Research Interests: Immunology, Adolescent, Clinical immunology, Humans, Child, and 15 moreFemale, Immunoglobulin E, Antibody, Cellular Immunity, Adult, Disease Progression, Immunoglobulin, immunoglobulin G, Diphtheria, Agammaglobulinemia, Immunoglobulin A, Child preschool, immunoglobulin M, Hypogammaglobulinemia, and Immunologic deficiency syndromes
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
A rational approach to the evaluation of the child with chronic asthma has been presented. The importance of careful historical, physical, and pulmonary assessment is stressed, especially since asthma may exist without overt wheezing.... more
A rational approach to the evaluation of the child with chronic asthma has been presented. The importance of careful historical, physical, and pulmonary assessment is stressed, especially since asthma may exist without overt wheezing. General allergic as well as sequential pharmacologic management of this disease is also discussed. A knowledge of the biochemical and pathophysiologic alterations in asthma should lead to rational and specific therapy that preserves normal function and decreases the long-term morbidity and mortality of the disease.
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
ABSTRACT RationaleStressful and costly revisits to an emergency department (ED) for asthma exacerbation occur often. This study examines the frequency with which asthmatic children require multiple ED visits and explores the effect of age... more
ABSTRACT RationaleStressful and costly revisits to an emergency department (ED) for asthma exacerbation occur often. This study examines the frequency with which asthmatic children require multiple ED visits and explores the effect of age and specialty care on this phenomenon.
Research Interests:
Research Interests:
Research Interests:
Research Interests:
RationaleThis study investigates the effectiveness of early intervention with increased dosing of ICS in controlling acute asthma exacerbations in children at home.
Research Interests:
Research Interests:
Research Interests:
Research Interests:
In mice, pneumococcal polysaccharide (PPS) vaccines generate antigen-specific immunoglobulin M (IgM) and immunoglobulins G1, G2, and G3. Antibody and complement-dependent opsonophagocytosis correlates with the protection induced by PPS... more
In mice, pneumococcal polysaccharide (PPS) vaccines generate antigen-specific immunoglobulin M (IgM) and immunoglobulins G1, G2, and G3. Antibody and complement-dependent opsonophagocytosis correlates with the protection induced by PPS vaccines in vivo. Since IgM is a very efficient immunoglobulin isotype in activating the complement system, we evaluated whether anti-PPS IgM alone is sufficient to confer protective immunity to Streptococcus pneumoniae. We found that immunization of wild-type and activation-induced cytidine deaminase–deficient mice capable of producing only IgM with Pneumovax 23 generated comparable anti-PPS IgM and resistance to lethal systemic challenge with S pneumoniae. These data suggest that an IgM response to PPS vaccines is sufficient for conferring immunity.
Research Interests:
Research Interests: Medicine and Scholarship
Research Interests: Medicine and Spina Bifida
Research Interests: Immunology and Medicine
Research Interests: Immunology, Dermatology, Medicine, Allergy, Humans, and 6 moreChild, Female, Male, Immunoglobulin E, Hypersensitivity, and Pruritus
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Ten ambulatory subjects with asthma experienced a seizure while they were receiving oral theophylline preparations and were evaluated prospectively according to a set protocol. The protocol included a lumbar puncture that permitted the... more
Ten ambulatory subjects with asthma experienced a seizure while they were receiving oral theophylline preparations and were evaluated prospectively according to a set protocol. The protocol included a lumbar puncture that permitted the simultaneous determination of plasma and cerebrospinal fluid (CSF) theophylline concentrations. A constant relationship was observed between the plasma theophylline concentration and that of the CSF. It was found that the theophylline concentrations in these two biologic fluids could be characterized by the regression equation y = 0.41 X + 0.7 where y is the CSF theophylline concentration and X is the plasma theophylline concentration. Two infants with hydrocephalus treated by ventriculoperitoneal shunt were also simultaneously evaluated for plasma and CSF theophylline concentrations. These infants demonstrated greater than expected entry of theophylline into the CSF. Some central nervous system abnormalities may be characterized by increased theophylline entry into the CSF.
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Recent reports note decreased T cell function in association with certain atopic conditions in man. This study was performed to determine whether numbers of circulating T cells are decreased in atopic children and adolescents in... more
Recent reports note decreased T cell function in association with certain atopic conditions in man. This study was performed to determine whether numbers of circulating T cells are decreased in atopic children and adolescents in comparison with nonatopic age-matched control subjects. The subjects were not selected on the basis of a particular atopic diagnosis, but relatively more had allergic rhinitis and/or asthma (52) than had atopic eczema (7). Numbers of circulating T cells were not found to be significantly different in allergic children aged 2 to 10 yr than in control subjects. Atopic children and adolescents over age 10 yr had significantly fewer T cells in relative percentages (p less than 0.05), but when absolute numbers were considered significance was lost. Atopic children aged 2 to 10 years had significantly more B cells in both relative percentages and absolute numbers than did control subjects (p less than 0.02 and p less than 0.05, respectively). When those subjects treated with corticosteroids were separated from the total atopic group, there were no significant differences between the atopic and control subjects. The effects of corticosteroids, bronchodilators, antihistamines, and immunotherapy were considered and could be shown to produce no consistent effect on lymphocyte subpopulations.
