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Biomedical subjects

G R Monif

Publications and source records attributed to G R Monif.

At least 55 records · Page 3Linked to original sources
PubMed1982

Clinical staging of acute bacterial salpingitis and its therapeutic ramifications.

The use of single-drug therapy results in an overall 13% to 17% failure rate, and even this figure is misleading, because of the high prevalence of patients with uncomplicated disease. In patients with polymicrobial peritonitis, the failure rate varies between 30% and 60%, depending upon whether Neisseria gonorrhoeae can be concomitantly isolated from the cul-de-sac and the criteria used to define therapeutic cure. THe complexity of disease as we now understand it requires a corresponding degree of therapeutic individualization. In the Gainesville staging, acute salpingitis is subdivided into five stages. Stage I is acute endometritis-salpingitis without peritonitis. Stage II is salpingitis with peritonitis. Stage III is acute salpingitis with superimposed tubal occlusion or tuboovarian complex. Stage IV is where a tuboovarian abscess has ruptured. Stage V is a repository category for different etiologic agents which may emulate acute salpingitis, i.e., Mycobacterium tuberculosis. Each stage of disease differs by virtue of its therapeutic goal and the means by which this goal is achieved.

Abscess↗
PubMed1982

Impact of diverging anaerobic technology on cul-de-sac isolates from patients with endometritis-salpingitis-peritonitis.

The probability of obtaining accurate identification of bacteria present in the cul-de-sac in cases of polymicrobial bacterial endometritis-salpingitis-peritonitis (ESP) was analyzed on the basis of a comparison of bacteriologic data derived from the hospital laboratory and those engendered by a research anaerobic laboratory. Two sets of paired cul-de-sac specimens from 20 cases of ESP were analyzed at two different laboratories whose anaerobic technology differed from that of the reference laboratory. At University Hospital (Jacksonville, Florida), 22 of 36 (61%) aerobic bacterial isolates were correctly identified, in contrast to only eight of 52 (15.4%) anaerobic isolates. The clinical facility of the University of Florida College of Medicine (Gainesville, Florida) identified 28 of 32 (86.5%) aerobic and 16 of 34 (47.9%) anaerobic isolates. The probability of accurately delineating the anaerobic bacteria present in polymicrobial peritonitis which may develop in patients with acute salpingitis was directly related to the degree of sophistication in anaerobiology. Since most institutions cannot provide sophisticated anaerobiology, the authors contend that therapy cannot be contingent upon microbiologic data and that the clinician must rely primarily on clinical and biophysical parameters to monitor the effectiveness of therapy.

Anaerobiosis↗
PubMed1982

Pragmatic factors influencing the detection of Neisseria gonorrhoeae.

The effects of the suboptimal temperature caused by delayed incubation or prolonged transport on the recovery of Neisseria gonorrhoeae were studied in 2 separate patient populations. The individual components of the John E. Martin Biological Environmental Chamber were used to define more precisely other variables that might influence the incidence of recovery. In a study of 1500 urethral and endocervical specimens processed in parallel for N gonorrhoeae, results quantitatively and qualitatively superior were achieved when an immediate source of CO2 and a zip-lock bag were used. The zip-lock bag appears to be a significant factor in the enhanced demonstration of N gonorrhoeae. Failure to incubate specimens before transportation decreased the numeric representation of N gonorrhoeae in 50 sets of triple cultures studied in parallel. Most low-inoculum cultures subjected to prolonged transportation without prior incubation will not demonstrate the presence of N gonorrhoeae. Even if preincubated before transportation, the cultures demonstrate a significant reduction in the number of colony-forming units per plate when subjected to normal room temperature during the course of transportation.

Bacteriological Techniques↗
PubMed1982

Association of Enterobacteriaceae septicemia in the immediate postpartum period and asymptomatic bacteriuria.

In an 8-year period, 16 cases of parturitional septicemia due to the Enterobacteriaceae in the immediate postpartum period were identified that were not due to pyelonephritis. Fourteen of the 16 patients had more than 100,000 colonies per milliliter of urine of the same member of the Enterobacteriaceae as was present in the blood. Twelve of the 16 patients had concomitant endometrial cultures. In 11 patients the same isolate was recovered from urine and endometrium as had been recovered from the intravascular compartment. The data suggest an etiologic relationship between asymptomatic bacteriuria and septicemia due to the Enterobacteriaceae in which the maternal implantation site affords the principal portal of infection.

Bacteriuria↗
PubMed1981

Antibiotic therapy for the Bacteroidaceae in post-cesarean section infections.

One hundred patients were treated for postpartum endometritis with ampicillin and clindamycin. Fifty patients were analyzed retrospectively and 50 prospectively for therapeutic response and development of late infectious sequelae. Seventy-eight patients exhibited an acceptable clinical response. One patient developed a wound infection from Staphylococcus aureus, which responded to drainage. The remaining 21 patients responded to the addition of an aminoglycoside. No patient developed a pelvic abscess or septic thrombophlebitis. The therapeutic response of the 2 groups treated with ampicillin and clindamycin is contrasted with the results derived from the traditional antibiotic regimen of a penicillin and an aminoglycoside.

Ampicillin↗
PubMed1980

Quantitative and qualitative effects of povidone-iodine liquid and gel on the aerobic and anaerobic flora of the female genital tract.

Povidone-iodine solution (Betadine Solution) produces a dramatic fall in the numbers of total aerobes and anaerobes recoverable from the posterior vaginal pool in the first 10 minutes following administration. Within 30 to 120 minutes, near baseline counts for both aerobic and anaerobic bacteria are re-established. When the vehicle for the povidone-iodine is changed to polyethylene glycol (Betadine Vaginal Gel) an effective antibacterial effect can be documented over a 3 hour period.

