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Biomedical subjects

G K Morris

Publications and source records attributed to G K Morris.

At least 73 records · Page 4Linked to original sources

Diagnostic value of indirect hemagglutination in the seroepidemiology of Shigella infections.

To evaluate the usefulness of the indirect hemagglutination (IHA) test in the epidemiological investigation of shigellosis, single serum specimens were tested from 50 patients with Shigella dysenteriae 1 (Shiga bacillus) infections, 103 asymptomatic contacts of these cases, 267 adult and 100 student control, and serum specimens collected during two outbreaks caused by S. sonnei and one outbreak due to S. flexneri 6. In patients with S. dysenteriae 1, 74% demonstrated titers of greater than or equal to 1:40, with 50% showing titers of greater than or equal to 1:160, whereas in the controls 10.4% had titers of greater than or equal to 1:40 and only 0.3% had titers of greater than or equal to 1:160. IHA titers in serum specimens collected from patients with S. sonnei and S. flexneri 6 were too low to be considered diagnostic for individual patients, but were useful in analysis of group results. Groups of ill individuals yielded titers significantly higher than non-ill groups; however, titers from ill groups were usually less than 1:40. The IHA test for S. dysenteriae 1 antibodies serves as a valuable adjunct to the diagnosis of Shiga bacillus dysentery. In our laboratory, an IHA titer of 1:40 or 1:80 is a "borderline positive." Shiga bacillus dysentery is strongly indicated when IHA titers are greater than or equal to 1:60.

Adult↗

Laboratory investigation of diarrhea in travelers to Mexico: evaluation of methods for detecting enterotoxigenic Echerichia coli.

A laboratory investigation was conducted on cultures collected from travelers before, during, and after a trip to Mexico to characterize the etiology of traveler's diarrhea. Four laboratory methods for detecting enterotoxigenicity of Escherichia coli were evaluated: the infant mouse assay, the Chinese hamster ovary (CHO) cell assay, the Y1 adrenal cell assay, and the rabbit ileal loop. Although a number of common enteric pathogens were identified as a cause of traveler's diarrhea, including six serotypes of Salmonella, two serotypes of Shigella, Vibrio parahaemolyticus, Giardia lamblia, and Entamoeba histolytica, enterotoxigenic Escherichia coli was most commonly isolated. Strains were identified that produced only heat-labile enterotoxin (LT), only heat-stable enterotoxin (ST), or both LT and ST. The infant mouse assay yielded results falling into two distinct groups, providing a clear separation of positive and negative cultures. The CHO assay also formed two groups, with positive cultures producing 11% or more of the elongated cells. There was good agreement between the CHO and the Y1 adrenal cell assays for detection of LT. The adrenal cell system for detection of LT was more suitable than the CHO assay for processing large numbers of specimens because of the miniculture modification of this method utilized in this study. The infant mouse method was a simple and reliable method for detecting ST.

Animals↗

Enhancement by sodium chloride of the selectivity of thiosulfate citrate bile salts sucrose agar for isolating Vibrio cholerae biotype El Tor.

In this study we utilized the salt-tolerant characteristics of vibrios to develop a more selective medium by addition of NaCl to thiosulfate citrate bile salts sucrose (TCBS) agar. The effect of adding salt to TCBS agar varied greatly among brands of TCBS agar and between lots of the same brand. The addition of salt at concentrations as high as 1.5% (2.5% total NaCl) caused the inhibition of growth of three species of commonly encountered normal bowel flora and one strain of classical Vibrio cholerae but did not compromise the use of TCBS agar for isolation of V. cholerae biotype El Tor.

Agar↗

Yersinia enterocolitica : a review of its role in food hygiene.

