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Biomedical subjects

M McIntyre

Publications and source records attributed to M McIntyre.

At least 91 records · Page 5Linked to original sources

Urine specimen collection with external devices for diagnosis of bacteriuria in elderly incontinent men.

We determined the validity of using external devices for urine specimen collection from 24 elderly incontinent men residing in a nursing home by collecting three sequential specimens, two with external devices and then one by catheterization. The positive predictive value of organisms isolated in quantitative counts of greater than or equal to 10(5) CFU/ml in external devices for bladder bacteriuria was 86% for either sterile or clean collecting devices and 93% for the same organism in two consecutive specimens. The negative predictive value for organisms present in quantitative counts of less than 10(5) CFU/ml was 90% for both sterile and clean devices and 86% when the organism was present in both specimens. Contamination in external collection devices was not influenced by whether the device was clean or sterile, circumcision of the resident, or duration of time between device application and specimen collection. These data suggest that urine specimens collected by ward nursing staff with external devices are reliable for the diagnosis of bacteriuria in this patient population.

Aged↗

Human infection with Streptococcus zooepidemicus (Lancefield group C): three case reports.

Three unrelated severe infections with Streptococcus zooepidemicus occurred in England in 1985. The first patient developed septic arthritis, which has not been recorded before with this organism. The second died with septicaemia, pneumonia and post-streptococcal glomerulonephritis, the only record so far of nephritis following sporadic S. zooepidemicus infection and of nephritis and systemic sepsis in the same patient. The third patient experienced septicaemia during pregnancy but recovered without complications. A likely animal source of infection was found in only one case.

Acute Kidney Injury↗

Biophysical characterization of rotavirus particles containing rearranged genomes.

Human rotaviruses containing rearranged genomes were found to package up to 1,800 additional base pairs in virus particles. The viruses compared were indistinguishable in respect of their particle diameters and their apparent S values. Particles containing rearranged genomes were found to be of a higher density than rotavirus particles containing a standard genome as determined by equilibrium density ultracentrifugation. The increase in density was directly proportional to the number of additionally packaged base pairs.

Biophysical Phenomena↗

Heterogeneity of genome rearrangements in rotaviruses isolated from a chronically infected immunodeficient child.

Rotaviruses with genome rearrangements, isolated from a chronically infected immunodeficient child, were adapted to growth in BSC-1 cells. Preparations of viral RNA from fecal extracts showed a mixed atypical rotavirus RNA profile, which was due to the presence of at least 12 subpopulations of viruses grossly differing in genotype. Besides various forms of genome rearrangements involving segment 8-, 10-, and 11-specific sequences, reassortment in vivo was likely to have occurred during the emergence of these viruses. The protein products of viral genomes with various forms of segmental rearrangements seemed to be largely unaltered. Genome rearrangement is proposed to be a third mechanism directing the evolution of rotaviruses.

Animals↗

The association of bacteriuria with resident characteristics and survival in elderly institutionalized men.

Ninety-one elderly male residents of a skilled nursing facility were classified as nonbacteriuric (41%), intermittently bacteriuric (34%), or continuously bacteriuric (25%) on the basis of urine cultures obtained over a 3-year period. Bacteriuric and nonbacteriuric residents were similar in age, number of diagnoses and medications, and mobility. However, bacteriuric residents were more frequently confused or demented, whether continuously bacteriuric (78%) or intermittently bacteriuric (62%) compared with nonbacteriuric residents (42%) (p less than 0.04). In addition, bacteriuria was significantly associated with incontinence of bladder (96% of continuous, 66% of intermittent, and 25% of nonbacteriuric; p less than 0.001) and bowel (52%, 39%, and 5.5%, respectively; p less than 0.002). At 6 years of follow-up there were no differences in survival among the three groups. Urinary tract infection caused or contributed to only two (2.9%) deaths. Thus, in this population, bacteriuria was associated with higher functional disability but not with increased mortality.

Aged↗

Sex differences in presentation of cutaneous malignant melanoma and in survival from stage I disease.

To explain the improved survival rates of females with malignant melanoma compared with that of males in this region of the United Kingdom (a recognized low incidence area for melanoma), clinicopathologic differences between the sexes of 477 patients presenting with primary melanoma at all stages, were examined between 1961 and 1976. The survival of 356 males and females presenting with Stage I melanoma were also compared, taking death from melanoma as the critical event. The data were analyzed using the Cox multivariate model, which allows several prognostic variables to be considered simultaneously, and enabled the assessment of the effect of, and interactions between, these variables. Female superiority in survival was due to: more lesions on the female lower limb, a site associated with a good prognosis; thinner lesions at presentation in the female; an interaction with age in which females between the age of 50 and 79 years fare significantly better than a similar age group of males. This age/sex interaction has not been observed in high incidence areas. It suggests, therefore, that melanoma may behave differently in different geographical areas.

Arm↗

Significance of pharyngeal colonization with aerobic gram-negative bacilli in elderly institutionalized men.

