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Biomedical subjects

M Finland

Publications and source records attributed to M Finland.

At least 19 recordsLinked to original sources
PubMed1979

Pneumonia and pneumococcal infections, with special reference to pneumococcal pneumonia. The 1979 J. Burns Amberson lecture.

An etiologic classification of acute pneumonia was presented and the relative importance of some of the causative agents was briefly reviewed. The early developments of the therapy of pneumococcal pneumonia with type-specific antisera, sulfonamide drugs, and antimicrobial drugs were reviewed, mostly from the experiences of the author at Boston City Hospital. Changes in the occurrence and relative importance of the pneumococcus as a cause of infections associated with bacteremia, empyema, and meningitis were demonstrated, based on cases observed at Boston City Hospital during 12 selected years between 1935 and 1972. These findings, among others, indicate that the pneumococcus is still one of the most important causes of serious bacterial infections and of mortality from such infections, particularly in the elderly. Some possible indications for polyvalent pneumococcal capsular polysaccharide vaccine were discussed, and the need for further extensive clinical and field trials to demonstrate its range of effectiveness was stressed.

Age Factors↗
PubMed1978

Changing ecology of acute bacterial empyema: occurrence and mortality at Boston City Hospital during 12 selected years from 1935 to 1972.

The occurrence, etiology, and demography of acute bacterial empyema are presented to reflect the widespread use of sulfonamides, penicillin, and other active antibiotics. In community-acquired (C-A) cases Streptococcus pneumoniae, hemolytic streptococci, and Staphylococcus aureus were the most frequent single organisms identified in initial positive cultures of pleural fluid during 1935. S. pneumoniae declined steadily until 1953 but continued to occur frequently in C-A cases. Hemolytic streptococci became infrequent. S. aureus increased and became the most frequent organism in 1955 and declined to original levels after 1965 while gram-negative rods increased. S. aureus, aerobic gram-negative rods, and enterococci were most frequent in originally mixed infections, hospital-acquired cases, and superinfections. Anaerobes with or without aerobes were mostly seen in C-A cases and did not vary in incidence. Mortality increased with age. Overall mortality was greater during the 10 antibiotic years, associated with a marked decrease in the proportion of patients younger than 50 years and increase in those over 60 years old, and was greater in patients with serious underlying diseases subjected to more complicated surgical procedures.

Age Factors↗
PubMed1978

Duration of hospitalization for acute bacterial empyema at Boston City Hospital during 12 selected years from 1935 to 1972.

The duration of hospitalization for acute bacterial empyema of the pleura was determined for all cases at Boston City Hospital during 12 selected years between 1935 and 1972. Patients whose infection was acquired after admission stayed in the hospital longer than those in whom the empyema, or the infection of which the empyema was a complication, was present at the time of admission. The differences were mostly related to serious underlying disease in the hospital-acquired cases. However, the duration of hospitalization after the empyema was bacteriologically confirmed was not much different in the community-acquired and hospital-acquired cases. Hospital stay was further prolonged in patients whose empyema was superinfected with new bacterial species after the original infecting organisms were determined. Hospitalization was shorter in the 10 selected years between 1974 and 1972, when penicillin and other active antibiotics were used, than in two years before penicillin became available, 1935 and 1941.

Acute Disease↗
PubMed1978

Bacteremic superinfections of patients with bacteremia: occurrence, bacteriology, mortality, and duration of hospitalization at Boston City Hospital during 12 selected years between 1935 and 1972.

During the course of hospitalization of 6,414 patients with bacteremic infections identified at Boston City Hospital (Boston, Massachusetts) during 12 selected years between 1935 and 1972, 6.0% developed verified bacteremic superinfections with organisms not isolated or identified in the primary bacteremic infection. Analysis of these cases reemphasizes the increasing occurrence of serious hospital-acquired infections despite the successive introduction and intensive use of a large number of effective antibacterial agents. The bacteremic superinfections, like the primary hospital-acquired bacteremias, increased in incidence over the years, particularly since 1961; they were more frequent and were associated with a higher mortality rate and longer duration of hospital stay in the primary hospital-acquired cases than in the patients in whom bacteremia was considered to be community-acquired. The organisms in superinfections were similar to those in primary hospital-acquired bacteremias. Superinfection was more frequent among the patients who died than among the survivors.

Bacterial Infections↗
PubMed1978

Duration of hospitalization for bacteremic infections at Boston City Hospital during 12 selected years between 1935 and 1972.

In survivors of both community-acquired (CA) and hospital-acquired (HA) bacteremic infections at Boston City Hospital during 12 selected years between 1935 and 1972, the mean hospital stay fluctuated widely from one selected year to the next, but it was generally shorter and early discharges were more frequent in the years when effective antibacterial agents were used. The greatest reduction in hospital stay occurred by 1941. The size of the fluctuations and reductions also varied with the causative organism. The average duration of hospitalization of all survivors of HA bacteremic infections after the first positive blood culture was 10.5 days longer than the total hospitalization of survivors of CA infections. The reduced length of hospital stay after 1935 is attributed to the successful use of effective antibacterial drugs, and the greater effect in CA than in HA cases is attributed to more frequent infections in the latter with organisms resistant to those drugs.

Boston↗
PubMed1978

New developments in antibiotics. Future clinical studies for the National Institute of Allergy and Infectious Diseases.

The classes of anti-infective agents and the numbers in each class that are currently available and in use in the United States are listed, and current activity with respect to discovery and development of new drugs in the most widely used categories is briefly reviewed. Fifteen major areas for future research in the therapy and control of infectious diseases are recommended, and the relative roles for industry, academic and clinical investigators, and government (National Institute of Allergy and Infectious Diseases) in these areas are discussed. There are many problems requiring extensive research and financial support.

