Sherwood L. Gorbach

OBJECTIVES: To ascertain the relationships between resting energy expenditure (REE), HIV RNA in plasma, and highly active antiretroviral therapy (HAART). DESIGN: Cross-sectional analysis using data of a large cohort study of nutrition in relation to HIV disease. METHODS: HIV RNA in plasma, REE, fat-free mass (FFM), and medication regimens were assessed at 530 visits among 372 participants in a cohort study of HIV-seropositive men and women. RESULTS: HIV RNA in plasma was directly correlated with REE. After adjustment for FFM, age, CD4 cell count and HAART use, there was an increase in REE of 90 kJ/day per log10 copies/ml increase in HIV RNA [95% confidence interval (CI) 16-164; P = 0.02). HAART use had an independent effect on REE. In patients reporting HAART use, adjusted REE was 339 kJ/day higher than in those not reporting HAART use (95% CI 177-501; P = 0.0001). CONCLUSIONS: Viral load and HAART appear to exert independent effects on REE. Although HAART may decrease metabolic rate by lowering viral burden, it appears to increase metabolic demands through some mechanism(s) independent of its effect on viral burden. This may result in elevated REE despite control of viral replication.

Journal Article Nutrition and the Gastrointestinal Microflora Get access Sherwood L. Gorbach, M.D., Sherwood L. Gorbach, M.D. Professor of Community Health and Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA. Search for other works by this author on: Oxford Academic PubMed Google Scholar Barry R. Goldin, Ph D Barry R. Goldin, Ph D Associate Professor of Community Health, Tufts University School of Medicine, Boston, Massachusetts, USA. Search for other works by this author on: Oxford Academic PubMed Google Scholar Nutrition Reviews, Volume 50, Issue 12, December 1992, Pages 378–381, https://doi.org/10.1111/j.1753-4887.1992.tb02485.x Published: 01 December 1992

