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Biomedical subjects

T D Mastro

Publications and source records attributed to T D Mastro.

98 records · Page 6Linked to original sources
PubMed1991

Nosocomial Legionnaires' disease and use of medication nebulizers.

Guidelines for the prevention of nosocomial pneumonia specify that only sterile fluids should be used for aerosol therapy; however, this recommendation may not be uniformly followed. Thirteen patients with nosocomial pneumonia due to Legionella pneumophila serogroup 3 (Lp3) were identified at a community hospital in the period from 1984 through 1988; 12 patients (92%) had chronic obstructive pulmonary disease; and 9 patients (69%) died. An epidemiologic investigation suggested that the use of nebulizers to deliver medication was associated with acquiring legionnaires' disease. The hospital potable water system was contaminated with Lp3, and a survey indicated that tap water was commonly used to wash medication nebulizers. Lp3 in respirable-size droplets was isolated from aerosols generated by a nebulizer containing Lp3 at one-tenth the concentration found in the hospital potable water. These findings support the recommendation that only sterile fluids be used for filling or cleaning respiratory care equipment and suggest that this guideline is not universally followed.

Administration, Inhalation↗
PubMed1990

Vancomycin-resistant Pediococcus acidilactici: nine cases of bacteremia.

Pediococci, vancomycin-resistant gram-positive cocci, have been isolated from human specimens, but an association with clinical illness has not been established. Clinical and epidemiologic data were obtained on nine patients who had Pediococcus acidilactici isolated from blood. Patients were eight elderly adults with complicated medical problems and one infant with congenital jejunoileal atresia. Seven patients were hospitalized before P. acidilactici was isolated. Eight had received multiple antibiotics; however, only two had received vancomycin. In all cases there was a delay in correct bacterial identification, and the significance of the isolate was uncertain. There was no clearly identified syndrome associated with P. acidilactici bacteremia. All eight adults had fever and six had pneumonia potentially attributable to other causes. The findings underscore the importance of proper identification of vancomycin-resistant gram-positive cocci. P. acidilactici may be an opportunistic pathogen in severely compromised hosts; however, further observations are necessary to clarify its role in human disease.

Aged↗
PubMed1990

Role of air sampling in investigation of an outbreak of legionnaires' disease associated with exposure to aerosols from an evaporative condenser.

Epidemiologic studies have suggested that legionnaires' disease can be transmitted to susceptible hosts by contaminated aerosolized water from cooling towers and evaporative condensers; however, epidemic strains of Legionella have not been isolated by air sampling at such sites during epidemiologic investigations. An outbreak of legionnaires' disease occurred at a retirement hotel; Legionella pneumophila serogroup 1 was isolated from an evaporative condenser and from potable water. A case-control study showed that the only significant exposure risk was in area A. L. pneumophila serogroup 1 was isolated during air sampling near the evaporative condenser exhaust site, the air conditioning intake vent, and an air vent in area A, but not in shower stalls. Monoclonal antibody subtype patterns of L. pneumophila serogroup 1 isolates from patients matched those from the evaporative condenser but not from shower water. Air sampling and monoclonal antibody subtyping results support epidemiologic evidence that the evaporative condenser was the source of this outbreak.

Aerosols↗
PubMed1989

The modern mycobacteriology laboratory. How it can help the clinician.

The mycobacteriology laboratory provides the information necessary to diagnose mycobacteriosis and to suggest proper patient management. When the definite diagnosis of disease due to M. tuberculosis is made on the basis of the laboratory result, contact follow-up studies should continue and the patient may be considered infectious if the bacilli were isolated from the sputum. A report of another Mycobacterium species suggests that a contact follow-up is not necessary, that the patient need not be isolated, and that a therapeutic regimen should be based on the results of drug-susceptibility tests with the isolate. Techniques of molecular biology are being used in the laboratory to provide the necessary information quickly for patient management. BACTEC has been accepted into most clinical laboratories to speed reporting of results. Other methods such as genetic and immunologic probes are under development. New DNA probes have been marketed by GenProbe for the identification of cultures of M. tuberculosis, M. avium, and M. intracellulare. HPLC and GLC have been used for the identification of cultures based on unique mycolic acid patterns of the species. Immunologic probes may eventually be the most specific and sensitive, but additional development is necessary. Mycobacteriophage typing of M. tuberculosis isolates has been developed as a tool to aid in epidemiologic studies. These and other technologies are essential in the support of programs for the elimination of tuberculosis.

Bacteriological Techniques↗
PubMed1988

The management of tuberculosis in refugees along the Thai-Kampuchean border.

The treatment of tuberculosis in refugees living in campus along the Thai-Kampuchean border has remained a controversial issue since the beginning of the Khmer relief operation in 1979. During the 1984-85 dry season, war-related disruptions forced the evacuation of the 240,000 residents of 21 camps into evacuation sites in Thailand. Seven tuberculosis treatment programmes, using a fully supervised, daily protocol of isoniazid(H), rifampicin(R), pyrazinamide(Z) and streptomycin(S) 3 HRZS/HR, (6 months for pulmonary and 9 months for extrapulmonary tuberculosis), were able to continue operation, with acceptably low rates of default from therapy. During the 18 month period beginning in July 1984, 984 patients were started on treatment: 755 completed a full course while 86 defaulted. The programme design and organisation are described.

Antitubercular Agents↗
PubMedDate not supplied

Modelling the female-to-male per-act HIV transmission probability in an emerging epidemic in Asia.

The per-sexual-act probability of transmission of the human immunodeficiency virus type 1 (HIV) from an infected person to a susceptible sex partner can be determined from a simple model if the number of contacts each study participant has with infected partners is known. The unusual epidemiologic situation in the emerging HIV epidemic in Thailand allowed this quantity to be estimated from a cross-sectional study of young men conscripted into the Thai military in 1991. Although the simple model does not fit the data, an errors-in-variables approach provides a model with adequate fit. Other sources of lack of fit, including heterogeneity of the transmission probability, are discussed. With adjustment for measurement error, the per-act probability is estimated to be 0.056, an order of magnitude higher than similar estimates in North America. Because data indicate that recently infected persons may be more infectious, and because extensive HIV transmission in Thailand began in 1988, this difference may be due, in part, to a higher proportion of recently infected individuals in the emerging Thai epidemic from 1988 to 1991.

Adult↗