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Biomedical subjects

J R Allen

Publications and source records attributed to J R Allen.

At least 163 records · Page 9Linked to original sources
PubMed1982

Streptococcal wound infections caused by a vaginal carrier.

During a four-month period, ten cases of group A streptococcal (GAS) postoperative wound infection occurred among patients in a community hospital. Bacteremia developed in two patients, and one patient died. Group A streptococcal surgical wound infections were associated with exposure to a circulating nurse and duration of surgery. Prophylactic antibiotic reduced the risk of infection. Vaginal, perineal, and anal cultures from nurse A yielded GAS, serotype M-4, T-4, as did the blood of two infected patients. Penicillin eradicated GAS colonization of nurse A, and she returned to work. Five months later, two additional cases of GAS postoperative wound infections occurred and were associated with recolonization of the same nurse with GAS, serotype M-nontypeable, T-12. She was relieved of patient-care duties, and no further cases have occurred.

Anal Canal↗
PubMed1982

Nosocomial hepatitis A transmission by an adult patient with diarrhea.

Hepatitis A occurred in five registered nurses, a licensed practical nurse, and a recently discharged patient at a community hospital; one of these seven was asymptomatic. All had been exposed to a woman with confirmed hepatitis A who had undergone elective cholecystectomy and who had had vomiting, diarrhea, and fecal incontinence during the eight days before onset of jaundice. Of the 107 hospital workers identified as having at least some exposure to the source patient, 58 (54.2 percent) had no pre-existing antibody to hepatitis A virus (anti-HAV) and were considered susceptible. Six persons, including the five clinically ill registered nurses, had IgM-specific anti-HAV. The infection attack rate was 5.6 percent for all exposed hospital workers but 10.3 percent for the 58 who were serosusceptible. Risk of infection was highest for persons with documented or probable contact with the source patient and for registered nurses. Among hospital personnel, the prevalence of anti-HAV increased with age but varied inversely with socioeconomic status. Hospital personnel and patients may be at risk for hepatitis A infection when exposed to patients who are in the prodromal stage of hepatitis A. Vomiting, diarrhea, and fecal incontinence may increase the risk of transmission.

Adult↗
PubMed1982

Identification of an arene oxide metabolite of 2,2',5-5'-tetrachlorobiphenyl by gas chromatography-mass spectroscopy.

Tritiated 2,2'5,5'-tetrachlorobiphenyl (3H-TCB) was incubated with phenobarbital(PB)-induced rat liver microsomes in the presence of an epoxide hydrase inhibitor and brominated analog (BrAO) of the expected metabolic intermediate, 2,2',5,5'-tetrachlorobiphenyl-3,4-oxide (TCBAO). A putative arene oxide intermediate (3H-AO), which was radiolabeled, was separated from 3H-TCB and BrAO by column chromatography, high pressure liquid chromatography (HPLC) and thin-layer chromatography (TLC), and was analyzed for TCBAO by methods that were independent of radiometric techniques. The retention times (Rt's) of TCBAO and 3H-AO on two gas chromatography (GC) columns were the same, both before and after acid catalyzed rearrangement. 3H-AO was further characterized by rearrangement to a mixture of 3- and 4-hydroxy-TCB that was identified by gas chromatography-mass spectroscopy (GC-MS). The rate of TCB metabolism and the production of 3H-AO by liver microsomes from a PB-induced, adult male rhesus monkey was less than that observed with rat microsomes. The 3H-AO from the monkey was also characterized as TCBAO by rearrangement to the characteristic TCB phenols that were analyzed by GC-MS using selective ion monitoring. This study is the first in which an arene oxide of a polychlorinated biphenyl (PCB) was actually isolated as a mammalian metabolite and subjected to direct chemical analysis.

Animals↗
PubMed1982

Observations on the behaviour of Dermacentor andersoni larvae infesting normal and tick resistant guinea-pigs.

