Search PubMed⌕ Search

Biomedical subjects

C T Keane

Publications and source records attributed to C T Keane.

At least 91 records · Page 5Linked to original sources
PubMed1988

Histological gastritis in duodenal ulcer: relationship to Campylobacter pylori and effect of ulcer therapy.

Antral gastritis has been described in up to 100% of patients with duodenal ulcer disease, and recently has been associated with Campylobacter pylori infection. The present study examines the effect of two ulcer therapies (cimetidine and colloidal bismuth subcitrate) on this lesion. Sixty-four consecutive patients with endoscopically diagnosed duodenal ulcer were randomized to treatment with either agent upon entry into the study. Antral biopsies were taken at both initial and final endoscopies for culture of C. pylori and assessment of degree of gastritis (as based on inflammatory cell infiltrate: grades 0 to 3). The organism was detected in 90% of the patients at initial biopsy, and grades 2 and 3 gastritis were documented in 76%. The presence of the organism and the gastritis were significantly correlated (p less than 0.001), and the bacterium was not cultured from histologically normal antral mucosa. Active chronic gastritis (grade 3) was seen in 65% of those with C. pylori, and was not found in any patient without the bacterium. Cimetidine had no effect on either the organism or the gastritis, whereas the bismuth preparation significantly (p less than 0.002) reduced the prevalence of both. The present study documents that therapy directed against C. pylori has a significant effect on the gastritis of duodenal ulcer disease and possible mechanisms for the observed effects are discussed.

Adult↗
PubMed1987

Clinical trial of cefuroxime axetil in children.

Cefuroxime axetil tablets were given to 12 children (aged 19 months to 13.5 years) for a total of 14 episodes of lower respiratory tract infection. Doses ranged from 15 to 32 mg/kg/day. Six infections were regarded as cured and seven improved. In four cases, Haemophilus influenzae was present at the end of treatment. Serum levels of cefuroxime showed great variability. Absorption and penetration of the drug into the lower respiratory mucosa may not be sufficient to kill organisms which are sensitive in vitro. Cefuroxime axetil tablets were acceptable to most children.

Acute Disease↗
PubMed1987

In vitro adhesiveness and biotype of Gardnerella vaginalis strains in relation to the occurrence of clue cells in vaginal discharges.

Haemagglutination and tissue culture adherence tests using a McCoy cell line were used to examine the adherence characteristics of 105 strains of Gardnerella vaginalis. Each strain represented one isolate per patient. For each patient, a direct smear of vaginal discharge was examined for clue cells. The relation between in vitro adherence and the presence of clue cells was examined. There seemed to be no appreciable relation between the presence of clue cells in smears and the haemagglutinating activity of strains. In contrast, adherence as judged by the McCoy tissue culture system showed a significant relation to the presence of clue cells (p less than 0.001). Though both adhesive characteristics were not inhibited by mannose, the mechanism of haemagglutination of human red cells appeared to differ from that of adherence of tissue culture cells. The findings imply that the clue cell phenomenon is due to attachment of adherent strains of G vaginalis to epithelial cells. Adherent strains of G vaginalis may play a part in the pathogenesis of bacterial vaginosis.

Bacterial Adhesion↗
PubMed1987

Clinical features of covert toxocariasis.

The clinical features found in 14 children with toxocara ELISA titres of greater than or equal to 0.7 were compared with those found in 34 toxocara negative children. Blood eosinophils were elevated in 7 of the 14 patients and the highest eosinophilia was 14%. There was a highly significant association between hepatomegaly, cough, sleep disturbance and a raised titre (p less than 0.01). Behaviour disturbance, abdominal pain and headache were also significantly associated with a raised titre (p less than 0.05). The combination of abdominal pain, headache and cough was even more significantly associated with a high titre (p less than 0.0005) than were individual clinical features. It is suggested that in addition to the two well recognised clinical conditions of visceral larva migrans and ocular toxocariasis the clinical entity of covert toxocariasis should receive recognition. Eosinophilia may or may not be present in this condition.

Abdomen↗
PubMed1986

Osteomyelitis with methicillin-resistant Staphylococcus aureus.

We describe 10 patients with hospital-acquired osteomyelitis due to methicillin-resistant Staphylococcus aureus. The patients were posttraumatic and eight had a foreign body in situ at the site of infection. Vancomycin therapy in association with radical debridement was followed by clinical and radiological cure in eight patients at 2-3.5 years follow-up, in two of whom a foreign body was left in situ. Only minor adverse effects of vancomycin therapy (one rash, two thrombophlebitis) were seen.

Adult↗
PubMed1986

Septicaemia and pleural effusion due to Plesiomonas shigelloides.

Plesiomonas shigelloides is a rare cause of invasive infection, most clinically significant isolates being from the gastrointestinal tract of animals and man. Recently it has been implicated as an increasing cause of opportunistic infections. We report a case of P. shigelloides septicaemia and pleural effusion in a patient with pre-existing alcoholic liver disease. This case serves to illustrate the possible role of P. shigelloides as an opportunistic pathogen in a compromised host especially where there is co-existing liver disease.

Humans↗
PubMed1985

Methicillin-resistant Staphylococcus aureus in Dublin 1971-84.

