Search PubMed⌕ Search

Biomedical subjects

G R Hodges

Publications and source records attributed to G R Hodges.

At least 55 records · Page 3Linked to original sources
PubMed1980

Needlestick and puncture wounds: definition of the problem.

During 1979, all hospital personnel who were victims of needlestick or puncture wounds completed an incident questionnaire so that the epidemiology of these events could be determined. The attack rate varied from a high of 20 to a low of 0.8 incident/100 employee years worked (mean 7.5) for different employee groups. Personal carelessness accounted for 55% of the 81 incidents, whereas 35% of the involved personnel were innocent victims. Needles were responsible for 58% of the incidents. Screening for hepatitis B surface antigen (HBsAg) revealed no positive patient or employee associated with needlestick or puncture wounds. Only 2 of 45 employees were hepatitis B surface antibody (anti-HBs) positive. Hepatitis B immune globulin (HBIG) was recommended for 4 employees, immune serum globulin (ISG) for 13, and no globulin for 65. The estimated cost of this surveillance program and globulin therapy was $60 per incident. This data is being used as the basis for in-service training of high-risk personnel in order to decrease the number of incidents.

Cross Infection↗
PubMed1980

Chemical injury of the spinal cord of the rabbit after intracisternal injection of gentamicin: an ultrastructural study.

We previously reported that rabbits with quadriplegia, after a single intracisternal injection of gentamicin sulfate, have multiple minute lesions in the white matter of the upper cervical spinal cord and the lower medulla oblongata, most marked at the C2 segment, when light microscopy is used to study the histopathologic changes. Using electron microscopy in the present investigations, we have found that 9 hours after injection of gentamicin sulfate there was marked edema of fibrous astrocytes in the soma and processes of glia limitans. Ribosomes were disarranged. Mitochondria were swollen, the matrix density was increased and contained paracrystalline lattice structure, and the cristae were reduced in number. Oligodendrocytes displayed hypertrophy, with proliferation of smooth ER, ribosomes, microtubules, Golgi complexes, and lysosomes. A few axons were subsegmentally swollen due to axoplasmic edema. At 24 hours, the lesions became obvious by light microscopy. Astrocytes were more edematous and oligodendrocytes remained hypertrophic. Myelin sheaths were tumefied by dissociation of myelin lamellae. Axons were edematously swollen. Lysed axons were surrounded by lysed myelin sheaths. At 48 hours, numerous neuroaxonal end bulbs were formed at the lysed end. Wallerian degeneration was also evident. The data suggest that oligodendroglia actively react to detoxify gentamicin, astroglia become severely edematous but survive, and axons and myelin sheaths are lysed in reaction to the toxicity of gentamicin. The unique distribution of gentamicin lesions in the deeper white matter, with sparing of the overlying marginal myelinated fibers, seems to depend primarily upon the distribution of edematous astrocytes, which are most sensitive to this noxious chemical. Since gentamicin is apparently detoxified by oligodendroglia, the regenerative process of axons starts after a short period of axonal lysis.

Animals↗
PubMed1980

Antigenicity and protective effects of type 3 pneumococcal polysaccharide in rats.

The response to type 3 pneumococcal polysaccharide vaccination, the protective effect of type 3 pneumococcal polysaccharide vaccination, and the ability of hemagglutinating antibody to type 3 pneumococcal polysaccharide to cross the blood-brain barrier were studied in rats. Hemagglutinating antibody response to vaccination with type 3 pneumococcal polysaccharide was found to be dependent on the dose and route of inoculation. Intraperitoneal vaccination with type 3 pneumococcal polysaccharide protected the rats from subsequent intraperitoneal challenge with type 3 Streptococcus pneumoniae but had no effect after intracisternal challenge with type 3 S. pneumoniae. In the presence or absence of sterile meningeal inflammation, hemagglutinating antibody could not be found in cerebrospinal fluid of animals vaccinated intraperitoneally with type 3 pneumococcal polysaccharide. These results suggest that type 3 pneumococcal polysaccharide is antigenic in rats and intraperitoneal vaccination with type 3 pneumococcal polysaccharide does not protect against experimental meningitis because antibodies do not cross the blood-brain barrier.

