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Biomedical subjects

J K Todd

Publications and source records attributed to J K Todd.

At least 73 records · Page 4Linked to original sources
PubMed1977

Bacteremia in hospitalized children.

The results of 6,951 blood cultures taken from hospitalized children are reviewed. One or more organisms grew from 6% (399) of the cultures, of which 189 (two thirds) were considered to represent confirmed bacteremia. The most common organisms associated with bacteremia were Haemophilus influenzae, Streptococcus pneumoniae, enterobacteriaceae, and Staphylococcus aureus. Patients with deficient host defenses (newborns, oncology patients) with bacteremia had a higher mortality than normal children. Laboratory techniques allowing more rapid detection of positive blood cultures resulted in major alterations in therapy in almost one half of all bacteremic patients.

Anti-Bacterial Agents↗
PubMed1977

Home follow-up of urinary tract infection. Comparison of two nonculture techniques.

Thirty children with recurrent urinary tract infection were followed up at home by their parents, using urine nitrite and urine glucose bacteruria detection methods. Their results were compared with traditional clinic culture techniques. The home testing chemical methods proved to be more effective than office cultures in detecting children with recurrent infections with a considerable saving in cost and inconvenience.

Adolescent↗
PubMed1977

Pneumonia in children.

Pneumonia in children tests the clinician's diagnostic and therapeutic acumen. Bacterial infection can occur at any age, while aspiration pneumonia is most common in the newborn, viral pneumonia is most prevalent in infants and preschoolers, and mycoplasmal pneumonia is most often encountered in school-aged children and young adults. Careful follow-up of outpatients will indicate whether the choice of therapy is adequate and should detect progressive disease requiring more specific diagnostic and therapeutic measures.

Anti-Bacterial Agents↗
PubMed1977

Rapid ampicillin susceptibility testing for Haemophilus influenzae.

Recent isolations of strains of Haemophilus influenzae resistant to ampicillin necessitate the development of a rapid, dependable, reproducible method of determining their antibiotic susceptibility. An agar-dilution method permitting susceptibility determinations on clinical specimens within 6-18 hours of specimen collection was designed. Chocolate agar biplates were made with one side having no additive and the other containing 2 mug/ml ampicillin. Seventy clinical specimens (cerebrospinal fluid, joint fluid, ear fluid, pleural fluid, blood culture broth) were streaked directly onto both sides of the plates when received in the laboratory and incubated at 35-37 C in 10% CO2. Reliable, readable results were usually available within 6-18 hours of receipt of the specimen and correlated completely with minimum inhibitory concentrations (MIC) determined by the agar-dilution plate method, although standard disk susceptibilities occasionally indicated false resistance. Susceptible strains (MIC less than 2 mug/ml) grew on the antibiotic-free side of the biplate only. The rapid determination of ampicillin susceptibility allows optimal antibiotic selection for the treatment of Haemophilus influenzae infections with early discontinuation of potentially toxic supplementary drugs.

Ampicillin↗
PubMed1977

Early detection and preliminary susceptibility testing of positive pediatric blood cultures with the Steers replicator.

Early replicator subculturing of blood specimens after 4 to 16 h of incubation detected 135 of 217 (59%) of all positive cultures, including 56 of 64 (87%) Haemophilus influenzae type b, 7 of 22 (32%) Staphylococcus aureus, 19 of 20 (95%) pathogenic streptococci, and 20 of 24 (83%) Enterobacteriaceae. The mean time to detection of the common pediatric pathogens (36 h) was significantly less than that of contaminants (85 h) (P less than 0.001). Blind subculturing to differential media aided in the rapid identification of isolates and the detection of mixed cultures. In addition, a method of obtaining rapid susceptibilities of blood and body fluid isolates to selected antibiotics by blind subculturing to antibiotic-containing media was evaluated. Immediate susceptibility information was obtained for 214 of the 245 (87.3%) isolate-antibiotic combinations. There was complete correlation with a standard Kirby-Bauer reading for 94.9% of these observations. Replicator blood subculturing before 24 h of incubation results in early detection of the majority of pediatric pathogens. The inoculation of additional differential and antibiotic-containing media with each blind subculture aids in rapid identification of isolates and may give limited, but clinically important, immediate susceptibility information.

Anti-Bacterial Agents↗
PubMed1977

Diagnosis of urinary tract infection. The interpretation of colony counts.

The results of 787 consecutive suprapubic specimens in children were studied. Ninety-two patients with 128 positive cultures were reviewed. Sixty-five children had documented urinary tract infection (UTI) proven by other cultures. Of these, 55 per cent had colony counts less than the traditional 100,000 colony forming units/ml., and 9 per cent had colony counts less than 10,000. Organisms usually regarded as "contaminants" (Staphylococcus epidermidis, mixed organisms) were occasionally proven to cause UTI.

Bacteriological Techniques↗
PubMed1977

Prediction of morbidity in Hemophilus influenzae meningitis.

