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286 results on '"Wheat, L J"'

19. Histoplasmosis After Solid Organ Transplant

Author

Assi, M., primary, Martin, S., additional, Wheat, L. J., additional, Hage, C., additional, Freifeld, A., additional, Avery, R., additional, Baddley, J. W., additional, Vergidis, P., additional, Miller, R., additional, Andes, D., additional, Young, J.-A. H., additional, Hammoud, K., additional, Huprikar, S., additional, McKinsey, D., additional, Myint, T., additional, Garcia-Diaz, J., additional, Esguerra, E., additional, Kwak, E. J., additional, Morris, M., additional, Mullane, K. M., additional, Prakash, V., additional, Burdette, S. D., additional, Sandid, M., additional, Dickter, J., additional, Ostrander, D., additional, Antoun, S. A., additional, and Kaul, D. R., additional

Published
2013
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20. A Multicenter Evaluation of Tests for Diagnosis of Histoplasmosis

Author

Hage, C. A., primary, Ribes, J. A., additional, Wengenack, N. L., additional, Baddour, L. M., additional, Assi, M., additional, McKinsey, D. S., additional, Hammoud, K., additional, Alapat, D., additional, Babady, N. E., additional, Parker, M., additional, Fuller, D., additional, Noor, A., additional, Davis, T. E., additional, Rodgers, M., additional, Connolly, P. A., additional, El Haddad, B., additional, and Wheat, L. J., additional

Published
2011
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23. Performance Characteristics of the Platelia Aspergillus Enzyme Immunoassay for Detection of Aspergillus Galactomannan Antigen in Bronchoalveolar Lavage Fluid

Author

Husain, S., primary, Clancy, C. J., additional, Nguyen, M. H., additional, Swartzentruber, S., additional, Leather, H., additional, LeMonte, A. M., additional, Durkin, M. M., additional, Knox, K. S., additional, Hage, C. A., additional, Bentsen, C., additional, Singh, N., additional, Wingard, J. R., additional, and Wheat, L. J., additional

Published
2008
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36. Guidelines for the Design and Conduct of AIDS Clinical Trials

Author

Cotton, D. J., primary, Powderly, W. G., additional, Feinberg, J., additional, Abrams, D. I., additional, Chaisson, R. E., additional, Wheat, L. J., additional, Finkelstein, D. M., additional, Tallman, V., additional, Zimmer, B., additional, Berzon, R., additional, Fogelman, I., additional, and Phair, J., additional

Published
1993
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39. Review article Rapid diagnosis of invasive aspergillosis by antigen detection.

Author

Wheat, L. J.

Subjects
*ASPERGILLOSIS, *MYCOSES, *ANTIGENS, *DIAGNOSTIC microbiology, *BONE marrow transplantation, *COMMUNICABLE diseases
Abstract

Aspergillosis is a serious and often fatal infection in the bone marrow or organ transplant patient, for which improved methods of diagnosis are desperately needed. Currently, the diagnosis is most often made based on clinical findings and radiographic findings, which are nonspecific, and toxic therapies are initiated empirically, often without ever establishing the diagnosis. Without a definitive diagnosis, physicians often withhold or reduce the doses of the antifungal agent when toxicity develops or the patient improves, permitting progression of disease in those with invasive aspergillosis. The Platelia Aspergillus galactomannan antigenemia assay may assist physicians in making these decisions. With a sensitivity of 81% and a specificity of 89% in the studies leading to its FDA clearance, physicians still must be aware of the potential for false-positive and false-negative results; the test does not replace careful microbiological and clinical evaluation. This report will review the relevant literature and provide guidelines for use of the test in patient management. [ABSTRACT FROM AUTHOR]

Published
2003
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48. Histoplasmosis relapse in patients with AIDS: detection using Histoplasma capsulatum variety capsulatum antigen levels.

Author

Wheat, L. Joseph, Connoily-Stringfield, Patricia, Blair, Robinette, Connoily, Kathleen, Garringer, Todd, Katz, Barry P., Wheat, L J, Connolly-Stringfield, P, Blair, R, Connolly, K, Garringer, T, and Katz, B P

Subjects
HISTOPLASMOSIS, AIDS patients, HISTOPLASMOSIS diagnosis, AIDS, COMPARATIVE studies, COMPLEMENT fixation, FREEZING, FUNGAL antigens, FUNGI, RESEARCH methodology, MEDICAL cooperation, POLYSACCHARIDES, RESEARCH, DISEASE relapse, EVALUATION research, PREDICTIVE tests, RETROSPECTIVE studies, DISEASE complications
Abstract

