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Biomedical subjects

R G Mathias

Publications and source records attributed to R G Mathias.

At least 55 records · Page 3Linked to original sources
PubMed1982

Serotyping of Campylobacter jejuni isolated from sporadic cases and outbreaks in British Columbia.

Campylobacter jejuni from sporadic cases and outbreaks of gastroenteritis were serotyped on the basis of heat-extracted soluble thermostable antigens identified with the use of the passive hemagglutination technique. A total of 168 isolates were separated into 45 different types. The largest proportion of the isolates fell into three serotypes, each with 11 to 12.5% of the total number. Three less frequently occurring serotypes each included approximately 5%, and the remaining 50% of the isolates were distributed among 39 other serotypes. In most cases, serotyping demonstrated that epidemiologically linked isolates were of the same serotype, but the outbreak strains could belong either to frequently or to infrequently isolated serotypes. The high correlation between clinical findings and serotyping results confirmed the applicability of the serotyping scheme in epidemiological investigations of C. jejuni infections.

British Columbia↗
PubMed1977

Bacteremia due to Bacteroidacceae: a review of 92 cases.

The clinical courses of 92 patients who had bacteremia due to Bacteroidaceae were reviewed. The overall mortality rate was 21% (19 patients). There was no significant difference between mortality rates when patients were grouped by anticipated clinical course of underlying disease (nonfatal, ultimately fatal, and rapidly fatal) and when they were grouped by type of antibacterial therapy (appropriate, including clindamycin, chloramphenicol, lincomycin, and carbenicillin; or inappropriate, signifying no antibiotic treatment or treatment with antibiotics other than the four listed above). However, there was a correlation between recovery of the patient and portal of entry of the infectious agent; patients whose source of infection was the gastrointestinal tract had a mortality rate of 29% (17 of 58 patients), whereas there were no deaths among the 26 women whose presumed source of bacteremia was the genital tract. Increasing age appeared to be an important factor as well; 17 of 19 deaths occurred in patients who were older than 40 years. There was no significant difference between the mortality rate of patients who were treated with clindamycin (15%, eight of 52 patients) and that of patients who were treated with chloramphenicol (44%, four of nine).

Adult↗
PubMed1976

Clinical evaluation of amikacin in treatment of infections due to gram-negative aerobic bacilli.

The efficacy and safety of amikacin were evaluated in 42 patients with infections presumed to be due to gram-negative rods. The dosage of 7.5 mg of amikacin/kg every 12 hr was administered intramuscularly to 32 patients and intravenously to seven patients; three patients with renal impairment were given a modified regimen. The duration of treatment was three to 51 days (mean, 9.6 days). Of 19 patients with acute pyelonephritis, five had positive blood culture results. Ten patients had chronic urinary infection, and isolates of Pseudomonas aeruginosa from four of these patients acquired resistance to amikacin during therapy. Of seven patients with gram-negative bacteremia from sources other than the urinary tract, four showed satisfactory and three had less than optimal responses to therapy with amikacin. Two patients with chronic osteomyelitis or soft tissue infection improved but subsequently relapsed. Two patients with acute febrile illness, in whom the etiologic agent was unidentified, recovered. Serial audiograms revealed no change in 26 of 27 patients; one had a significant deterioration in hearing. A transient rise in the level of serum creatinine was noted in three patients. Serial tests of liver function revealed no abnormalities.

Adolescent↗
PubMedDate not supplied

An evaluation of oligoclonal banding and CSF IgG index in the diagnosis of neurosyphilis.

It can be difficult to determine which patients would benefit from therapy to control central nervous system infection with Treponema pallidum. The authors have followed patients prospectively to evaluate two new diagnostic tests available. They performed lumbar punctures on 107 consecutive patients with syphilis of unknown duration, untreated (n = 19) or with serology that did not decrease sufficiently during follow-up (n = 88). The mean age was 47 years, with 91 males and 16 females. Twelve had neurologic symptoms. In order to establish a gold standard, the authors required the cerebrospinal fluid Venereal Disease Research Laboratory (CSF VDRL) test to be reactive (n = 25). They then examined oligoclonal banding and CSF IgG index as diagnostic tests by comparing them to the gold standard. Oligoclonal banding, abnormal in 20, had a sensitivity of 52% and a specificity of 91%. The CSF IgG index, abnormal in 56, had a sensitivity of 92% and a specificity of 60%. The posttest likelihoods of a positive test result were low, and hence neither test ruled in the diagnosis. With a post-test likelihood (PTL) negative of 4%, a negative CSF IgG index assisted in ruling out the diagnosis. Oligoclonal banding was not a satisfactory test for neurosyphilis. The CSF IgG index appears to help only in ruling out infection. Further effort is needed in developing diagnostic tests to assist the clinician in the diagnosis of neurosyphilis.