The prevalence of pharyngeal colonization with aerobic Gram-negative rods was studied on three occasions during one year in 68 elderly males resident on two long-term care wards. For the three surveys, pharyngeal carriage was identified in 43%, 43%, and 37% of residents. Each resident tended to remain either colonized or noncolonized. Pharyngeal colonization was associated with resident incontinence, the development of infection, and increased mortality during the year of observation.

Aerobiosis↗

Oat cell carcinoma of esophagus: a report of six British patients with a review of the literature.

This paper presents 6 British patients with a diagnosis of oat cell carcinoma of the esophagus. Sixty-six patients have previously been reported in the literature, the majority (30) being British. Approximately two-thirds of these tumors have been reported as pure oat cell carcinoma of the esophagus. Four other histological patterns have been described: oat cell carcinoma with squamous carcinoma in situ; oat cell carcinoma with squamous carcinoma; oat cell carcinoma with adenocarcinoma; and oat cell carcinoma with carcinoid differentiation. A preponderance of males has also been noted, although this series shows a 2:1 female:male ratio. The tumor arises most commonly in the mid or lower esophagus. The cell of origin of these tumors in considered to be the Kulchitsky or APUD cell of neuroectodermal derivation. They may show neurosecretory granules on electron microscopy. Polypeptides have been identified within the tumor cells. One previous report describes a patient with primary oat cell carcinoma of the esophagus and hypercalcemia. A patient with the syndrome of inappropriate anti-diuretic hormone secretion is described in this paper. Survival is poor following radiotherapy, with a median survival of 3 months in this series. On reviewing the records of the Radiation Oncology Unit in Edinburgh, no patient with oat cell carcinoma of the esophagus was reported before 1972. This suggests that awareness of this tumor is increasing and, although rare, its incidence is greater than previously reported.

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Improving communication: a practical programme for teaching trainees about communication issues in the general practice consultation.

This paper describes a teaching programme, for use in general practice vocational training, which provides a theoretical and practical framework for exploring key aspects of the consultation with trainees. A particular emphasis is on the educational or 'cognitive' outcomes of the consultation and skills for improving them. The five stages of the programme are described and an example of experience of each stage is given. The paper concludes with an evaluation of the programme by the trainers, trainees and social scientist involved.

Communication↗

Twelve-month surveillance of infections in institutionalized elderly men.

Surveillance of infectious episodes in institutionalized elderly men permanently resident on two wards of a veterans' hospital was undertaken for a 12-month period. One-hundred eleven episodes were identified in 50 residents (74 per cent). The most frequent infections included lower respiratory tract infections (incidence 59/100 patient-years), febrile episodes with no source (43.4), skin and soft tissue infections (36.5), and gastroenteritis (33). Only pneumonia was associated with significant mortality. A specific etiologic agent was seldom identified other than for skin and soft tissue infections. Antimicrobial therapy was prescribed for 87 per cent of all infections. Ward staff absenteeism was associated with peak occurrences of infections in residents. Resident characteristics that correlated with infection were incontinence of bladder and of bowel. Mental status or degree of mobility did not correlate. While infections occur frequently in this population, mortality is common only with pneumonia. Infections occur more frequently in residents who have greater functional impairment.

Absenteeism↗

Relationship between acute suppurative otitis media and chronic secretory otitis media: role of antibiotics.

A total of 204 chronic middle ear effusions from 122 children have been studied. Bacteria were isolated from 30 effusions. The commonest species found were Strep. pneumoniae and H. influenzae. These are also the commonest organisms causing acute otitis media (AOM). A similar pattern of serotypes was also demonstrated. In vitro sensitivity testing showed that most of the organisms isolated were sensitive to most commonly-used antibiotics. The main exception was resistance to penicillin amongst strains of H. influenzae and Staph. aureus. It is suggested that some cases of chronic secretory otitis media (SOM) may arise as a result of incomplete resolution of AOM and that the use of penicillin to treat AOM may be one factor in this process.

Acute Disease↗

Liquid chromatographic determination of urinary metanephrines after pre-column oxidation to vanillin.

Urine after the addition of phenylephrine as internal standard is hydrolyzed and passed through a disposable BondElut SCX column. After washing the column, metanephrines and the internal standard are eluted with dilute ammonia. The eluate is treated with periodate and extracted with toluene. The toluene layer is collected and phenols are extracted into dilute tetramethylammonium hydroxide. An aliquot of the aqueous layer is chromatographed on a nonsilica resin base reversed phase column with an alkaline mobile phase. The peaks are detected by an absorbance detector at 350 nm. There is a baseline separation of vanillin formed by metanephrines and of m-hydroxybenzaldehyde formed by phenylephrine. The procedure is linear from 0.2 mg to 10 mg of metanephrine per liter of urine. The procedure has a high degree of specificity as the commonly prescribed antihypertensive drugs and their metabolites do not interfere.

Benzaldehydes↗

Osteosarcoma of the esophagus.

The case of a 70-year-old man who underwent esophagectomy for a large polypoid sarcoma is described. Detailed examination of the surgical specimen established a diagnosis of osteosarcoma. Although osteosarcomas of the esophagus have been described in dogs, such tumors in humans do not appear to have been previously reported.

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