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Biomedical subjects

W C Bailey

Publications and source records attributed to W C Bailey.

At least 73 records · Page 4Linked to original sources

Computed tomography of invasive pleural mesothelioma.

The computed tomography (CT) findings in three patients with invasive pleural mesothelioma are presented, and the invasive route and metastatic extension of the disease in the abdomen and retroperitoneum are discussed. These findings indicate the value of CT in detecting the extrathoracic extension of mesothelioma. Abdominal CT studies should be obtained in evaluating mesothelioma patients for extrathoracic extension of the disease.

Abdominal Neoplasms↗

The deterrent effect of capital punishment during the 1950s.

This investigation examines the deterrence hypothesis of an inverse relationship between state execution rates and homicides. Although this question has received some attention in recent studies, the findings of these investigations are mixed. Cross-sectional analyses of states have typically shown execution and homicide rates to be positively associated, while at least two national time-series studies report support for the deterrence hypothesis. To test whether these divergent findings are result of the two different methodologies employed (cross-sectional vs. time-series), a methodology that combines the strengths of each is used in the present study. For the period 1950 to 1960, we examine cross-sectionally for states the relationship between changes in execution rates and changes in murder rates. This analysis does not find support for the deterrence argument for the certainty of the death penalty when a number of models of the execution rate--murder rate relationship are considered, and when a variety of imprisonment and socio-demographic factors are considered as control variables.

Adult↗

Treatment of atypical mycobacterial disease.

The most common disease patterns produced by atypical mycobacteria are pulmonary disease, cervical lymphadenitis, and infection of soft tissue, bones, and joints. The treatment of disease due to atypical mycobacteria can be confusing unless one clearly differentiates the organisms according to clinical characteristics and response to various chemotherapeutic agents. For this reason, we have attempted to simplify the task by proposing a new classification system. The organisms that might be isolated from human material are divided into the following three classes: nonpathogens; those that are easy to treat with standard mycobacterial therapy; and finally, those that are difficult to treat with standard mycobacterial therapy and require other approaches. This new system of classification should help the clinician in dealing with these organisms. Because even the pathogens may sometimes appear as a contaminant in human material, including sputum, one must document that these organisms are associated with disease prior to instituting therapy.

Drug Resistance, Microbial↗

Cellulitis and necrotizing fasciitis of the abdominal wall in pediatric patients.

Soft tissue infections of the abdominal wall in 14 children were classified as cellulitis (8), necrotizing fasciitis (5), or myositis/myonecrosis (1). These 3 categories were characterized by increasing anatomic depth of infection, clinical severity, and need for more radical surgical treatment. Ten of the 14 children were neonates. The most frequent associations were omphalitis (5), necrotizing enterocolitis (4), and urachal anomalies (3). The severest infections were usually polymicrobial and contained both aerobic and anaerobic bacteria. Important clinical findings in children with necrotizing fasciitis and myositis/myonecrosis were tachycardia, systemic toxicity, severe edema, and, in older children, pain out of proportion to the apparent degree of infection. None of the children had fever or crepitation of the wound. An ominous sign, indicative of the need for immediate, radical debridement was the appearance of a patch of dusky or gangrenous skin. There were two deaths associated with delayed diagnosis of necrotizing fasciitis. One child did not receive radical debridement, and the other received it too late to be of benefit. Although these infections are rare in children, their lethal potential and early diagnostic signs must be recognized.

Abdominal Muscles↗

Risk factors for isoniazid (NIH)-induced liver dysfunction.

We examined prospectively risk factors which might contribute to INH-induced liver damage in 113 patients taking preventive INH for at least 8 weeks. Twelve who had abnormal initial liver tests did not get worse with INH, while 19/101 with normal initial tests developed significant liver dysfunction, mostly hepatocellular, three having overt hepatitis. When 12 other patients who drank alcohol were excluded from analysis, there were still 15/89 with significant liver dysfunction, 12 of whom were slow acetylators (p less than 0.05). The only other risk factor was age. By combining acetylator phenotype with age, but excluding alcohol, we calculated the risk of INH-induced liver enzyme elevation as follows: under 35 years--fast acetylators, 3.7%, slow acetylators, 13%; over 35--fast acetylators, 13.2%, slow acetylators, 37% (p less than 0.02). Fast acetylation is thus not a risk factor for developing INH-induced liver dysfunction; indeed, the contrary seems to be the case.

Acetylation↗

Epizootiology and histopathology of Chloromyxum trijugum (Myxospora: Myxosporida) in centrarchid fishes from Iowa.

