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Biomedical subjects

A Barry

Publications and source records attributed to A Barry.

At least 19 recordsLinked to original sources
PubMed2003

Quality control limits for fluconazole disk susceptibility tests on Mueller-Hinton agar with glucose and methylene blue.

An international collaborative study was performed in order to propose quality control limits for fluconazole disk diffusion susceptibility tests on Mueller-Hinton agar with 2% glucose and 0.5 micro g of methylene blue per ml. The supplements may be added before autoclaving the agar, or Mueller-Hinton agar plates may be flooded with a glucose-methylene blue solution. Replicate tests on both types of agar plates generated data to propose zone size limits for tests of Candida parapsilosis ATCC 22019 (22 to 33 mm), C. tropicalis ATCC 750 (26 to 37 mm), and C. albicans ATCC 90028 (28 to 39 mm). C. krusei ATCC 6258 was not useful for this purpose.

Agar↗
PubMed1998

Measuring the spin polarization of a metal with a superconducting point contact

A superconducting point contact is used to determine the spin polarization at the Fermi energy of several metals. Because the process of supercurrent conversion at a superconductor-metal interface (Andreev reflection) is limited by the minority spin population near the Fermi surface, the differential conductance of the point contact can reveal the spin polarization of the metal. This technique has been applied to a variety of metals where the spin polarization ranges from 35 to 90 percent: Ni0.8Fe0.2, Ni, Co, Fe, NiMnSb, La0.7Sr0.3MnO3, and CrO2.

Journal Article↗
PubMed1998

Provisional quality control parameters and interpretive criteria for testing susceptibility of Streptococcus pneumoniae and Haemophilus influenzae to quinupristin/dalfopristin (RP59500). Antimicrobial Testing Quality Control Group.

Studies were undertaken to select tentative criteria for susceptibility testing of quinupristin/dalfopristin against Streptococcus pneumoniae and Haemophilus influenzae. Against 612 isolates of Streptococcus pneumoniae, MICs of quinupristin/dalfopristin were < or = 1.0 microg/ml for all but one strain. With a tentative MIC breakpoint of either < or = 1.0 microg/ml or < or = 2.0 microg/ml for susceptible, a disk diffusion zone diameter breakpoint of > or = 19 mm embraced all but two of the susceptible pneumococci; > or = 16 mm included all strains. For Haemophilus influenzae, MICs of quinupristin/dalfopristin clustered near the tentative breakpoints; 91.5% of the MICs were 2.0 to 8.0 microg/ml. This precluded satisfactory performance of the disk diffusion test in discriminating between resistant and susceptible isolates unless MIC breakpoints are modified for this species: clinical experience will be needed before that can be justified. Based on data from a multilaboratory study, the following quality control limits are proposed for Streptococcus pneumoniae ATCC 49619 when testing quinupristin/dalfopristin: 0.25 to 1.0 microg/ml for broth microdilution tests and 19 to 24 mm for disk diffusion tests. For tests of Haemophilus influenzae ATCC 29247, MIC limits are 2.0 to 16 microg/ml; disk tests were very reproducible but are not yet recommended.

Anti-Bacterial Agents↗
PubMed1996

Development of interpretive criteria and quality control limits for macrolide and clindamycin susceptibility testing of Streptococcus pneumoniae.

A six-laboratory collaborative study was conducted to develop MIC and zone diameter quality control limits and interpretive criteria for antimicrobial susceptibility testing of Streptococcus pneumoniae with azithromycin, clarithromycin, dirithromycin, and clindamycin. The MICs of all of the agents plus erythromycin for 302 clinical isolates of pneumococci that had been selected with an emphasis on resistant strains were determined by use of the National Committee for Clinical Laboratory Standards (NCCLS)-recommended broth microdilution procedure. The zone diameters of the isolates were also determined for the same agents except erythromycin by the NCCLS disk diffusion test procedure. Repeated testing of S. pneumoniae ATCC 49619 with different sources and lots of media and disks allowed development of MIC and zone diameter quality control ranges for these agents. Interpretive criteria for the MIC of azithromycin were established and were as follows: susceptible, < or = 0.5 microgram/ml; intermediate, 1 microgram/ml; and resistant, > or = 2 micrograms/ml. The interpretive criteria advocated for the MICs of clarithromycin and clindamycin were as follows: susceptible, < or = 0.25 microgram/ml; intermediate, 0.5 microgram/ml; and resistant, > or = 1 microgram/ml. Comparison of MICs and disk diffusion zone diameters led to the development of interpretive criteria for the zone diameters for azithromycin, clarithromycin, and clindamycin that correlated well with these MIC breakpoints. Testing of this organism collection also led to the reestablishment of the erythromycin MIC breakpoints as being identical to those of clarithromycin, which resulted in equivalent cross-susceptibility and cross-resistance for the three macrolides that are currently marketed in the United States. Thus, the susceptibility of pneumococci to azithromycin and clarithromycin can be predicted accurately by testing only erythromycin in clinical laboratories. This recommendation, as well as the interpretive and quality control criteria that are described, have been accepted by NCCLS and are included in the latest NCCLS susceptibility testing guidelines.