Since Yersinia enterocolitica, now classified as a member of the Enterobacteriaceae, was recognized as a distinct species in 1964 it has been isolated with increasing frequency from man and animals (including dogs and pigs) and from some human foods. Y. enterocolitica infections are now seen as a cause for some concern in both human and veterinary medicine. The organism is commonly found in specimens from swine slaughterhouses and has been isolated from samples of market meat, vacuum-packed beef, mussels, oysters, and ice-cream. It has also been found in nonchlorinated well water used for drinking purposes. Infections in man therefore probably have an alimentary origin. Only 23 human infections were recorded in 1966 but the number increased to over 4000 in 1974. However, reported incidence is affected by growing awareness about the role of the organism in human and animal disease and by intensive laboratory analyses. While knowledge about the geographical distribution of Y. enterocolitica is still fragmentary it is clear that infections are very frequent in some parts of the world and probably common but unrecognized in many countries. The most common symptoms of Y. enterocolitica infections in man are fever, abdominal pain, and diarrhoea. In the USA most isolations in human infections were made from blood and mesenteric lymph node samples. The pathogenic mechanism is not known. In one experiment involving a human volunteer subject a dose of 3.5 x 10(9) organisms was required to produce an infection. Only recently has some success been obtained in establishing experimental infections in mice, guinea-pigs, rats, and rabbits. Laboratory cultivation techniques for Y. enterocolitica are described together with a table of minimal tests for characterizing the organism and two biotyping schema. Little is known about methods for controlling this disease, but environmental hygiene and sanitation with regard to food and water should apply.

Animals↗

Survey of general practitioners' attitudes to management of patients with heart attacks.

Out of 305 general practitioners sent a questionnaire asking how they would treat three hypothetical patients with heart attacks 231 (76%) replied. Of these, only 179 were prepared to make an unqualified choice of home or hospital treatment for a middle-aged man with an uncomplicated attack, 70 (39%) saying that they would keep the patient at home. Practitioners qualifying before 1960 were more likely to do this than those qualifying in 1960 or later. If a patient declined hospital treatment 161 (70%) of the practitioners would keep him in bed for a week or less, but the date of the practitioners' qualification significantly affected the time they would advise him to remain off work. Faced with a patient acutely ill after a heart attack, 162 (70%) of the practitioners would arrange his immediate admission to hospital and 51 (22%) would send him to hospital after initial treatment at home. The numbers of partners in the practice, the nature of the premises, and the location of the practice in urban or rural areas affected the practitioners' attitude to the management of severely ill patients but not to the management of patients with uncomplicated attacks.

Attitude of Health Personnel↗

Diarrhoea associated with heat-stable enterotoxin-producing strains of Escherichia coli.

Five patients who developed acute watery diarrhoea while travelling in Mexico in October, 1974, were found to have enterotoxigenic Escherichia coli in their stool which produced heat-stable enterotoxin (S.T.) without producing heat-labile enterotoxin (L.T.). These S.T.-only E. coli, which have previously been described as causing diseases in animals, must now be regarded as pathogenic for humans as well.

Adult↗

Comparison of mobilization after two and nine days in uncomplicated myocardial infarction.

A total of 189 patients with uncomplicated myocardial infarction were selected at random for early or late mobilization and discharge from hospital. Patients were admitted to the study after 48 hours in a coronary care unit if they were free of pain and showed no evidence of heart failure or significant dysrhythmia. Randomization was achieved by monthly cross-over of the three medical wards to which the patients were discharged. One group of patients was mobilized immediately and discharged home after a total of nine days in hospital, and the second group was mobilized on the ninth day and discharged on the 16th day. Out-patient assessment was carried out six weeks after admission. No significant differences were observed between the groups in terms of mortality or morbidity, as reflected by the incidence of recurrent chest pain or myocardial infarction, heart failure, dysrhythmia, or venous thromboembolism detected either clinically or by (125)I-labelled fibrinogen scanning.

Arrhythmias, Cardiac↗

Evaluation of methods for isolating Salmonella and Arizona organisms from pet turtles.

Two methods for isolating Salmonella and Arizona organisms from turtles, blending and excretion, were evaluated, and the percentage of isolates obtained by each method was compared with the percentage of isolates obtained by culture of turtle organs. The blending and excretion methods were equally effective in detecting the overall incidence of Salmonella and Arizona infections in turtles. The percentage of isolates obtained by specific organ culture, however, was less than the percentage obtained by the other two methods. The blending method detected a greater number of turtles with Arizona infections than did the excretion method, but there was no difference in the number of Salmonella infections detected by the two methods. The frequency of isolation of Arizona organisms from organs other than the small intestine and colon was higher than that of Salmonella.

Animals↗

Colicin typing of Shigella sonnei.

The colicin typing method for differentiating epidemic strains of Shigella sonnei was evaluated. Forty percent of the strains were untypable, but the method divides 60% of the strains into 15 established colicin types. The method has reasonably good reproducibility, but should not be interpreted with the same degree of confidence as some other characteristics such as serotypes. For this reason, known type strains should be included as controls in each analysis to ensure uniformity of results.

Bacteriocins↗