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Biomedical subjects

I Brook

Publications and source records attributed to I Brook.

At least 379 records · Page 21Linked to original sources
PubMed1981

Measurement of lactate in ascitic fluid: an aid in the diagnosis of peritonitis with particular relevance to spontaneous bacterial peritonitis of the cirrhotic.

Lactate concentrations were measured in the ascitic fluid of patients using the Monotest Lactate Kit, an inexpensive, reliable bedside test that gives results within 15 min. The values were significantly higher in 24 patients with proven bacterial peritonitis, eight of them with spontaneous bacterial peritonitis, than in 53 patients with uninfected ascites of various other etiologies. In only two patients from the latter group, both with hepatic carcinoma and peritoneal metastases, were the values in the range found in bacterial peritonitis. Lactate determination was at least as sensitive as measurement of WBC levels for diagnosing peritonitis. Serial determinations in two patients with peritonitis showed declining values as the disease responded to treatment. The test has particular relevance for patients with spontaneous bacterial peritonitis, because this disease, which is potentially life-threatening although frequently asymptomatic, requires immediate treatment, yet currently depends on time-consuming culture procedures for diagnosis.

Adolescent↗
PubMed1981

Lactic acid in urine of children with lower and upper urinary tract infection and renal obstruction.

Preliminary evidence suggests that the concentration of lactic acid in urine may be a good means of distinguishing lower urinary tract infection (cystitis) from upper urinary tract infection (pyelonephritis) and may be helpful in detecting urinary tract obstruction. To test this hypothesis the lactic acid concentrations in 291 urine samples from 250 children were tested. Sixty-four patients had no bacterial infection and served as the control group. A second group (153 patients) had cystitis, and the third group (24 patients) showed radiologic, clinical, and laboratory evidence of pyelonephritis. A fourth group of nine patients who had prolonged urinary tract retention was also analyzed. Patients in the control group, as well as those with cystitis, showed relatively; low concentrations of urinary lactic acid. All levels were less than 2 mg/dl; (mean, 0.8 mg/dl; range, 0.1-2 mg/dl). Patients who had clinical pyelonephritis had lactic acid concentrations of 3.3 mg/dl (mean, 11.4 mg/dl; range, 3.3 mg/dl-40.5 mg/dl). There was no overlap in lactic acid concentrations between the two groups. Furthermore, lactic acid concentrations in urine from patients who had pyelonephritis gradually declined after the initiation of therapy, attaining a level of less than 1 mg/dl by the end of the treatment. Recurrence of the pyelonephritis was consistently documented by a renewed increase of urinary lactic acid concentration. Lactic acid levels were also elevated in urine samples collected immediately after relief of obstruction in the nine patients who had urethral obstructions, showing a mean concentration of 15.8 mg/dl (range, 4.2-37.2 mg/dl).

Adolescent↗
PubMed1981

Aerobic and anaerobic bacterial flora of burns in children.

Aerobic and anaerobic bacterial flora of burn sites in 180 children were monitored. Specimens were obtained twice a week; each patient had between one and 21 cultures taken (mean 2.4). A total of 392 specimens were collected over 2 years, of which 319 were positive. Aerobic bacteria alone were present in 225 specimens (71%) and anaerobic bacteria alone were present in 26 (8%). Mixed aerobic and anaerobic bacteria were present in 68 burn specimens (21%). A total of 580 isolates (448 aerobes and 132 anaerobes) were recovered, accounting for 1.8 isolates per specimen (1.4 aerobes and 0.4 anaerobes). The predominant aerobic isolates were S. epidermidis, S. aureus, alpha hemolytic streptococcus, Pseudomonas sp., and Group D streptococcus. The predominant anaerobic isolates were: P. acnes, anaerobic Gram-positive cocci, and Bacteroides sp. Blood cultures were drawn from 45 children: four showed bacterial growth of one of each of the following isolates: S. aureus, E. coli, Peptococcus asaccharolyticus, and B. fragilis. The numbers of isolates per specimen were higher in the oral and anal area (3.2 and 2.8) than in the extremities and trunk (1.8 and 0.9). Gram-negative enteric rods and Group D streptococci were more frequently recovered from the anal area. S. aureus, S. epidermidis, and P. acnes were more frequently recovered from extremities. Bacteroides sp. and Fusobacterium nucleatum were more frequently recovered from the anal and oral areas. All children were treated with local application of silver sulfadiazine, and antimicrobial therapy was used in 128 children. Statistical analysis showed no correlation between the bacteria isolated and use of antimicrobial agents. These data suggest a role for anaerobic bacteria in the colonization of burns in children, especially in burns of the anal and oral areas.

