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Biomedical subjects

F Cox

Publications and source records attributed to F Cox.

At least 37 records · Page 2Linked to original sources
PubMed1983

Adherence of Candida albicans to buccal epithelial cells in children and adults.

Adherence of Candida albicans to BEC was determined in 20 children with oral candidiasis, 20 with oral colonization with C. albicans, and 40 uninfected controls not receiving antibiotics. Mean adherence was 15.3 +/- 0.08 yeast/cell in controls and significantly increased to 16.2 +/- 0.5 in colonized children (p less than 0.001) and 19.3 +/- 0.8 in children with oral candidiasis (p less than 0.001). Adherence was the same in normal adults and children, suggesting a stable cell receptor system that is not age dependent. Adherence was also tested daily in 15 initially noncolonized, previously healthy children receiving antibiotics. Normally adherent background bacteria decreased significantly (p less than 0.004) on the first day of narrow- or broad-spectrum antibiotic therapy. C. albicans adherence increased significantly (p less than 0.004) on the second day. Oral colonization with C. albicans occurred on the third day of therapy. None of the children developed oral candidiasis over 3 to 9 days of observation. Healthy control children showed no change in adherence when tested daily for 1 week. Increased fungal adherence to BEC during antibiotic therapy may explain, in part, the increased incidence of Candida colonization in patients receiving antibiotics. Persistence of organisms may then permit disease to develop.

Adhesiveness↗
PubMed1982

Prevention of group B streptococcal colonization with topically applied lipoteichoic acid in a maternal-newborn mouse model.

An animal model of maternal-newborn transmission of group B streptococci (GBS) was developed. Pregnant Swiss-Webster mice were colonized by applying 10(8) GBS to the oral cavity, vagina, and nipples daily for 3 days before delivery. Lipoteichoic acid (LTA) from type III GBS or phosphate buffered saline was applied topically to the oral cavity, perineum or nape of newborn mice. Cultures of newborn mice at 3 days of age revealed 35 of 75 (47%) controls and 0 of 79 animals given 2 doses of LTA (2 mg/ml) were positive for GBS at one or more sites. One to two% of control and LTA-treated mice remained culture positive at 7 days of age. None developed GBS disease and no obvious toxicity was noted. This is the first in vivo evidence that colonization with GBS can be prevented by interfering with their adherence to epithelial surfaces. LTA also prevented colonization by 60,000 GBS in the oral cavity of 1-day-old newborn mice. A minimum concentration of 0.5 mg LTA/ml was required and similar dose response curves were obtained in preventing maternal-newborn transmission or oral newborn colonization. LTA from type III GBS also protected against types Ia and II. Only 6 of 15 (40%) vaginally colonized, nonpregnant mice became noncolonized 3 days after LTA treatment. Topically applied lipoteichoic acid from group B streptococci may be a useful method of preventing GBS colonization and/or disease in human infants at birth if it is nontoxic. The method avoids the problems associated with antibiotic prophylaxis and vaccine development.

Animals↗
PubMed1982

Metastatic endophthalmitis: a complication of meningococcal meningitis.

A 13-month-old child with Neisseria meningitidis developed bilateral metastatic endophthalmitis. Treatment with systemic and periocular injections of penicillin G and steroids resulted in resolution of the meningitis and the endophthalmitis. This case should alert the pediatrician to the possibility of binding endophthalmitis in a patient with meningitis and ocular abnormalities.

Conjunctiva↗
PubMed1981

Rifampin prophylaxis for contacts of Haemophilus influenzae type b disease.

Rifampin prophylaxis (20 mg/kg once daily for four days) was used in close contacts of children with Haemophilus influenzae type b (HIB) disease. Two hours after a dose, the concentration of rifampin in serum and saliva exceeded the minimum bactericidal concentrations of organisms obtained from four of the carriers. In both a randomized prospective and an open study, nasopharyngeal carriage was eradicated in 37 (95%) of 39 contacts. No cases of serious H influenzae disease occurred in four to six months of follow-up. At the dose and treatment schedule used, rifampin was safe and effective for eradication of HIB carriage.

Adult↗
PubMed1980

Pneumocystis pneumonia in hospitals: outbreaks or improved recognition?

A presumed outbreak of Pneumocystis carinii pneumonitis occurred at a large teaching hospital. The diagnosis was made by lung biopsy or at autopsy in seven patients over a 22 1/2-year period and only by percutaneous lung aspirate in seven patients over a 2 1/2-year period. Apparent outbreaks may be related to both an increase in the number of cases of disease and improved diagnostic methods.

Adult↗
PubMed1979

Gallium 67 scanning for the diagnosis of infection in children.

Gallium 67 scintigraphy was studied prospectively in 26 children with clinically suspected abscesses. Scan interpretation agreed with the clinical outcome in 21 patients (81%). The true-negative rate was 71% and the true-positive rate was 92%. False-positive scans were related to bleeding and bone infarcts. False-negative scans were related to neutropenia (less than 500 neutrophils/cu mm) and to lesions smaller than 1 cm. Gallium scanning is a safe and reliable method of diagnosis of infection in children, except for patients with neutropenia or whose lesions are smaller than 1 cm. Two-hour scans may be useful in some patients, particularly those with osteomyelitis.

Abscess↗
PubMed1978

Polymicrobial infective endocarditis: an increasing clinical entity.

