 +/- 462 micrograms/l (P less than 0.001) in 27 patients with AIDS. Similarly, beta 2-M levels in the urines of patients with chronic diarrheal syndrome, lymphadenopathy syndrome, and those meeting the CDC surveillance definition of AIDS were also significantly elevated (P less than 0.025). The mean lysozyme levels in the sera of 11 patients with the lymphadenopathy syndrome was 16.58 +/- 0.04 microgram/ml, and in 27 patients with AIDS 15.40 +/- 1.16 microgram/ml, compared to the mean level obtained in normal heterosexual men of 6.67 +/- 0.42 microgram/ml (P less than 0.001). The results of this study suggest that measuring beta 2-M in serum and urine and lysozyme levels in serum might provide additional useful parameters for the evaluation of patients with AIDS and prodromal syndromes.

Aseptic cavitary pulmonary infarction

A seventy-eight year old woman with congestive heart failure and multiple aseptic cavitary pulmonary infarcts is described and the literature reviewed. This lesion should be considered in the differential diagnosis of cavitary lung disease. It is noteworthy that cavitation has been observed only in lesions greater than 4.0 cm. in diameter.

Beclomethasone dipropionate aerosol in the treatment of chronic bronchial asthma

In a double-blind, randomized study, 93 corticosteroid-independent patients with chronic bronchial asthma were treated with either beclomethasone dipropionate aerosol at 400 mug per day of its vehicle for 4 wk to determine and compare the effectiveness and safety of the preparations. Evaluations made before, at weekly intervals during, and 1 wk after treatment indicated that beclomethasone dipropionate aerosol was superior to its vehicle is improving FVC, FEV1, FEF25%--75%, and clinical signs and symptoms, and in the overall evaluations by both the investigators and the patients. Plasma cortisol levels measured at the end of the second and fourth weeks were not substantially different from those before treatment in either group. No significant side effects or abnormalities in laboratory results were noted.

Immunological Studies in Methadone Maintained Patients

Rosettes formed by circulating T and B lymphocytes obtained from 30 methadone maintained narcotic addicts were compared with those of 23 normal control subjects. Abnormal percentages of T rosette-forming cells were found in 6 of 30 patients (20%) while the percentages of B rosette-forming cells were increased in 40% and reduced in 27% of methadone patients. It appears that alterations in the percentages of peripheral lymphocytes, particularly those with cell surface complement receptors, should be added to the list of immunological abnormalities evident in some methadone-treated narcotic additics.

Hypermacroglobulinemia associated with heroin use in adolescents.

Abstract Increases of serum 19S IgM globulin were detected in adolescent patients admitted for narcotic detoxification. The mean IgM level was 294 ± 130 mg. per cent compared to 164 ± 63 mg. per cent in a control group. Twenty-six of the 64 adolescent narcotic users (40.6 per cent) had IgM levels above 290 mg. per cent, the upper limit of normal. There was no evidence of cytomegalovirus infection, infectious mononucleosis, primary biliary cirrhosis, mixed cryoglobulinemia, or cold agglutinins. The presence of Australia antigen in 2 patients and elevated serum glutamic oxaloacetic transaminase (SGOT) levels in 19 suggests that the increased IgM levels may be related to the presence of chronic persistent hepatitis. Heroin use should be considered as an important cause of elevated serum IgM, especially in association with relatively normal levels of IgG and IgA.