Aminoglycosides↗
PubMed1977

Acute bacterial meningitis at Boston City Hospital during 12 selected years, 1935-1972.

Data are presented on the occurrence of and mortality rate from acute bacterial meningitis at Boston City Hospital during 12 years between 1935 and 1972 selected in relation to the introduction of potent antibacterial agents. The most frequent causative organisms were Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae, but large proportions were caused by other gram-positive cocci and gram-negative bacilli. The greatest reduction in mortality rate after antibiotics became widely used was in patients with meningococcal and influenzal meningitis who were less than or equal to 19 years old. Less striking reductions occurred in cases of other etiologies in patients less than or equal to 59 years old, but in those greater than or equal to 60 years old, the mortality rate remained high, and the proportion of cases of meningitis in that age group more than doubled. Comparisons with similar data on all bacteremic infections are presented.

Acute Disease↗
PubMed1977

In vitro activity of p-hydroxybenzyl penicillin (penicillin X) and five other penicillins against Neisseria gonorrhoeae: comparisons of strains from patients with uncomplicated infections and from women with pelvic inflammatory disease.

Minimum inhibitory concentrations (MICs) of six penicillins against 95 strains of Neisseria gonorrhoeae from patients with uncomplicated anogenital infections and 22 strains from women with pelvic inflammatory disease were determined by an agar plate dilution method, using an inocula replicator. Against all 117 strains, the order of activity observed was: BL-P1654 > penicillin X > penicillin G > ampicillin > amoxicillin = carbenicillin. MICs against strains isolated from women with gonococcal pelvic inflammatory disease were significantly higher than those against isolates from uncomplicated infections: BL-P1654, P < 0.001; penicillin X, P < 0.001; penicillin G, P < 0.001; ampicillin, P < 0.001; and amoxicillin, P < 0.05. MICs of penicillin G were >/=0.125 mug/ml against 33 (36%) of the 92 strains from patients with uncomplicated infections, as contrasted with 15 (68%) of the 22 isolates from women with pelvic inflammatory disease (P < 0.01). The means of the MICs of penicillin G were 0.06 mug/ml for the former and 0.14 mug/ml for the latter.

Female↗
PubMed1977

Quantitative inhibition of Haemophilus influenzae by trimethoprim/sulfamethoxazole.

We evaluated the inhibitory effect of trimethoprim (TMP) and sulfamethoxazole (SMZ), alone and in combination, against 34 strains of Haemophilus influenzae. Growth inhibition was determined after incubation for 18 h by comparing viable counts of cultures in drug-containing medium with corresponding counts of control cultures in drug-free medium. In a modified, thymidine-deficient Levinthal broth, the numbers of colony-forming units of all the isolates tested were reduced 100-fold or more by TMP/SMZ (1.25/25 mug/ml) as compared with growth without drug. Inhibition was significantly greater with TMP/SMZ than with either TMP or SMZ alone. Ampicillin-susceptible and ampicillin-resistant strains were equally susceptible to TMP/SMZ. Growth of nontypable strains was inhibited more than growth of type b organisms.

Haemophilus influenzae↗
PubMed1977

Changes in occurrence of capsular serotypes of Streptococcus pneumoniae at Boston City Hospital during selected years between 1935 and 1974.

The number of patients with pneumococcal bacteremia, empyema, and meningitis at Boston City Hospital during selected years between 1935 and 1974 is reported. The distribution of specific types in the bacteremic patients during each of the selected years and in the various focal infections in all the years is also detailed. The numbers and rates per 1,000 admissions of bacteremic pneumococcal infections and the numbers of cases of pneumococcal meningitis and empyema varied independently over these years and differed from those previously reported for 1929 to 1936. The types most frequent in pneumococcal bacteremias varied over the years, and the distribution of types among them differed markedly from that among the patients with focal infections. Variations in the distribution of pneumococcal types at different times in the same place, in different places, and in various sites of infection may be important in selecting types to include in pneumococcal vaccines for different populations.

Boston↗
PubMed1976

Nosocomial infections in surgical patients. Observations on effects of prophylactic antibiotics.

In a "spot survey" to determine prevalence of nosocomial infections in the Surgical Services of Boston City Hospital in January 1972, the use of antibiotics prophylactically did not significantly affect the occurrence of infections either in patients who had undergone surgery or in those who had not at the time of the survey. Among both groups, whether they had acquired infections or not, the use of antibiotics for prophylaxis did not affect the duration of hospitalization up to the time of the survey. In another study (August through October 1971) of the incidence of infections among patients admitted to the Orthopedic Service of the same hospital, the incidence of infections was the same in patients who received antibiotics prophylactically and in those who did not receive any during their period of hospitalization.

Anti-Bacterial Agents↗
PubMed1976

Susceptibility of "enterobacteria" to aminoglycoside antibiotics: comparisons with tetracyclines, polymyxins, chloramphenicol, and spectinomycin.

Strains of enterobacteria, including common, aerobic, pathogenic gram-negative bacilli, and enterococci were tested for susceptibility to 11 aminoglycoside antibiotics by a twofold agar-dilution method with an inocula replicator. For comparison, similar tests were done with seven tetracycline analogues, two polymyxins, chloramphenicol, and spectinomycin. Tobramycin compared favorably with the more active aminoglycosides, with some exceptions related to individual strains of species. The tetracyclines and chloramphenicol were generally less active than the more active aminoglycosides. The polymyxins were as active or more active against most species of gram-negative rods but were essentially inactive against Proteus, Providencia, and many strains of Enterobacter.

Acinetobacter↗