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Biomedical subjects

L Jokipii

Publications and source records attributed to L Jokipii.

At least 19 recordsLinked to original sources
PubMed1992

Leishmaniasis diagnosed from bronchoalveolar lavage.

A 51-year-old renal transplant patient, whose spleen had been removed 11 years ago, was admitted to hospital for elective surgery, which was cancelled as she developed spiking fever and nonproductive cough and her general condition deteriorated. After 2 weeks, leishmaniasis was unexpectedly diagnosed from a bronchoalveolar lavage specimen, which had been subjected to parasitological examination under the suspicion of pneumocystosis. Isoenzyme typing identified the parasite as Leishmania infantum. The patient had visited Malaga, Spain, twice a year, the last trip taking place 1 month before admission. Specific treatment was followed by rapid recovery without relapse during 1.5 years. Splenectomy and immunosuppressive medication obscured the clinical suspicion of leishmaniasis. The case is a reminder of the interstitial pneumonitis in leishmaniasis and emphasizes the value of broad-spectrum methods detecting a variety of parasites.

Animals↗
PubMed1979

Metronidazole bioassay with increased sensitivity.

The bioassay of metronidazole using Clostridium butyricum incorporated in agar plates detected concentrations higher than 1.0 microgram/ml. Gentamicin in the sample did not affect the growth of the target organism or the inhibition by metronidazole. Penicillin in the sample could be eliminated by the incorporation of penicillinase in the agar or by using as the target organism a surface inoculum of the penicillin-resistant Bacteroides fragilis. Increasing duration and temperature of aerobic prediffusion before allowing the growth of the strictly anaerobic Cl. butyricum increased the diameters of inhibition by metronidazole, but did not affect the threshold of detectability. The incorporation of metronidazole in the agar increased the sensitivity of the assay ten- to 100-fold.

Bacteroides fragilis↗
PubMed1979

Bacteria in chronic maxillary sinusitis.

Sixty-one chronically inflamed maxillary sinuses produced 131 bacterial strains from mucosal pieces that were taken during a Caldwell-Luc operation and cultured aerobically and anaerobically. Sinus secretions showed only 62 and nasal secretions 106 bacterial strains. Fourteen mucosal strains, including 11 Haemophilus influenzae, grew heavily. None of 24 mucosal anaerobes showed heavy growth. Of 52 antral mucosae with culturable bacteria, 37 disclosed mixed and 15 pure growth. The bacteriological characteristics of the diseased sinus and the nose did not correlate. The duration or extent of the disease, the macroscopic appearance of the diseased sinus, or the presence or absence of allergy were unrelated to bacteriological findings, except that H influenzae was concentrated in purulent sinuses. Intraoperative culture of antral mucosa seems to give the most reliable picture of the bacteriological condition in chronic maxillary sinusitis.

Adult↗
PubMed1979

Single-dose metronidazole and tinidazole as therapy for giardiasis: success rates, side effects, and drug absorption and elimination.

Eighty-five symptomatic patients with parasitologically confirmed, recently acquired giardiasis were treated in a comparative trial of 2.4 g of metronidazole either once or on two successive days or 2.0 g of tinidazole once. The follow-up period was eight weeks; the parasitological follow-up consisted of 871 stool and 30 duodenal specimens. Reinfections were unlikely. The rates of success were: metronidazole, single dose, 13 of 26; metronidazole, two doses, 24 of 31; and tinidazole, single dose, 26 of 28. Clinical and parasitological effects were parallel in nearly all cases. Tinidazole was more effective, produced fewer side effects, and was recommendable as the drug of choice in single-dose therapy. Pharmacokinetic explanations for therapeutic failure was sought with use of a bioassay of drug concentrations in serum. The outcome of therapy was not related to serum levels at 1hr or 24 hr, or to the rate of elimination. The mean serum half-lives of active metronidazole and tinidazole were 9.5 and 13.0 hr, respectively.

Absorption↗
PubMed1979

Recognition of group B streptococci in dip-slide cultures of urine.

One hundred strains of group B streptococci isolated from human infections were tested for growth on dip-slides available for the culture of urine. All grew on CLED agar, and none grew on MacConkey agar. The colonies were barely or not at all visible to the naked eye after overnight incubation (diameter, around 0.1 mm). The colony size increased eith prolonged incubation, but not if the inoculum density exceeded 10(6)/ml. Differences were found between lots of dip-slides. Poor growth on dip-slides may explain why group B streptococci have received little attention as pathogens of the urinary tract. The dip-slide screening personnel of one laboratory were informed of the experimental findings, and they started the practice of frequent subculture and prolonged incubation. The proportion of group B streptococci in significant bacteriuria increased from 0 to about 2% of positive cultures, whereas there was no conmitant increase of group B streptococci in dip-slides screened in several other laboratories serving as controls.

