Biomedical subjects
Publications and source records attributed to R J Andrews.
We compared treatment with one daily intravenous dose of cefonicid and multidose nafcillin in 65 patients with severe infections of the skin or skin structure. Clinical cure or improvement was achieved in 91% of the patients given cefonicid and in 87% of the patients given nafcillin (P = 0.97). The use of cefonicid may allow outpatient therapy of some severe infections.
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A patient with traumatic thoracic intramedullary hematoma underwent operation 1 month postinjury. Evacuation and syringosubarachnoid shunting resulted in return of bladder control and of sufficient strength in the lower extremities to permit independent walking. The outcome is discussed in light of the literature on traumatic intramedullary hematoma. The value of magnetic resonance imaging is noted. We suggest an aggressive diagnostic and therapeutic approach toward intramedullary spinal cord hematomas.
The efficacy of fluconazole, a new bis-triazole antifungal agent, was compared with that of orally administered ketoconazole and parenterally administered amphotericin B against aspergillus and cryptococcus infections in mice. Fluconazole was 5-20-fold more active than ketoconazole against systemic aspergillosis and against systemic, intracranial and pulmonary cryptococcosis but was less active than amphotericin B.
UK-49,858 (fluconazole), a new, orally absorbed bis-triazole derivative, has been evaluated against systemic infections with Candida albicans in normal and immunosuppressed mice and against an intestinal infection with C. albicans in immunosuppressed mice. Orally administered ketoconazole was used as a comparison agent throughout, and orally administered amphotericin B was included for comparative in the experimental intestinal infection. In a 10-day dosage regimen, UK-49,858 was far more active than ketoconazole against systemic infections with C. albicans in normal and immunosuppressed mice. In normal mice, extension of UK-49,858 dosing to 30 days resulted in prolongation of survival to over 90 days, and up to 60% of treated animals had no detectable C. albicans in their kidneys. In addition, over 90% of mice with intestinal candidiasis had culture-negative feces after a 3-day treatment with UK-49,858, but only 62 and 23% of mice gave this response after amphotericin B and ketoconazole therapy, respectively. These data suggest that UK-49,858 may be of value in the treatment of systemic and gastrointestinal infections due to C. albicans in humans.
Changes in the level of the tissue damage marker enzyme, N-acetyl-beta-D-glucosaminidase (NAGase) in quarter fore milks were found to be related to the presence and types of pathogenic bacteria present and to somatic cell counts (SCC). Minor pathogens (coagulase-negative staphylococci, Corynebacterium bovis) elicited a mild SCC increase (from a mean of 243 X 10(3)/ml in healthy quarters to 504 X 10(3)/ml in infected quarters) with marginal tissue damage (mean NAGase activity increased from 21 in healthy quarters to 28 in infected quarters). Major pathogens (i.e. Staphylococcus aureus, Streptococcus agalactiae, Str. dysgalactiae and Str. uberis) caused more severe tissue damage (mean NAGase of 48) and SCC increases (mean, 2803 X 10(3)/ml). The NAGase test could also be used effectively on composite milk samples where regular monthly NAGase analysis was able to identify correctly 74% of animals having infected quarters. The possibility of combining SCC and NAGase data in order to give a more definite diagnosis of bovine mastitis is discussed.
N-acetyl-beta-D-glucosaminidase ( NAGase ) levels and somatic cell counts (SCC) were determined monthly for 6 months in the bulk milk of 181 suppliers (1063 samples). A highly significant correlation (r = 0.74; P less than 0.001) was found between supplier's bulk herd milk geometric mean NAGase activity and SCC. Monthly trends which grouped suppliers into various categories defined by different NAGase and SCC thresholds showed that a similar overall pattern was obtained with both SCC and NAGase . However, further analysis indicated that 18% of the bulk milk which had SCC less than 500 X 10(3)/ml had NAGase levels greater than 25 units. Also, 34% of samples with SCC greater than 500 X 10(3)/ml had NAGase levels less than 25 units. Overall, 24% of all samples did not have corresponding NAGase and SCC results. When the bulk milk of 2 commercial dairy herds was tested monthly over 12-18 months whilst the infection status of all quarters in the herds was regularly monitored, those herds with low incidence of mastitis (5% quarters infected) had significantly lower bulk milk SCC and NAGase levels than those with a high incidence of mastitis (22% of quarters infected). This suggests that NAGase measurement on bulk herd milk would be a simple means of monitoring infection status of dairy herds and of rapidly classifying a supplier's milk as being of low, medium or high SCC status. The possible combined use of SCC and NAGase levels in bulk milk monitoring schemes is discussed.
