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Biomedical subjects

T J Marrie

Publications and source records attributed to T J Marrie.

At least 127 records · Page 7Linked to original sources
PubMed1988

In vivo ultrastructural study of microbes in necrotizing fascitis.

Direct ultrastructural examination of tissue from three patients with necrotizing fascitis showed a large number of bacterial morphotypes that differed in cell size, cell shape, cell wall architecture, and cell wall structure. These bacteria occurred in small microcolonies in contrast to the larger monospecies microcolonies that form in chronic polymicrobial infection.

Bacteria↗
PubMed1988

Cell-mediated immunity of healthy adult Nova Scotians in various age groups compared with nursing home and hospitalized senior citizens.

We used the Multitest CMI to define the delayed-type hypersensitivity response (DTH) of 149 healthy adult Nova Scotians (49 male and 100 female subjects, ranging in age from 25 to 82 years) and to define and compare the response of the healthy senior citizens (66 to 82 years old) with 79 self-sufficient senior citizens in a nursing home, 25 senior citizens in a nursing home but not self-sufficient, and 15 senior citizens hospitalized in an acute care hospital. The DTH response decreased with increasing age and with increasing dependency in a nursing home. Thus, 1.5%, 9.5%, 17.9%, 41.8%, 60%, and 40%, respectively, of the subjects in the groups listed above were anergic. For the healthy subjects, age and sex were significant factors in predicting a positive response to the skin test antigens. Use of a logistic model revealed that for male subjects, the probability of a positive response was Ln (p/1 - p) = 1.72 - 0.038 (age), whereas for female subjects, it was Ln (p/1 - p) 0.59 - 0.0213 (age). When this model was applied to the responses of senior citizens, those living at home had a significantly greater response than did those in nursing homes. Furthermore, those self-sufficient while they were living in a nursing home had a significantly greater response than those who were not self-sufficient.

Adult↗
PubMed1988

Exposure to parturient cats: a risk factor for acquisition of Q fever in Maritime Canada.

Over a 34-mo period we studied 51 patients with Q fever and 102 control subjects (with various lower-respiratory-tract infections) who were matched for age, sex, and time of onset of infection. By univariate analysis (not adjusted for multiple comparisons), cases differed significantly from controls in the following activities: working on a farm; slaughtering or dressing animals; and contact with cats, cattle, and sheep. The strongest association was with exposure to stillborn kittens--11 of 51 cases vs. none of 102 controls (P less than .00000)--and with exposure to parturient cats (odds ratio, 10.3; 95% confidence interval, 3.5-31.8). Exposures to newborn animals (chiefly kittens) and stillborn kittens were significant risk factors by multivariate analysis, as were rural residence and slaughtering or dressing animals. In 13 Q fever incidents following exposure to parturient cats, 80 people became ill, 52 of whom had serological evidence of recent Coxiella burnetii infection (most of the others were not tested).

Animals↗
PubMed1988

Seroepidemiology of Q fever in New Brunswick and Manitoba.

A seroepidemiological survey, using an indirect immunofluorescence test, was carried out on serum samples obtained from New Brunswick and Manitoba blood donors during 1986. The antigens were Coxiella burnetii phase I and phase II from strain Nine Mile. Eighty of the 503 (15.9%) Manitoba blood donors had a phase II antibody titer of greater than or equal to 1:8, while 41 (4.2%) of the 966 New Brunswick blood donors had such antibodies. We have recently diagnosed three cases of Q fever in New Brunswick but none have been diagnosed in Manitoba. Our data suggest that Q fever may be increasing in New Brunswick and repeated seroepidemiological studies are indicated. It is likely that undetected cases of Q fever are occurring in Manitoba.

Antibodies, Bacterial↗
PubMed1988

An outbreak of Q fever probably due to contact with a parturient cat.

Thirty-three cases (24 definite, nine probable) of Q fever were diagnosed in Victoria County, Cape Breton, Nova Scotia from May to August, 1985. Twenty-six of the cases occurred in residents of Baddeck (population 900, attack rate 2.8 percent), and 21 of the cases occurred during the month of June. There was geographic clustering of the cases: 14 of the 33 (42 percent) lived or worked in four buildings located side by side in the center of town. A case control study revealed that 25 of 29 cases were exposed to a cat that gave birth to stillborn kittens on June 8, 1985 and had bled per vaginum for three weeks prior to delivery. The cat lived in one of the buildings where geographic clustering occurred and frequently visited the other buildings. None of the 40 control subjects was so exposed (p less than 0.001). This cat had an antibody titer of 1:512 to Coxiella burnetii phase 1 antigen and a titer of 1:1024 to phase 2 antigen. Exposure to cattle, sheep and goats, the traditional reservoirs of Q fever, was uncommon among patients and control subjects and none of eight cattle tested had antibodies to C burnetii phase I antigen. We conclude that the infected parturient cat was probably responsible for this outbreak of Q fever affecting 2.8 percent of the population of the town of Baddeck.

Adolescent↗
PubMed1988

Cardiac effects of common viral illnesses.

We compared the clinical, electrocardiographic and echocardiographic findings of 32 patients during the acute and recuperative phases of viral illness with similar data from a healthy age- and sex-matched normal control group. During the acute phase, no patient had cardiac symptoms and none had clinical evidence of left ventricular or valvular dysfunction, nor pericarditis. Electrocardiograms revealed no differences in mean sinus rate or ectopic dysrhythm between the two groups. Spatial 12- and 120-lead body surface electrocardiographic patterns were normal in 30 patients; two others had nonspecific T wave abnormalities. There were no differences in echo-determined left ventricular cavity size or systolic shortening fraction between the two groups. Three patients had segmental ventricular hypokinesis; 17 patients had small pericardial effusions. Data herein suggest effects on myocardial electrical and mechanical function in patients with viral illness. It may be prudent for such patients to minimize cardiac stress during illness.

