Biomedical subjects
J T Macfarlane
Publications and source records attributed to J T Macfarlane.
Creatine kinase and confusion in pneumonia.
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Hospital study of adult community-acquired pneumonia.
The cause of primary pneumonia was diagnosed in 124 of 127 consecutive adult patients admitted to hospital with community-acquired illness. Pneumococcal infection was found in 96 (76%) patients and legionnaries' disease was the second commonest infection identified (15%). Other bacterial infections were uncommon. 11 patients had atypical pneumonia, including 7 with psittacosis. There were several mixed infections and most of the 11 patients with viral infections also had bacterial pneumonia. 19 patients died (15%) and mortality was associated with increasing age, the presence of coexisting disease, and the cause of the pneumonia. Recognition of the most likely causes of severe pneumonia allows logical initial antibiotic treatment for such patients admitted to hospital.
Vidarabine in fulminating chickenpox pneumonia.
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Abnormalities in lung function following clinical recovery from Mycoplasma pneumoniae pneumonia.
Pulmonary function was studied in 15 patients who had clinically and radiologically recovered from proven Mycoplasma pneumoniae pneumonia, 21 weeks (mean) previously. Ten patients were tested again 43 weeks (mean) later. Lung volumes and measurements of airways resistance were generally normal. Transfer factor and diffusion constant were initially reduced in the smokers and significantly improved between the two studies, being normal at the second testing. It is suggested smokers take longer to recover from mycoplasma pneumonia although all cases had returned to normal a year after the illness.
Pittsburgh pneumonia agent and legionellosis in Nottingham.
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Why request reprints?
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Reducing risks from intravenous cannulae.
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Safety, usefulness and acceptability of fibreoptic bronchoscopy in the elderly.
The safety and usefulness of fibreoptic bronchoscopy in the elderly was assessed retrospectively in 204 consecutive patients aged 70 and over. One third of patients were examined as day cases. A bronchial tumour was seen in 67% patients, and biopsies showed malignancy in 78% of these cases. Certain knowledge of a diagnosis of bronchial carcinoma helped in the management of the elderly patient. Fibreoptic bronchoscopy proved to be safe in the presence of marked ventilatory impairment. A prospective questionnaire study in 114 patients showed that most patients found the procedure acceptable and would agree to a repeat if necessary and this was largely independent of age.
Recurrent erythema nodosum and pulmonary sarcoidosis.
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Risks from cannulae used to maintain intravenous access.
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Pneumococcal serotypes in West Africa.
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Treatment of acute meningococcaemia with chemotherapy and immune plasma.
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Irregularities in the use of regular aerosol inhalers.
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A case of primary amebic meningoencephalitis in a Nigerian farmer.
A fatal case of primary amebic meningoencephalitis (PAME) in a 35-year-old Nigerian Muslim farmer is described. The disease was contracted during ritual washing before prayers, which involved the sniffing of water up his nose to clean it. The water came from a man-made pond at his farm. The clinical presentation, isolation of the ameba from the cerebrospinal fluid and nasal passages, poor response to amphotericin B, and ultimate fatal outcome prove this to be a case of PAME. On the basis of its ability to grow at 42 degrees C, morphology of the trophozoite, cyst, and flagellate forms, animal pathogenicity, and nuclear division the ameba was identified as Naegleria fowleri. Pathogenic N. fowleri were recovered from samples of water and soil from the pond. This represents the fourth proven case of PAME from northern Nigeria.
Single injection treatment of meningococcal meningitis. 1. Long-acting penicillin.
A single injection of a long-acting preparation of penicillin (Triplopen) was compared with a five-day course of crystalline and procaine penicillin in the treatment of meningococcal meningitis. The clinical response of patients treated with Triplopen was very similar to that of patients treated with crystalline penicillin and much more convenient to administer. However, four patients treated with Triplopen had a positive CSF culture 48 or 72 hours after their injection. One injection of Triplopen cannot, therefore, be recommended as an entirely safe form of treatment for meningococcal meningitis unless patients can be carefully followed.
Single injection treatment of meningococcal meningitis. 2. Long-acting chloramphenicol.
A single injection of a long-acting oily preparation of chloramphenicol (Tifomycine) was compared with a five-day course of crystalline and procaine penicillin in the treatment of 131 adult patients with meningococcal meningitis. The clinical response to treatment was similar in the two groups of patients. Serial lumbar punctures showed a parallel fall in CSF cell count, protein and lactate and all posttreatment cultures were sterile. Single injection chloramphenicol treatment was cheaper and much easier to administer than penicillin. Long-acting chloramphenicol is thus an effective form of treatment for meningococcal meningitis and is likely to prove of particular value in the management of epidemics in areas with limited medical resources.