Agglutinins↗
PubMed1980

Antimicrobial activity of heparin.

Single clinical isolates of eight species of microorganisms were incubated in solutions of heparin and brain heart infusion broth at various concentrations to determine the possible antibacterial effect of heparin. At heparin concentrations ranging from 12.5 to 400 U/ml, the effect on Escherichia coli, Pseudomonas aeruginosa, Candida albicans, Staphylococcus aureus, and S. epidermidis varied with brain heart infusion broth concentrations of 1.2 to 10% and inocula of 10(2) to 10(6) colony-forming units per ml; similar effects were not observed with Klebsiella pneumoniae, Enterobacter aerogenes, and Citrobacter spp. The minimal inhibitory concentrations of heparin for ten strains of each species were determined in 2.5% brain heart infusion broth with inocula of 10(4) colony-forming units per ml. All 10 isolates of S. aureus and all 10 of S. epidermidis were inhibited by heparin concentrations of 125 to 500 U/ml. Three E. coli, four P. aeruginosa, and nine C. albicans strains were inhibited by </=500 U of heparin per ml. None of the K. pneumoniae, E. aerogenes, Enterobacter cloacae, and Citrobacter spp. was inhibited by heparin at </=500 U/ml. Heparin inhibition of S. aureus in 2.5% brain heart infusion broth-500 U of heparin per ml could be quantitatively overcome by addition of magnesium, calcium, or magnesium and calcium. These data suggest that the growth of microorganisms from heparin-containing material may be suppressed.

Anti-Bacterial Agents↗
PubMed1980

Misdiagnosis caused by fungal contaminant in a histological stain solution.

Silver stains on tissue and cytology specimens are important in the evaluation of patients with suspected fungal infections. Care must be taken, however, to prevent misinterpretation of contamination artifacts. Two cases presenting such a problem are reported. The first patient had granulomatous leg lesions that microscopically showed characteristics of erythema induratum but with budding yeastlike organisms demonstrated by Grocott methenamine silver stain. Cultures and subsequent biopsies were negative for fungi. The second patient had a steroid-dependent chronic obstructive lung disease, and during evaluation for possible Pneumocystis carinii pneumonia, the Grocott methenamine silver stain on expectorated sputum showed budding yeastlike organisms. Sputum cultures were negative for fungi. Examination of the two Grocott light-green counterstain solutions demonstrated black, budding yeast cells similar to those seen in the specimens from the patients. Culture of the counterstain grew Exophiala (Phialophora) jeanselmei. Further studies revealed that this cause of misdiagnosis could be prevented by either filtering or adding thymol to the counterstain solution. Care regarding contamination of histological stain solutions is emphasized.

Granuloma↗
PubMed1980

Pseudobacteremia caused by Clostridium sordellii.

Thirteen of 280 (4.6%) blood cultures collected over a 12-day period were positive for Clostridium sordellii, a spore-forming anaerobe, rarely considered a human pathogen. Nosocomial bacteremia and intrinsic contamination of material used to culture blood were excluded as the source of the organism. Contaminated tincture of thimerosal used to swab the rubber stoppers of blood culture bottles prior to venting (aerobic) or during blind subculturing after 24 hours of incubation (anaerobic) in the clinical microbiology laboratory was determined to be the cause of the pseudobacteremia. After appropriate safe-guards were implemented, we have continued to use tincture of thimerosal for these procedures with no further growth of C sordellii from blood cultures. The importance of less-conspicuous steps in the routine processing of culture material have been reemphasized.

Blood Specimen Collection↗
PubMed1979

Complications with heparin-lock needles.

The incidence of phlebitis was determined for heparin-lock needles after use of three different methods of skin preparation and follow-up care. Phlebitis was significantly more frequent when iodophor solution and iodophor ointment, respectively, were used than when iodophor solution alone was used for heparin-lock needles in use longer than 48 hours, with more than ten manipulations of the systems, and when only one drug was infused through the systems. Iodophor solution skin preparation followed by daily application of iodophor solution is recommended to minimize the occurrence of associated phlebitis.