In three separate experiments the behaviour of Dermacentor andersoni larvae on normal and tick-resistant guinea-pigs was studied at intervals throughout 5-day infestation periods. Fewer larvae survived on resistant hosts and their mean sizes were less than those of larvae on normal hosts, the differences becoming more obvious as time progressed. When measured at 32 degrees C, the peristaltic rates of midgut diverticula of the larvae surviving on resistant hosts were consistently lower than those of larvae from normal hosts. Mean surface temperatures of infested ears were higher on resistant than on normal hosts. This was assumed to be a result of cutaneous hypersensitivity reactions in the resistant animals. Larvae detached, or changed attachment sites, more often on resistant than on normal hosts. This was consistently evident after 26 h post-infestation and correlated with the known timing of basophil cell infiltration and degranulation in the skin of infested, resistant guinea pigs. It appeared that most larvae, after detaching from the resistant host, died off the host. However, some died in situ while still attached. Such deaths occurred on resistant but not on normal animals between 8 and 26 h post-infestation.

Animals↗
PubMed1982

Granulomatous enteritis in a thoroughbred horse.

A case of granulomatous enteritis in a three-year-old thoroughbred horse is described. Onset of clinical signs succeeded pyrexia of unknown aetiology. The horse was emaciated, depressed and inappetent but diarrhoea was not a feature of the condition. There was hypoproteinaemia, anaemia, leucopaenia and abnormal small-intestinal carbohydrate absorption. Rectal biopsy revealed granulomatous changes in the rectal mucosa. As a result of these findings, euthanasia was performed and an autopsy was carried out. Histopathology showed marked villous atrophy in the small intestine with a diffuse mononuclear cellular infiltration involving mainly the submucosa and lamina propria. There were occasional granulomatous foci. The mononuclear cells consisted mainly of lymphocytes and histiocytes. No aetiological agent was isolated.

Journal Article↗
PubMed1982

Alkaline phosphatase-positive Langerhans cells in the epidermis of cattle.

Dendritic alkaline phosphatase-positive cells in the epidermis of cattle were studied. By light microscopy they were shown to occur in basal and suprabasal positions in the epidermis, with their dendrites reaching into outer layers of the stratum spinosum. They were also found in the external root sheaths of hair follicles. In separated epidermal sheets from ears of cattle these cells were found to be uniformly distributed with an average concentration of approximately 1,600 cells/mm2. Langerhans cells were identified in the epidermis by the presence of dendritic cells of Langerhans cell granules, a lobated nucleus and clear cytoplasm and the absence of desmosomes, tonofilaments, premelanosomes, and melanosomes. Alkaline phosphatase activity was associated with the plasmalemma of such cells and occasionally with cytoplasmic inclusions which may have been Langerhans cell granules. Enzyme activity was not associated with melanocytes or keratinocytes. It is confirmed that alkaline phosphatase activity is a feature of Langerhans cells, and possibly "indeterminate" cells in the normal epidermis of cattle.

Alkaline Phosphatase↗
PubMed1982

Growth of nosocomial pathogens in multiple-dose parenteral medication vials.

The extent to which microbial contamination of medications dispensed in multiple-dose vials might serve as a source of infection to patients has not been fully investigated. To characterize the effects of microbial contamination, we studied the growth-supporting properties of eight medications dispensed in multiple-dose vials. Two medications, procainamide and methohexital, demonstrated no survival of any microbes 24 h after inoculation. Succinylcholine chloride, regular insulin, potassium chloride, heparin, and thiopental slowly killed or allowed limited survival of several of the microorganisms used as contaminants. Lidocaine allowed survival or proliferation of several microbial strains suspended in 0.25% peptone water in saline, but slowly killed all strains except Pseudomonas cepacia suspended in 0.9% saline. Endotoxin, measured by the Limulus amebocyte lysate assay, was found in the two medications tested, lidocaine contaminated with Pseudomonas cepacia and insulin contaminated with enterococci. Inadvertent microbial contamination of at least some parenteral medications in multiple-dose vials may result in the exposure of patients to viable organisms. The potential, however, for medications such as lidocaine to support growth of organisms under selected circumstances should be noted by those responsible for preparing and administering these drugs. The potential hazard to patients from endotoxin in contaminated medications under these circumstances has not been assessed. Additional studies of this type should be pursued to provide more complete information about the risk of microbial contamination of products for parenteral use.

Bacteria↗
PubMed1982

Pseudomonas cepacia peritonitis associated with contamination of automatic peritoneal dialysis machines.