Anti-Bacterial Agents↗
PubMed1995

Comparative antimicrobial activities of the penem WY-49605 (SUN5555) against recent clinical isolates from five U.S. medical centers.

The in vitro activity of WY-49605 (SUN5555) (WY) was compared with those of cefaclor, cefixime, and amoxicillin-clavulanic acid against 2,958 consecutive clinical isolates from five medical centers and 402 respiratory pathogens from 18 other facilities. Most members of the family Enterobacteriaceae were inhibited by WY (MIC at which 50% of the isolates are inhibited [MIC50], < or = 2.0 micrograms/ml). MIC90s of > or = 8.0 micrograms/ml were observed for Enterobacter cloacae, Serratia spp., and Proteus mirabilis. WY was the most active drug against methicillin-susceptible Staphylococcus aureus (MIC90, 0.12 microgram/ml) and other coagulase-negative staphylococci (MIC90, 4.0 micrograms/ml). The four drugs were not active against nonenteric gram-negative bacilli, methicillin-resistant Staphylococcus aureus, and Staphylococcus haemolyticus. At 2.0 micrograms/ml, WY inhibited 82% of Enterococcus faecalis strains and was equal to or superior to the other drugs against streptococci, Haemophilus influenzae, and Moraxella catarrhalis.

Amoxicillin↗
PubMed1994

Interpretive criteria and quality control for antimicrobial susceptibility tests of levofloxacin.

To confirm preliminary interpretive breakpoints for prototype 5 micrograms levofloxacin disks, 490 strains were tested in vitro using commercially manufactured disks. For in vitro susceptibility testing, 5 micrograms levofloxacin disks can be used with interpretive criteria of < or = 12 mm for resistant (MIC > or = 8.0 micrograms/ml) and > or = 16 mm for susceptible (MIC < or = 2.0 micrograms/ml). Proposed quality control limits for tests of levofloxacin are as follows: Escherichia coli ATCC 25922, zones 29-37 mm or MIC 0.008-0.03 microgram/ml; Pseudomonas aeruginosa ATCC 27853, zones 19-26 mm or MIC 0.5-2.0 micrograms/ml; Staphylococcus aureus ATCC 25923, zones 24-31 mm; Staphylococcus aureus ATCC 29213, MIC 0.06-0.25 microgram/ml and Enterococcus faecalis ATCC 29212, MIC 0.25-2.0 micrograms/ml.

Bacteriological Techniques↗
PubMed1994

Regional anaesthesia and subsequent long-term pain.

The incidence of long-term pain (between 1 and 48 weeks and at 2 year follow-up) unrelated to the surgical site following either regional brachial plexus or general anaesthesia was determined. In 834 patients with regional anaesthesia, the incidence (11.1%) was significantly higher than in the 86 patients with general anaesthesia (3.6%; P = 0.03). The incidence of pain was not significantly different among four common techniques of positioning the needle tip in the axillary sheath (9.9 to 11.1%). Parascalene blocks had a slightly but not significantly higher rate (16.3%). A regional re-block was not associated with a higher incidence when compared to those blocked only once. A more distal local re-block was associated with a higher incidence of pain (23%). 2 years post-operatively, 0.5% of patients had pain related to the regional block. A significant proportion of patients developed some long-lasting post-operative pain following regional brachial plexus anaesthesia, although ultimate morbidity was minimal.

Anesthesia, Conduction↗
PubMed1993

Relative efficacy of tazobactam, sulbactam and clavulanic acid in enhancing the potency of ampicillin against clinical isolates of Enterobacteriaceae.

Three beta-lactamase inhibitors were combined with ampicillin in a fixed 2:1 ratio. The activity of ampicillin was enhanced by tazobactam and by clavulanic acid, and to a lesser extent by sulbactam when tested against fresh clinical isolates of Enterobacteriaceae. At a concentration of 8 micrograms/ml, ampicillin alone inhibited 49.6% of 2,434 consecutive isolates of enteric bacilli compared to 81% inhibited by ampicillin combined with tazobactam or clavulanic acid and 69.3% inhibited by the sulbactam/ampicillin combination. A four-fold or greater reduction in ampicillin MICs was observed in comparable numbers of isolates with all three combinations, but the most marked effects were seen with strains that were highly resistant to ampicillin.

Ampicillin↗
PubMed1993

Ampicillin-sulbactam susceptibility testing criteria.

In vitro studies in five different medical centers documented the susceptibility of 2,440 consecutive isolates of the Enterobacteriaceae against ampicillin-sulbactam disks of different potencies. For determination of MICs, both 2:1 or 1:1 ratios were used as long as the concentrations of sulbactam at the breakpoints remained the same, i.e. MIC < or = 16/8.0 micrograms/ml or < or = 8.0/8.0 micrograms/ml for the susceptible category. Disks containing 10 micrograms of ampicillin and 10 micrograms of sulbactam are still to be preferred with interpretive criteria of > or = 15 mm for susceptible and < or = 11 mm for resistant (MIC > or = 64/32 micrograms/ml or > or = 32/32 micrograms/ml). The reliability of the disk test actually diminished when the amount of sulbactam in the disk was increased.

