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Biomedical subjects

J B Selkon

Publications and source records attributed to J B Selkon.

At least 37 records · Page 2Linked to original sources
PubMed1987

Prospective randomized controlled trial of urethral versus suprapubic catheterization.

Sixty-six patients requiring catheterization in the course of general surgical operations were randomly allocated into two groups. Of the 34 patients catheterized urethrally 16 developed urinary tract infections whereas of the 32 suprapubically catheterized patients only 2 developed an infection (P less than 0.001). Five patients required recatheterization after removal of their urethral catheters. There were no major complications associated with the use of suprapubic catheters. We propose that, when catheterization is required during a general surgical procedure, the suprapubic route is to be preferred.

Catheters, Indwelling↗
PubMed1987

Comparison of culture media for detecting methicillin resistance in Staphylococcus aureus and coagulase negative staphylococci.

The detection of methicillin resistance was examined in 51 strains of Staphylococcus aureus and 135 strains of coagulase negative staphylococci using Isosensitest, Diagnostic Sensitivity Test (DST), Mueller-Hinton (MH), Columbia, and Sensitest agars. MH agar with 5% added sodium chloride incubated at 35 degrees C was the most effective in detecting resistance in S aureus, and Columbia agar with 5% added sodium chloride incubated at 35 degrees C was most effective for coagulase negative staphylococci. For clinical purposes, a provisional report of sensitivity for S aureus could be issued after 18 hours; with coagulase negative staphylococci, only resistant strains could be reported at this time. For definitive results cultures must be examined after 40 hours of incubation.

Coagulase↗
PubMed1984

The effect of covert bacteriuria in schoolgirls on renal function at 18 years and during pregnancy.

Schoolgirls shown to have covert bacteriuria (CB) by a screening programme and followed up for 5 years to assess whether chemotherapy had any beneficial effect, underwent a further assessment of renal function at the age of 18 years and during subsequent pregnancies. At age 18, glomerular filtration rate (GFR) and urine concentrating ability were the same as in controls, but fractional reabsorption of glucose was significantly reduced in those who had previously been prescribed chemotherapy because of renal scarring or who had been randomly allocated not to receive prophylactic chemotherapy. Those who had had CB as schoolgirls had a higher frequency of CB in pregnancy than did controls, whether or not prophylactic chemotherapy had been given to the subjects when they were schoolgirls. Furthermore, compared with girls who had had such treatment, untreated patients had smaller increments in GFR, reduced fractional reabsorption of glucose, and more than usual degree of glycosuria during pregnancy. This suggests that subclinical renal damage may be prevented by prophylactic chemotherapy but this advantage is unmasked only by the physiological demands of pregnancy.

Adolescent↗
PubMed1983

An open study of the use of ceftazidime in Gram-negative infections.

An open study of the use of ceftazidime in patients with Gram-negative infections was undertaken in a district general hospital. Ceftazidime was used in three groups of patients: 17 adults with infections due to Pseudomonas sp. or multi-resistant enterobacteria, three children with cystic fibrosis who had chest infections, and two premature neonates with severe pseudomonal pneumonia. The infections in the adult group included respiratory tract (6), urinary tract (4), wound infection (3), abdominal sepsis (2), osteomyelitis and panophthalmitis. In this group, ceftazidime was given as 1-2 g tid intravenously. In three patients, gentamicin was used concurrently and in four metronidazole was added. 76% of the adult group achieved complete clinical cure, all three cystic fibrosis cases improved markedly, and the two neonates showed complete resolution of the pneumonia. No adverse biochemical or haematological side effects occurred, although one patient developed an urticarial skin rash on the last day of a ten-day treatment course which resolved after discontinuing the ceftazidime.

Adult↗
PubMed1983

Characteristics of motile curved rods in vaginal secretions.

Motile curved rods seen in vaginal secretions have been isolated on Columbia agar supplemented with 5% human blood and vitamin K. Growth occurred anaerobically and in 5% oxygen but not in more aerobic conditions. There were two distinct groups of these organisms, distinguishable by morphology, biochemical activity and susceptibility to metronidazole. All isolates were sensitive to a wide range of antimicrobial agents, with the exception of nalidixic acid and polymyxin, but one group was resistant to metronidazole. There was little difference between the results of tests of susceptibility to aminoglycosides or to metronidazole performed in anaerobic and microaerophilic conditions. Motile curved rods were isolated from 18 of 80 patients with a clinical diagnosis of non-specific vaginitis, but from only two of 39 without the disease.