A dramatic decrease in mortality from Hemophilus influenzae meningitis has occurred in recent years. Morbidity and long-term sequellae remain significant problems. A follow-up investigation of 73 cases of H. influenzae meningitis seen over a three-year period revealed: 2 deaths, 6 children with major sequellae (retardation, spastic quadriplegia, blindness, persistent seizure disorder), 10 with minor residua, and 55 with no detectable disability. Statistical analysis of clinical parameters demonstrated a significant risk of death or major morbidity in those patients who, at the time of admission, had seizures, coma, hypothermia, shock, age less than 12 months, hemoglobin less than 11 gm/100 ml, pretreatment symptoms for longer than three days, a spinal fluid white blood cell count less than 1,000/cu mm, or a spinal fluid glucose value less than 20 mg/100 ml. Using these parameters, those patients at highest risk of having lasting major morbidity with H. influenzae meningitis can be predicted, allowing more vigorous intensive care which may reduce the mortality and morbidity further.

Colorado↗
PubMed1976

Mucocutaneous lymph node syndrome in Denver.

Four children with acute febrile mucocutaneous lymph node syndrome (MLNS) were hospitalized in Denver over a two-year period. The children had most of the principle features of this recently described syndrome, including prolonged fever unresponsive to antibiotics, an erythematous rash, conjunctivitis, pharyngitis, and nonsuppurative cervical lymphadenitis. Three of the children exhibited characteristic desquamation from the fingertips or toes during convalescence. None developed clinical or electrocardiographic evidence of coronary thromboarteritis, the most serious complication of the disease. Additional cases undoubtedly will be reported in the United States as physicians become famililar with this new syndrome and learn to distinguish it from the other acute febrile exanthems.

Bacterial Infections↗
PubMed1976

Urinary tract infections in children and adolescents.

Recent advances in the understanding of urinary tract anatomy, function, and disease should lead to a reassessment of the clinical approach to urinary tract infection. Many traditional concepts must be seriously questioned in light of new information. These include the belief that pyuria or "typical" signs and symtoms are diagnostic. Diagnosis depends on detection of persistent bacteriuria by careful screening and culture of properly collected uring specimens. Once diagnosis is confirmed, oral administration of a single antibiotic for ten days is usually effective. Patients with suspected pyelonephritis or with recurrent or unresponsive urinary tract infection should be treated with two antibiotics. Success of treatment must always be confirmed by culture after discontinuance of therapy. In all cases, follow-up every one to two months should continue until the patients have remained free of infection for a period of one year. Refractory cases may require radiologic study and referral to a urologist.

Adolescent↗
PubMed1976

Influence of age and sex on plasma zinc levels in normal and diabetic individuals.

Plasma zinc levels were measured in both healthy and diabetic individuals having an age range of 10-93 years. No significant differences in plasma zinc concentrations were found between males and females in either healthy or diabetic individuals. Up to the age of 50 years, the mean plasma zinc of normal individuals remained relatively constant at 70 +/- 32 mug/100 ml (+/- 2 SE) after which the levels decreased. This decreasing pattern was absent in diabetics, whose plasma zinc of 65 +/- 32 mug/100 ml remained constant over the entire age range. For women on oral contraceptive agents, the mean plasma zinc was 59 +/- 18 mug/100 ml, which was significantly lower than that of controls.

Adolescent↗
PubMed1976

Hypoglycorrhachia in pediatric patients.

Hypoglycorrhachia (abnormally low cerebro spinal fluid glucose content) eludes exact numerical definition, largely because of the dynamic equilibrium between blood and CSF glucose. A group of 181 pediatric patients with a CSF glucose less than 50 mg/100 ml or a CSF/blood glucose ratio less than 0.50 were studied. Hypoglycorrhachia was present in patients with bacterial meningitis, aseptic meningitis, meningeal carcinomatosis, subarachnoid hemmorrhage, and hypoglycemia. Markedly diminished CSF glucose values were seen primarily in patients with bacterial meningitis. Higher CSF/blood glucose ratios predominated in those with hypoglycemia and neonates with low-normal blood sugars. Following bacterial meningitis and hypoglycemia, aseptic meningitis (including five children with documented enterovirus meningitis and one with documented mumps meningitis) was the third most common cause of hypoglycorrhachia in children. When readily available, positive CSF viral cultures may allow early cessation of antibiotic therapy in two types of patients with meningitis and hypoglycorrhachia: (1) those receiving previous recent antibiotic therapy, and (2) those with CSF findings more typical of a bacterial meningitis.

Adolescent↗
PubMed1975

Severe Haemophilus influenzae infections.

From May 1973 thorugh April 1974, a total of 83 children with severe Haemophilus influenzae infections were treated in three Denver pediatric hospitals. Although meningitis was the most common clinical manifestation (45 cases), other foci of infection were also noted (pneumonia, 12 cases; cheek cellulitis, eight cases; epiglottitis, eight cases; empyema, seven cases; pericarditis, three cases; arthritis, one case; periorbital cellulitis, one case; and abscess, one case). Nine children had positive blood cultures with H influenzae without an initial detectable focus of infection. Two patients developed clinically apparent sites of infection (osteomyelitis and scalp abscesses).

Abscess↗