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Biomedical subjects

I Phillips

Publications and source records attributed to I Phillips.

At least 127 records · Page 7Linked to original sources
PubMed1990

Effect of ibotenic acid lesions of the medial prefrontal cortex on amphetamine-induced locomotion and regional brain catecholamine concentrations in the rat.

To determine the influence of intrinsic medial prefrontal cortex (MPFC) neurons on regional brain catecholamine turnover, dopamine (DA) and its metabolites were assayed in several brain areas 14 and 28 days after bilateral ibotenic acid (IA) lesions of the MPFC in the rat. The locomotor response to D-amphetamine was also assessed. On the 14th postoperative day levels of DA, homovanillic acid concentrations and 3,4-dihydroxyphenylacetic acid were elevated in the anterior striatum of IA-lesioned animals. Spontaneous and amphetamine-induced locomotion were also increased. These changes disappeared by the 28th postoperative day. It is concluded that destruction of the efferents of the MPFC induces transient increases in DA turnover within the medial striatum and transiently increases spontaneous and amphetamine-induced locomotion.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1990

Glutamate receptor changes in brain synaptic membranes from human alcoholics.

Brains from human alcoholics and non-alcoholics were obtained shortly after death. The hippocampus was dissected, homogenized, and processed for the isolation of a synaptic membrane-enriched fraction and the study of L-[3H]glutamic acid and 3-((+-)-2-carboxypiperazin-4-yl)-[1,2(3H)propyl-1-phosphonic acid ([3H]CPP) binding sites. The pharmacological characteristics of L-[3H]glutamic acid binding to synaptic membranes isolated from hippocampus corresponded to the labeling of a mixture of N-methyl-D-aspartate (NMDA), kainate and quisqualic acid receptor sites. Synaptic membranes prepared from the hippocampus of individuals classified as alcoholics had significantly higher density of glutamate binding sites than identically prepared membranes from non-alcoholic individuals. In addition, there was a clear definition of a population of L-glutamate binding sites (approx. 10% of total) in the membranes from alcoholics that had a higher affinity for the ligand than the major set of sites labeled in membranes from both alcoholics and non-alcoholics. Neither the age of the individuals at the time of death nor the time that elapsed between death and processing of brain tissue were significant factors in determining either recovery of purified synaptic membranes from brain homogenates or L-[3H]glutamate binding to synaptic membranes. In order to determine whether some of the changes in L-[3H]glutamic acid binding were due to alterations in binding at the NMDA receptor subtype, we also measured binding of [3H]CPP to extensively washed crude synaptosomal membranes. Membranes from brains of alcoholics had higher affinity (3-fold) for [3H]CPP but lower binding capacity (3-fold) when compared with those of non-alcoholics.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcoholism↗
PubMed1990

Comparative in vitro activity of cefpirome and cefepime, two new cephalosporins.

In in vitro tests the broad-spectrum cephalosporins cefpirome and cefepime were highly active against Enterobacteriaceae, although often less so against strains resistant to amoxicillin-clavulanate and ticarcillin-clavulanate, and against most strains of Acinetobacter spp. and Aeromonas hydrophila. They were also active against Pseudomonas aeruginosa, although strains with non-plasmid mediated beta-lactam resistance were sometimes less sensitive. Other Pseudomonas spp. varied in their sensitivity. Both agents were highly active against Haemophilus influenzae, but beta-lactamase-producing Branhamella catarrhalis were somewhat less sensitive. Neisseria gonorrhoeae were susceptible, although non-beta-lactamase producing penicillin-resistant strains had higher MICs. Gardnerella vaginalis was also susceptible and Campylobacter coli/jejuni usually susceptible. Both antibiotics had good activity against Staphylococcus aureus and coagulase-negative staphylococci except for methicillin-resistant strains and Staphylococcus haemolyticus which were of borderline sensitivity. All streptococci were sensitive, with the exception of highly penicillin-resistant pneumococci and enterococci against which cefpirome had greater activity than cefepime. Both antibiotics had little useful activity against the Bacteroides fragilis group or Bacteroides oralis group but were active against most other anaerobes. Clostridium difficile and some other Clostridium species were resistant.