Adolescent↗
PubMed1981

Bilateral peritonsillar abscess: an unusual presentation.

Bilateral peritonsillar abscess is uncommon. We have described a patient in whom it was misdiagnosed as bilateral hypertrophy of the tonsils. Direct palpation of the tonsils, which helped in the diagnosis in our patient, should be done routinely in patients with suspected peritonsillar abscess.

Child↗
PubMed1981

Ultrasonography in the diagnosis of cervical incompetence in pregnancy-a new diagnostic approach.

Ultrasonography was used to measure the width of the internal os in 24 patients, for whom a McDonald operation was planned because they were considered to have cervical incompetence and in 19 women with normal obstetric histories. The mean widths of the internal os were 2.57 cm +/- 0.36 and 1.67 cm +/- 0.23, respectively (p less than 0.001). This new and objective procedure, which is used during pregnancy, provides an additional method for the diagnosis of cervical incompetence.

Cervix Uteri↗
PubMed1981

Aerobic and anaerobic bacteriology of peritonsillar abscess in children.

Aspiration of peritonsillar abscess (quinsy) was aseptically performed in 16 children. Patients' median age was 10 years (range 6 to 17 years), and 12 were males. Unilateral abscess was present in all but one child. All aspirates were cultured for aerobes and anaerobes and yielded bacterial growth in all patients. Anaerobes were isolated in all patients; in 3 patients (19%), they were the only organism isolated, and in 13 (81%), they were mixed with aerobes. There were 91 anaerobic isolates (5.7 per specimen): 42 Bacteroides sp. (including 23 B. melaninogenicus, 5 B. oralis and 4 B. ruminicola ss. brevis); 18 anaerobic Gram-positive cocci (including 10 Peptostreptococcus sp., 4 Peptococcus sp. and 4 microaerophilic streptococci); 15 Fusobacterium sp.; and 3 Clostridium sp. There were 32 aerobic isolates (2.0 per specimen): 11 gamma-hemolytic streptococci, 8 alpha-hemolytic streptococci, 4 Group A beta-hemolytic streptococci, 4 Haemophilus sp. and 3 S. aureus. Beta-lactamase production was noted in 13 isolates recovered from 11 patients (68%). These were all isolates of S. aureus (3), 8 of 23 B. melaninogenicus (35%), and 2 of 5 B. oralis (40%). Our findings indicate the major role of anaerobic organisms in the polymicrobial etiology of peritonsillar abscesses in children, and demonstrate the presence of many beta-lactamase-producing organisms in two thirds of the patients.

Adolescent↗
PubMed1981

Quantitative nephelometric determination of Haemophilus influenzae antigen in body fluids.

Nephelometry, an immunological technique widely used for the quantification of blood proteins, was adapted to provide a quantitative method of detecting Haemophilus influenzae capsular antigen in body fluids. Using specific antiserum directed against H. influenzae capsular antigen, samples of serum, cerebrospinal fluid, urine, and joint fluid from 38 cases of H. influenzae infections were analyzed. The results were compared for reliability to counterimmunoelectrophoresis, a widely used diagnostic tool. The nephelometric technique has the same advantages of speed and specificity as counterimmunoelectrophoresis and provides the clinician and researcher with a quantitative method that is as reliable as the qualitative counterimmunoelectrophoresis procedure. The method allowed directly quantitative readouts on patient specimens, with no necessity for serial dilutions or densitometric readings.

Antigens, Bacterial↗
PubMed1981

The treatment of the carrier state of group A beta-hemolytic streptococci with clindamycin.

