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Biomedical subjects

E G Smith

Publications and source records attributed to E G Smith.

52 records · Page 3Linked to original sources
PubMed1990

Serological response in Enterococcus faecalis endocarditis determined by enzyme-linked immunosorbent assay.

Enterococcus (Streptococcus) faecalis expresses three species-specific surface protein antigens of molecular weights 73,000, 40,000, and 37,000. On Western blotting (immunoblotting), they were detected strongly by immunoglobulin G (IgG) in sera from patients with E. faecalis endocarditis, but not in sera from patients with other E. faecalis infections or with endocarditis due to other streptococci. We developed an enzyme-linked immunosorbent assay system to measure IgG, IgM, and IgA levels to these antigens and evaluated its potential as a serodiagnostic test for E. faecalis endocarditis. The test correctly diagnosed E. faecalis endocarditis in 15 of 16 cases. Of 10 cases of endocarditis due to other streptococci and 10 E. faecalis infections other than endocarditis, 9 and 8, respectively, gave negative results. The test should prove particularly useful in culture-negative cases, for which choice of appropriate antibiotic therapy for E. faecalis endocarditis is vital.

Antibodies, Bacterial↗
PubMed1988

Product line management: financial incentives mean healthier patients.

For the past few years, The Washington Hospital Center has had a prepaid obstetric clinic program for uninsured patients. Although the program was satisfactory, some deficiencies had developed. For example, research had shown a high correlation between a mother's lack of prenatal care and high healthcare expenditures. By implementing a new program that included financial incentives for various prenatal care programs, the hospital was able to financially break even with the old program, have a more predictable financial performance evaluation, and have healthier mothers and babies.

District of Columbia↗
PubMed1987

Cryptosporidium-associated diarrhoea in children.

Over a 3-month period during summer, 30 out of a group of 194 children admitted with a primary diagnosis of gastro-enteritis with dehydration were found to excrete cryptosporidium oocysts in their stools. On retrospective analysis, children with cryptosporidia in their stools had a significantly higher mortality than those without. They spent a longer time in hospital and were more likely to have intestinal salmonella infection. They also had a higher incidence of bronchopneumonia. They were not significantly different from the group of children without cryptosporidia in respect of age, mass for age, duration of symptoms prior to hospitalization, prior treatment, or severity of metabolic derangement on admission. Since cryptosporidiosis has a recognized association with immune deficiency, the presence of cryptosporidium oocysts in the stools of our children with diarrhoea may be a pointer to morbidity and mortality.

Cryptosporidiosis↗
PubMed1987

Serodiagnosis of Streptococcus faecalis endocarditis by immunoblotting of surface protein antigens.

We describe a method for the serodiagnosis of Streptococcus faecalis in infective endocarditis which could be of value in culture-negative cases. Serum-grown cells of S. faecalis produced three major characteristic protein antigens (73,000, 40,000, and 37,000 molecular weight) which were separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis of solubilized whole cells. After electrophoretic transfer to a nitrocellulose membrane, these antigens were visualized by probing with serum from patients with endocarditis caused by S. faecalis. Serum from patients with endocarditis caused by other organisms did not react with the S. faecalis-specific antigens. This procedure should facilitate positive early diagnosis of S. faecalis endocarditis or establish its absence in culture-negative cases.

Antibodies, Bacterial↗
PubMed1981

Four-hour presumptive identification of Enterobacteriaceae from blood cultures.

A modification of the Minitek identification system for the four-hour identification of gram-negative bacilli recovered from blood cultures was developed. This method enabled our laboratory to identify correctly 99 of 100 consecutive isolates of all members of Enterobacteriaceae representing seven genera and nine species. All rapid identifications were confirmed using conventional biochemical methods. The procedure employs 11 Minitek biochemical discs inoculated with 0.1 ml of a dense organism suspension. Two-tenths milliliter of this suspension was added to a blank well for motility testing. In most instances, identification reactions were identical to those routinely used for the Minitek system. Only with the biochemical citrate disc does the interpretation vary from the Minitek standard. In addition to the blood culture isolates, 22 unknown organisms were also tested. All were correctly identified within four hours of the detection of visible turbidity in broth. This method offers a convenient, economic, and rapid means of identifying gram-negative bacilli isolated from blood cultures.

Bacteriological Techniques↗
PubMed1979

Antibiotic susceptibility of Haemophilus vaginalis (Corynebacterium vaginale) to 21 antibiotics.

A total of 56 strains of Haemophilus vaginalis were tested for their in vitro susceptibility to 21 antimicrobial agents by an agar dilution method. All strains were inhibited by 1 mug or less of penicillin, ampicillin, carbenicillin, and vancomycin per ml. The cephalosporins were less active; 4 mug of cefazolin per ml, 16 mug of cephalothin per ml, or 128 mug of cephalexin per ml was required to inhibit all strains. Kanamycin, gentamicin, tobramycin, and neomycin were relatively inactive against H. vaginalis. All strains were inhibited by 4 mug of streptomycin per ml and 2 mug of chloramphenicol per ml. Only 57% of the strains were inhibited by 4 mug of tetracycline per ml, whereas 43% were inhibited by 16 to 64 mug/ml. The combination sulfamethoxazole/trimethoprim was relatively inactive against H. vaginalis. All strains tested exhibited minimal inhibitory concentrations of >/=128 mug when tested against colistin, nalidixic acid, and sulfadiazine. Erythromycin and clindamycin were the most active of the antibiotics tested; for all strains the minimal inhibitory concentrations were </=0.06 mug/ml.