Polymicrobial endocarditis was very uncommon until ten years ago. However, since that time, at least 21 cases were reported, and 10 patients with this mixed infection were seen at our hospital. All, except one of these infections, occurred in patients who had undergone heart surgery or abused intravenous drugs. Although, generally clinically indistinguishable from mono-microbial endocarditis, these mixed infections carried a very high mortality rate (greater than 30 per cent), and an unusually large number of the patients (greater than 50 per cent) needed heart surgery either to control the infection or to repair cardiac defects resulting from the infection. The prognosis depended on the species rather than the number of organisms isolated and on aggressive antimicrobial and surgical therapy.

Adult↗
PubMed1978

Comparison of pentamidine isethionate and trimethoprim-sulfamethoxazole in the treatment of Pneumocystis carinii pneumonia.

Fifty patients with P. carinii pneumonitis were randomized to receive either pentamidine isethionate or trimethoprim-sulfamethoxazole therapy. Those not responding favorably to the first drug after three or more days of therapy were changed to the alternate drug. Of the 26 patients initially treated with TMP-SMZ, 20 recovered (0.77)-17 after TMP-SMZ alone and three of nine who were crossed over to pentamidine. Of the 24 patients initially treated with pentamidine, 18 recovered (0.75)-14 of 15 who received only pentamidine and four of nine who were crossed over to TMP-SMZ. Abnormal values for blood urea nitrogen, creatinine, or glucose; inflammation at injection sites; or combination of these effects occurred in 14 of the 15 patients treated with pentamidine alone. Only one of the 17 patients treated with TMP-SMZ alone developed any of these abnormalities. This study shows that TMP-SMZ is as effective as pentamidine in the treatment of PCP, and that it offers the advantages of minimal adverse effects, oral administration, and ready availability.

Administration, Oral↗
PubMed1977

Percutaneous transthoracic needle aspiration of the lung. Diagnosing Pneumocystis carinii pneumonitis.

Percutaneous transthoracic needle aspiration was performed on 228 occasions to obtain lung specimens from 202 patients with suspected Pneumocystis carinii pneumonitis. In 121 patients the diagnosis was established by identifying P carinii organisms in lung aspirates. Six patients whose aspirates did not contain P carinii were found to have the organism at autopsy. Findings from toluidine blue O and Gomori methenamine silver nitrate stains were equally satisfactory for detecting P carinii, but the percentage of specific diagnosis was higher when specimens were stained with both. Pneumothorax that required a thoracotomy tube occurred in 39 patients. Other infectious agents, either bacteria or fungi, were found in only four patients. Percutaneous pulmonary needle aspiration--when performed under fluoroscopic guidance--is a rapid and effective method for the diagnosis of P carinii pneumonitis.

Adolescent↗
PubMed1977

Pulmonary resection.

Seventy-seven patients who had elective pulmonary resections were enrolled in a prospective double-blind study to assess the role of prophylactic antibiotics in preventing postoperative infections. Criteria for infection were strictly defined. A five-day course of a cephalosporin (2 gm/day in divided doses) was compared to an identical placebo. There were 17 infections in the 34 patients in the placebo group (50%), compared to only eight infections in the 43 patients in the antibiotic group (19%) (P = .005). When infections unrelated to thoracotomy and minor infections were excluded, the advantage of prophylactic antibiotics proved even more evident. Fourteen thoracic infections occurred in the placebo group (41%) compared to only two thoracic infections (4.7%) in the antibiotic group (P = .0002). No relationship of infection rate to the extent of pulmonary resection was found. A history of smoking, the presence or absence of chronic bronchitis, spirometric abnormalities, and obesity were all analyzed; none was related to the development of infection. We conclude that the routine use of perioperative antibiotics is indicated to prevent postoperative infections in pulmonary resection.

Abscess↗
PubMed1977

Tuberculous meningitis in an urban general hospital.

We analyzed the clinical and laboratory findings of 19 patients with tuberculous meningitis seen between 1966 and 1974 at the Henry Ford Hospital. Eighteen patients were adults at the time of diagnosis. In eight patients, the history suggested that the infection with the tubercle bacillus had occurred in the remote past. Cerebrospinal fluid analysis was often typical for tuberculous meningitis; stains for Mycobacterium tuberculosis were usually negative. Of 16 patients who were treated, five died and five suffered permanent neurological sequelae. The addition to rifampin to isoniazid therapy did not improve either survival or permanent sequelae. We were not able to analyze the effect of steroids on the disease.

Adult↗
PubMed1976

Intramuscular clindamycin for therapy of infective endocarditis. Report of 23 cases and review of the literature.

Twenty-three patients with infective endocarditis received intramuscular clindamycin (Cleocin) for treatment. Thirteen had acute Staphylococcus (S.) aureus endocarditis but none had involvement of the aortic valve. Eleven of these 13 infections were heroin-related and involved the tricuspid valve.Twenty-one patients were successfully treated. Two patients with heroin-related S. aureus infection failed to respond to intramuscularly administered clindamycin, but responded to retreatment with methicillin. There have been 34 reported cases of endocarditis treated with clindamycin. Although 80 percent of all cases due to staphylococci responded favorably, almost all were heroin-related tricuspid valve infections. In addition 91 percent of cases due to aerobic streptococci responded but, surpisingly, treatment failed in three of four cases of anaerobic endocarditis. Although clindamycin can be useful in streptococcal endocarditis and in some cases of heroin-related S. aureus tricuspid endocarditis, caution should be exercised in its use. It is "less" bactericidal than the penicillins or cephalosporins, and organisms have become resistant during treatment. Furthermore, patients with anaerobic endocarditis have not responded well, and data are not available to recommend administration of clindamycin for acute S. aureus infections engrafted on the aortic or mitral valve.

Adolescent↗