Acute Disease↗
PubMed1988

Methods of controlling cephalosporin use in Canadian hospitals.

Cephalosporin antibiotics contribute significantly to hospital antibiotic costs. A survey was conducted to determine cephalosporin use and prescribing control in Canadian hospitals over 300 beds. Of the 125 hospitals surveyed, 84 responses were received; 76 were included in data analysis. Thirty-two percent of hospitals had no restriction policies for intravenous cephalosporins and 88 percent had none for oral cephalosporins. Restrictions were more common for the second and third generation agents. The most common method of restricting cephalosporins was by requiring consultation with an infectious disease service. The yearly cost of cephalosporins varied considerably and was unrelated to the number of beds in the hospital. The data provided allows hospitals to compare their use of cephalosporin antibiotics with other institutions in Canada.

Anti-Bacterial Agents↗
PubMed1988

A positive response to any of seven intradermal antigens predicts favorable outcome in patients hospitalized with community-acquired pneumonia.

We used the commercially available Multitest (R) CMI to assess the response of 100 adults hospitalized with community-acquired pneumonia to the following seven antigens: tetanus toxoid, diphtheria toxoid, Streptococcus, Proteus, tuberculin, Candida, and trichophyton. Thirty-one of the patients responded to one or more of these antigens and survived their acute illness. Of the Multitest (R) CMI negative patients, 49 lived and 20 died. A comparison of the three groups revealed that the 31 patients with positive tests were significantly younger and had a higher mean serum albumin than did those with negative tests who died. Multivariate analysis revealed that a positive Multitest (R) CMI and the albumin level were independent predictors of survival. A positive Multitest (R) CMI identified a less seriously ill group of patients as evidenced by 100% survival, by a very low rate of complications (0.18/patient), and by less utilization of resources (fewer hemograms and chest radiographs). Thus a positive Multitest (R) CMI may identify patients who could be discharged earlier, and a negative test should target its patients for more aggressive therapy.

Adult↗
PubMed1987

Pneumonia--the quality of medical records data.

The quality of medical records data for patients who were hospitalized with community-acquired pneumonia was assessed by comparing medical records data with data obtained in a prospective study of pneumonia for the period April 1, 1984, to December 31, 1984. One hundred five patients fulfilled the case definition of pneumonia for entry into the prospective study. One hundred twenty-seven patients were identified by medical records data. Seventy-three of the patients appeared in both studies. The positive predictive accuracy of the medical records data was 57%. When the etiologic diagnoses for the 73 patients identified by both studies were compared, there was agreement only 52.6% of the time. Streptococcus pneumoniae was overdiagnosed, and Mycoplasma, specific viral causes, and Haemophilus influenzae were not recorded by the medical records data. The quality of medical records data regarding pneumonia can be improved by changing the current ICD-9-CM coding system for pneumonia and by providing instruction and an algorithm for abstractors to follow in assigning a diagnosis of pneumonia.

Humans↗
PubMed1987

Pneumonia associated with the TWAR strain of Chlamydia.

From November 1981 to August 1984, 301 adult patients with community-acquired pneumonia were admitted to the major referral hospital of Nova Scotia. Serologic tests done on these patients included microimmunofluorescence using the TWAR strain of Chlamydia and all Chlamydia trachomatis serovars as antigens. The TWAR strain has been shown to cause mild pneumonia in teenagers and young adults. Of the 301 patients, 18 (6%) had serologic evidence of recent infection with the TWAR organism. Their mean age was 64 years. Pneumonia associated with the presence of acute TWAR antibody had no characteristic clinical or radiographic features when compared with pneumonia without acute chlamydia antibody. Six patients, who all had preexisting serious chronic disease, had severe illness, and 2 died. Both patients who died had complicated hospital courses and other concomitant infections. We conclude that the TWAR organism may cause pneumonia in older adults and persons with chronic diseases that require hospitalization.

Adolescent↗
PubMed1987

Ultrastructure of cardiac bacterial vegetations on native valves with emphasis on alterations in bacterial morphology following antibiotic treatment.

Bacterial vegetations involving the aortic valves of six patients were studied by scanning and transmission electron microscopy. The microorganisms isolated were Staphylococcus aureus--2, coagulase-negative staphylococcus--1, Streptococcus fecalis--2 and Streptococcus MG--1. The surface of the vegetations was usually amorphous. However, in areas where the surface of the vegetation was broken, myriads of microorganisms were seen. Transmission electron microscopy revealed bacteria embedded in an electron dense matrix in all vegetations despite the fact that they were negative on culture. Cell wall rupture was common. Thinning, and in some instances thickening, of the cell wall was also observed. The Streptococcus MG cells showed abnormal division with daughter cells being unable to separate. It is likely that the altered morphology of these bacterial cells is due to antibiotic treatment, however studies of an animal model of endocarditis are needed to dissect out the various possible contributions to these changes: host defenses; bacterial malnutrition in the depths of the vegetation; and antibiotic effect.

Adult↗
PubMed1986

Q fever pneumonia associated with exposure to wild rabbits.

4 patients with atypical pneumonia and a history of exposure to wild rabbits were found to have antibodies to Coxiella burnetii but not to the other organisms also commonly associated with atypical pneumonia. 10 (45%) of 22 snowshoe hares caught in the area where 1 of the patients snared his rabbits had antibodies to Coxiella burnetii. Q fever ought to be included in the differential diagnosis of pneumonia acquired following exposure to wild rabbits.

Animal Population Groups↗