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Biomedical subjects

K Y Yuen

Publications and source records attributed to K Y Yuen.

At least 217 records · Page 12Linked to original sources
PubMed1992

An evaluation of inpatient consultations conducted by clinical microbiologists in a teaching hospital.

A systematic procedure for conducting consultations by clinical microbiologists requested by their clinical colleagues is described. The method was evaluated over a period of 17 months and involved sequential consultations related to 229 patients with known or probable infections. An attempt was made to elucidate the contributions of the clinical microbiologists in achieving a better understanding of the problems experienced in this particular setting and which in turn led to improved management of patients. It is hoped that this paper may provide a practical working framework for clinical microbiologists in the care of patients suffering from infection.

Adult↗
PubMed1992

An outbreak of Candida tropicalis peritonitis in patients on intermittent peritoneal dialysis.

An outbreak of Candida tropicalis peritonitis in intermittent peritoneal dialysis patients during a 6-week period is reported from a general hospital. Five patients were involved and there were three deaths. The strains recovered from affected patients were identical to those recovered from the water baths on the basis of biotyping, antimicrobial susceptibility pattern and chromosomal DNA fingerprints. No further cases were identified on subsequent surveillance after the prohibition of wet-warming of peritoneal dialysate in the hospital.

Candidiasis↗
PubMed1992

Serotype prevalence of Candida albicans from blood culture isolates.

Blood culture isolates of Candida albicans were collected from 102 patients in Seattle, Wash., hospitals (n = 77) and Hong Kong (n = 25). The patients were classified by immune status into two groups. Group I patients were severely immunosppression, and group II patients had underlying risk factors for candidemia but no underlying immunosuppression. Serotyping by Hasenclever tube agglutination was done. In the Seattle area, the odds of fungemia with type B C. albicans were 3.62 times greater than the odds of type B fungemia in group II patients. Although the odds ratio could not be computed for Hong Kong patients, the direction of the relationship in this population was consistent with the data on Seattle patients. Despite the magnitude of the odds ratios, the relative prevalence of type B over type A in group I compared with group II was not significant when analyzed separately by region, probably because of relatively low numbers of isolates in group II. Accepting that the effect of immune status on serotype is equivalent across regions but presupposing that a regional effect on type B prevalence exists, the pooled odds for fungemia with serotype B in group I patients are increased 5.4-fold over those of group II patients. Logistic regression analysis controlling for region gave similar results.

Adult↗
PubMed1991

Herpes zoster associated encephalitis in dialysis patients.

Two patients on dialysis because of chronic renal failure who developed herpes zoster associated encephalitis are reported. Both developed overt encephalopathy despite treatment with oral acyclovir for the preceding herpes zoster eruption. The encephalopathy responded rapidly to intravenous acyclovir.

Acyclovir↗
PubMed1991

The enhancement of infection control in-service education by ward opinion leaders.

Opinion leaders are members within a social group with significant social influence over others. A guideline on urinary catheter care was introduced in three groups (A, B, and C) of two randomly allocated wards. Two opinion leaders per ward were identified by nurses in groups A and B with the use of a sociometric method. For education, in-service lectures for 30% of nurses and opinion leaders' tutorials for all nurses were used in group A; opinion leaders' tutorials alone in B, and lectures alone in C. Before and after the education program, the guideline's frequency of practice was assessed by surveying 30% of randomly selected nurses and by direct observation. Results of the survey were comparable for groups A and B and both groups were significantly higher (p less than 0.05) than C, suggesting that informational transmission by opinion leaders was superior to that by the lecture. However, practices by direct observation in group A were significantly better (p less than 0.05) than those in B, indicating that staff compliance is best achieved by using both opinion leaders and lectures. The lecture probably endorsed the opinion leaders' leadership, enhancing their ability to influence the staff.

Communication↗
PubMed1991

Peripartum haemoperitoneum.

We report the case of a young pregnant woman who presented with abdominal discomfort and giddiness. After an induced labour, the patient collapsed. Mid-line laparotomy revealed a ruptured and bleeding secondary deposit in the liver. A tumour of the sigmoid colon was also found.

Adult↗
PubMed1990

Streptococcus zooepidemicus (Lancefield group C) septicaemia in Hong Kong.

The clinical findings relating to 11 patients in Hong Kong (HK) and to 43 patients described elsewhere, all with Streptococcus zooepidemicus septicaemia, are reviewed. There was a particular association with cardiovascular disease (27%) with seven cases of endocarditis, three of abdominal aortic aneurysm and two of deep venous thrombosis. Associations not previously reported included two cases of pharyngitis and two patients with persistent post-operative fever. The overall mortality was 22%. Both human and porcine strains of S. zooepidemicus from HK did not hydrolyse aesculin in contrast to the aesculin-positive biotypes reported previously. HK strains also had very mucoid colonies and capsules of hyaluronic acid were seen in electron micrographs. Samples of chromosomal DNA, extracted by means of HindIII restriction endonuclease, of strains from human beings and pigs were identical. The MIC of penicillin for all strains was less than or equal to 0.03 mg/l but the MBC for all was greater than 32 mg/l. Penicillin alone is generally sufficient for cure but combination with an aminoglycoside may be indicated in seriously ill patients. In our locality, pigs were incriminated as a possible source of human infection whereas consumption of contaminated dairy products is important elsewhere.