1-Propanol↗
PubMed1979

Chemical injury of the spinal cord of the rabbit after intracisternal injection of gentamicin.

A single intracisternal injection of 0.4 ml of 1.25 and 2.5 percent gentamicin sulfate with preservative to healthy adult rabbits caused acute respiratory paralysis and severe seizure activity initially and paralysis of the limbs subsequently. In the white matter of the upper cervical spinal cord, multiple, minute, disseminated, spongy lesions were observed. They consisted of lysis of axis cylinders, edematous dilatation of myelin sheaths, and loss of astroglia and interfascicular oligodendroglia. Axonal end-bulbs formed at the periphery of the lesions. Clinically and morphologically, 0.025 and 0.25 percent gentamicin sulfate solution did not produce myelopathy. The spinal lesions were distributed differently from those of other chemical myelopathies in that they developed in the deeper white matter with sparing of marginal myelinated fibers. Circumscribed high concentrations and gentamicin, and vulnerability of myelinated axis cylinders and interfascicular oligondendroglia to gentamicin may be the main factors causing these lesions. When gentamicin sulfate without preservative was injected, neutrophil leukocyte infiltration occurred actively in the spongy lesions. In the cervical spinal ganglia some nerve cells underwent cytoplasmic vacuolation. In control animals a single intracisternal injection of saline or preservative did not result in the production of these lesions.

Animals↗
PubMed1979

Response to influenza A vaccine among high-risk patients.

In recent years, it has been recommended that "high-risk" patients receive influenza immunizations annually. During the 1976 National Influenza Immunization Program, a higher priority was given to these patients than to the general population. The present study was undertaken to compare the antibody response of high-risk patients with that of a group of individuals with no underlying disease after immunization with 0.5 ml of bivalent, split-virus vaccine containing 200 CCA units each of influenza A/New Jersey/76 and A/Victoria/75. Sera were obtained before and after immunization from 41 "healthy" volunteers and from 57 cariology, 31 hematology, 13 hemodialysis, and 16 renal transplant patients. The control, cardiology, and hemodialysis groups responded equally well to A/Victoria/75 antigen, but the hematology and renal transplant groups did not respond as well (P less than .05). Only the hematology patients responded at a significantly lower level (P less than .05) than the control group to A/New Jersey/76. The control and renal transplant groups had a significantly greater response to A/New Jersey/76 antigen than to A/Victoria/75 antigen (P less than .002). Although the same pattern was demonstrated by the other patient groups, the differences were not significant. Because hematology and renal transplant patients responded relatively poorly to influenza immunization, prophylactic administration of amantadine during influenza outbreaks should be considered in patients with renal function adequate to excrete this drug.

Antibodies, Viral↗
PubMed1979

Corticosteroids as adjunctive therapy for acute bacterial meningitis.

Although anecdotal reports and the results of clinical trials suggest that corticosteroids may be efficacious in the treatment of acute bacterial meningitis, controlled and double-blind studies fail to support this view with the exception that corticosteroids may be of benefit for patients with pneumococcal meningitis. Corticosteroids may also be of benefit to patients with acute bacterial meningitis in the presence of life-threatening complications of increased intracranial pressure, such as coma, seizures, fluctuating blood pressure, or rapidly deteriorating mental status, but results of controlled or double-blind studies to substantiate this have not been reported. The possible advantages gained from the use of corticosteroids must be considered with regard to a significant detrimental effect in patients over 16 years of age.

Acute Disease↗
PubMed1978

Neurotoxicity of intrathecal gentamicin: a case report and experimental study.

Distinctive lesions occurred in the brainstem of a 59-year-old patient who had had recent Pseudomonas aeruginosa meningitis treated with parenteral and intrathecal gentamicin sulfate. The lesions were multiple, minute, and discrete, and were characterized by loss of axons, spongiosis, axonal swelling with frequent calcification, loss of astroglia and oligodendroglia, and slight inflammatory response. These lesions were restricted to the myelinated fiber bundles of the pons and mesencephalon. Because similar lesions can occur with other intrathecally administered medications and emboli to the brain, an experimental study in rabbits was done. Similar lesions were produced in normal adult rabbits after a single intracisternal injection of gentamicin sulfate with or without preservative at doses equivalent to 50 and 100 times the human therapeutic dose. Lesions were not seen after injection of normal saline, preservative, or gentamicin sulfate with preservative at doses equivalent to 1 and 10 times the human therapeutic dose. A direct relationship was observed between the cerebrospinal fluid concentrations of gentamicin, brain tissue concentrations of gentamicin, and occurrence of the lesions.

