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Biomedical subjects

S E Thompson

Publications and source records attributed to S E Thompson.

65 records · Page 4Linked to original sources

Auxotypes and antibiotic susceptibility patterns of Neisseria gonorrhoeae from disseminated and local infections.

The arginine-hypoxanthine-uracil auxotype has been linked with the propensity of gonococci to cause disseminated infections. Gonococci recovered from 25 patients with disseminated gonococcal infections were compared with gonococci recovered from matched controls, patients with uncomplicated gonorrhea selected during the same month. Minimal inhibitory concentrations of penicillin, tetracycline, erythromycin, and ampicillin, and the nutritional requirements (auxotypes) for proline alone, arginine alone, arginine, hypoxanthine and uracil together, serine alone and cysteine-cystine (wild type) were analyzed by discriminant analysis. Significant susceptibility to penicillin characterized strains causing disseminated infection, and a proline requirement was the most common auxotype (48%) among strains isolated in Atlanta. Together the minimal inhibitory concentration of penicillin and the proline auxotype best separated the strains causing gonorrhea. The arginine-hypoxanthine-uracil auxotype was was found in only 24% of strains causing disseminated infections. A trait other than auxotype must determine the capacity of the organisms to disseminate.

Adult↗

Treatment of uncomplicated gonococcal infection with trimethoprim-sulfamethoxazole.

The efficacy of trimethoprim-sulfamethoxazole (TMP-SMZ; 80 mg of TMP and 400 mg of SMZ per tablet; nine tablets taken once daily for three days; total, 27 tablets) was compared with the U.S. Public Health Service recommended regimen of 2 g of tetracycline daily for five days for the treatment of uncomplicated genital gonorrhea. Fourteen (3%) of the 461 patients treated with tetracycline and 24 (5%) of the 477 patients treated with TMP-SMZ failed to be cured; the difference between the two groups was not significant. Treatment of patients with TMP-SMZ was more likely to fail if the isolates of Neisseria gonorrhoeae had MICs of > or = 0.5 microgram of TMP/ml and > or = 9.5 micrograms of SMZ/ml. Adverse effects were more often reported by patients receiving TMP-SMZ. The results show that TMP-SMZ is an effective therapy for uncomplicated gonococcal infections in men and women and may also eliminate agents causing postgonococcal urethritis. The utility of this drug combination may be limited by the adverse effects that are associated with the large dose used.

Anti-Bacterial Agents↗

Serogrouping of Neisseria gonorrhoeae: correlation of serogroup with disseminated gonococcal infection.

Gonococci can be divided into serogroups WI, WII, and WIII by coagglutination. To assess the clinical correlation of serogroups of gonococci, we studied isolates of gonococci from patients with disseminated and uncomplicated gonococcal infections in three cities in the United States. Strains of Neisseria gonorrhoeae belonging to serogroup WI represented 85 (84%) of 101 isolates from patients with disseminated gonococcal infection (DGI) and 68 (40%) of 168 isolates from patients with uncomplicated gonorrhea (P less than .001). The auxotype Arg-, Hyx-, Ura- (AHU) represented 62 (61%) of 101 isolates from DGI and 54 (32%) of 168 isolates from uncomplicated infection (p less than .001); all AHU isolates were serogroup WI. Among other auxotypes, WI strains represented 25 (64%) of 39 isolates from patients with DGI and 14 (12%) of 114 from uncomplicated infections (P less than .001). In Atlanta only, 13 (34%) of 38 isolates from DGI were AHU, but 31 (82%) were serogroup WI (P less than .001). Thus gonococci of serogroup WI are associated with DGI in these cities of the United States, and this correlation appears to be independent of auxotype. Serogroup WI is correlated with serum resistance.

Black People↗

Tissue fluid penetration and anti-treponemal activity of trospectomycin (a new spectinomycin analog) in the rabbit syphilis model.

The antitreponemal activity of trospectomycin (a novel 6'-propyl analog of spectinomycin) was correlated with concentrations in serum and tissue chamber fluid in a cutaneously-infected rabbit model of syphilis. After single-dose intramuscular (im) injections of trospectomycin, spectinomycin hydrochloride, and aqueous procaine penicillin G(APPG), concentrations of the drugs in paired specimens of serum and tissue fluid were determined and correlated with response of Treponema pallidum-infected lesions. Lesions responded most rapidly in APPG-treated animals. Rapid response correlated with more prolonged levels of APPG in both serum and tissue fluid. Trospectomycin, when given in single doses exceeding 40 mg/kg, surpassed penicillin in peak serum levels (greater than 60 micrograms/ml at 1 hr) but not in duration of activity. Higher and prolonged concentrations of trospectomycin in tissue fluid correlated with more effective clearance of treponemes from cutaneous lesions. Animals treated with less than 40 mg of trospectomycin/kg or with 20-80 mg/kg of the parent compound (spectinomycin hydrochloride) had cutaneous lesions that were persistently darkfield-positive, as confirmed by three or more consecutive smears.

