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Biomedical subjects

M R Spence

Publications and source records attributed to M R Spence.

At least 19 recordsLinked to original sources
PubMed1991

The relationship between recent cocaine use and pregnancy outcome.

We conducted urine screening for cocaine metabolite in 500 consecutive women admitted to a labor and delivery unit. The pregnancy outcome of 411 of the women was determined at that admission. The prevalence of cocaine-positive urines was 15.3% (95% confidence interval 11.8-18.8%). A subset of this population that had not received prenatal care had a prevalence of 62% (95% confidence interval 47.2-76.6%). Women with positive urines were almost four times more likely to have preterm labor and over twice as likely to deliver a premature infant or one with a 1-minute Apgar score of 6 or lower. Our findings support the concept that urine drug screening for cocaine and/or other drugs of abuse should be considered in patients who present with no prenatal care, premature labor, premature delivery, and delivery of an infant with a 1-minute Apgar score of 6 or less. This strategy may enable us to identify and bring to therapy a population of women that could potentially go unrecognized.

Adult↗
PubMed1979

Transport of Neisseria meningitidis cultures: growth-supporting media and freezing as an alternative.

The abilities of Transgrow (TG), Thayer-Martin (TM), and New York City (NYC) solid media to maintain the viability of 12 strains of Neisseria meningitidis under various controlled conditions were assessed. The effects of charcoal impregnation of swabs, temperature, and an enriched CO2 atmosphere were examined with holding for up to 21 days. Recovery from samples held at 35 degrees C was, in almost all instances, greater than at 22 or 4 degrees C. A strong requirement for added CO2 was demonstrated, especially at lower temperatures. No positive effect could be attributed to the use of charcoal-impregnated swabs. NYC and TM media were the best overall, with the former permitting recovery from more than 75% of all samples held on slants for 20 days at 4 degrees C in an atmosphere of 5% CO2 in air. Freezing, with holding on dry ice, was a useful alternative to the use of growth-supporting media. This latter method eliminated the requirement for an enriched CO2 atmosphere.

Culture Media↗
PubMed1979

The in vitro and in vivo effects of a surgical lubricant on the recovery of gonococci from the endocervical canal.

A surgical lubricant containing phenylmercuric borate, tested in vitro, was shown to alter the recovery of the gonococcus. In vivo studies of 150 patients, 60 (40%) of whom were infected with Neisseria gonorrhoeae, were performed to determine if examination with the surgical lubricant, as compared to tap water, altered the ability to recover N. gonorrhoeae from the cervix. Results indicated that although the surgical lubricant containing phenylmercuric borate was bacteriostatic in vitro, it did not alter the recovery of N. gonorrhoese from infected patients.

Adolescent↗
PubMed1978

Cytologic detection and clinical significance of Actinomyces israelii in women using intrauterine contraceptive devices.

Pancervicovaginal (Papanicolaou) smears exhibiting pseudomycilial-like clumps of organisms obtained from 35 women employing IUD's were studied by direct immunofluorescent technique for identification of A. israelii and A. naeslundi. In every case the specific fluorescence was achieved with species-specific antiserum against A. israelii. The clinical profile of these 35 women was retrospectively analyzed.

Actinomyces↗
PubMed1978

The cold sterilization of abortion cannulae.

The purpose of this study was to determine if cold sterilization is a feasible method for sterilizing abortion cannulae and, if so, to find the appropriate solutions and time intervals for this sterilization process. Study findings show that abortion cannulae can be cold sterilized by soaking them for a minimum of 10 minutes in a solution of Cidex or 95% ethanol. Soaking the cannulae for 20 minutes in a 2% tincture of iodine solution also appears to be useful for decontamination purposes.

Abortion, Induced↗
PubMed1978

Bacteriologic culture results obtained before and after elective midtrimester urea abortion.

