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Biomedical subjects

R H George

Publications and source records attributed to R H George.

At least 37 records · Page 2Linked to original sources
PubMed1988

Evaluation of use of Signal system of blood culture in paediatrics.

A new method of blood culture, the Signal system (Oxoid), was assessed in paediatric practice. Isolation rates of pathogens, frequency of contamination (false positive results), and time taken to detect positive cultures were analysed. Four hundred and seventy nine organisms were isolated from 457 of 3000 cultures collected, of which 283 organisms were considered to be clinically important. The overall rate of positive cultures was 15.2%, and clinically important organisms were isolated from 9.1%, giving an overall contamination rate of 6.1%. The rate of contamination with Gram positive bacilli was 1.1% and coagulase negative staphylococci 4.2%. Over 51.6% of all isolates were detected within 24 hours, 81% within 48 hours, and 86% within three days: 91.1% of clinically important organisms were isolated within three days. Unimportant organisms tended to give a delayed signal, although this sometimes occurred with Candida spp, Klebsiella spp, Pseudomonas spp and a small number of other such organisms. Four hundred and forty nine of the 457 positive cultures gave a visible signal. Six of seven isolates of Haemophilus influenzae failed to give a signal, as did two coagulase negative staphylococci. The Signal system is a convenient and cost effective method of blood culture.

Adolescent↗
PubMed1987

Oral candida: is dummy carriage the culprit?

Oral candida in subjects who sucked dummies was almost double that of controls. Although the carriage of Candida albicans on silicone dummies was significantly reduced compared with latex dummies, oral colonisation was unaffected, suggesting that dummy carriage is not the cause of the observed increase.

Candidiasis, Oral↗
PubMed1986

An outbreak of tuberculosis in a children's hospital.

A 3-year-old girl was admitted to a children's hospital; subsequently her mother was found to have pulmonary tuberculosis with smear-positive sputum. Of over 400 patients, their families and staff at risk in the hospital, 30 inpatients, three outpatients, two sibling visitors and one staff member became infected. A retrospective cohort study of exposed inpatients identified exposure duration, exposure proximity and primary diagnosis as independent predictors of infection risk. Children with neoplastic disease who were being treated with cytotoxic and immunosuppressive therapy with clotting factors were at a greater risk of developing clinical disease including disseminated infection. Altogether three generations of infected children and adults were diagnosed amongst community and hospital contacts in this extended outbreak. These findings support current recommendations for the follow-up of highly susceptible casual contacts of cases of pulmonary tuberculosis with smear-positive sputa.

Adult↗
PubMed1986

Candida albicans arthritis in an infant.

Candida albicans arthritis, preceded by peritonitis and septicaemia arose in an infant following cardiac surgery. Details of the case are described. Diagnosis and management of this condition are discussed.

Amphotericin B↗
PubMed1986

Ten years' experience of Haemophilus influenzae infection at Birmingham Children's Hospital.

A survey of serious infections due to Haemophilus influenzae, in the years 1973-1984, was made at the Birmingham Children's Hospital. Eight-three cases were recorded, comprising 42 of meningitis, 18 of septicaemia, 16 of epiglottitis and seven of septic arthritis or osteomyelitis. The mortality rate for meningitis and septicaemia was 5%, but no child with epiglottitis or septic arthritis died. The data are compared with those of American studies. The incidence of severe haemophilus infection in the inner city area of Birmingham was estimated to be at least 1 in 950 children during the period of the study.

Arthritis, Infectious↗
PubMed1986

Improving survival in bacterial endocarditis.

Twenty six cases of bacterial endocarditis in infancy and childhood were treated with a mortality of less than 8%. Twenty two had recognised congenital heart disease and four had previously normal hearts. Thirteen out of the 24 cases with positive blood cultures had staphylococcal infection. Appropriate antibiotics were identified by measurement of the minimum bactericidal concentration as an indicator of antibiotic sensitivity. The bactericidal activity of the patient's serum during treatment was monitored by back titration against the causative organism to assess the optimal antibiotic combination and dosage. Treatment was continued for six weeks in most cases, comprising intravenous treatment for at least the first three weeks, but then being substituted with oral treatment in some. Twenty one cases were successfully treated medically. Five developed complications requiring surgery, two of whom died.

Administration, Oral↗
PubMed1985

Single dose pharmacokinetics of trimethoprim.

Single oral dose trimethoprim pharmacokinetics were determined in 18 children aged 3 months to 13 years. Trimethoprim suspension was rapidly absorbed and quickly and widely distributed. The mean clearance was considerably faster and the elimination half life considerably shorter than values reported in adults. Only one third of the administered drug dose was recovered from the urine within 24 hours which is considerably less than in adults, suggesting that children may metabolise a greater proportion of the dose given. Urine trimethoprim concentrations greatly in excess of minimum inhibitory concentrations for common pathogens were rapidly achieved and sustained for at least 16 hours.

Adolescent↗
PubMed1985

Unusually high incidence of tuberculosis among boys with haemophilia during an outbreak of the disease in hospital.

Of 30 children with bleeding disorders exposed to an index tuberculosis case, six developed primary pulmonary tuberculosis and two others became positive skin reactors. There was a significant correlation between the amount of replacement treatment received and the development of evidence of tuberculous infection. Only two of those who developed evidence of tuberculosis had antibodies to the human T cell lymphotropic virus. These two boys showed much later Mantoux positive conversion than the six others.

Child↗