Ruptured branchial cleft cyst presenting as acute thyroid infection.
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Biomedical subjects
Publications and source records attributed to M B Kleiman.
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An enzyme-linked immunosorbent assay (ELISA) using commercially available reagents was compared with standard serological tests for determination of antibody titers in patients with acute measles. The measles-specific ELISA was as sensitive as complement fixation, hemagglutination inhibition, and indirect fluorescent-antibody methods. The ELISA method used was simple, sensitive, inexpensive, and reproducible and may conveniently be used in a small clinical laboratory.
A necrotizing meningoencephalitis complicated by ventricular compartmentalization and abscess formation caused by Enterobacter sakazakii in a previously healthy 5-week-old female is described. A detailed description of the isolate is presented. This communication firmly establishes the pathogenicity of E. sakazakii.
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The American Academy of Pediatrics' Standards and Recommendations for Hospital Care of Newborn Infants recommends that linen in newborn intensive care, intermediate care, continuing care and admission observation areas be autoclaved. Questionnaires sent to 269 directors of newborn intensive care units (69% returned) showed that 74% of the respondents do not autoclave linen used in their newborn intensive care unit. There were 284 linen cultures performed in our newborn intensive care unit where linen is not autoclaved; 68% of the cultures were positive, but only 2.5% had a colony count greater than 20 colonies per plate. The most common organisms obtained were Staphylococcus epidermidis, diphtheroids, and Micrococcus species. Two cultures grew Staphylococcus aureus, one colony and two colonies per plate. Three-factor analysis of variance showed that the location of the linen in the top of the pile exerted a statistically significant effect on the bacterial contamination rate. The fact that three fourths of neonatal intensive care centers in this country do not autoclave nursery linen, the lack of reports in the literature relating linen contamination to nosocomial infections, and the microbiologic results of this study suggest that the recommendations of the American Academy of Pediatrics merit further study and reevaluation.
Thrombophlebitis in children is almost always related to intravenous therapy. In most cases the inflammatory reaction is self-limited and resolves when the intravenous catheter or needle is removed. In some cases contamination may result in suppurative thrombophlebitis, a potentially life-threatening complication of intravenous therapy. This report describes two-6-year-old children with suppurative thrombophlebitis that was successfully treated by drainage of periphlebitic abscess and excision of the infected vein. Early recognition and prompt surgical management should reduce morbidity and prevent mortality in these cases.
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Thirteen infants with compartmentalization of the lateral ventricles diagnosed by air encephalography, computerized tomography, or autopsy are reported. In each case, the body of one or both lateral ventricles was completely divided by a membrane posterior to the foramen of Monro. Recognition of this entity is important from both therapeutic and prognostic standpoints.
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The incidence of non-traumatic, traumatic and unsuccessful lumbar punctures in 181 neonates was similar whether a needle with a stylet, a butterfly needle without stylet, or a standard venipuncture needle without stylet was used. Comparison of 20 lumbar puncture pairs in 17 patients showed that traumatic lumbar puncture does not result in a cerebrospinal fluid pleocytosis between two and 13 days after initial traumatic lumbar puncture.
In recent years health services researchers have become increasingly aware of the importance of a regular doctor to whom the patient usually goes when sick or in need of advice about health, as a means of providing a point of entry to needed medical care. For example, persons who have a regular source of care seem more likely to receive an annual physical examination, to experience continuity of care when needed, and to be satisfied with the care received. Yet, despite the importance of an established tie to a regular treatment source, evidence is scanty with respect to the aged. To address the issue, this study employs data from a national probability sample of 11,619 persons, of whom 1,506 were aged 65 or older. The findings indicate that several factors (e.g., sex, race, education, and community size) which traditionally have served as important indicators of the use of health services fail to emerge as strong determinants regarding the regular source of care among the aged. The consequences of these findings and implications for future research are discussed.
Chloramphenicol can be assayed by a sensitive and selective high-pressure liquid chromatographic assay technique. The method described is easily adapted to analysis of many other drugs.