Research Interests:
Research Interests:
Research Interests:
RationaleTransient Hypogammaglobulinemia of Infancy is considered a primary immune deficiency, but is not well defined, and long term follow-up not reported. The purpose of this study is to: 1) Characterize infants with recurrent... more
RationaleTransient Hypogammaglobulinemia of Infancy is considered a primary immune deficiency, but is not well defined, and long term follow-up not reported. The purpose of this study is to: 1) Characterize infants with recurrent infections and low immunoglobulins 2) Provide long-term follow-up.
Research Interests: Pediatrics, Immunology, Asthma, Medicine, Humans, and 15 moreFemale, Male, Infant, Antibody, Immunoglobulins, Immunoglobulin, Immunodeficiency, immunoglobulin G, Agammaglobulinemia, Immunoglobulin A, Child preschool, immunoglobulin M, Hypogammaglobulinemia, Common variable immunodeficiency, and Paediatrics and reproductive medicine
Objective. To identify psychological and demographic correlates of children and adolescents known to overuse β2-agonist metered dose inhalers (β-MDIs). Design. During residential care for severe asthma, demographic and psychological... more
Objective. To identify psychological and demographic correlates of children and adolescents known to overuse β2-agonist metered dose inhalers (β-MDIs). Design. During residential care for severe asthma, demographic and psychological characteristics of 17 children and adolescents known to be β-MDI overusers were compared with 38 asthmatic subjects of similar age without such history. Results. β-MDI overuse occurred among all groups; however, males, minorities, and those from lower socioeconomic groups were overrepresented. Overusers scored significantly lower on standardized IQ tests. Subtests of arithmetic for numeric reasoning, comprehension for understanding of social values, and picture completion for visual attention to detail were also significantly lower in β-MDI overusers, as were reading achievement tests. Testing also revealed tendencies toward dominant, shrewd, and undisciplined personality traits in the overusers. Conclusion. Recognition of these characteristics of childr...
Research Interests:
ABSTRACT Immunodeficiency with hyper-IgM is characterized by increased susceptibility to infection, decreased concentrations of IgG and IgA and normal or elevated levels of IgM. It has been described in X-Iinked, autosomal recessive,... more
ABSTRACT Immunodeficiency with hyper-IgM is characterized by increased susceptibility to infection, decreased concentrations of IgG and IgA and normal or elevated levels of IgM. It has been described in X-Iinked, autosomal recessive, autosomal dominant, and acquired forms. The acquired forms are usually due to insults such as malignancy and congenital rubella. The X-linked form is due to a mutation in the CD40 ligand (CD40L) gene located at Xq26–27, causing defective expression of CD40L. While CD40L expression has been found to be normal in several cases of non X-linked familial and sporadic forms, this has not been evaluated in cases of congenital rubella syndrome. We describe two female patients with immunodeficiency with hyper-IgM and clinical features suggestive of congenital rubella syndrome. In each patient, CD40L expression was normal. While in one patient with immunologic defect has persisted after 10 years, the other patient now has normal levels of IgG and IgM and undetectable IgA. To the best o...
Research Interests:
Research Interests:
Research Interests:
The inpatient records of all children up to 19 years of age admitted to Thomas Jefferson University Hospital from July 1968 to January 1978 with diagnosis of bronchial asthma were reviewed. Among 475 admissions, radiologic evidence of... more
The inpatient records of all children up to 19 years of age admitted to Thomas Jefferson University Hospital from July 1968 to January 1978 with diagnosis of bronchial asthma were reviewed. Among 475 admissions, radiologic evidence of right middle lobe atelectasis or pneumonia was found in 21 patients encompassing 28 admissions (5.85% of all admissions). Thirteen patients (62%) had sinus roentgenograms consistent with sinusitis. Bronchoscopy and bronchogram were not deemed necessary. Conservative management, including theophylline preparations (100%), beta-agonists (89%), antibiotics (79%), corticosteroids (57%), postural drainage (75%), chest physical therapy (25%), and potassium iodide (18%), was employed. Mean length of hospitalization was 8.5 days, with a range of 3–16 days. Nineteen of the 28 admissions resulted in reexpansion of the middle lobe at discharge, and in 7, reexpansion occurred within the following 6 months. Two patients were lost to follow-up. Patients with more than one admission respon...