Management of sore throat.
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Anti-Bacterial Agents↗
Biomedical subjects
C T Le
Publications and source records attributed to C T Le.
Teichoic acid serology in staphylococcal infections of infants and children.
Counterimmunoelectrophoresis and gel diffusion were utilized for the detection and titration of antibodies to staphylococcal teichoic acids in various disease states caused by coagulase-positive staphylococcus in infants and children. Serum samples were obtained on admission and serially for 2 to 12 weeks during illness. Teichoic acid antibodies were found by CIE in 12 of 21 patients (57%) with invasive CPS disease with bacteremia (Group A), in two of 17 patients (12%) with CPS infection without bacteremia (Group B), in none of 27 patients with bacteremia and/or invasive infections caused by organisms other than CPS (Group C), and in none of 24 noninfected, hospitalized patients or healthy children (Group D). Gel diffusion was useful for titrating antibodies in seropositive sera. Teichoic acid serology is a useful adjunct in the diagnosis of invasive CPS infections. The presence of these antibodies by CIE and gel diffusion may help to identify patients with endothelial or metastatic infections associated with staphylococcal bacteremia.
Antibodies, Bacterial↗
The lack of nurse-infant transmission of type B hepatitis in a special care nursery.
Twenty-four infants cared for by a nurse who developed acute B hepatitis with HBsAg present in her serum and saliva were examined for serologic evidence of hepatitis B virus transmission. None of the infants had HBsAg by radioimmunoassay or anti-HBc by complement fixation. One infant had anti-HBs whose transient presence was consistent with passive acquisition. Using sensitive serologic tests, no identifiable risk to newborn infants in a special care nursery could be documented as a result of exposure to a nurse who developed acute type B hepatitis during their period of care.
Cross Infection↗
Pulmonary alveolar macrophage: demonstration of Na+ - K+, Mg++ ATPase activity.
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Adenosine Triphosphatases↗
Statistical comparison of two handwashing protocols.
This paper describes statistical procedures for use in an experiment that compares two handwashing protocols. The evaluation of a handwashing protocol entails collection of the wash effluent. Colony counts for the effluent reflect the number of flora removed by the wash protocol. The analysis aims to formulate and estimate an odds ratio that represents the relative efficacy of a test as compared with a standard protocol.
Biometry↗
Prognostic factors, models and related statistical problems in the survival of endstage renal disease patients on hemodialysis.
We investigate factors associated with the survival of end-stage renal disease patients on hemodialysis. A model derived for non-diabetics includes five significant prognostic factors: age at initiation of dialysis, arteriosclerotic heart disease, cerebrovascular accident, cancer and chronic obstructive pulmonary disease. For diabetics, age at initiation of dialysis was the only significant prognostic factor. We also show that a simple exponential model adequately represents hemodialysis survival data, the relationship between age and survival hazard is not log-linear and data for diabetics require independent analysis or inclusion of interaction terms. In this paper, we chose the first approach.
Actuarial Analysis↗
Effect of tympanostomy tubes on the pathogenesis of acute otitis media.
Intubation of the tympanic membrane as a treatment for acute otitis media is extremely controversial. This study was designed to determine the effect of tympanic membrane intubation in an experimental model for acute purulent otitis media. The right tympanic membrane of the chinchilla was intubated with Paparella Type I tympanostomy tubes. This procedure was followed in seven days by nasopharyngeal inoculation of Streptococcus pneumoniae and in an additional three days by nasopharyngeal inoculation of influenza A virus. Nasopharyngeal inoculation with these microorganisms results in acute purulent otitis media in 70 per cent of animals. The presence of the tympanostomy tubes did not reduce the incidence of clinical otitis media, nor did it reduce the pathologic changes within the middle ear space. The tympanostomy tubes did, however, significantly reduce the incidence and severity of pathologic changes in the subepithelial space of the middle ear mucosa.
Acute Disease↗
Residual mesenchyme persisting into adulthood.
PURPOSE: (1) To detect the presence of residual mesenchyme in temporal bones of adults and children above 5 years of age; (2) to evaluate its regression with increasing age, and; (3) to detect pathologic conditions associated with the presence of unresolved mesenchyme. MATERIALS AND METHODS: We examined 1,404 human temporal bones of donors from 5 to 94 years of age for histopathologic evidence of mesenchyme. The presence of stellate (star-shaped) cells with interdigitating processes and large nuclei embedded in a structureless ground substance was labeled as "pure mesenchyme." Temporal bones showing these features and focal areas of fibrosis, fibroblasts, and capillaries were classified as showing "transitional mesenchyme." Selected sections were stained with Gomori's trichrome. Pathological features indicating otitis media and congenital anomalies of the ear were also documented. Case histories were reviewed, and any otologic complaints were noted. Statistical analysis was performed with the Chi-square test, analysis of variance, regression analysis, and confidence interval. RESULTS: Mesenchyme was found in 2.07% of temporal bones of patients from 5 to 81 years of age. Of these, 92.1% had transitional mesenchyme, whereas 7.9% had pure mesenchyme. Seventy-six percent of the bones showed mesenchyme in the mastoid air cells. In all 3 bones with pure mesenchyme, it was present in the round window niche. Otitis media was associated with residual mesenchyme in 84.2% of the temporal bones. No pattern of regression of mesenchyme with increasing age was observed in temporal bones from patients over the age of 5 years. CONCLUSIONS: Residual mesenchyme can be present in patients older than 5 years of age and can persist into adulthood, especially in the mastoid air cells. Persistence of mesenchyme is closely associated with evidence of otitis media.