The gall bladder parasite, Chloromyxum trijugum, shows marked host specificity within the sunfish family Centrarchidae. During 1977-78 80% of 230 bluegills (lepomis macrochirus) in Iowa were infected. Prevalence in green sunfish (L. cyanellus) was lower (17%); one of 2 specimens of the hybrid L. macrochirus x L. cyanellus was infected; orangespotted sunfish (L. humilis) and hybrids (L. humilis x L. macrochirus) were not infected. Intensity of infection in bluegills varied throughout the year. Prevalence of free-floating plasmodia in bluegill gall bladders was highest (100%) during winter and spring months, and decreased to 40-50% during summer and fall. Prevalence of attached plasmodia may remain 80-100% throughout the year. Sporulation and plasmotomy were observed year-round. Plasmodia were attached to underlying epithelial cells by pseudopodia-like projections and were associated with various stages of breakdown in the mucosal layer.

Animals↗

Simple primary tuberculosis in an elderly woman.

The diagnosis of primary tuberculous infection was made in a 78-year-old woman. The chest roentgenographic findings were remarkably similar to those often seen in children and adolescents with primary infection. Like the majority of adults with this entity, the patient was asymptomatic; the diagnosis was suspected epidemiologically and was confirmed by culture of M. tuberculosis from the sputum. As the incidence of new tuberculosis cases declines, the diagnosis of primary tuberculosis in the adult may be made more frequently.

Age Factors↗

Isoniazid phenotyping of black as well as white patients.

The isoniazid phenotyping in black patients from Birmingham (Alabama) as well as from South Africa yielded a higher frequency of fast inactivation than that in the Canadian and U.S. white participants. Following an oral test dose of 10 mg isoniazid per kilogram, the incidence of fast acetylation was 58.7 and 60.3% in South African and Birmingham blacks, respectively. In the Canadian and Birmingham Caucasians the rate was 41.9 and 41.0%, respectively.

Black People↗

Nursery exposure of 528 newborns to a nurse with pulmonary tuberculosis.

Newborn infants are thought to be particularly susceptible to infection with Mycobacterium tuberculosis, and the possibility of exposure to unrecognized clinical tuberculosis in nursery and hospital personnel is ever present. To reduce this possibility, periodic skin testing of hospital personnel is often carried out, and tuberculin-positive personnel are given preventive treatment with isoniazid (INH). Also, environmental controls, such as ultraviolet light and periodic air exchange, are used. The efficacy of these measures has not been fully established. A nursery supervisor with smear- and culture-positive pulmonary tuberculosis and a productive cough exposed 528 newborns over a three-month period before her disease was diagnosed. All 514 infants available for skin testing at approximately 3 months of age had negative skin tests. None received isoniazid preventive treatment. The nursery rooms all had ultraviolet lighting mounted above eye level. Calculated air changes per hour with positive pressure ventilation of fresh air ranged from 12 to 18. The hospital did not regularly test employees for tuberculosis. Periodic tuberculin testing of hospital personnel with preventive treatment of reactors presumably would have prevented this exposure.

Child, Preschool↗

Mycobacterium avium-intracellulare from a Vietnamese refugee.

Mycobacterium avium-intracellulare grew from the sputum of a Vietnamese woman, a recent immigrant, seen at a tuberculosis clinic in Birmingham, Alabama. The possibility that she had acquired this Mycobacterium in her native Vietname was considered, since current literature, indicates these agents have no predictable geographic patterns of distribution. Data indicate that outside the United States group III mycobacterial isolates are most common in Japan, Western Australia, and parts of Canada. No data are available for Vietnam. US physicians should be alert for possible nontuberculous mycobacteria in the 115,768 Vietnamese immigrants known to have entered the United States in the mid-1970s.

Aged↗

Tuberculosis and alcoholism. A partial solution through detection.

Alcoholism and tuberculosis often coexist, and patients with this combination have the most frequent failures of therapy. Several intriguing alternatives to standard outpatient chemotherapy are now available. The brief MAST interview (a shortened version of the Michigan Alcoholism Screening Test) has been demonstrated to be effective in identifying alcoholism in public health clinics for tuberculosis in New Orleans and Birmingham, Ala., with scores indicating populations of alcoholic patients of 25% and 28%, respectively. The test could be administered without interrupting the routine of the clinic. We believe that the problem of inadequate therapy in the alcoholic patient with tuberculosis is significant and widespread and is not being handled well is most places. Identification of the potential problem patient at first contact will be most helpful in choosing candidates for specialized forms of therapy, including short-term and supervised treatment, begun before failure of therapy ensues.

Alabama↗