Anti-Bacterial Agents↗
PubMed1982

Evaluation of the role of the Treponema pallidum immobilisation test in Britain.

After specimens of sera from 100000 patients had been screened by a reagin and Treponema pallidum haemagglutination assay (TPHA) 2.7% required further examination. The fluorescent treponemal antibody-absorption (FTA-ABS) test confirmed either a negative or positive TPHA result in 95% of the samples, so that no further investigations were required. This accounted for 99% of the specimens submitted to the laboratory. Repeat tests on a further sample resolved many of the remaining discrepancies. Only 0.05% of patients, in whom repeat tests confirmed a positive TPHA but a negative FTA-ABS result, benefited from a TPI test.

Fluorescent Antibody Technique↗
PubMed1981

Phagocytosis and killing of bacteria in aerobic and anaerobic conditions.

Phagocytosis and intracellular killing of several facultative anaerobes were observed in aerobic and anaerobic conditions. The presence of anaerobes affected these processes. Bacteroides asaccharolyticus and B. fragilis were killed by phagocytes only at bacterial concentrations less than 1 x 10(7) cfu/ml; at higher concentrations of the anaerobes, killing of B. fragilis and concomitant facultative anaerobes was inhibited. This effect appeared to be due to an interaction, in appropriate reducing conditions, between anaerobe and serum, which allowed engulfment of organisms by phagocytes but markedly impaired intracellular killing.

Aerobiosis↗
PubMed1981

Fifteen-year review of the mortality of brain abscess.

Ninety consecutive cases of brain abscess admitted to this center between 1964 and 1978 have been reviewed. The overall mortality has fallen in three consecutive 5-year periods from 42 to 21 to 9.7%. A number of factors seem to be responsible for this. Early surgical intervention was associated with the reduction in mortality between the first and second 5-year periods. Recognition of the significance and extent of cerebral edema, confirmed since computed tomographic (CT) scans have been available, led to a greater use of steroids during the last 5-year period, but the number of patients thus treated was too small to permit an assessment of any effect on mortality. There is no evidence to suggest a change in the natural history of the disease, and surgical management has not altered significantly. Experience with CT scanning in this center in the diagnosis of brain abscess is limited. It is therefore not possible no assess whether any improvement in mortality may have arisen from the early and accurate diagnosis obtainable with this technique. Improvement in culture technique has been of major importance, leading to a better understanding of the bacteriology of brain abscesses. This has allowed a more rational antibiotic program to be instituted, in particular the use of agents active against obligate anaerobes.

Anti-Bacterial Agents↗
PubMed1981

The need for and choice of chemotherapy for anaerobic infections.

The Clostridia remain a frequent cause of anerobic infections and they also remain fully sensitive to benzylpenicillin, which continues to be the antibiotic of choice in their treatment. Penicillin is also the first choice for the treatment of dental and pulmonary infections due to anaerobic bacteria. However, currently the anerobic pathogen most frequently encountered in infections related to the gastro-intestinal and genital tracts is Bacteroides fragilis, an organism which produces beta-lactamase active against both the penicillins and cephalosporins. The antibiotics available for the treatment of B. fragilis infections are the tetracyclines, chloramphenicol, clindamycin, metronidazole and cefoxitin. Since at least 30% of strains of B. fragilis are now resistant to tetracycline and in view of the serious potential toxicity of chloramphenicol, the choice of agent thus lies with the latter three antimicrobial agents. If the in vitro activity of these agents is considered in relation to their pharmacodynamics, it is clear that only clindamycin and metronidazole can be expected to be effective in over 90% of infections with B. fragilis. Studies of the bactericidal activity of these agents against B fragilis have shown a kill of greater than 10(7) in 6 hours in metronidazole, of 10(5) to 10(6) in 30 hours in clindamycin and of 10(2) in 24 hours with cefoxitin.

Anaerobiosis↗