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Biomedical subjects

L Adkins

Publications and source records attributed to L Adkins.

7 recordsLinked to original sources
PubMed1999

Helicobacter pylori antibody profile in household members of children with H. pylori infection.

Intrafamilial spread is implicated as a major route for acquisition of Helicoobacter pylori infection. Investigating H. pylori cytotoxin-associated protein (CagA) and vacuolating toxin (VacA) antibodies within family members enabled the authors to evaluate this possibility further. Serum samples were collected prospectively from household members after their index children were diagnosed with active H. pylori infection. Serum samples were evaluated for anti-H. pylori immunoglobulin G antibody using the enzyme immunoassay (IEA) method and for H. pylori CagA and VacA antibodies with the commercially available immunoprobing Western blot kit. Ten different families participated in the study, including 10 pediatric patients and 31 household members. All patients and 28 household members (90%) were seropositive for H. pylori antibody by IEA and Western blot tests. Overall, 17 subjects (41.4%) were CagA positive, 14 (34.1%) were VacA positive, 11 (26.8%) were positive for both antibodies, and 22 (53.6%) were negative for both antibodies. A significant association in bacterial antibody profile was found between the patient index members and all household members (Cohen's kappa and Mentel-Haenszel methods). In four families, more than 66% of the household members harbored the same antibody profile, and in two families a completely different profile was observed. Moreover, a similar H. pylori antibody profile between the index patient and the mother was found in six families, and between the index patient and the father in two families. The data strongly suggest an intrafamiliar transmission for H. pylori infection.

Adult↗
PubMed1988

Profile of patients from a Veterans Administration medical center.

Data were analyzed to establish a general patient profile that could be the basis for specific profiles to be utilized for infectious disease and microbiologic studies. The analysis revealed that the average patient in this institution is a 57-year-old, white, married, Protestant man residing in Oklahoma.A personal-interview survey of 42 inpatients showed that 95 percent had smoked for a number of years, and of the smokers, 60 percent were current smokers while the remaining 40 percent had stopped smoking for at least one year. Primary treatment services were medicine (47.9 percent) and surgery (31.6 percent) with 7.4 percent of the patients treated on both of these services. The ten most common diagnostic-related groups for the medicine and surgery services are also noted.

Aged↗
PubMed1987

Bacteremia in adult men.

A prospective study was done to characterize positive blood cultures in adult male veterans. The research included 277 patients over a 15-month period. There were 348 organisms isolated, of which 65 percent were pathogens, 6 percent probable pathogens, 4 percent probable contaminants, and 25 percent contaminants. The most common isolates were coagulase-negative staphylococci (23 percent), Escherichia coli (12 percent), Klebsiella pneumoniae (10 percent), Staphylococcus aureus (9 percent), Streptococcus pneumoniae (6 percent), and Pseudomonas aeruginosa (5 percent). The number of positive blood cultures was significantly greater for pathogens (mean 1.8 bottles) than contaminants (mean 1.2). Patients with pathogens were more likely to have hypotension than those with contaminants. At least 40 percent of all patients with a positive blood culture died within 14 days after their first positive culture. The vast majority of bacteremias were community acquired. As lungs and wounds comprised about one half of the sites of entry for the bacteremias, it appears that more emphasis should be placed on early diagnosis and efficient treatment of infections from these sites to reduce subsequent mortality.

Adult↗
PubMed1986

Understanding the blood culture report.

There are no hard-and-fast rules for judging whether an organism is a pathogen or contaminant. Experience is critical. In the end, the physician is responsible for determining whether an organism is a contaminant or a pathogen on the basis of laboratory and clinical data, which often include patient history, physical examination, body temperature, peripheral leukocyte count and differential, clinical course, and culture results. When blood culture results are given to a nurse, she or he should communicate this information to the attending physician as soon as possible, with greatest emphasis placed on positive cultures with probable pathogens. The assumption that a blood culture isolate is a pathogen, in the absence of other supporting facts, can lead to inappropriate therapy. On the other hand, assuming a pathogen to be a contaminant can ultimately lead to patient mortality if treatment is delayed. Questions as to how blood cultures are handled should be directed to microbiology personnel, whereas interpretation problems should be discussed with infectious disease specialists. Good communication among the nurses, laboratory personnel, and physicians involved with blood culture studies is invaluable to effective patient care.

Anaerobiosis↗