During a 3-month period, Pseudomonas cepacia was recovered from the peritoneal fluid of 10 patients having chronic dialysis therapy at a peritoneal dialysis center. Six patients developed clinical evidence of peritonitis; one patient developed septicemia. Epidemiologic studies showed that dialysis on specific peritoneal dialysis machines was associated with an increased risk of infection. Laboratory investigation showed contamination of two machines with P. cepacia. Inadequacies in the cleaning and disinfection practices of the automatic peritoneal dialysis machines were identified. Cross-contamination between machines probably occurred through the peritoneal fluid discharge from infected patients during dialysis. Also, the intermittent 2-hour exposure of the machine to 2% formaldehyde may have been inadequate. P. cepacia has not been isolated from the peritoneal fluid of any peritoneal dialysis patient after machine cleaning and disinfection practices were altered.

Adult↗
PubMed1982

The emergence of methicillin-resistant Staphylococcus aureus infections in United States hospitals. Possible role of the house staff-patient transfer circuit.

Infections with methicillin-resistant strains of Staphylococcus aureus appear to be occurring with increasing frequency in some U.S. hospitals about a decade after a similar increase in Britain and other countries. In the United States, clustered methicillin-resistant S. aureus infections reported in scientific journals and in three hospital surveys have been almost entirely in large, tertiary referral hospitals affiliated with medical schools. Among 63 hospitals regularly reporting infections from 1974 to 1981 in the National Nosocomial Infections Study, the increase in methicillin-resistant S. aureus infections was entirely due to substantial increases in only four hospitals, all of which were large, tertiary referral centers affiliated with medical schools. The predominance of methicillin-resistant S. aureus infections in these large hospitals may be due to the large numbers of patients at high risk of infection and to the interhospital spread of the organism by the transfer of infected patients and house staff from similar hospitals or from nursing homes.

Cross Infection↗
PubMed1982

Red cell ouabain-sensitive Na+-K+-adenosine triphosphatase: a state marker in affective disorder inversely related to plasma cortisol.

Ouabain-sensitive Na+-K+-stimulated ATPase was measured in red cell membranes using a spectrophotometric assay. The mean enzyme level in patients in the depressed state (1.2 nM/mg protein per min +/- 0.18 SEM) was lower lower than that in well-state patients (2.0 +/- 0.26) and hypomanic patients (2.4 +/- 0.31). Lithium treatment itself did not alter ATPase levels. Levels in patients in the well state were not significantly different from controls and thus ATPase does not constitute a "trait" marker for affective illness. Plasma cortisol level was higher in well-state patients (15.9 micrograms/dl +/- 1.46) than in controls (11.5 +/- 0.75). There were no significant differences in cortisol in these single morning samples during different mood states. Cortisol level correlated negatively with ATPase level in the total group of patients (r = 0.42, p less than 0.005), especially in those who were euthymic. These data indicate a relationship between cortisol and ATPase levels in affectively ill patients. Ouabain-sensitive NaK ATPase may be useful as an indicator of state in affective illness; plasma cortisol may be continuously elevated in some individuals with affective disorder.

Adult↗
PubMed1981

Secular trends in nosocomial infections: 1970-1979.

Nosocomial infection data from a mean of 81 hospitals has been reported to the National Nosocomial Infections Study (NNIS) each year since 1970. Surveillance has been conducted by the hospitals on an average of 1.16 million patients annually. The median nosocomial infection rate is 341 per 10,000 patients discharged, ranging from 312 in 1970 to 358 in 1975. Since 1975, the rate has steadily declined to 329 in 1979. By category of hospital, infection rates for community-teaching and municipal hospitals have declined in recent years whereas those for community and university hospitals have not. Infection rates for patients on the surgical service have declined steadily since 1975 to the lowest levels reported, 457 per 10,000 surgical patients discharged in 1979, primarily due to a decrease in the rate of surgical wound infections. On obstetrics, infection rates have increased steadily since 1970, also primarily due to surgical wound infections. Bacteremias have increased in frequency, particularly those associated with infection at other sites. No major shifts have been noted in the relative frequency of the most common sites of infection or pathogens causing infections.

Cross Infection↗
PubMed1981

Pseudobacteremia attributed to contamination of povidone-iodine with Pseudomonas cepacia.

