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Biomedical subjects

B B Dan

Publications and source records attributed to B B Dan.

41 records · Page 3Linked to original sources

Toxic-shock syndrome in menstruating women: association with tampon use and Staphylococcus aureus and clinical features in 52 cases.

To determine the risk factors associated with toxic-shock syndrome (TSS) in menstruating women, we conducted a retrospective telephone study of 52 cases and 52 age-matched and sex-matched controls. Fifty-two cases and 44 controls used tampons (P < 0.02). Moreover, in case-control pairs in which both women used tampons, cases were more likely than controls to use tampons throughout menstruation (42 of 44 vs. 34 of 44, respectively; P < 0.05). There were no significant differences in brand of tampon used, degree of absorbency specified on label, frequency of tampon change, type of contraceptive used, frequency of sexual intercourse, or sexual intercourse during menstruation. Fourteen of 44 cases had one or more definite or probable recurrences during a subsequent menstrual period. In a separate study, Staphylococcus aureus was isolated from 62 of 64 women with TSS and from seven of 71 vaginal cultures obtained from healthy controls (P < 0.001).

Adolescent↗

Chronic pulmonary histoplasmosis following the excavation of a bird roost.

The clinical and epidemiologic characteristics of chronic pulmonary histoplasmosis, as compared with the more familiar acute pulmonary histoplasmosis, are relatively unknown. Opinions vary as to the pathogenesis, and only the severe forms of the disease are readily recognized. Over a 22 month period following the excavation of blackbird roost, an unusual outbreak of chronic pulmonary histoplasmosis occurred in a town in southern Kentucky. Thirteen of the cases developed over a span of only four months. An associated outbreak of acute pulmonary histoplasmosis did not occur. During the course of the ensuing investigation, the residential addresses of the affected persons were noted to be clustered about the previously excavated blackbird roost. A case-control study was initiated; the median distance of the residential addresses of the affected persons was found to be 1.0 miles from the roost, compared with 3.2 miles for the control subjects (P less than 0.001). It was concluded that (1) the excavated blackbird roost had served as the common source of the epidemic; (2) the inhalation of exogenous spores accounted for the infections; (3) the spectrum of clinical illness ranged from asymptomatic and mild illness to cavitary disease with considerable morbidity; and (4) following excavation, blackbird roosts may remain an infection hazard for an indefinite period of time.

Animals↗

Nosocomial surgical infections: incidence and cost.

The data reported in this article support the findings of Dr. Altemeier; that is, infections among surgical patients remain a serious problem today. Urinary tract infections account for approximately 40 per cent of nosocomial infections among surgical patients. Surgical wound and skin infections account for one third of the nosocomial infections among surgical patients. Rates for wound infections rise with age, with increased length of hospitalization before surgery, and with increased duration of surgery. They are higher for patients who have an infection at a distant site and for those who have the more hazardous surgical procedures as determined by risk categories. Gram-negative organisms are more prevalent than gram-positive organisms. A nosocomial surgical wound infection lengthens the hospitalization by an average of 7.4 days and raises the cost of hospitalization by more than 800 dollars. Further analysis of the data is necessary in order to identify the risk factors likely to be most helpful in determining which patients are at increased risk of acquiring a nosocomial infection. Only when these factors are identified can the most direct and effective contact and preventive measures be implemented.

Aged↗

Bacteremia related to IV cannulation: variability of underlying venous infection.

During 1977, 22 of 66 cases of nosocomial bacteremia in our hospital were directly or indirectly attributable to infection from the intravenous (IV) site. IV-site-related bacteremia (IVSRB) occurred most frequently in patients with serious underlying disease. The characteristic clinical picture was one of fever, tachycardia, and hypotension. Signs at the IV site appeared most commonly at the onset of IVSRB but varied in time of appearance from six days before to 11 days after bacteremia. The degree of abnormality at the IV site accompanying IVSRB varied from none detectable through uncomplicated cellulitis and phlebitis to vein suppuration. Short percutaneous plastic catheters were incriminated in most cases, and gram-negative rods, especially Klebsiella and Serratia, were the most frequent infecting bacteria. Initial treatment consisted of removal of the IV cannula and administration of parenteral antibiotics. Although no deaths could be attributed to recognized and treated IVSRB, it resulted in significant morbidity including the need for excision of veins contiguous with the IV site in six patients.

Anti-Bacterial Agents↗

One-minute medicine.

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Health Education↗