Objective: To assess the accuracy of Histoplasma capsulatum variety capsulatum polysaccharide antigen testing for the identification of histoplasmosis relapse in patients with the acquired immunodeficiency syndrome (AIDS).Design: A retrospective study using stored specimens.Setting: A referral center and several private hospitals.Patients: Twenty episodes of histoplasmosis relapse were evaluated in 17 patients with AIDS from November 1987 to August 1990. Controls included 30 patients with AIDS and histoplasmosis who did not have a relapse during maintenance therapy and who were initially tested during the same week as the patients with relapse. A second control group included seven patients with AIDS and histoplasmosis who were evaluated for relapse on 23 occasions; relapse, however, was excluded on each occasion.Measurements: To avoid interassay variability, specimens were tested for H.c. var. capsulatum polysaccharide antigen with the same radioimmunoassay.Main Outcome Measure: The change in the H.c. var. capsulatum polysaccharide antigen level during successful as opposed to unsuccessful maintenance therapy for the prevention of histoplasmosis relapse.Main Results: For the 20 episodes of relapse (17 patients), H.c. var. capsulatum antigen levels increased by at least 2 radioimmunoassay units in 12 of 14 serum specimens tested (85.7%; 95% Cl, 57.2% to 98.2%) and in 17 of 18 urine specimens tested (94.4%; Cl, 72.7% to 99.9%). Antigen levels increased in the urine or serum in 1 of 83 specimens (1.2%; CI, 0.03% to 6.6%) obtained on 56 occasions (1.8%; CI, 0.04% to 9.6%) from controls (specificity, 98.2%; CI, 90.4% to 99.96%). In three cases of relapse, antigen levels increased before clinical relapse, antigen levels increased before clinical relapse was suspected. Complement fixation titers increased by at least 2 dilutions in 4 of 11 cases (36.4%; CI, 10.9% to 69.2%) but in 0 of 9 control patients (CI, 0% to 28.3%).Conclusion: An increase in H.c. var. capsulatum polysaccharide antigen levels of 2 units or more strongly suggests histoplasmosis relapse. The presence of increasing titers of anti-H.c. var. capsulatum antibodies by complement fixation is less accurate for the diagnosis of relapse. [ABSTRACT FROM AUTHOR]

Published
1991
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49. Rapid radioimmunoassay diagnosis of Legionnaires' disease: detection and partial characterization of urinary antigen.

Author

Kohler, R B, Zimmerman, S E, Wilson, E, Allen, S D, Edelstein, P H, Wheat, L J, and White, A

Subjects
BACTERIAL antigens, COMPARATIVE studies, IMMUNOGLOBULINS, LEGIONELLA, LEGIONNAIRES' disease, RESEARCH methodology, MEDICAL cooperation, RADIOIMMUNOASSAY, RESEARCH, EVALUATION research
Abstract

Urine from nine patients with serogroup 1 Legionnaires' disease, 100 with infected or contaminated urine, 50 with bacteremic infections, 26 with infectious or infiltrative pulmonary diseases, and 65 with miscellaneous infectious or noninfectious illnesses, was examined by radioimmunoassay for the presence of Legionella pneumophila antigen(s). Urine of all nine Legionnaires' disease patients was clearly differentiated from that of the 241 control subjects by the assay. The antigen was detected from 2 to at least 10 days after the initiation of erythromycin therapy. A probable false-positive results occurred in a patient with necrotizing nosocomial pneumonia who died before definitive serologic evaluation for Legionnaires' disease could be completed. The antigen was stable at 100 degrees C for 30 minutes and was not degraded by trypsin. Its elution behavior suggested that its molecular weight is approximately 10 000. The radioimmunoassay appears to be a useful method for rapidly diagnosing serogroup 1 Legionnaires' disease. [ABSTRACT FROM AUTHOR]

Published
1981
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50. Performance Characteristics of the Platelia AspergillusEnzyme Immunoassay for Detection of AspergillusGalactomannan Antigen in Bronchoalveolar Lavage Fluid

Author

Husain, S., Clancy, C. J., Nguyen, M. H., Swartzentruber, S., Leather, H., LeMonte, A. M., Durkin, M. M., Knox, K. S., Hage, C. A., Bentsen, C., Singh, N., Wingard, J. R., and Wheat, L. J.

Abstract

ABSTRACTWe have evaluated the Platelia Aspergillusenzyme immunoassay for detection of galactomannan in bronchoalveolar lavage (BAL) specimens in solid organ transplant patients with aspergillosis. The precision and reproducibility in serum or BAL to which galactomannan was added were similar. Sensitivity was 81.8% in patients with aspergillosis, and specificity was 95.8% in lung transplant patients who underwent BAL for surveillance for infection or rejection. Among transplant controls, positive results were more common in patients (i) who underwent diagnostic BAL performed for evaluation of symptoms or chest computed tomographic abnormalities, (ii) who had undergone lung transplantation, or (iii) who were colonized with Aspergillus. Galactomannan testing in BAL is useful for diagnosis of aspergillosis in transplant patients. The significance of positive results in patients without confirmed aspergillosis requires further evaluation.

Published
2008
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