Pseudomonas cepacia was recovered from the blood cultures of 52 patients in four hospitals in New York over 6 months from April through October 1980. Epidemiologic investigation in one hospital indicated that the positive results of blood culture represented pseudobacteremias and implicated a 10% povidone-iodine solution used as an antiseptic and disinfectant (Pharmadine; Sherwood Pharmaceutical Company, Mahwah, New Jersey) as the source of contamination. Physicians who drew blood cultures positive for P. cepacia were more likely to have left povidone-iodine on the skin before venipuncture (p = 0.026) and were more likely to have applied povidone-iodine to the blood culture bottle tops and to have left it there while inoculating the blood culture media (p = 0.007) than those who drew cultures negative for P. cepacia. Direct inoculation of Pharmadine into brain-heart infusion broth yielded P. cepacia; however, 2 weeks after the first cultures, the same Pharmadine bottles were culture negative. The iodine concentrations of the contaminated Pharmadine solutions were similar to those of 10% povidone-iodine solutions distributed by other manufacturers.

Blood Specimen Collection↗
PubMed1981

Promoting effects of polychlorinated biphenyls (Aroclor 1254) and polychlorinated dibenzofuran-free Aroclor 1254 on diethylnitrosamine-induced tumorigenesis in the rat.

The hepatic tumor-promoting activity of a commercial polychlorinated biphenyl mixture, Aroclor 1254 (AR 1254), with and without its intrinsic polychlorinated dibenzofuran (PCDF) impurities, was investigated. Male Sprague-Dawley non-inbred albino rats were treated with 66 microgram diethylnitrosamine (DENA)/ml drinking water for 5 weeks and subsequently given a control diet or a diet supplemented (100 ppm for 18 wk) with either AR 1254 or AR 1254 from which the PCDF moieties were removed (AR 1254-PCDF). Of those animals receiving DENA alone, 16% exhibited hepatocellular carcinomas. Of those rats treated with DENA followed by administration of AR 1254 or AR 1254-PCDF, 64 or 84%, respectively, developed hepatocellular carcinomas. Thus promotion with either AR 1254 or AR 1254-PCDF significantly (P less than 0.05) increased the incidence of DENA-initiated hepatocellular carcinomas. Administration of AR 1254 or AR 1254-PCDF alone did not induce hepatic tumors. Therefore, PCDF impurities were not necessary for the promoting activity of AR 1254.

Animals↗
PubMed1981

The calcar replacement femoral component for total hip arthroplasty: design, uses and surgical technique.

A new femoral component for total hip arthroplasty (THA) has been designed for use in patients in whom the calcar region is missing, hence called the calcar replacement device. Experience with its use in 18 hips has indicated that common causes for calcar deficiency requiring this implant are resorption of the calcar region secondary to failure of a prior THA, settling of an endoprosthesis or destruction by tumor. The use of a conventional femoral component in these situations is not recommended because of the lack of adequate bony support. The device is also valuable in restoring leg length in cases of substantial bone loss in the proximal part of the femur. In an entirely different indication, this device may be used to restore hip motion in patients with severely restricted movement secondary to extensive heterotopic ossification. In three of four hips with this condition, excision of the heterotopic bone and use of the calcar replacement device achieved restoration of an arc of 75 degrees or more in the flexion-extension plane.

Adult↗
PubMed1981

Prevention of infection in patients receiving total parenteral nutrition.

Total parenteral nutrition (TPN) is an extremely important therapy widely used for nutritional support of many hospitalized patients with complicated medical and surgical problems. One of the most significant complications of TPN therapy however is sepsis. Catheter-associated sepsis is the most frequent infectious complication, although intrinsic or extrinsic contamination of TPN fluid or administration sets or local catheter site infection also occur. Most of the infectious complications of TPN therapy can be prevented with meticulous attention to aseptic technique. An organized team approach to providing TPN for patients will reduce the frequency of complications and will help assure that proper technique is followed at all times. Members of the team need to be aware of hazards presented by new procedures or equipment which have not been thoroughly evaluated and must constantly be aware of new types of problems associated with this therapy. When proper techniques are followed by a well-coordinated team, TPN can be safely provided to most patients who need the therapy.U

Anti-Bacterial Agents↗
PubMed1981

Challenges of the 80s.

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Community Mental Health Services↗