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Biomedical subjects

J J Klimek

Publications and source records attributed to J J Klimek.

At least 37 records · Page 2Linked to original sources
PubMed1983

Aggregation, release and desensitization induced in platelets from five species by platelet activating factor (PAF).

PAF-induced aggregation and dense granule release (ATP release) were investigated in human, primate, guinea pig, rabbit and rat platelet-rich plasma (PRP). Guinea pig PRP was most sensitive to PAF, followed by rabbit and then human. PRP from rats and primates did not aggregate or release when exposed to PAF. In guinea pig and rabbit PRP, release was independent of aggregatory response. In human PRP high doses of PAF (5 X 10(-7) M) caused maximum aggregation and a biphasic ATP release, whilst lower concentrations (3 X 10(-8) M) induced biphasic aggregation and one phase of ATP release concomitant with the second phase of aggregation. Aggregation and ATP release induced by PAF in guinea pig and rabbit PRP is dependent upon Ca++ levels, whilst the response of human platelets is relatively independent of the Ca++ level above a certain threshold concentration. The PRP from the three species which aggregated with PAF also demonstrate the phenomenon of desensitization.

Adenosine Triphosphate↗
PubMed1983

Community-acquired bacterial pneumonia requiring admission to hospital.

Patients who develop bacterial pneumonia in the community often require admission to acute-care hospitals. Knowledge of the incidence of pneumonia due to different pathogens that are brought into an institution from the community may play a role in determining the patterns of infecting organisms responsible for hospital-acquired pneumonia. For 1 year, we prospectively reviewed the records of patients admitted to our 1000-bed community hospital with community-acquired bacterial pneumonia (CABP). Patients had clinical signs and symptoms, positive radiologic findings, and pure cultures of potential pathogens from sputum, blood, pleural fluid, lung aspirate, lung biopsy, or transtracheal aspirate. Pneumonia due to Legionella pneumophila was diagnosed by serum indirect fluorescent antibody (IFA) titer greater than or equal to 1:256 and clinical signs and symptoms along with response to erythromycin. Of 204 patients with bacterial pneumonia, the following pathogens were implicated: Streptococcus pneumoniae, Haemophilus species, L. pneumophila, Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli, oral anaerobic bacteria, Psuedomonas aeruginosa, Serratia marcescens, and others. Most patients were more than 50 years of age and many had evidence of underlying pulmonary disease. The etiology of CABP may not be as predictable as in the past. Empiric antimicrobial therapy for CABP should include agents with activity against the pathogens prevalent in the community.

Adult↗
PubMed1982

A prospective analysis of hospital-acquired fever in obstetric and gynecologic patients.

Of 2,725 obstetric and 4,090 gynecologic patients admitted to a community hospital during a 12-month period, 131 obstetric patients (4.8%) and 294 gynecologic patients (7.2%) had temperature elevations (rectal) of 38.3 degrees C or higher. All patients with fever were seen and followed up until discharge, and 80 different parameters were recorded for each patient, including sex, age, underlying illness, operative or diagnostic procedures, height and duration of fever, laboratory data, medications received, and ultimate cause of fever. Sixty-three obstetric patients (48%) with temperature elevations were found to have infections and fever, with skin and soft-tissue infections (59%), urinary tract infections (16%), and bacteremias (10%) being most common. Sixty-eight febrile obstetric patients (52%) were not found to have an infection. Eighty-six gynecologic patients (29%) with fever had an infection. Pelvic inflammatory disease (37%), urinary tract infection (18%), and abscess (14%) were the most common infections. Two hundred eight gynecologic patients (71%) had fever, but the exact cause of the fever in these patients remains obscure. While fever can be an early indicator of infection, it may be due to noninfectious causes in almost two thirds of hospitalized obstetric-gynecologic patients.

Bacterial Infections↗
PubMed1982

Penetration of amoxicillin, cefaclor, erythromycin-sulfisoxazole, and trimethoprim-sulfamethoxazole into the middle ear fluid of patients with chronic serous otitis media.

Penetration into the middle ear of four antibiotics commonly used in treatment of otitis media was studied by administering a single oral dose of amoxicillin, cefaclor, erythromycin-sulfisoxazole, or trimethoprim-sulfamethoxazole to 83 children with chronic serous otitis media. The antibiotic was given 15-240 min before the removal of middle ear fluid (MEF) by ventilation tubes inserted through the tympanic membrane. At the time MEF was obtained, a sample of blood was drawn from the patient, and concentrations of antibiotic in both specimens were assayed either microbiologically by a disk diffusion method or by high-pressure liquid chromatography. Amoxicillin had the highest ratio of mean peak concentration in MEF to minimal inhibitory concentration (MIC) for the three most common pathogens of otitis media (Streptococcus pneumoniae, ampicillin-sensitive Haemophilus influenzae, and Streptococcus pyogenes), whereas trimethoprim-sulfamethoxazole had the highest ratio of mean peak concentration in MEF to MIC for ampicillin-resistant Haemophilus influenzae.

Amoxicillin↗
PubMed1982

Meningovascular syphilis after 'appropriate' treatment of primary syphilis.

Meningovascular syphilis developed in a patient two years after the treatment of primary syphilis with a single intramuscular injection of 2.4 million units of penicillin G benzathine as recommended by the Centers for Disease Control. Although it could not be established with certainty whether this infection represented a reinfection or a treatment failure, the case emphasizes the necessity for serologic follow-up examination in all patients treated for primary syphilis.