Animals↗
PubMed1978

Clinical significance of citrobacter isolates.

Little is know about the clinical significance of isolating Citrobacter in the clinical laboratory. During a one-year period, 116 Citrobacter isolates were obtained from 77 patients with 83 suspected infectious episodes. The majority of the suspected infectious episodes involved the urinary tract (45%) or respiratory tract (41%). Citrobacter diversus was associated with 42% of the episodes, Citrobacter freundii with 29%, and Citrobacter species with 29%. In 42% of the suspected infectious episodes, the presence of Citrobacter was considered clinically significant; in the others, the significance of the Citrobacter isolates was indeterminate or considered to be commensal. Two thirds of the significant infections were hospital-acquired. Most patients (73%) from whom Citrobacter was cultured had underlying diseases or factors predisposing to infection. These data suggest that Citrobacter is a cause of significant opportunistic nosocomial infection in the hospital.

Adult↗
PubMed1978

Community-acquired bacteremic Achromobacter xylosoxidans type IIIa pneumonia in a patient with idiopathic IgM deficiency.

A man was hospitalized with bacteremic Achromobacter xylosoxidans type IIIa pneumonia. The authors are aware of no previously reported similar infections caused by this bacterium. A clinical cure was achieved with a combination of carbenicillin and kanamycin therapy. Microtiter susceptibility testing revealed that carbenicillin was the antibiotic to which A. xylosoxidans IIIa was most sensitive (minimal inhibitory concentration, 1.6 microgram/ml) and that synergy between carbenicillin and kanamycin existed. During the patient's hospitalization, deficiency of IgM (21 mg/dl) was found. Specific serum activity against A. xylosoxidans IIIa was detected by the agglutination method. Specific anti-A. xylosoxidans IIIa IgG, but not IgM, was detected by indirect immunofluorescence. It appears that a defect in immunologic recognition of A. xylosoxidans IIIa as an invasive bacterium, a defect in synthesis of specific IgM, or both, contributed to this patient's infection.

Agglutination Tests↗
PubMed1978

Nafcillin-associated granulocytopenia.

Three patients treated with nafcillin developed granulocytopenia. Only three other such cases have been reported. This complication is most likely due to a direct toxic effect on the bone marrow; markers for an immunologically mediated mechanism have not been found. Nafcillin-associated granulocytopenia usually occurs during the third week of therapy and remits spontaneously with prompt cessation of nafcillin administration.

Adolescent↗
PubMed1978

Pharmacological evaluation of cefaclor in volunteers.

The plasma and urine concentrations of cefaclor were measured after oral administration of single and multiple doses to volunteers. Cefaclor was rapidly absorbed, rapidly excreted in the urine, well tolerated without toxicity, and failed to accumulate in the plasma with chronic dosing.

Adult↗
PubMed1978

Zygomycosis of the maxillary sinus and palate caused by Basidiobolus haptosporus.

Basidiobolus haptosporus is known to cause subcutaneous zygomycosis in tropical Africa and Asia. We cared for a 49-year-old hyperglycemic, asplenic man who had never traveled outside the United States and who was seen initially for a painless palatal ulcer with cutaneous hypesthesia of the right cheek and upper lip. An invasive process involved the right middle nasal turbinate, maxillary antrum, maxillary division of the trigeminal nerve, and bony palate. Histological examination of biopsy tissue showed necrotizing granulomata with broad, nonseptate hyphae. Basidiobolus haptosporus was cultured from this tissue. Various laboratory studies revealed no immunologic defect and his lesions responded to therapy with amphotericin B. To our knowledge, this represents the first case of zygomycosis caused by B haptosporus in the Americas and the first culture-documented case of invasive mycosis caused by this mold.

Fungi↗