Anti-Bacterial Agents↗
PubMed1990

A comparison of four culture methods for diagnosing infection in continuous ambulatory peritoneal dialysis.

Dialysate effluent from 41 patients presenting with 54 episodes of CAPD peritonitis was examined by four culture techniques, three employing methods for the lysis of peritoneal leucocytes. The most efficient method employed a distilled water lysis-centrifugation technique (81% of episodes culture-positive). Filtration (without leucocyte lysis) was less effective (74% culture-positive). The results of a mechanical leucocyte lysis technique were less satisfactory still, the culture positive rate of 74% being compromised by the recovery of the infecting organism in low numbers, and by an association with a high incidence of plate contamination. The results of a bile-salt lysis technique were the least satisfactory (67% culture-positive).

Bacteria↗
PubMed1990

Hyperproduction of TEM-1 beta-lactamase in clinical isolates of Escherichia coli serotype O15.

During an outbreak of infection with ampicillin-resistant, TEM-1 beta-lactamase-producing Escherichia coli serotype O15, some strains were noted to differ from the majority in that they showed reduced susceptibility to amoxycillin/clavulanic acid (Augmentin), ureidopenicillins and first generation cephalosporins and produced increased amounts of beta-lactamase. The plasmid from one such isolate was compared with that from an isolate that produced normal amounts of beta-lactamase. Restriction analysis with EcoRI revealed extra fragments in the plasmid from the beta-lactamase hyperproducer and use of DNA-DNA hybridisation with a biotinylated TEM-1 probe showed genetic rearrangement in the beta-lactamase hyperproducer so that the TEM gene appeared to be present in larger amounts and was located on a smaller fragment than for the plasmid from the strain that produced normal amounts of beta-lactamase.

DNA, Bacterial↗
PubMed1990

Importance of organisms producing broad-spectrum SHV-group beta-lactamases into the United Kingdom.

We report the isolation of three strains of Klebsiella pneumoniae sensu lato, brought into the United Kingdom by patients from Greece and Egypt, that showed plasmid-determined resistance to ceftazidime. All three produced beta-lactamases shown by DNA hybridisation studies to belong to the SHV group. One produced an enzyme that appeared to be related to, but distinguishable from, SHV-1; another SHV-2 and the third SHV-5.

Blotting, Southern↗
PubMed1990

Intraperitoneal ciprofloxacin for the treatment of peritonitis in patients receiving continuous ambulatory peritoneal dialysis (CAPD).

Ciprofloxacin was evaluated as single-agent therapy for the empirical treatment of patients presenting with CAPD peritonitis in an open, uncontrolled trial. Seventy-five episodes of peritonitis in 44 patients receiving continuous ambulatory peritoneal dialysis were entered in the study. The antibiotic was administered intraperitoneally, at a dose of 50 mg/l in each bag of dialysate, for seven days. Treatment with ciprofloxacin was appropriate (organisms isolated sensitive to ciprofloxacin) and successful (clinical and bacteriological cure of peritonitis) in 62 (83%) of the 75 episodes. The mean ciprofloxacin concentrations in serum and effluent were 1.1 mg/l (range 0-2.9 mg/l) and 10.0 mg/l (range 0.2-33.4 mg/l), respectively, with no evidence of accumulation. Side effects were seen in two patients only, and were mild and transitory.

Adult↗
PubMed1990

The computerized documentation of septicaemia.

At St Thomas' Hospital for the past 20 years, medical microbiologists have documented all cases of septicaemia, as part of the routine service offered by the department. These records are used in the day-to-day management of patients and have provided much research and teaching material. When the number of paper records became so large that manual extraction of data was impossible we computerized the records. In 1986 information from the paper charts was transferred to a microcomputer, and since the beginning of 1988 the details of each new case have been added to this computer file at the end of the septicaemic episode. At present, collection of data during the course of a patient's illness continues on paper, but it is hoped that in future this process will also be computerized. Apart from our own data, little computerized information is to be found on patients or the treatment they receive, both within our hospital and nationally. The present system can be viewed as a prototype for other groups of patients.