Anti-Bacterial Agents↗
PubMedDate not supplied

Early lead exposure produces lasting changes in sustained attention, response initiation, and reactivity to errors.

The present study tested the hypothesis that early lead (Pb) exposure causes lasting attentional dysfunction. Long-Evans dams were fed Pb-adulterated water during gestation and/or lactation; the offspring were tested as adults. The results of a visual discrimination task revealed no Pb effects on learning rate or information-processing speed. However, lasting effects of the early Pb exposure were seen in the subsequent vigilance tasks, particularly in the final task in which onset of the visual cue and cue duration varied randomly across trials. Exposure during both gestation and lactation impaired response initiation. In addition, animals exposed to Pb during lactation only or lactation+gestation committed significantly more omission errors than controls under two specific conditions: (1) trials in which a delay was imposed prior to cue presentation and (2) trials that followed an incorrect response. The pattern of treatment differences indicated that early Pb exposure produced lasting impairment of sustained attention and increased reactivity to errors. Both effects may contribute to the cognitive impairment, problematic classroom behaviors, and increased delinquency associated with early Pb exposure in children. These findings also demonstrate that the developmental timing of the exposure determines the pattern of effects. Thus, conclusions regarding whether or not a particular cognitive or affective function is impaired or spared by early Pb exposure must be limited to the specific timing and intensity of exposure.

Administration, Oral↗
PubMedDate not supplied

Imipenem/cilastatin in the treatment of serious bacterial infections.

Imipenem (N-formimidoyl thienamycin) is a new carbapenem beta-lactam antibiotic with a broad antibacterial spectrum. Forty-five patients were treated with either 500 or 1,000 mg of imipenem/cilastatin four times daily, the duration varying according to clinical response. The diagnoses were urinary tract infection, 10 patients; septicemia, six; intraabdominal sepsis, six; pneumonia, six (two cases of Legionnaires' disease); skin and soft tissue infection, four; and other diagnoses, 13. Of the 32 clinically assessable patients, 17 were cured, nine improved, three died, and three were withdrawn from the trial. Of 21 patients who were microbiologically assessable, 13 were cured. In six cases of complicated urinary tract infection, the organism--which had been eradicated from the urine during treatment--reappeared after completion of antibiotic therapy. Two patients developed adverse clinical reactions that were thought to be drug-related (drug-induced fever and nausea plus vomiting, respectively). Both patients had mildly abnormal results in liver function tests, and one developed a positive direct Coombs' test. Fifty-seven percent of the patients developed some degree of phlebitis, which was moderate to severe in 19%. In this study imipenem/cilastatin proved to be a highly effective agent for the treatment of a variety of serious bacterial infections.

Adolescent↗
PubMedDate not supplied

An epidemiological study of severe osteoarthritis.

A study was made of the relationship between weight, education, use of tobacco and alcohol, participation in athletics and family history of arthritis and severe osteoarthritis of the hip. Estimated relative risk of osteoarthritis was highest for those whose weight was at least 20% or more above ideal, having more than a high school education or with a familial history of arthritis. There was no association between severe osteoarthritis and participation in high school athletics or regular use of alcohol.

Aged↗
PubMedDate not supplied

Physician delivery of smoking-cessation advice based on the stages-of-change model.

The purpose of this study is to assess whether a stage-based program of brief physician-delivered smoking-cessation advice changes smoking stages of readiness to quit smoking. First-year residents were trained to assess the stage of their continuity care patients who smoke, using Prochaska and DiClemente's methods, and to deliver brief messages and handouts based on the stages of precontemplation, contemplation, and action. Concurrent with the training, we administered a survey to 252 smokers, before their physician encounter. Eighty-nine smokers saw trained residents (intervention group), and 163 saw untrained residents (usual care group). A follow-up survey was administered six months later. Seventy-four percent of the subjects completed the follow-up survey. After we controlled for baseline stage, the percentage of precontemplators was lower in the intervention group (25%) than in the usual care group (36%) (P < .05, log-linear model). In the intervention group, 50% of the subjects had positive stage shifts versus 40% in the usual care group (P = .2). Subjects in the intervention group moved ahead a mean of 0.63 stage per subject, whereas subjects in the usual care group moved ahead 0.34 stage per subject (P < .05). The self-reported cessation rate was 15.5% and did not differ between the two groups. We conclude that our stage-specific brief advice program enhances short-term movement through the stages-of-change of smoking cessation. Measurement of this movement may be an important intermediary in evaluating small clinical trials of brief advice. Our findings indicate potential benefits of a staged approach for both clinicians and their patients.

Female↗