Between 1971 and 1975, methicillin-resistant Staphylococcus aureus (MRSA) caused sporadic infection in eight Dublin hospitals although a case of bacteraemia was not recorded until 1976. From then on gentamicin-resistant MRSA rapidly became endemic in Dublin hospitals. The frequency of MRSA bacteraemia reached a peak in 1979-82 but MRSA infection remains an important problem. The most effective antimicrobial agent in treatment of invasive infection was vancomycin; little drug toxicity was seen. Where appropriate, concomitant surgical treatment such as debridement and drainage was usually necessary. Infection control measures directed at eliminating carriage proved effective in reducing spread. Molecular analysis showed two distinct MRSA phenotypes with similar phage-typing patterns. Gentamicin resistance was chromosomally encoded.

Gentamicins↗
PubMed1985

The in-vitro activity of some antimicrobial agents against methicillin-resistant Staphylococcus aureus.

A total of 185 strains of methicillin resistant Staphylococcus aureus was investigated for sensitivity to five other antimicrobial agents. The vast majority of these strains were also resistant to gentamicin and fusidic acid. Rifampicin was the most active drug tested (MIC90, 0.007 mg/l), while two newer compounds teichomycin and ciprofloxacin showed equal and appreciable activity (MIC90, 0.5 mg/l).

Anti-Bacterial Agents↗
PubMed1985

Vancomycin toxicity: a prospective study.

A prospective study of 34 patients treated with 39 courses of intravenous vancomycin, was undertaken in order to assess toxicity. Six patients received vancomycin alone and 27 courses were associated with aminoglycoside administration either concurrently or within two weeks of the first dose of vancomycin. Hearing loss was slight and uncommon; patients were unaware of its occurrence. Tinnitus and dizziness was noted by two patients and resolved on withdrawal of vancomycin. Diminution of renal function was seen both during (7%) and after (9%) vancomycin therapy. A striking feature of these patients with renal deterioration was the severity of their underlying disease. No evidence of synergistic toxicity between vancomycin and aminoglycosides was seen.

Adolescent↗
PubMed1985

Susceptibility to antimicrobial agents and analysis of plasmids in gentamicin- and methicillin-resistant Staphylococcus aureus from Dublin hospitals.

Methicillin- and gentamicin-resistant Staphylococcus aureus (MGRSA) strains isolated from Dublin Hospitals were classified into two groups (phenotypes). Phenotype-I strains expressed high level resistance to gentamicin and were susceptible to fusidic acid; strains resistant to tetracycline harboured a 3 X 10(6)-mol. wt plasmid. Strains in phenotype II usually expressed low level resistance to gentamicin, were resistant to fusidic acid and often harboured a (22-24) X 10(6)-mol. wt plasmid that specified resistance to ethidium bromide, tetracycline, kanamycin, neomycin and trimethoprim, or to combinations of these markers. A few phenotype-II strains expressed higher levels of resistance to gentamicin and other aminoglycosides. All MGRSA strains carried a 21 X 10(6)-mol. wt plasmid conferring resistance to penicillin, ethidium bromide, cadmium and mercury. Gentamicin resistance was invariably chromosomal and all strains carried chromosomal resistance to methicillin, erythromycin, streptomycin and spectinomycin. Several methicillin-resistant S. aureus (MRSA) strains isolated before the emergence of gentamicin resistance harboured a 21 X 10(6)-mol. wt penicillinase plasmid with the same restriction endonuclease profile as that from some MGRSA strains. Some MRSA strains carried other plasmids related to those found in MGRSA strains.

Anti-Bacterial Agents↗
PubMed1985

Antimicrobial chemotherapy of septicemia due to methicillin-resistant Staphylococcus aureus.

The outcome of treatment of 48 episodes of septicemia due to methicillin-resistant Staphylococcus aureus (MRSA) in 44 patients was assessed. Twenty-six of the patients died; nineteen of them died of infection, and infection was a major contributing factor to the deaths of the remaining seven patients. Fourteen of fifteen patients treated with inadequate antibiotic therapy died, and the other patient developed a mycotic aneurysm of the femoral artery, for which amputation was necessary. Eight of eleven patients treated with amikacin (alone or combined with another antimicrobial) died, and three recovered slowly; only one recovered fully without sequelae. In an additional two patients who failed to respond to amikacin, treatment was changed to vancomycin. Vancomycin was used to treat 18 episodes of MRSA septicemia in 17 patients. In 14 of these episodes the patients recovered fully. One patient died of uncontrolled infection, and in three, infection was a contributing factor but not the major cause of death. Vancomycin was confirmed as antibiotic of choice in treating MRSA septicemia.

Adult↗
PubMed1984

Pseudomonas aeruginosa cross-infection following endoscopic retrograde cholangiopancreatography.

In a 6 week period, three of 50 patients developed Pseudomonas aeruginosa septicaemia following Endoscopic Retrograde Cholangiopancreatography (ERCP). Pseudomonas aeruginosa serotype 10 was isolated from each of the patients and from the endoscope. The outbreak was related to inadequate disinfection of the air and water channel of the endoscope. Following the introduction of a modified decontamination technique, which involved rinsing the air and water channel with glutaraldehyde, no further cases of pseudomonas infection occurred, and the organism could not be isolated from the instrument. Obstruction of the biliary tract was a predisposing factor in the development of infection; and administration of antibiotics immediately following the procedure failed to prevent it. This may have been due to inadequate dosage. We suggest that patients presenting for ERCP, in whom obstruction of the biliary tract is suspected, should come prepared for immediate drainage of the obstructed system at the time of the procedure.

Adult↗