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Biomedical subjects

J L Clayton

Publications and source records attributed to J L Clayton.

9 recordsLinked to original sources
PubMed2000

Comparison of three assays for cytomegalovirus detection in AIDS patients at risk for retinitis.

The purpose of this study was to determine the sensitivity and specificity of three different methods of cytomegalovirus (CMV) detection for AIDS patients at risk for CMV retinitis. Patients with CD4(+) counts of <100/microl and negative baseline screening eye examinations were tested for CMV infection by (i) pp65 antigenemia expression in leukocytes, (ii) the Digene Hybrid Capture CMV DNA System, and (iii) the Roche Amplicor Qualitative PCR Test. The incidence of CMV retinitis in our study of 296 patients at the Medical Center of Louisiana-New Orleans HIV Outpatient Clinic was 7. 2 per 100 person-years (a total of 20 episodes in 18 patients from April 1997 to February 1999). Receiver operating characteristic curves were calculated for each assay to determine optimal cutoff points which maximized the sensitivity and specificity of each assay. The sensitivities of the assays compared to the eye examinations were 80% for the pp65 antigenemia assay (cutoff, >0 cell per 1.5 x 10(5) leukocytes), 85% for the Digene assay (cutoff, 1,400 genome copies/ml of whole blood), and 60% for the Amplicor assay. The specificities of the assays were 84, 84, and 87%, respectively. The Digene assay with a cutoff of >/=1,400 genome copies/ml gave optimal sensitivity and specificity and was found to have predictive values equal to those of the more technically cumbersome antigenemia assay.

AIDS-Related Opportunistic Infections↗
PubMed1996

Decontamination, sterilization, and disinfection.

Creating and maintaining a sterile environment before and during the surgical procedure minimizes the patient's risk of acquiring a postoperative wound infection. The most important measure in preventing postoperative wound infection is the application of flawless aseptic technique principles. It is important that everyone understands their role in reducing the risk of infection to the surgical patient. Prevention of infection begins in central supply with the decontamination, assembly, preparation, and sterilization of surgical items and continues with the surgical team as it monitors the implementation of aseptic technique principles in the operating suite.

Animals↗
PubMed1989

Large volume lipoplasty.

As experience accumulates, previously held beliefs about the risks and dangers of large scale lipoplasty are being challenged. We present our experience with over 300 patients who underwent large scale suctions ranging in volume from 2500 to 8000 cc. We have found that the incidence of postoperative complications does not correlate directly with the volume of fat extracted. Preoperative fluid loading, adequate intraoperative fluid management, and the liberal use of autologous whole blood transfusions appear to reduce the risks of large scale suctions. It is the belief of the author that, when indicated, single stage lipoplasty of greater than 2500 cc is an appropriate alternative to staged procedures, and can be safely undertaken when adequate provisions are made for blood replacement.

Abdomen↗
PubMed1985

Infections acquired in clinical laboratories in Utah.

We reviewed laboratory-acquired infections occurring in Utah from 1978 through 1982. Written and telephone interviews of supervisors of 1,191 laboratorians revealed an estimated annual incidence of 3 laboratory-acquired infections per 1,000 employees. Infections, in order of frequency, included hepatitis B (clinical cases), shigellosis, pharyngitis, cellulitis, tuberculosis (skin test conversion), conjunctivitis, and non-A, non-B hepatitis. One-half of large laboratories (over 25 employees), but only 12% of smaller laboratories, reported infections. The annual incidence, however, at smaller laboratories was more than three times greater than at large laboratories (5.0 versus 1.5 per 1,000; P less than 0.05, chi-square test). Microbiologists were at greatest risk of infection, with an incidence of almost 1%, followed by generalists and phlebotomists. Shigellosis was acquired only by microbiologists and accounted for more than half of their infections. The most common laboratory-acquired infection, hepatitis B, affected a microbiologist, a hematologist, a phlebotomist, a pulmonary blood gas technician, and a blood bank technologist who died from her illness. Clinical cases of hepatitis B occurred at a rate 10 times higher than the rate in the general U.S. population. The incidence of tuberculosis skin test conversion was intermediate between rates reported for hospital employees and for the state of Utah.

Aerosols↗