Agar↗
PubMed1978

Access of metronidazole into the chronically inflamed middle ear with reference to anaerobic bacterial infections.

Strictly anaerobic bacteria were found in about one third of 138 consecutive cases of active chronic otitis media. These infections were always mixed involving aerobes as well. In 79 cases only aerobes were found and 16 cultures were sterile. To provide a basis for possible clinical trials, the penetration of metronidazole into the ear was studied after an oral dose of 2.4 g to patients with chronic otitis media. Significant amounts of biologically active metronidazole were found in 8 of 12 middle ear discharges at 2--4 h, the concentrations varying between 9.4 and 65.0 microgram/ml. Between 2 and 13 h after administration, significant drug concentrations all exceeding the highest reported bactericidal ones were found in the middle ear mucosa in 6 cases of the 8 in which the determinations were possible. Neither the mucosal nor the discharge concentrations correlated with the simultaneous serum levels of metronidazole, which were high in all 23 patients studied.

Administration, Oral↗
PubMed1978

Comparison of four dosage schedules in the treatment of giardiasis with metronidazole.

Sixty patients with parasitologically confirmed giardiasis were treated with metronidazole using four different regimens administered to four groups of 15 patients each. A seven-day course of 200 mg thrice daily successfully eliminated the organism in 11 patients. A repetition of the seven-day course after an interval of one week was successful in 14 patients, a single dose of 2400 mg in nine patients, and two 2400 mg doses on successive days in 12 patients. Late relapses, detected more than one month after therapy, were relatively common in the single-dose groups. Side-effects associated with the 2400 mg dosages were frequent but tolerable.

Adolescent↗
PubMed1978

Comparative evaluation of two dosages of tinidazole in the treatment of giardiasis.

Forty-five patients with parasitologically confirmed symtomatic giardiasis were treated with tinidazole. A course of 150 mg twice daily for 7 days cured 14 of 19 patients (74%), and a single dose of 2,000 mg cured 24 of 26 (92%). After the single dose, mild side effects were common including maltase, lassitude, and dizziness. Three probable cases of the so-called "postgiardiac syndrome" were seen. Either dosage of tinidazole initially cleared all stool samples of Giardia lamblia, and most clinical and parasitological failures were first detected a few weeks after the treatment. This emphazises the significance of long follow-up periods.

Adult↗
PubMed1977

Prepatency of giardiasis.

Recently acquired giardiasis was suspected in 199 patients because of typical symptoms following a trip to a known endemic area. In 130 cases giardiasis was confirmed by stool examination, although most of the samples obtained less than 3 wk after probable infection were negative for Giardia lamblia. Prepatency was documented in 35 patients who, after one or more negative stool examinations, started to excrete Giardia. The median prepatent period was 14 days, and in most cases the prepatent period was less than 3 wk. The median incubation time of giardiasis was 8 days, and in two-thirds of the cases the symptoms had continued for over a week before the parasite became detectable in faeces. A practical conclusion was that, in suspected cases of giardiasis with negative stool findings during the first 3 wk after possible exposure to Giardia, examination of repeated faecal samples is still effective in confirming the diagnosis.

Disease Outbreaks↗
PubMed1977

Anaerobic bacteria in chronic otitis media.

The bacteriology of 70 consecutive cases of active chronic otitis media was studied. Using appropriate technology, anaerobic bacteria were recovered in 33%, Bacteroides species accounting for one half of them. They were always found in mixed infections involving the average of 3.8 bacteria, 1.9 anaerobic, and 1.9 facultative species. The bacteriology was relatively stable from one ear to the other in the ten bilateral cases studied. The results were alike in the groups differing with respect to local antimicrobial therapy or appearance of the middle ear discharge. The cases with chronic otitis in spite of previous radical surgery presented more often with anaerobic infection than the unoperated ones, and none of them yielded sterile cultures. The recognition of anerobic middle ear infections may be clinically significant because the susceptibilities of the organisms to antimicrobial agents and to air are characteristically different from those of aerobic or facultative bacteria.

Administration, Topical↗
PubMed1977

Haemophilus influenzae in otitis media and sinusitis: serotypes and susceptibilty to ampicillin and amoxycillin in vitro.