Hospital Information Systems↗
PubMed1990

The causative organisms of septicaemia and their epidemiology.

During the 20 years, 1969-88, nearly 4000 episodes of septicaemia were studied prospectively at St. Thomas' Hospital. Forty percent were community-acquired and 60% hospital-acquired. Overall the commonest isolate was Escherichia coli (22%). In community-acquired bacteraemias, Esch. coli, Streptococcus pneumoniae and Staphylococcus aureus accounted for almost 60% of episodes, and the commonest foci of infection were the urinary tract (Esch. coli) and the respiratory tract (Str. pneumoniae). Esch. coli was particularly common in diabetic patients and Str. pneumoniae in alcoholics. In hospital-acquired septicaemia, Esch. coli and Staph. aureus accounted for 40% of episodes, but a further 30% were caused by enterobacteria other than Esch. coli, and Pseudomonas aeruginosa. The commonest foci of infection were the urinary tract, often with catheterization or instrumentation, and intravascular access sites, from which episodes of septicaemia were increasingly caused by coagulase-negative staphylococci.

Adolescent↗
PubMed1990

The antibiotic sensitivity of bacteria isolated from the blood of patients in St Thomas' Hospital, 1969-1988.

We have monitored the antibiotic sensitivity of bloodstream isolates of common bacteria over a period of 20 years. Among the Gram-positive bacteria, the proportion of isolates of Staphylococcus aureus resistant to methicillin, erythromycin, fusidate, or gentamicin has increased marginally, while that of coagulase-negative staphylococci (mostly Staph. epidermidis) has increased markedly. Enterococci are becoming serially more resistant to high concentrations of aminoglycosides. The Enterobacteriaceae have become considerably less sensitive to ampicillin (and amoxycillin) and trimethoprim but more sensitive to the aminoglycosides, whilst their susceptibility to cefotaxime, ceftazidime, cefepime, cefpirome, imipenem, meropenem and temocillin has remained constant. We have some evidence that in-vitro resistance is clinically relevant since the mortality rate rises if inappropriate antibiotics are used empirically. Although many drug regimens could be used, we are able to recommend initial therapy with a combination of gentamicin and cefuroxime for most of our patients, the exceptions being those known to be infected with resistant organisms before the onset of septicaemia.

Coagulase↗
PubMed1990

Diversity of staphylococci exhibiting high-level resistance to mupirocin.

Plasmids mediating high-level resistance to mupirocin (MIC greater than 1000 mg/L) in staphylococci from various sources were studied by restriction endonuclease cleavage. Several patterns were obtained but six plasmids isolated from various Staphylococcus aureus and S. epidermidis strains were indistinguishable. The diversity and spread of these plasmids is illustrated.

Coagulase↗
PubMed1990

Evaluation of fine needle aspiration of the male breast for the diagnosis of gynaecomastia.

Fine needle aspiration of the male breast can present problems of diagnosis because the cytological presentation of gynaecomastia can be confused with that of adenocarcinoma. We reviewed breast aspirates from 24 male patients in order to determine the accuracy of cytology as a method of diagnosing gynaecomastia. Discrepancies were observed between the original cytology reports on one hand and the review cytology and biopsies on the other. Of the 24 aspirates from the male breast, the cytology was reported as negative in 16 cases, suspicious in three cases and malignant in five. In four cases of the negative group, a specific diagnosis of gynaecomastia was made. In two of the negative cases the subsequent biopsies revealed adenocarcinoma. Of the five cases reported on the original cytology as adenocarcinoma, two on review showed the features of florid gynaecomastia and this was confirmed on biopsy and three confirmed the initial diagnosis of adenocarcinoma. The cytological features of gynaecomastia which distinguish it from adenocarcinoma are discussed.

Adenocarcinoma↗