Adolescent↗
Serum antibody responses of high-risk children and adults to vaccination with capsular polysaccharides of Streptococcus pneumoniae.
Pneumococcal antibody was measured in the sera of splenectomized children, children with neprotic syndrome, adult with chronic renal failure, adults maintained on hemodialysis, adult recipients of renal allografts, and normal children and adults before and after vaccination with a polyvalent vaccine against Streptococcus pneumoniae. The medical conditions of these patients are associated with increased morbidity and mortality due to pneumococcal disease. Nonimmunosuppressed splenectomized children, children with steroid-responsive nephrotic syndrome, and adults maintained on hemodialysis had normal concentrations of antibody in serum and normal antibody responses to pneumococcal vaccine. Children with steroid-resistant nephrotic syndrome and adult recipients of renal allografts had low concentrations of antibody in serum before and after vaccination but showed an antibody increase after vaccination. During the first year after vaccination of the splenectomized patients, serum antibody concentrations declined linearly by 24%-32% from the peak antibody level. These results suggest that immunization with pneumococcal polysaccharides may reduce the indicence of pneumococcal disease in some high-risk patients but not in others.
Adolescent↗
Summarized vs. type-specific analysis of antibody to pneumococcal capsular polysaccharides.
Type-specific analysis (based on the measurement of concentrations of individual types of pneumococcal antibody in sera from many patients) and summarized analysis (based on the measurement of the geometric mean concentrations of many different pneumococcal antibody types in serum from one patient) were compared to determine which type of analysis provided the better measure of central tendency of the response of a patient group to immunization with tetradecavalent pneumococcal vaccine. With use of data from a group of normal children and patients with idiopathic vaccine. With use of data from a group of normal children and patients with idiopathic nephrotic syndrome and the statistical method of linear discriminant analysis applied to the logarithms of the antibody concentrations, type-specific analysis was shown to be the preferable measure of central tendency.
Adolescent↗
The bacteriology and cytology of chronic otitis media with effusion.
The bacteriology and cytology of middle ear effusion from 729 children with persistent otitis media with effusion were studied. Thirty-five percent of these chronic effusions were culture-positive. Type b and non-type b Haemophilus influenzae, Streptococcus pneumoniae, Neisseria sp. and Staphylococcus epidermidis were the predominant isolates. Serous and mucoid effusion cultures yielded bacteria more often in younger than in older children. In addition bacteria were seen in 17% of the Gram-stained smears of the sterile effusions; Gram-positive cocci predominated in these effusions. Disparate effusion culture results were obtained in 32% of bilateral otitis media cases. Effusions which yielded H. influenzae and S. pneumoniae on culture had more polymorphonuclear leukocytes than did effusions which yielded S. epidermidis or Neisseria or were sterile. Phagocytic cells were equally prevalent in sterile effusions with or without bacteria on Gram stain. Phagocytic cells were seen less often in mucoid effusions from antibiotic-treated patients than in mucoid effusions from untreated patients. The results suggest that certain bacteria in chronic middle ear effusion contribute to the pathogenesis of this condition by eliciting a local inflammatory cell response.
Age Factors↗
The cefaclor-amoxicillin controversy.
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Amoxicillin↗
Sensorineural hearing loss in otitis media.
Additional evidence is presented to support the hypothesis that both acute purulent otitis media (POM) and chronic suppurative otitis media (COM) can cause high frequency sensorineural hearing loss. In selected patients and in animals (chinchillas) in a pilot study using electrophysiological methods, both temporary threshold shifts and permanent threshold shifts of basal cochlear turn involvement were demonstrated in POM. Data of cochlear involvement in 475 ears with bilateral COM, 607 ears with unilateral COM, and 607 ears serving as controls were obtained from six centers in five countries. In group 1 (15 dB or greater), 43% of ears with unilateral COM and 42% of ears with bilateral COM showed losses, for a combined odds ratio eight times that in controls. In group 2 (30 dB or greater), 16% of ears with unilateral COM and 17% of ears with bilateral COM demonstrated, respectively, seven and ten times that in controls. These statistically significant findings influence clinical considerations.
Acoustic Impedance Tests↗
Bacterial and polymorphonuclear leukocyte contribution to middle ear inflammation in chronic otitis media with effusion.
Bacteria can be cultured from approximately one third of chronic middle ear effusions, yet the contribution of these bacteria to the pathogenesis of chronic otitis media with effusion (OME) is not clear due to the absence of signs and symptoms of acute infection in most children with this disease. To explore the role of bacteria in chronic OME, lysozyme, lactoferrin, serum complement factors C3 and C5a, and polymorphonuclear leukocyte (PMNL) chemotaxin content was measured in 21 chronic middle ear effusion samples. Concentrations of lysozyme, lactoferrin, and chemotaxin were significantly higher in culture-positive than in sterile effusions. Lysozyme appeared to be contributed by both PMNL and non-PMNL sources in the middle ear space. These non-PMNL sources, presumably middle ear epithelial cells, accounted for 50% to 80% of the lysozyme variation in middle ear effusion. Although C3 and C5a were present in effusion, chemotaxin content correlated poorly with the C3 and C5a content, suggesting that chemotaxins were derived from bacterial peptides rather than from complement activation products. These results suggest that bacteria contribute to chronic middle ear inflammation with effusion. The eradication of bacteria from chronic middle ear effusion might disrupt the host responses which maintain chronic OME.
Bacterial Physiological Phenomena↗