Editorials1 April 1983Penicillin or Clindamycin for Primary Lung Abscess?JOHN G. BARTLETT, M.D., SHERWOOD L. GORBACH, M.D.JOHN G. BARTLETT, M.D.Search for more papers by this author, SHERWOOD L. GORBACH, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-98-4-546 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptPenicillin is generally regarded as the preferred drug for treatment of anaerobic lung abscess. This consensus is reflected in recent authoritative texts dealing with internal medicine (1), infectious diseases (2), chemotherapy (3), and pulmonary disease (4). "Penicillin" was the "right" answer for the query regarding the preferred drug for primary lung abscess in the 1982 examination of the American Board of Internal Medicine. Notwithstanding such conventional wisdom, in this issue Levison and associates (5) present data suggesting that clindamycin therapy is superior. The findings in this comparative trial, and especially the high rate of penicillin failures, run counter to current...References1. HIRSCHMANN J, MURRAY J, and PETERSDORF R. Pneumonia and lung abscess. In: ISSELBACHER KJ, ADAMS RD, BRAUNWALD E, PETERSDORF RG, WILSON JD, eds. Principles of Internal Medicine. New York: McGraw-Hill Book Company; 1980:1228-9. Google Scholar2. FINEGOLD S. Lung abscess. In: MANDELL GL, DOUGLAS RG JR, BENNETT JE, eds. Principles and Practice of Infectious Diseases. New York: John Wiley & Sons; 1979:509-15. Google Scholar3. SANDE M and MANDELL G. Antimicrobial agents. In: GILMAN AG, GOOD LS, GILMAN A, eds. New York: MacMillan Publishing Company, Inc.; 1980:1086-93, 1139. Google Scholar4. FRASER R and PARE J. Diagnosis of Diseases of the Chest. Philadelphia: W. B. Saunders Company; 1978:725-31. Google Scholar5. LEVISON M, MANGURA C, and LORBER B. Penicillin versus clindamycin for the treatment of anaerobic lung abscess. Ann Intern Med. 1983;98:466-71. LinkGoogle Scholar6. ALLEN C and BLACKMAN J. Treatment of lung abscess with a report of 100 consecutive cases. J Thorac Surg. 1936;6:156-72. CrossrefGoogle Scholar7. BARTLETT J. Lung abscess. Johns Hopkins Med J. 1982;150:141-7. MedlineGoogle Scholar8. WEISS W. Delayed cavity closure in acute nonspecific primary lung abscess. Am J Med Sci. 1968;255:313-9. CrossrefMedlineGoogle Scholar9. WEISS W and FLIPPIN H. Treatment of acute nonspecific primary lung abscess. Arch Intern Med. 1967;120:8-11. CrossrefMedlineGoogle Scholar10. WEISS W. Cavity behavior in acute, primary, nonspecific lung abscess. Am Rev Respir Dis. 1973;108:1273-5. MedlineGoogle Scholar11. WEISS W and CHERNIACK N. Acute nonspecific lung abscess: a controlled study comparing orally and parenterally administered penicillin G. Chest. 1974;66:348-51. CrossrefMedlineGoogle Scholar12. GOPALAKRISHNA K and LERNER P. Primary lung abscess. Clev Clin Q. 1975;42:3-13. CrossrefGoogle Scholar13. BARTLETT J and GORBACH S. Treatment of aspiration pneumonia and primary lung abscess. JAMA. 1975;234:935-7. CrossrefMedlineGoogle Scholar14. BARTLETT J, GORBACH S, TALLY F, and FINEGOLD S. Bacteriology and treatment of primary lung abscess. Am Rev Respir Dis. 1974;109:510-8. MedlineGoogle Scholar15. LANDAY M, CHRISTENSEN E, BYNUM L, and GOODMAN C. Anaerobic pleural and pulmonary infections. AJR. 1980;134:233-40. CrossrefMedlineGoogle Scholar16. KIRBY B, GEORGE W, SUTTER V, CITRON D, and FINEGOLD S. Gram-negative anaerobic bacilli: their role in infection and patterns of susceptibility to antimicrobial agents: I. Little known Bacteroides species. Rev Infect Dis. 1980;2:914-51. CrossrefMedlineGoogle Scholar17. MURRAY P and ROSENBLATT J. Penicillin resistance and penicillinase production in clinical isolates of Bacteroides melaninogenicus. Antimicrob Agents Chemother 1977;11:605-8. CrossrefMedlineGoogle Scholar18. SEN P, TECSON F, KAPILA R, and LOURIA D. Clindamycin in the oral treatment of putative anaerobic pneumonias. Arch Intern Med. 1974;134:73-7. CrossrefMedlineGoogle Scholar19. HAND W and KING-THOMPSON N. Membrane transport of clindamycin in alveolar macrophages. Antimicrob Agents Chemother. 1982;21:241-7. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JOHN G. BARTLETT, M.D.; SHERWOOD L. GORBACH, M.D. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMacrolides, Clindamycin, and KetolidesMacrolides, Clindamycin, and KetolidesOs abcessos pulmonares em revisãoOs abcessos pulmonares em revisãoAspiration pneumonia and primary lung abscess: diagnosis and therapy of an aerobic or an anaerobic infection?Clinical presentation and management of empyema, lung abscess and pleural effusionChanging Bacteriology of Adult Community‐Acquired Lung Abscess in Taiwan: Klebsiella pneumoniae versus AnaerobesAntibiotic use in the emergency department. III. The quinolones, new beta lactams, beta lactam combination agents, and miscellaneous antibioticsClindamycin and metronidazoleCase 32-1989Recent Developments in the Understanding of the Pathogenesis and Treatment of Anaerobic InfectionsUtility of Radiography and Clinical Features in the Diagnosis of Community-Acquired PneumoniaOverwhelming pneumoniaDrug Information Analysis ServiceFuture Aspects on the Clinical Use of Clindamycin: A Symposium Held at SAS Royal Hotel, Copenhagen, Denmark, April 6, 1984 1 April 1983Volume 98, Issue 4 Page: 546-548 Keywords Abscesses Chemotherapy Clindamycin Drugs Infectious diseases Lungs Penicillin Pulmonary diseases Respiratory system procedures ePublished: 1 December 2008 Issue Published: 1 April 1983 PDF downloadLoading ...