Electrophoresis, Agar Gel↗
PubMedDate not supplied

Public health and hepatitis C.

This paper reviews key public health aspects related to surveillance, transmission and primary prevention of hepatitis C. Hepatitis C is now a reportable disease in all Canadian provinces and territories. Although prevalence in Canada is estimated at under 1%, that associated with injection drug use (IDU) approaches 90%. The epidemiology of new HCV infections in Canada is now primarily defined by IDU behaviour, with annual incidence rates among new drug injectors exceeding 25%. HCV is less efficiently transmitted through other routes of exposure. An effective vaccine against HCV remains elusive. Some jurisdictions offer hepatitis A and hepatitis B vaccine to HCV-infected persons. An array of harm reduction strategies targeting IDU has been implemented but underdeployed across Canada, and has been ineffective to date in controlling the HCV epidemic. Public policy alternatives, such as legalization and regulation of injection drugs, are being debated. Improved HCV preventive strategies are urgently required and need careful evaluation.

Canada↗
PubMedDate not supplied

Lack of an association between endemic giardiasis and a drinking water source.

Waterborne outbreaks of giardiasis have been documented in many areas of North America associated with contaminated surface water supplies. The Greater Vancouver Water District (GVWD) administers the distribution of surface waters to 1.4 million people. We wished to determine if endemic giardiasis was associated with this water supply. One hundred and eighty cases, an equal number of laboratory (enteric) controls and 94 neighbourhood (friend) controls were interviewed by questionnaire. The cases and controls were similar in age, sex and community of residence. Risk factors for giardiasis included having a child under six in the house and travel, both in B.C. but outside of the GVWD, and in Africa, the Americas, south of the U.S. or Asia. The cases drank 3.6 cups of water per day, the enteric controls 3.5 and the friend controls 3.7. These amounts are similar to those reported ingested in outbreak studies. Water consumption was not a risk for endemic giardiasis.

Adolescent↗
PubMedDate not supplied

Giardiasis outbreak from a chlorinated community water supply.

A giardiasis outbreak from a chlorinated, unfiltered surface water supply in Penticton, British Columbia (pop. 25,000) from June to August 1986 resulted in 362 laboratory-confirmed cases. A telephone survey estimated an attack rate of over 12%. A reservoir pond containing Giardia-infected beaver was implicated as the source. A case-control study with 65 cases did not find any significant associations. A retrospective case-finding survey of records from eight (out of 35) general physicians estimated that 1,500 physician visits occurred and produced an epidemic curve in close parallel with that from laboratory-confirmed and reported cases. Despite improvements on the reservoir, another outbreak occurred when this water source was reinstituted in October for several weeks, confirming our conclusion that it was the source of the first outbreak. Various options for reducing the risk of future outbreaks are being explored including full water treatment.

Animals↗
PubMedDate not supplied

The effects of inspection frequency and food handler education on restaurant inspection violations.

The effectiveness of restaurant inspections and food handler education are not known. Consequently, the optimal frequency of neither has been determined. Thirty randomly selected restaurants from seven health units in three provinces were inspected by one of three senior inspectors. A questionnaire was used to collect the data. The violation score worsened when the time since last inspection was greater than 12 months, but did not worsen when the interval was shorter. Those restaurants in which supervisors and food handlers had completed food handler education courses had better inspection scores than those without. Restaurants whose food handlers had food service education had better scores only for time and temperature violations. These outcomes were all significant in a multiple regression model. The duration of most education courses was under five days. The time since the last food service education course was not significant. Routine inspections should be done yearly. Food service education should be offered to both supervisors and food handlers.

Canada↗