Ampicillin↗
PubMed1993

Interstitial iodine 125 and concomitant cisplatin followed by hyperfractionated external beam irradiation for malignant supratentorial glioma. Preliminary experience at the University of Tennessee, Memphis.

Between November 1989 and October 1992, 28 consecutive patients with glioblastoma multiforme (n = 18) or anaplastic astrocytoma (n = 10; includes one patient with oligodendroglioma with anaplastic astrocytoma component) were treated with interstitial iodine 125 (60 Gy over 6 days) and with concomitant cisplatin (via infusion on days 2-6 of the implant), then followed by hyperfractionated external beam irradiation (110 cGy delivered twice daily; 66 Gy planned total dose). Of 26 patients (60%) who received both 125I and HEBI, 15 are alive with no evidence of recurrent disease at a median follow-up of 18 months post-125I (range: 11 to 34 months). Four other disease-free patients succumbed to nontumor-related events. Two patients with local control had distant failure outside the HEBI treatment fields. Overall local control is 77%. Local failure occurred in 6 patients (23%) 2 to 11 months post-125I. Time to disease progression ranged from 4 to 18 months (median: 10 months). Survival (measured from the date of diagnosis) has ranged from 6 to 26 months (median: 15 months). All patients have maintained Karnofsky Performance Status within 20 points of their preimplant status, with the exception of a single patient who, following diagnosis of radiation necrosis and surgical intervention for symptomatic relief, had a 30-point drop in KPS. Radiation necrosis or persistent mass effect were noted by neuroimaging in seven patients, four of whom required surgical intervention following failed medical management. Ototoxicity, nephrotoxicity, peripheral nerve dysfunction, or hematologic toxicities have not been observed. This new innovative treatment approach offers a promising alternative to the normally dismal prognosis for patients with malignant gliomas.

Adult↗
PubMed1990

Anorexia nervosa in males.

Although anorexia nervosa is usually considered a disorder of young women and girls, 5% to 10% of cases occur in men and boys. Onset can range from prepubertal years to adulthood. The unique conflicts that may lead to anorexia nervosa in males must be considered when treating these patients.

Adaptation, Psychological↗
PubMed1986

Medical care costs of AIDS in Massachusetts.

Previous investigation has suggested that the direct cost of medical care for the 24,011 reported patients with acquired immunodeficiency syndrome (AIDS) may be as high as $147,000 per patient. To evaluate the use and cost of medical services for patients with AIDS in Massachusetts, we performed a one-year cost of illness study of 45 AIDS patients. Sociodemographic and clinical data as well as information on medical utilization were obtained from review of outpatient and hospital records. Patients with AIDS required a mean of 3.3 (+/- 3.2) hospitalizations per year and 18.4 (+/- 21.8) ambulatory visits per year. Overall, medical costs averaged $46,505 +/- $38,720 per patient per year, with 91% of these expenditures related to use of inpatient services. These results suggest that the cost of medical care for AIDS patients may be substantially less than previously estimated.

Acquired Immunodeficiency Syndrome↗
PubMed1985

More and more is less and less the myth of massive psychiatric need.

The idea of massive unmet need for mental health services is a myth, generated and perpetuated by processes within the system which provides psychiatric care and within society. Diffusion of the traditional boundaries of mental health care, lack of norms and standards, medicalisation and 'healthism', specialoid practice and patient selection, diversion of resources from the long-term mentally ill and their absorption by better-functioning patients, substitution and development of new mental health service providers, and changes in the threshold for help-seeking all affect our assumptions of need. Needs are less massive, if the boundaries of psychiatry are defined so as to include only those disorders which the profession is best able to treat.

Delivery of Health Care↗
PubMed1984

[Changes in the mean corpuscular volume during the cytotoxic treatment of cancer and risk of secondary leukemia. Preliminary results].

Changes in mean corpuscular volume (MCV) were studied in cancer patients. Vitamin B12 or erythrocyte folate deficiencies were observed in only 9% of macrocytic patients (MCV greater than or equal to 100 fl). Bone marrow study in seven macrocytic patients with normal hemograms and normal levels of vitamin B12 and folic acid, on per os daily cyclophosphamide single agent therapy, showed myelodysplastic features. The highest MCV and MCV increases during therapy among 203 patients were observed in those cancers and cytotoxic therapies most commonly followed by secondary leukemia: Hodgkin's disease treated with MOPP and radiotherapy, and multiple myeloma and ovarian cancer treated with Melphalan. 21 patients who developed secondary leukemia had a higher MCV and a greater MCV increment than the control patients. Differences were significant in Hodgkin's disease. This preliminary report strongly supports monitoring MCV changes during cytotoxic therapy to attempt identification of patients at high risk of secondary leukemia.

Adult↗