Adult↗
PubMed1980

Significance of polymicrobial bacterial superinfection in the therapy of gonococcal endometritis-salpingitis-peritonitis.

The application of sophisticated anaerobic technology coupled with culdocentesis has radically altered out concepts of endometritis-salpingitis-peritonitis (ESP). The demonstration of a polymicrobial predominantly anaerobic peritonitis in selected cases of ESP polarized conceptual thought into gonococcal and nongonococcal etiology. The data that substantiated the concept of anaerobic infection following initial infection by Neisseria gonorrhoeae are reviewed. Therapy studies utilizing doxycycline have indicated that there is an anticipated therapeutic response when dealing with monoetiologic disease (gonococcal ES or gonococcal ESP). When polymicrobial infection ensues with or without the concomitant presence of N gonorrhoeae, an alternate therapeutic response may evolve. It is currently postulated that the significance of an altered therapeutic response is due to augmented structural damage to the fallopian tubes by superinfecting anaerobes. The current goal of therapy is to reproduce as closely as possible the anticipated therapeutic response observed with monoetiologic disease.

Bacterial Infections↗
PubMed1979

Living cytology--revisited. In vitro demonstration of intraabdominal adenocarcinomatosis.

An in vitro culture technique, "living cytology", was used in a single-blind study to study 36 paracentesis and 7 intracystic fluid specimens for possible adenocarcinomatosis. Islets of epithelial cells were demonstrated only in the 20 patients who were ultimately shown to have intraabdominal adenocarcinomatosis. Ten patients with nonmalignant conditions and 6 patients with nonmetastatic malignancies did not exhibit a comparable pattern. One of the 7 intracystic fluid specimens grew out epithelial islets similar to those observed in patients with intraabdominal adenocarcinomatosis.

Abdominal Neoplasms↗
PubMed1979

The significance of temperature during the first 24 hours postpartum.

One thousand gravidas were prospectively monitored for the development of a temperature greater than or equal to 38 C during the first 24 hours postpartum. Fever occurred in 6.5% of patients. Of the 858 gravidas who had vaginal deliveries, 33 had temperature elevations. Only 7 required antibiotics. Of the 142 patients undergoing cesarean section, 32 patients exhibited 1 or more temperature elevations of greater than or equal to C. Of these 32 patients, 23 required antibiotics. Thirteen of the 14 patients with a recorded temperature of greater than 38.4 C required antibiotics. Eighteen of the 22 patients who underwent cesarean section and had 2 consecutive temperatures of greater than or equal to 38 C (taken 4--6 hours apart) required antibiotics.

Anti-Bacterial Agents↗
PubMed1979

The role of ultrasonography in the management of endometritis/salpingitis/peritonitis.

Ultrasonography has been used as an adjunct in managing pelvic infections when culdocentesis is contraindicated. Twenty-three of 42 women presenting with endometritis/salpingitis/peritonitis (ESP) had ultrasonographic masses. The erythrocyte sedimentation rate (ESR), white blood cell count (WBC), and the highest temperature in the first 24 hours failed to distinguish those with sonographic masses from 19 patients without pelvic masses. The clinical parameter that tended to distinguish patients with masses versus no masses occurred in individuals who had an IUD at the time of admission. If a patient had an ESR greater than 65 mm/hr and an IUD, sonography demonstrated a mass in 71.4% of the cases. The clinical response to multidrug therapy (bactericidal-bacteriostatic, bactericidal-bactericidal, and triple-drug therapy) were comparable in the patient populations with or without a sonographic mass. Sonography is of little use in the acute phase of ESP. It is best reserved for those patients who do not respond to adequate antibiotic therapy and for the serial evaluation of a large tubo-ovarian complex when conservative management is indicated.

Anti-Bacterial Agents↗
PubMed1978

Susceptibility of the anaerobic bacteria, group D streptococci, Enterobacteriaceae, and Pseudomonas to semisynthetic penicillins: carbenicillin, piperacillin, and ticarcillin.

Sodium piperacillin T-1220, a new semisynthetic penicillin, was tested in vitro against 297 clinical isolates of anaerobic bacteria and 669 aerobic bacteria by the conventional agar dilution method and compared with carbenicillin and ticarcillin. At a 100-mug/ml concentration the three drugs showed comparable effectiveness against the anaerobes tested. However, at 20 mug/ml, piperacillin was the most effective drug against Bacteroides fragilis, peptostreptococci, and group D streptococci. At this drug concentration only 48% of the B. fragilis strains exhibited susceptibility to carbenicillin only, 64% exhibited susceptibility to ticarcillin but 90% exhibited susceptibility to piperacillin. Similar findings were observed with peptostreptococci and group D streptococci. On a weight basis piperacillin was statistically shown to be the most effective antibiotic of the three tested against these anaerobes. At 20 mug/ml, piperacillin exhibited a statistically significant difference (P < 0.01) over carbenicillin and ticarcillin for Serratia marcescens, Escherichia coli, Klebsiella species, Klebsiella pneumoniae, Pseudomonas isolates, and Citrobacter diversus. At both 20- and 100-mug/ml concentrations, piperacillin appeared to be the most effective (calculated P < 0.01) upon Klebsiella species, K. pneumoniae, S. marcescens, and C. freundii in activity over ticarcillin and carbenicillin.

Aerobiosis↗
PubMed1978

Progressive necrotizing wound infections in postirradiated patients.

Five cases of postoperative progressive gangrenous wound infection are described in patients who had received whole pelvis irradiation prior to surgery for genital tract cancer. The syndrome described as distinct from Meleney Type I and II ulcers. Predicated on the experience derived, a scheme for its management is proposed.

Adult↗