A Lock Box for investigating problem-solving behaviour in pre-schoolers was used with seventeen Down's syndrome children (mean CA 37.4 months, S.D. 10.1 months) and seventeen 'normal' children (mean CA 37.4 months, S.D. 10.2 months) while their mothers were present. The behaviour was found to be different for the two groups, with the normal children showing greater competence, more organization and less perseverance. Significant associations between Lock Box measures and the mental age of the Down's syndrome children paralleled those reported by Goodman for older mentally retarded children in a test situation without the mother. The Lock Box is especially appropriate for assessing the ability of language-delayed children and it is suggested that a situation with the mother present may extend its usefulness with very young children.
A toddler temperament questionnaire was completed by the mothers of fifteen Down's syndrome children who had been assessed two years earlier with the Carey infant temperament questionnaire. The results suggest that infants who have been scored as showing signs of difficult temperament move towards the easier signs on the toddler scale. If these temperament questionnaires are biased by maternal perceptions, this move may reflect a reduced level of maternal anxiety.
Eleven Down syndrome infants were individually matched for sex and socioeconomic status with 11 nonretarded children. Looking behavior for the two groups was coded when the children were 6 and 9 months of age while they played with their mothers without toys. No significant group differences were found for maternal looking, holding, and vocalization behavior, but the Down syndrome infants spent almost half the play time looking toward their mother, nearly twice the time spent by the contrast group. Results were discussed in terms of Down syndrome fixation characteristics, maternal behavior, and referential looking.
Data are presented from an unselected series of 212 aneurysm patients for aneurysms at three major sites: the internal carotid-posterior communicating artery junction, the anterior communicating artery, and the middle cerebral artery. More than 70% of the anterior communicating artery aneurysms occurred as single aneurysms; less than 30% of the middle cerebral artery aneurysms were single. Anterior communicating artery aneurysms showed a right-side predominance in males but not in females. Both males and females had significantly higher mean systolic and diastolic blood pressures for left-sided anterior communicating artery aneurysms than for right-side aneurysms. A brief review of factors relevant to anterior communicating artery aneurysms is presented.
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In a study with 17 Down's syndrome infants, the older infants (mean age = 20 months, 6 days) responded to the regular reappearance of a squeaky doll with significantly more affective behavior than did younger infants (mean age = 9 months, 24 days). When the 10 younger infants were included in a longitudinal study of their responses to this same event, the onset of affective behavior was significantly correlated with the mental development index of the Bayley Scales of Infant Development, and was also associated with some aspects of temperament as measured by the Carey Survey of Temperamental Characteristics: these aspects were poor adaptability to change and a low tendency to approach new situations.
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Quarter fore-milk samples, blood serum, and mammary gland tissue extracts were tested for N-acetyl-B-D-glucosaminidae, lactate dehydrogenase, glutamate--oxaloacetate transmaninase, arylesterase, bovine serum albumin, sodium, conductivity, and somatic cell count. Bovine serum albumin, arylesterase, and sodium were high in blood serum while the first three listed were high in mammary gland tissue. All of these components in milk increased as somatic cell count increased. Correlation coefficients between somatic cell count and each component in order were .84, .53, .55, .81, .74, and .75. Some of these procedures (e.g., serum albumin, dehydrogenase, and transaminae) for estimating the extent of udder epithelial cell damage were less valuable because of lengthy assay times, tedious sample preparation, and unsatisfactory assay procedures. The most suitable approach for measuring udder tissue epithelial damage was the glucosaminidase test which was simple and rapid with high sample throughput. It should be a useful diagnostic aid in mastitis monitoring programs.
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All cases of intracranial aneurysm, arteriovenous malformation, and subarachnoid hemorrhage of undetermined etiology seen at one hospital over a 13-year period were reviewed to assess relationships between age, sex, systolic and diastolic blood pressure, and number of aneurysms. There were 350 patients, of whom 212 had aneurysms. The major findings were as follows: 1) Hypertension was not significantly more prevalent in the aneurysm population than in the age-matched general population, except for females aged 18 to 54 years (systolic pressure elevation of 10 to 15 mm Hg). 2) Under 55 years of age, both male and female hypertensive patients were twice as likely to have multiple aneurysms as normotensive patients. 3) Females were more likely than males to have multiple aneurysms. 4) For females but not males, increasing age, higher systolic pressure, and higher diastolic pressure all correlated with an increasing number of aneurysms. Hypertension appears to be more prevalent in certain subgroups of the total aneurysm population, although the individual relationships between hypertension, atherosclerosis, and aneurysms cannot be determined from either the present or previous studies. The possible role of familial factors, as well as implications for both diagnosis and further research, are briefly noted.
UK-18,892, a new semisynthetic aminoglycoside, was active against bacteria possessing aminoglycoside-inactivating enzymes, with the exception of some known to possess AAC(6') or AAD(4') enzymes. This activity has been rationalized by using cell-free extracts of bacteria containing known inactivating enzymes, where it was shown that UK-18,892 was not a substrate for the APH(3'), AAD(2''), AAC(3), and AAC(2') enzymes. It was also demonstrated that UK-18,892 protected mice against lethal infections caused by organisms possessing aminoglycoside-inactivating enzymes.