Twenty patients undergoing elective midtrimester abortion by urea amnioinfusion had bacteriologic culture data obtained before and after the procedure. Despite the presence of pathogens in the vagina and cervix prior to the procedure, only 20% of patients exhibited endometrial growth following abortion. Factors that seem to favor such endometrial growth include increased injection-abortion intervals and the requirement for curettage to manage incomplete abortion.

Abortion, Induced↗
PubMed1978

Pelvic actinomycosis and the intrauterine contraceptive device. A cyto-histomorphologic study.

In 350 pancervico-vaginal (Fast) smears obtained from women using intrauterine contraceptive devices, organisms consistent with Actinomycetes have been found. Actinomycetes, representing cervicitis, endometritis, and pelvic abscesses clinically, have been observed histologically in some of these cases. Special stains, immunofluorescence, and anaerobic cultures have confirmed these organisms to be Actinomyces israelii. Actinomyces in the Fast smear occur in isolated clumps, revealing branching, filamentous organisms, and sulfur granules. They can be detected and diagnosed in a Papanicolaou-stained routine pancervico-vaginal smear. This diagnosis in Fast smears can identify users of intrauterine contraceptive devices who may have Actinomyces infection in the genital tract and who are at risk of developing clinical disease related to this infection.

Abscess↗
PubMed1978

Sporadic (nonepidemic) puerperal mastitis.

Sporadic puerperal mastitis is an acute cellulitis, characterized by fever and segmental erythema in the breast. Staphylococcus aureus can be cultured in approximately one-half of the cases. With early antibiotic therapy, the infection can be cleared and abscess formation prevented. Breast engorgement may also contribute to abscess formation, and so nursing should not be discontinued. No ill effects are observed in infants who continue to nurse. Twenty women with acute puerperal mastitis had breast milk cultures, and Staphylococcus aureus was recovered in seven cases. All patients were treated with antibiotics and continued nursing. No abscesses developed, and no ill effects were observed in any infants.

Female↗
PubMed1978

Unilateral ovarian abscess associated with the intrauterine device.

Four cases of primary ovarian abscess associated with intrauterine contraceptive devices are presented. It is proposed that both their unilaterality and the fact that they were primary in the ovary rather than tuboovarian are due to the fact that bacteria from the intrauterine device are shed continuously through the fallopian tubes, resulting in the inoculation of the corpus luteum, a unilateral structure. Removal of the ovarian abscess without additional surgical therapy is sufficient for a patient with this type of pelvic infection.

Abscess↗
PubMed1976

Oropharyngeal gonorrhea during pregnancy.

The frequency of oropharyngeal infections with Neisseria gonorrhoeae in pregnant women was studied in two prenatal clinics in Bandkok, Thailand. A third group of women visiting a dental clinic on a routine basis was included for comparison purposes. Group I, from an American dependent clinic, had an oropharyngeal infection rate of 15% while only 0.7% had cervical infections. None had infections in more than one site. In Group III, from a Thai clinic, no patients had oropharyngeal infections while 11.9% had infections from either the cervix or rectum or both. One and eight-tenths percent of the patients attending the dental clinic had oropharyngeal infections. Oropharyngeal gonorrhea was found in a prenatal population of American military dependents at a high rate. We propose that all women visiting a prenatal clinic routinely have their oropharynx cultured for N gonorrhoeae.

Adolescent↗
PubMed1976

Changing penicillin resistance of the gonococcus in Thailand.

Minimum inhibitory concentrations (MIC) of penicillin in units per milliliter were determined for 2.241 gonococcal isolates submitted to the SEATO Medical Research Laboratory between January 1, 1972, and December 31, 1974. Isolates were separated into 3 groups, determined by the calender year in which they were submitted. The mean penicillin MIC+/-2 standard errors was calculated for each of the 3 groups. These values were 0.58+/-0.02 units/ml in 1972, 0.72+/-0.04 units/ml in 1973, and 1.05+/-0.04 units/ml in 1974. These means were found to be significantly different (p less than 0.0001).

Gonorrhea↗