Adult↗
PubMed1990

A new semiquantitative culture method for early detection of surgical incisional wound infection.

A semiquantitative culture technique for early detection of surgical wound infection was done by rolling a segment of a plastic intravenous catheter across a blood agar plate after insertion into the most inflamed part of the wound on postoperative day 3. Patients were monitored daily for purulent discharge until healing. Of the 53 wounds studied, 44 (83%) had no growth or low-density superficial colonization on the blood agar (generally less than 15 colony-forming units and within the upper 1.5 cm of the catheter). None of these 44 wounds was subsequently infected; therefore, these colonies represented colonization. Of the 9 wounds (17%) that yielded greater than 15 colony-forming units and a diffuse subcutaneous pattern (colonies below the upper 1.5 cm of the catheter), all developed purulent discharge with a positive culture of the same organisms found by semiquantitative culture. This result differed significantly (P less than .01) from the 44 wounds without subsequent infection. This semiquantitative technique has the potential to distinguish infection from colonization and may be useful in diagnosing surgical wound infection.

Bacteria↗
PubMed1990

Rapid endoscopy room diagnosis of Campylobacter pylori-associated gastritis in children.

A modified urease broth test was used in 109 gastric biopsy specimens of children that yielded a 96% sensitivity and a 100% specificity rate for Campylobacter pylori infection. The longest reaction time was less than or equal to 4 min. The correlation between the degree of C. pylori infection and the reaction time was found to be highly significant (gamma = 0.78, p less than 0.001). Patients were examined as outpatients, and immediate medications were prescribed for eradication of the bacteria on the basis of the urease broth test results. This is the first report on the use of this modified rapid urease test for the diagnosis of C. pylori infection in children.

Adolescent↗
PubMed1990

Septicemia caused by cysteine-dependent Escherichia coli.

A case of septicemia and urinary tract infection caused by cysteine-dependent Escherichia coli in a 70-year-old woman with bilateral staghorn calculi is described. This is the second report of a cysteine-dependent E. coli bacteremia. The bacterium was falsely susceptible to ampicillin and co-trimoxazole when tested on a medium without cysteine supplement.

Aged↗
PubMed1990

Helicobacter pylori and associated duodenal ulcer.

Twenty three children with coexistent duodenal ulcer and Helicobacter pylori infection were treated with either two weeks of amoxycillin (25 mg/kg/day) in addition to six weeks of cimetidine, or cimetidine alone. Endoscopy with antral and duodenal biopsies for urease test, microaerophilic culture, and histological studies were performed at entry, six weeks, 12 weeks, and at six months. Children with persistent H pylori infection at six weeks were given a further two weeks' course of amoxycillin. H pylori persisted in all children not receiving amoxycillin treatment but cleared in six of the 13 children (46%) treated with amoxycillin. With failure of H pylori clearance at six months, only two out of six (33%) ulcers had healed and 50% of patients had experienced ulcer recurrence. In contrast, when H pylori remained cleared all ulcers healed and no ulcer recurred. Persistent H pylori infection was associated with persistent gastritis and duodenitis despite endoscopic evidence of ulcer healing. Detection and eradication of H pylori deserves particular attention in the routine management of duodenal ulceration in children.

Adolescent↗
PubMed1989

The significance of Branhamella catarrhalis in bronchopulmonary infection--a case-control study.

Data, including clinical features of bronchopulmonary infections, i.e. cough with purulent sputum, fever, peripheral blood leucocytosis, patchy pulmonary shadows on chest radiographs and the presence of crepitations or dullness on examination of the chest, were prospectively recorded in 107 consecutive adult patients whose expectorated sputum yielded Branhamella-like bacterial colonies in routine cultures. Subsequently, isolates from 26 patients were confirmed to be Branhamella catarrhalis. Of 81 patients (unmatched controls) with confirmed commensal Neisseria species, 40 (matched controls) were age and sex matched with the 26 patients (cases) positive for B. catarrhalis. Clinical features of bronchopulmonary infection were significantly more among cases compared to unmatched controls. Compared with matched controls, significantly more of the cases had three or more clinical features of bronchopulmonary infection (P less than 0.05). This is the first study of the clinical significance of B. catarrhalis in expectorated sputum that included controls to circumvent the confounding effects of oropharyngeal and airway colonisation in patients with bronchopulmonary infections. The isolation of this organism in routine sputum culture was found to be significantly related to clinical infection.

Adolescent↗