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Biomedical subjects

M R Spence

Publications and source records attributed to M R Spence.

71 records · Page 4Linked to original sources
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↗
PubMedDate not supplied

Cross-allergenicity and immunogenicity of aztreonam.

The immunochemistry of aztreonam, the prototype of the new monobactam class of beta-lactam antibiotics, was studied in a series of experimental and clinical investigations. Rabbit antibodies to aztreonam and naturally occurring human antibodies that recognize aztreonam were found to have negligible cross-reactivity with benzylpenicillin, cephalothin, and cefotaxime. Aztreonam likewise displayed negligible cross-reactivity (less than or equal to 0.001%) with antibodies to penicillin (including human IgE antibodies to major and minor penicillin determinants) and to cephalothin. These studies suggest that aztreonam may be well tolerated by penicillin-allergic individuals, and this possibly is now being evaluated in clinical trials. Seven (6.25%) of 112 healthy persons tested had preexisting IgG antibodies to aztreonam in low titer, presumably as a result of exposure to naturally occurring cross-reacting moieties. Only two of seven patients with preexisting IgG antibodies to aztreonam had a rise in titer following aztreonam treatment. No IgE antibody to aztreonam was detected in serum specimens obtained on day 10 during any of the 112 courses of therapy. These clinical observations suggest but do not prove that aztreonam has only weak potential to elicit a drug-specific immunologic response.

Allergens↗
PubMedDate not supplied

The clinical and laboratory diagnosis of Trichomonas vaginalis infection.

One hundred consecutive female patients attending an inner-city clinic for treatment of sexually transmitted diseases were evaluated for the presence of Trichomonas vaginalis by history, physical examination, 0.85% NaCl wet mount, Papanicolaou smear, and culture. Of the 100 women, 54 were found to be harboring the parasite, as determined by one or more positive diagnostic tests. This prevalence corresponds with that reported previously. The information gained from the history (symptoms and phase of menstrual cycle) and physical examination correlated poorly with results of cultures for T. vaginalis; the organism was isolated more often than symptoms or physical findings would have indicated. Culture was the most sensitive of diagnostic techniques; 48 (89%) of the 54 patients were identified by this method. The Papanicolaou smear detected 35 infections (65%), and the 0.85% NaCl wet mount, 28 (59%). The simplest and most efficient technique for screening women for infection with T. vaginalis may be the Papanicolaou smear, since it is part of the annual physical examination.

Adolescent↗
PubMedDate not supplied

A comparative evaluation of vaginal, cervical and peritoneal flora in normal, healthy women: a preliminary report.

Twelve healthy women undergoing laparoscopic tubal sterilization were studied. Specimens were obtained for culture of aerobic and anaerobic bacteria, Mycoplasma hominis, Ureaplasma urealyticum, and Chlamydia trachomatis. The sites cultured included cul-de-sac (through a laparoscope), cul-de-sac (by transvaginal culdocentesis), the vaginal wall, and the endocervical canal. Anaerobic bacteria were isolated from the peritoneal cavity of three (25%) of the subjects. These isolates included B. melaninogenicus from two specimens obtained by laparoscope from the peritoneal cavity and from two peritoneal specimens obtained by culdocentesis. The data suggest that the peritoneal cavity of normal healthy women is not always sterile. We did not encounter contamination of transvaginal culdocentesis specimens with vaginal flora.

Bacteria↗
PubMedDate not supplied

The isolation of Neisseria gonorrhoeae: a comparison of three culture transport systems.

Endocervical swabs for the culture of Neisseria gonorrhoeae from 417 patients attending a pelvic infections clinic were evaluated. Three swabs were obtained from each patient. One swab was plated directly onto Thayer-Martin medium and taken shortly thereafter to a microbiology laboratory for evaluation. A second swab was inoculated into modified Stuart's transport media and transported soon afterward to the hospital microbiology laboratory. The third specimen was plated onto Transgrow media and transferred according to routine transportation protocols to the Maryland State Health Department for evaluation. The prevalence of Neisseria gonorrhoeae infection in this population was 14.6% (61/417). The sensitivities of the direct plating and modified Stuart's systems with on-site evaluation were 87% (53/61) and 85% (51/61), respectively, while the sensitivity of Transgrow plating with off-site evaluation was only 64% (39/61). These findings argue against the use of a system of Transgrow plating and off-site processing of culture specimens to screen for infections with Neisseria gonorrhoeae.

Bacteriological Techniques↗
PubMedDate not supplied

Seroprevalence of human immunodeficiency virus type I (HIV-1) antibodies in a family-planning population.

Blind testing of 743 women who attended an inner-city hospital family-planning clinic showed 8 (1.1%) patients to have serum antibodies to human immunodeficiency virus type I (HIV-1). A retrospective chart survey did not show an association between HIV-1 antibody seropositivity and ethnicity, marital status, education, history of sexually transmitted diseases, drug and/or alcohol use, and contraceptive method. This failure to establish previously reported correlation may be a function of methods, sample size, or reflect a different population. Nonetheless, the seroprevalence the authors found shows that all patients in a family-planning clinic setting should be offered HIV-1 antibody testing.

Adult↗
PubMedDate not supplied

Development of new-onset seizures in the peripartum period. Should human immunodeficiency virus infection be considered a cause?

The case histories of two women who developed new-onset seizures in the peripartum period of their pregnancies are presented. These two women had divergent medical histories and prenatal courses. Both women developed grand mal seizures that could be attributed to several established etiologies, yet no specific diagnoses were made. Although their risk factors for developing human immunodeficiency virus (HIV) infection were quite different, both women subsequently were confirmed as HIV positive. Since new-onset seizures have been described as a presenting symptom of HIV infection in other studies, the seizures experienced by these two women could be the presenting symptom of their HIV infection. The authors suggest that HIV testing should be considered for any pregnant woman who develops new-onset seizures during the course of her pregnancy, regardless of her risk factor assessment for HIV infection.

Adult↗