In order to obtain Haemophilus influenzae, other than Type b, with highly probable human pathogeniticy strains were collected that had been isolated in abundant numbers from middle ear or maxillary sinus secretions of 157 patients with otitis media or sinusitis. The distribution of serotypes was as follows: nontypable 33.8%, Type b 26.1% Type a 19.1%, Type c 7.6%, Type e 5.7%, Type f 5.1%, and Type d 2.5%. The type distribution did not depend on the source of the strains. All strains were susceptible to ampicillin and amoxycillin in vitro; the broth dilution minimum inhibitory concentrations (MIC) of both antibiotics varied only fourfold; typical MIC values were 0.125 microgram/ml and 0.25 microngram/ml, respectively. Susceptibility did not vary with the source or type of the strains nor with the presence or absence of concomitant penicillin therapy.

Amoxicillin↗
PubMed1977

Bactericidal activity of tinidazole. An in vitro comparison of the effects of tinidazole and metronidazole against Bacteroides fragilis and other Anaerobic bacteria.

The new antiprotozoal agent, tinidazole, was found to be bactericidal against all 52 isolates of obligate anaerobic bacteria tested, 42 Bacteroides fragilis, 4 clostridia and 6 peptostreptococci. The minimum bactericidal concentrations of tinidazole for B. fragilis ranged from 0.25 to 4 mug/ml, and those of metronidazole from 0.25 to 8 mug/ml, i.e. several times lower than the serum concentrations achievable after oral administration. In most cases the MIC was identical with MBC or half of it. On the average, tinidazole was slightly more effective against B. fragilis than metronidazole. Although essentially the activities of the two drugs were positively correlated, there was a fourfold difference in their MBC for 10 of the 42 B. fragilis.

Bacteria↗
PubMed1976

Presumptive identification and antibiotic susceptibility of group B streptococci.

The comparative performance of three presumptive identification tests for group B haemolytic streptococci was investigated, using 371 different clinical isolates of group B streptococci. Hippurate was hydrolysed by 96-1%, the CAMP reaction was positive in 95-0%, and pigment was produced by 97-3%. A combination of any two tests would have detected over 99-8%. On bile esculin agar 99-0% were able to grow, but non hydrolysed esculin; 5-1% were susceptible to bacitracin. The minimum inhibitory concentrations of five antibiotics for 279 group B streptococci were determined. All were susceptible to penicillin G, ampicillin, cephalothin, and erythromycin, while 80% were resistant to tetracycline. The MIC distributions were independent of the results of any identification test.

Ampicillin↗
PubMed1976

Studies on the quantitative relationship between specific antigen recognition and manifestation in delayed hypersensitivity.

Delayed skin reactions or peritoneal cell migration inhibition were elicited in guinea-pigs or rats with egg albumin, diphtheria toxoid, or tuberculin-purified protein derivative either separately or with various combinations of two antigens. When the skin reactions or migration inhibition with the component antigens alone were relatively strong, the corresponding combination elicited weaker reactions than calculated assuming that the antigens would add upon each other independently, i.e. the non-specific phase was limiting the manifestation. When the reactivity to both components was undetectable or very weak, the combination elicited stronger reactions than calculated, implying synergism of antigen recognition. The combinations of two weakly positive or intermediate reactivities were close to the calculated values in both the diameter of erythema, skin thickness and migration percentage. These results may help in assessing the biological significance of findings in delayed hypersensitivity: even minor differences in strong manifestations may mean great differences in terms of specific lymphocytes, while marginal changes of antigen recognition may lead to apparently great changes of manifestation, when very weak reactivities are measured.

Animals↗
PubMed1976

Organ distribution of immunocompetent cells in guinea pigs. II. Spleen, lymph node, bone marrow, or thymus cells in the restoration of the splenic plaque-forming cell response to sheep erythrocytes after irradiation.

The splenic plaque-forming cell response of inbred guinea pigs to sheep erythrocytes was abolished by whole-body X-irradiation with 600 rad. The minimum doses of various cell types from normal syngeneic donors to restore the response significantly were 100 X 10(6) spleen or lymph node cells or 500 X 10(6) bone marrow or thymus cells. The combination of 100 X 10(6) thymus and 100 X 10(6) bone marrow cells provided statistically significant restoration, but not much more than 100 X 10(6) bone marrow cells alone. The lack of thymus-marrow synergism suggests that in guinea pigs the antigen-reactive cells and antibody-forming cell precursors are not in the same way enriched in the thymus and bone marrow as in mice.

Animals↗