20 children who were chronic carriers of group A beta-hemolytic streptococci (GABHS) were treated with oral clindamycin. Surface tonsillar cultures were obtained prior to therapy and 2 weeks after termination of therapy. They were processed for aerobic and anaerobic microorganisms. Mixed aerobic and anaerobic flora were obtained from all cultures. Prior to therapy, the average yield was 9 isolates (5 aerobes and 4.1 anaerobes) per specimen; after completion of therapy, the average yield was 5.7 isolates (3 aerobes and 2.7 anaerobes). GABHS, Staphylococcus aureus, Bacteroides fragilis, and Bacteroides oralis were completely eliminated after clindamycin therapy and the number of isolates of Bacteroides melaninogenicus and Fusobacterium sp. was reduced. Beta lactamase production was detected prior to therapy in 21 isolates recovered from 16 tonsillar surfaces (80%). These included all isolates of S. aureus (8) and B. fragilis (2), 8 of 18 B. melaninogenicus (44%), and 3 of 5 B. oralis (60%). Only one isolate of beta-lactamase-producing strain of B. melaninogenicus was recovered after conclusion of therapy. Follow-up of the patients for 18 - 24 months (average 22 months) showed no recurrence of GABHS in 19 of the 20 children.

Aerobiosis↗
PubMed1981

Aspiration pneumonia in institutionalized children. A retrospective comparison of treatment with penicillin G, clindamycin and carbenicillin.

The antibiotic therapy of aspiration pneumonia was retrospectively reviewed in 74 institutionalized children with lung abscess (10), necrotizing pneumonia (12), and pneumonitis (52). Anaerobic bacteria were isolated in 69 patients (93%); and in 67 (90.5%), they were mixed with aerobic bacteria. Penicillin G was given to 20 patients, clindamycin to 20, and carbenicillin to 34. Gentamicin was concurrently given to 35 of the patients. The mean duration of therapy in the three types of pulmonary infection was: lung abscess 30.2 days, necrotizing pneumonia 26.6 days, and pneumonitis 15.1 days. The mean duration of fever after initiation of therapy was 5.8 days, 8.1 days, and 3.4 days, respectively. The mean time for radiologic clearance was 35.6 days for lung abscess, 39.2 days for necrotizing pneumonia, and 13.5 days for pneumonitis. The three antibiotics were equally effective in all patients, including those from whom Bacteroides fragilis was recovered.

Bacteroides fragilis↗
PubMed1981

Aerobic and anaerobic bacteriology of cholesteatoma.

Cholesteatoma specimens were obtained from 28 patients undergoing surgery for chronic otitis media and cholesteatoma. All specimens were cultured for aerobic and anaerobic organisms. Bacterial growth was present in specimens of 24 of the 28 patients. A total of 74 bacterial isolates were present (40 aerobes and 34 anaerobes). Aerobes alone were isolated from 8 (33%) of culture positive patients, 4 patients (26.7%) yielded only anaerobes, and 12 (50%) had both aerobic and anaerobic bacteria. Fifty isolates (27 aerobes and 23 aerobes) were present in a concentration greater than 10(6) CFU/gm. The most commonly isolated aerobic organisms were P. aeruginosa (9), Proteus sp. (7), K. pneumoniae (5), S. aureus (5), and E. coli (4). The anaerobic bacteria most commonly isolated were gram-positive anaerobic cocci (12), Bacteroides sp. (12, including 5 B. fragilis group), Clostridium sp. (3), and Bifidobacterium sp. (3). The above findings indicate the polymicrobial aerobic and anaerobic bacteriology of cholesteatoma.

Adolescent↗
PubMed1981

Bacteriology and treatment of gram-negative pneumonia in long-term hospitalized children.

Gram-negative bacillary pneumonia was diagnosed in 39 longterm hospitalized children, ranging in age from 4 months to 14 years (mean seven years). Fifteen had pneumonitis, 18 necrotizing pneumonia, and six lung abscess. An associated empyema was noted in six cases. Specimens for culture were obtained through percutaneous transtracheal aspiration. Five microorganisms were the predominant isolates: P aeruginosa (13 instances), K pneumoniae (11), E coli (7), S marcescens (6), and P mirabilis (2). There were 112 aerobic and 25 anaerobic isolates recovered from the 39 patients, accounting for 3.5 isolates per specimen. Other aerobic and or anaerobic organisms were mixed with the Gram-negative bacilli in half the patients. All patients were treated with gentamicin for 10 to 26 days (average 19.5 days), and all were cured. In 12 patients in whom other organisms resistant to gentamicin were also present, other antimicrobial agents were concomitantly administered.

Adolescent↗