Animals↗

Intraoperative monitoring of ischiatic nerve function with sensory evoked potentials.

Serial recordings of sensory evoked potentials (SEP) generated in response to stimulation of each tibial nerve were obtained from 23 anesthetized dogs. Five dogs were anesthetized for 3 hours to evaluate changes in serial SEP during general anesthesia. Nonsurgical and surgical manipulations were performed on one hind limb of five dogs to determine the effects of limb positioning and nerve retraction on SEP. In 13 dogs, the ischiatic nerve was exposed surgically and retracted until the SEP deteriorated and disappeared, to determine the relationship between amount of tension on the nerve and the time to complete deterioration of the SEP. Sensory evoked potential waveforms, which consisted of two to five peaks, were stable throughout the anesthetic period. The first two peaks were the most stable. Latency of the first two peaks was the easiest and most reliable parameter to evaluate. Although the peak latency in recordings from the superior hind limb was always slightly longer, SEP recordings from the inferior limb were good controls to monitor nerve function. There was considerable variation in sensitivity to nerve retraction. The technique proved to be a reliable way to monitor nerve function in normal anesthetized dogs.

Anesthesia, General↗

Analgesia in dogs after intercostal thoracotomy. A comparison of morphine, selective intercostal nerve block, and interpleural regional analgesia with bupivacaine.

Three postoperative analgesic protocols were assigned randomly to 24 healthy dogs after thoracotomy at the left fourth intercostal space. Morphine was administered parenterally to eight dogs after tracheal extubation; selective intercostal nerve blocks with bupivacaine hydrochloride and epinephrine were administered to eight dogs before closure of the thorax; and bupivacaine hydrochloride and epinephrine were administered through an interpleural catheter to eight dogs after tracheal extubation. Heart rate, respiratory rate, rectal temperature, hematocrit, plasma protein, blood gas, and pain score evaluations were recorded before surgery and 30 minutes, 1 hour, 2 hours, and 3 hours after extubation. Morphine caused significant decreases in blood pH and blood oxygen tensions, and significant increases in carbon dioxide tensions. Dogs treated with intercostal nerve blocks had no significant changes in these parameters, and dogs treated with interpleural bupivacaine had significant decreases in blood oxygen tension. All dogs had significant decreases in rectal temperature, and hypothermia was prolonged after morphine. Analgesia was initially adequate in most dogs, but some dogs in each treatment group had recurrence of pain and were treated with interpleural bupivacaine. One dog developed pneumothorax. Interpleural administration of bupivacaine produced analgesia equal to that produced by systemic administration of morphine or selective intercostal nerve block with bupivacaine. Bupivacaine was easily readministered through an interpleural catheter. Respiratory compromise was less in dogs treated with bupivacaine than in dogs treated with morphine. After intercostal thoracotomy, interpleural bupivacaine provided prolonged analgesia with fewer blood gas alterations than morphine.

Acid-Base Equilibrium↗

Pelvic inflammatory disease and fertility. A cohort study of 1,844 women with laparoscopically verified disease and 657 control women with normal laparoscopic results.

From 1960 10 1984, 2,501 women underwent diagnostic laparoscopy (index laparoscopy) because of a clinical suspicion of acute pelvic inflammatory disease (PID). Of these women, 1,844 had abnormal laparoscopic findings (patients) and 657 had normal findings (control subjects). The reproductive events after index laparoscopy of 1,732 patients and 601 control subjects were followed. The patients and control subjects were followed for a total of 13,400 and 3,958 woman-years, respectively. During the follow-up period, 1,309 (75.6%) of the patients and 451 (75.0%) of the control subjects attempted to conceive. Of these women, 209 (16.0%) of the patients and 12 (2.7%) of the control subjects failed to conceive. A total of 141 (10.8%) of the patients and 0 (0%) of the control subjects had confirmed tubal factor infertility, 21 (1.6%) of the patients and 3 (0.7%) control subjects had other causes of infertility, and 47 (3.6%) patients and 9 (2.0%) control subjects did not have a complete infertility evaluation. Additional information on tubal morphology (hysterosalpingography, laparoscopy, or laparotomy) in women from couples for whom evaluation was incomplete indicated that 165 (12.2%) patients and 4 (0.9%) of the control subjects had abnormal tubal function or morphology after index laparoscopy. Tubal factor infertility after PID was associated with number and severity of PID episodes. The ectopic pregnancy rate for first pregnancy after index laparoscopy was 9.1% among the patients and 1.4% among control subjects.

Adult↗