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Biomedical subjects

S M Smith

Publications and source records attributed to S M Smith.

At least 361 records · Page 20Linked to original sources
PubMed1986

Procedures requiring signed consent. A survey of practice.

Despite extensive discussion of informed consent within the medical and legal literature, those diagnostic or therapeutic procedures which may specifically require written consent remain poorly identified. Survey results from 105 JCAH-approved hospitals show that 56 percent set forth a general policy statement regarding when and for which procedures consent is needed. The remaining hospitals specify individual procedures for which signed authorization is required by the hospital or medical staff guidelines. The potential liability, advantages and disadvantages of a general versus specific consent practice are discussed. A listing of those procedures itemized by responding hospitals from this national survey is also presented.

Consent Forms↗
PubMed1986

Detection of bacterial antigens in body fluids by the Phadebact system.

150 infected patients from 2 study centers had body fluids examined for presence of bacterial antigens (group B streptococcus, Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae type b) using the Pharmacia Phadebact system. The rates of detection of the pneumococcal antigens in the urine or serum of the patients with pneumococcal pneumonia, pneumococcal bacteremia and pneumococcal meningitis were 0.38, 0.47 and 0.5, respectively. The overall detection rate for H. influenzae infections was 0.92 and for group B streptococcal infections 0.87. Serum and urine from 100 non-infected patients were also tested for the presence of group B streptococcus, S. pneumoniae, N. meningitidis and H. influenzae type b antigens with only 1 false positive (H. influenzae type b).

Antigens, Bacterial↗
PubMed1986

Medicolegal aspects of mental retardation.

This article reviews practical medicolegal issues that have arisen within the field of mental retardation. Important medicolegal issues involved in education, employment, community living, marriage, parenthood, guardianship, sterilization, and the right to treatment and refusal of treatment are discussed. Criminal issues affecting the mentally retarded are also reviewed.

Canada↗
PubMed1985

Rifampin resistance. Development during the therapy of methicillin-resistant Staphylococcus aureus infection.

The incidence of methicillin-resistant staphylococcal infections, for which vancomycin hydrochloride remains the only active cell-wall antibiotic therapy, is rising. Some physicians have been combining other antibiotics with vancomycin in hopes of obtaining a more effective regimen for the therapy of these infections. Rifampin has been advocated as a concurrent second antibiotic because of its extraordinary potent bactericidal activity for Staphylococcus aureus. When rifampin is used in combination with a cell-wall antibiotic, suppression of the development of rifampin resistance has been thought possible. We report a case of infection caused by a methicillin-resistant S aureus in which the rifampin resistance occurred during therapy with vancomycin and rifampin. The rifampin resistance was stable and was present after ten serial broth and agar passages. Physicians are cautioned against the indiscriminant or routine use of rifampin as a second antibiotic in combination with vancomycin for the therapy of infections caused by S aureus.

Adult↗
PubMed1985

Experimental allergic orchitis in mice. I. Genetic control of susceptibility and resistance to induction of autoimmune orchitis.

Inbred strains of mice were studied for their susceptibility to the induction of experimental allergic orchitis after sensitization with mouse testicular homogenate in complete Freund's adjuvant accompanied by injections of extract from Bordetella pertussis. Susceptibility to autoimmune orchitis was found to be linked to the major histocompatibility complex in BALB/c and C57BL/10 mice and mapped to genes encoded within the H-2Dd region. In five of six groups of bidirectional (susceptible X resistant)F1 hybrids, H-2Dd-linked susceptibility was inherited as a dominant autosomal trait. However, in (BALB/cByJ X DBA/2J)F1 and (DBA/2J X BALB/cByJ)F1 hybrids, dominant autosomal resistance to the induction of autoimmune orchitis was observed. Backcross analysis between the resistant F1 hybrid and the susceptible BALB/cByJ parent suggests that a single independently segregating DBA/2J locus is capable of negating H-2Dd-linked susceptibility, and controls resistance to the induction of autoimmune orchitis.

Animals↗
PubMed1985

Effectiveness of antibiotic removal by the antibiotic-binding blood culture systems.

The effectiveness of antibiotic removal by the BACTEC aerobic resin-containing blood culture medium (16B) and the Antimicrobial Removal Device (ARD) was compared for 12 antibiotics: ampicillin, cephalothin, cefoperazone, cefotaxime, moxalactam, nafcillin, gentamicin, tobramycin, azlocillin, mezlocillin, piperacillin, and ticarcillin. The ability to recover eight commonly encountered species of bacteria from antibiotic-containing serum by these two systems showed that recovery of antibiotic-exposed bacteria was dependent not only upon the amount and rate of the antibiotic removal but also upon the kinetics of bacterial killing by the antibiotic(s). The 16B medium had difficulty recovering organisms exposed to ticarcillin and moxalactam, whereas the ARD had difficulties with moxalactam and sometimes with cefotaxime and cefoperazone. Although neither system was able to recover all species of microorganisms tested, these in vitro results suggest that to use optimally these new culture systems, knowledge of the suspected pathogen(s), the amount and kind of antibiotic(s) administered, and the rate of bacterial killing by the antibiotic(s) is required.

Adsorption↗
PubMed1985

Incidence of IgA-related nephritides in American Indians in New Mexico.

The racial distribution of the findings in 664 renal biopsies was studied for the state of New Mexico. The incidence of IgA-related nephritides (Berger's disease and Henoch-Schönlein purpura) was significantly greater in American Indians than in Hispanics and Anglos; IgA-related nephritides were found in 38 per cent of renal biopsies in American Indians. The clinicopathologic presentations of IgA-related nephritides were similar in the three ethnic groups.

Adolescent↗
PubMed1985

Recovery of blood-borne bacteria from human urine.

