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Biomedical subjects

E Hilton

Publications and source records attributed to E Hilton.

45 records · Page 3Linked to original sources
PubMed1988

Central catheter infections: single- versus triple-lumen catheters. Influence of guide wires on infection rates when used for replacement of catheters.

A prospective study was conducted over six months to determine if triple-lumen catheters were associated with a higher rate of infection than single-lumen catheters. A total of 502 central intravascular catheters were prospectively collected from 362 consecutive patients in the adult intensive care units. Semiquantitative and broth cultures were performed on distal and proximal catheter segments, with peripheral blood culture specimens drawn in febrile patients. The overall infection rate for the 502 catheters was 11.8 percent or 2.2 infections per 100 days at risk. The infection rates were: single-lumen lines, 8 percent; triple-lumen lines, 32 percent; and triple-lumen pulmonary artery catheters, 12 percent. When corrected for time at risk, the triple-lumen lines and the triple-lumen pulmonary artery catheters had the same rate of infection, which was three times greater than that of the single-lumen catheters. After correction for confounding variables such as the presence of diabetes mellitus, the use of hyperalimentation, the degree of illness, dialysis, or ultrafiltration, and the use of a guide wire to place a replacement line over a pre-existing one, the risk of infection remained significantly higher for triple-lumen than for single-lumen catheters. The use of a guide wire to place a new line over an old one also was associated with a trend towards an increased risk of infection.

Adult↗
PubMed1988

Microbiology of indwelling central intravascular catheters.

Indwelling central-line catheters (n = 502) from 362 patients in intensive care units were analyzed prospectively. The skin site, 6-cm-distal and -proximal subcutaneous segments of the catheter, exudates, and blood were cultured. Semiqualitative roll plate cultures of the catheter segments were followed by broth cultures and examined for 72 h. All isolates were identified, and susceptibilities were determined. Line infections, defined clinically, yielded 22 different microbial species; 10 different species were recovered from colonized lines. Of the Staphylococcus epidermidis isolates recovered, 39% occurred singly and 21% occurred in combination with other microorganisms; Enterococcus faecalis, S. hominis, and Pseudomonas aeruginosa were next in frequency of isolation. Line infections also yielded other staphylococci, viridans group streptococci, several members of the family Enterobacteriaceae, acinetobacters, anaerobic bacteria, Candida spp., and Aspergillus fumigatus. While S. epidermidis was also the most frequent isolate among the line colonizers, different species and different frequencies of isolation were found among this group. The study showed that the distal catheter segment broth culture was the best predictor of clinical line infections; in addition, gram-negative bacteria were isolated only from the catheters of patients with overt infections.

Bacteria↗
PubMed1986

Acid-fast bacilli in sputum: a case of Legionella micdadei pneumonia.

Legionella micdadei has been implicated as a cause of nosocomial pneumonia. There are no reports of L. micdadei pneumonia diagnosed by acid-fast stain of expectorated sputum. We report a case of L. micdadei pneumonia in which expectorated sputum harbored acid-fast bacteria that reacted specifically with fluorescent antiserum to L. micdadei, confirmed by culture. In a patient at risk for nosocomial infection, the differential diagnosis of a positive sputum stain for acid-fast bacilli should include L. micdadei in addition to mycobacteria. Therapy for L. micdadei infection should be considered pending confirmation of the diagnosis.

Aged↗
PubMed1985

Imipenem/cilastatin: general experience in a community hospital.

Imipenem/cilastatin is a new carbapenem antibiotic with broad spectrum antimicrobial activity. Forty two patients with infections of various types, including skin and soft tissue, respiratory tract, bone and joint, and urinary tract, were treated with this antibiotic in an open noncomparative study. Clinical responses to therapy were excellent and failures were only encountered with infections caused by Pseudomonas aeruginosa strains that developed resistance during therapy. Superinfection rates were minimal as were toxicities. Imipenem/cilastatin appears to be a relatively safe and highly effective broad spectrum antibiotic.

Adult↗
PubMed1984

'Culture-negative' prosthetic valve endocarditis. Hazards of postoperative steroid therapy for unexplained fever.

Two patients had prolonged unexplained fever along with multiple negative blood cultures after cardiac valve replacement surgery. Following the administration of corticosteroids for presumed postpericardiotomy syndrome, both patients improved symptomatically and defervesced, only to have positive blood cultures for Staphylococcus epidermidis shortly thereafter. The theoretical and practical risks of the empiric use of anti-inflammatory agents for unexplained post-operative fever are reviewed. "Culture-negative" prosthetic valvular infection due to prior antibiotic prophylaxis or therapy must be strongly considered in the evaluation of such unexplained fever.

Adrenal Cortex Hormones↗
PubMed1983

Nosocomial bacterial eye infections in intensive-care units.

A cluster of ten nosocomial eye infections occurred in three intensive-care units during an 18-month period. Nine of the ten patients were intubated, all were obtunded, and all had copious sputum production. The bacteria isolated from the patients' sputum samples and from the eyes were identical in nine cases. Pseudomonas aeruginosa caused six of the infections, including all those with complications (three corneal ulcers, two hypopyon, one opaque cornea, two corneal rupture). Three patients lost their sight. Only the left eye was infected in nine cases. In a prospective study of bacterial dispersion during tracheal suctioning of twenty intubated patients, patients with copious secretions had significantly higher bacterial colony counts on settle plates than those without. Colony counts were higher on the side opposite to the hand the nurse used to withdraw the catheter than on the same side. Nurses tended to withdraw the catheter diagonally across the patient's face, which may explain the selective involvement of the left eye.

Adolescent↗
PubMed1966

Exchange of structurally bound phosphate in muscular activity.

1. When rectus abdominis and sartorius muscles of the frog are incubated with (32)P-orthophosphate and subsequently minced, extracted with carbonate-bicarbonate buffer and water, and converted to acetone powders, considerable radioactivity remains associated with the solid material.2. Muscles labelled with (32)P and subjected to contracture at room temperature with KCl or ACh yield acetone powders which, in comparison with those of uncontracted control muscles, show a significantly decreased radioactivity. There is no evidence for a corresponding decrease in the total phosphate content.3. Relaxation of a contracted muscle restores the (32)P content of its acetone powder at least to the level for a resting, control muscle.4. When two recti are incubated with 5 x 10(-4)M-DNP after labelling with (32)P, subsequent depolarization of one muscle with KCl usually results in an increase in the activity of the bound phosphate fraction, with little or no contracture in addition to that already caused by the DNP.5. It is concluded that the bound phosphate fraction undergoes exchange during activation, shortening and relaxation of muscle, and may represent a source of energy for muscular activity.

Acetylcholine↗