Adult↗
PubMed1980

Effect of protein binding on the penetration of nonmetabolized cephalosporins into atrial appendage and pericardial fluids in open-heart surgical patients.

At various times before surgery, 33 patients undergoing coronary artery bypass or cardiac valve replacement surgery received a single 2.0-g dose of either cefazolin or cephradine. Simultaneous single serum, atrial appendage, and pericardial fluid samples were obtained from the patients at various times and analyzed for drug content. Compared with cephradine, cefazolin yielded higher total serum, atrial appendage, and pericardial fluid levels. Unbound (free) levels of cephradine in serum and pericardial fluid were, however, higher than those of cefazolin. It remains uncertain whether the higher and more prolonged total levels of cefazolin in the right atrial appendage and in serum, or the higher free levels of cephradine in pericardial fluid and in serum, provide either one with a therapeutic advantage.

Adult↗
PubMed1980

A common source outbreak of Acinetobacter pulmonary infections traced to Wright respirometers.

Over a 30-day period, Acinetobacter calcoaceticus var. antiratus was the responsible pathogen for hospital-acquired pneumonia in 10 patients, and resulted in the colonization of the upper respiratory tract in an additional 9 patients. Wright respirometers contaminated by this organism were shown to be the common source for the outbreak as indicated by the recovery of a single serotype (8J), the inability to recover Acinetobacter from any other environmental source, and the demonstration that moisturized Wright respirometers are capable of "aerosolizing" fluids containing Acinetobacter.

Acinetobacter Infections↗
PubMed1978

Flavobacterium meningosepticum meningitis: report of selected aspects.

Two patients developed meningitis due to Flavobacterium meningosepticum. Because of resistance to most available antimicrobial agents, intravenous and intraventricular erythromycin was administered to one patient. Subsequent development of resistance to erythromycin prompted the use of intravenous and intraventricular rifamycin, which eventually resulted in cure. Diagnosis of F. meningosepticum meningitis in the second patient was delayed, and appropriate therapy was not administered until 4 days prior to the patient's death. Of 82 previously published cases, only 4 occurred in adults. Therapy of meningitis due to this organism has been a difficult problem, and we suggest possible modes of therapy, based on our experience and a review of the literature.

Aged↗
PubMed1977

Comparison of concentrations of amoxicillin and ampicillin in serum and middle ear fluid of children with chronic otitis media.

Twenty-eight children aged five to nine years with chronic serous otitis media received a single dose of either ampicillin or amoxicillin by the oral route 1-2 hr before the removal of middle ear fluid by ventilation tubes inserted through the tympanic membrane. At the time middle ear fluid was obtained, a sample of blood was drawn from the patient, and levels of antibiotic in both specimens were microbiologically assayed by a disk diffusion method. Levels of amoxicillin (mean+/-standard error [SE], 1.48+/-1.6 microng/ml) in middle ear fluid were consistently and significantly higher (P less than 0.05) than levels of ampicillin (mean+/-SE, 6.2+/-5.0 microng/ml).

Administration, Oral↗
PubMed1977

Myocardial dysfunction and hemolytic anemia in a patient with Mycoplasma pneumoniae infection.

A patient with evidence of myocardial abnormalities and hemolytic anemia is described, in whom the responsible pathogen appeared to be Mycoplasma pneumoniae (as indicated by a 64-fold rise in complement-fixation titers, and by a change in cold-agglutinin titers from 1:8 to 1:4,096). Both cardiac and hematologic problems occurred during the recovery phase from pneumonia and were associated with marked deterioration in the patient's clinical status. Electrocardiographic and serum enzymatic changes mimicked the patterns seen in acute myocardial infarction.

Adult↗
PubMed1977

Safety and efficacy of combining obstetric and noninfectious gynecologic hospital patients.

Unoccupied obstetric beds and unused delivery rooms represent inefficient use of hospital facilities and loss of revenue, both of which adversely affect the quality of care rendered patients. Hartford Hospital has permitted the admission of obstetric and noninfectious gynecologic patients to the same patient care areas of the hospital as well as use of delivery rooms by both groups of patients. Elaborate surveillance of these patients by the epidemiology section for a 1-year period (July 1974-July 1975) demonstrated no increase in the incidence of hospital-acquired infections associated with this combined approach as compared with the more traditional separation system of maternity and nonmaternity patients.

Connecticut↗
PubMed1976

Clinical, epidemiologic and bacteriologic observations of an outbreak of methicillin-resistant Staphylococcus aureus at a large community hospital.

Over a 12 month period, 61 isolates of methicillin-resistant Staphylococcus aureus (MR-SA) were obtained in 23 hospitalized patients. Eight-six per cent of the patients were over 50 years of age, and 91 per cent were in the postoperative period. In 10 patients (42 per cent), MR-SA was the major pathogen, producing either pneumonia, empyema, osteomyelitis, lung abscess, enterocolitis, wound infection or bacteremia with sepsis. Three patients in this group died despite therapy with antibiotics with in vitro activity against these organisms. All the patients probably acquired their MR-SA in the hospital, and five carriers of the organism were identified among hospital personnel. This outbreak demonstrates the ability of MR-SA not only to colonize many patients in a relatively brief period of time, but also to produce serious disease.

Adult↗