Recovery from the urine of organisms causing bacteraemia may depend on the bacterial species involved. The survival of the more common species of bacteria which cause bacteraemia was examined in human urine, serum and normal saline. All species survived well or grew in serum. Haemophilus influenzae, Streptococcus pneumoniae, Streptococcus sanguis and group A streptococci were killed in all urine samples. The number of colony-forming units of Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus and group B streptococci either remained the same or increased in the urine, while the numbers of Escherichia coli and Klebsiella pneumoniae increased rapidly. These data suggest that the observed differences in recovery from urine of these bacterial species that cause bacteraemia are related to the viability of the species in human urine.

Bacteria↗
PubMed1985

Differences in ability of cell-wall antibiotics to suppress emergence of rifampicin resistance in Staphylococcus aureus.

Rifampicin resistance developed easily in methicillin-susceptible and methicillin-resistant strains of Staphylococcus aureus during an overnight incubation in broth containing 0.1 mg/l of rifampicin. Incubation of methicillin-susceptible Staph. aureus and 0.1 mg/l of rifampicin with 1 mg/l of nafcillin reduced the emergence of rifampicin resistance with only 5 of 50 strains (10%) becoming rifampicin-resistant. However, incubation of the methicillin-susceptible or methicillin-resistant strains with 0.1 mg/l of rifampicin and 1 mg/l of vancomycin did not prevent the development of rifampicin resistance. Rifampicin resistance developed in 25 of 50 (50%) of methicillin-susceptible and 32 of 50 (64%) methicillin-resistant Staph. aureus strains tested. These data would suggest that differences exist in the abilities of nafcillin and vancomycin to suppress the development of rifampicin resistance in Staph. aureus (P less than 0.01). Caution should be exercised when the combination of vancomycin and rifampicin is used for infections caused by Staph. aureus and Staph. aureus isolates recovered during therapy should be monitored for the development of rifampicin resistance.

Anti-Bacterial Agents↗
PubMed1985

The perisplenic halo of Ga-67 citrate. A sign of perisplenic abscess.

Two cases are presented which display a scintigraphic picture of increased Ga-67 activity around the spleen with a relative photon deficient center. We call this pattern the perisplenic halo of Ga-67, which represents a perisplenic abscess. The anatomy of the perisplenic compartment and the possible pitfalls in diagnosing the perisplenic halo are discussed within the paper.

Abscess↗
PubMed1985

Activity of ciprofloxacin against methicillin-resistant Staphylococcus aureus.

Ciprofloxacin, a carboxy quinolone antibiotic with a broad spectrum of activity, was tested against 54 strains of methicillin-resistant Staphylococcus aureus. The ciprofloxacin MICs for 50 and 90% of the isolates were 0.25 and 0.5 micrograms/ml, respectively, and its MBC for 90% of the isolates was 1.0 microgram/ml. Killing kinetic studies were conducted in vitro with ciprofloxacin and vancomycin individually and in combination. The results of these studies showed that ciprofloxacin at 2 micrograms/ml and vancomycin at 10 micrograms/ml decreased the number of organisms by approximately 1.5 log10 after 6 h. The combination of ciprofloxacin plus vancomycin did not alter the rate of killing over that achieved by ciprofloxacin alone. The in vitro killing of resistant staphylococci was rapid, and the potential use of ciprofloxacin for infections caused by methicillin-resistant S. aureus should be further explored.

Anti-Bacterial Agents↗
PubMed1985

Inoculum effect of beta-lactam antibiotics on Enterobacteriaceae.

Seven beta-lactam antibiotics were studied for both their antimicrobial activity and the degree to which they produced inoculum effect on Escherichia coli, Klebsiella pneumoniae, and Salmonella typhimurium. Aztreonam, cefoperazone, and ceftazidime were poorly bactericidal, caused marked bacterial filamentation, and exhibited a large inoculum effect on E. coli, K. pneumoniae, and S. typhimurium. Cefotaxime and ceftriaxone were more rapidly bactericidal, caused only a moderate amount of filamentous forms, and exhibited a modest inoculum effect, while cefoxitin and imipenem both were rapidly bactericidal and exhibited only a minimal-to-no-inoculum effect. The inoculum effect did not correlate with drug stability during incubation with the bacteria. Inoculum effect on these species of the family Enterobacteriaceae appears to be a manifestation of increase in optical density secondary to the development of filamentous bacterial forms with an increase in bacterial mass during exposure to antibiotics which are not rapidly bactericidal. These observations have a clear significance for the susceptibility testing of beta-lactam antibiotics when turbidity is used as a parameter to determine presence of bacterial growth.

Anti-Bacterial Agents↗
PubMed1985

Pseudomonas mesophilica infections in humans.

Reported here is the case of a patient with metastatic adenocarcinoma of the lung who had bacteremia involving Pseudomonas mesophilica. Of the common laboratory media tested at 35 degrees C, buffered charcoal yeast extract agar and nutrient agar provided the best growth; however, other media supported growth at lower temperatures. Since blood cultures are routinely subcultured onto chocolate agar and then incubated at 35 degrees C, awareness of the characteristics of P. mesophilica and of the isolation techniques as outlined may enhance the recovery of this and related bacterial species.

Adult↗
PubMed1985

Salmonella infections in patients with acquired immunodeficiency syndrome.

Salmonella infections occurred in six patients with acquired immunodeficiency syndrome (AIDS) and one patient with probable AIDS. The immune system defects increase the susceptibility of patients with AIDS to salmonella infections. Recognition of salmonellosis in patients with AIDS is important because of a high propensity of this organism to invade the bloodstreams of these patients, and because, unlike other infections in patients with AIDS, this infection can be easily treated.

Acquired Immunodeficiency Syndrome↗