Showing papers on "Infectious disease (medical specialty) published in 1986"

The eradication of infectious diseases.

Abstract: The concept of 'eradication' of an infectious disease has been applied to interruption of its transmission within a defined area, such as a country, a group of adjacent countries or a continent, or world-wide.

Role of the infectious disease specialist in containing costs of antibiotics in the hospital.

Abstract: Antimicrobial agents account for a significant proportion of drug expenditures and are used inappropriately approximately half the time in hospital practice. This has led to substantial increases in medical costs for hospitalized patients. Methods have been proposed to reduce inappropriate use of antibiotics, particularly in hospitalized patients. Two of these methods, education and control, were employed effectively by infectious disease specialists at a university teaching hospital to reduce inappropriate use of second-generation cephalosporins. These efforts resulted in significant savings of approximately $130,00 per year. The infectious disease specialist may also make major contributions to cost containment of antibiotics in other equally important areas, including other classes of antibiotics, inappropriate daily frequency, excessive duration of administration, and prevention of adverse drug reactions. The infectious disease specialist is better trained in appropriate antimicrobial use and clinically more knowledgeable in treating infections than other medical specialists and is the best-equipped member of the medical staff to educate the medical community on antibiotic use and to control antibiotic costs.

Epidemiological Research on Infectious Disease: Quantitative Rigor or Rigormortis? Insights from Ethnomedicine

Abstract: Epidemiology often forsakes the richness of a people’s way of living for quantitative rigor. And, although statistical calculations may be built on valid mathematical models, they run a serious risk of being inaccurate by excluding a vital human element: the way people really approach illness and cope with death.

Effect of vitamin e on the immune response to influenza virus vaccine and the incidence of infectious disease in man

Abstract: Dietary antioxidants may ameliorate the increasing susceptibility to infectious disease with age as they have been shown to enhance both humoral and cell-mediated immune responses. To evaluate this possibility, the effect of vitamin E at 0, 200 mg and 400 mg per day was determined on the humoral responses by 103 patients (aged 24–104) in a chronic care facility to a polyvalent influenza virus vaccine (Fluogen) and concurrently on the incidence of pulmonary, urinary tract and other infections.

Fever in mammals: is it beneficial?

Abstract: Fever appears to protect ectotherms against infectious disease perhaps because it increases their aerobic metabolic capacity, which is temperature-dependent. Mammals, however, have a high aerobic capacity and normally regulate a high body temperature. Thus, the further increase in temperature induced by interleukin-1 may be dangerous, and the resulting increase in aerobic capacity may not be necessary for an effective defense. In fact, recent evidence suggests that although the neuroendocrine cold defense responses that are stimulated in fever enhance the defenses of the host, the increase in temperature harms these defenses. Data, however, are scarce and equivocal, and the function of fever in mammals is still uncertain.

Penetration of ciprofloxacin into human lung tissue following intravenous injection.

Abstract: Recently published data on ciprofloxacin concentrations in bronchial secretions (1, 2) pleural exudates (3) and nasal secretions (4) indicate that penetration of ciprofloxacin into the respiratory tract is marked. This communication describes ciprofloxacin concentrations in human lung tissue following a single i.v. injection of 100 mg to surgical patients. Nineteen patients were enrolled into the study after they had given their written informed consent. Serum and tissue samples were withdrawn simultaneously 1, 2, 3 and 4 h after injection of 100 mg ciprofloxacin. Specimens were processed as recently described (5). Briefly, ciprofloxacin concentrations were quantitated microbiologically by means of the conventional cup-plate agar diffusion test using a serum resistant Escherichia coli as test organism. The lower limit of detectability was 0.01 mg/l and mg/kg, respectively. Results summarized in Table 1 indicate firstly that lung tissue concentrations exceeded the corresponding serum concentrations approximately 3.5-fold (range 1..88 to ll.5-fold). Secondly, distribution coefficients between lung tissue and serum concentrations were within the same range throughout the study period, indicating that tissue concentrations declined in parallel to serum concentrations. Thirdly, absolute lung tissue concentrations ranged from 7.62 mg/kg at 1 h to 0.30 mg/kg at 4 h: Although the correlation of in vitro susceptibility data of pathogens to achievable serum and tissue concentrations does not necessarily correlate with in vivo efficacy of a drug (6), such correlations may be a useful guide. Minimal inhibitory concentrations (MIC) of ciprofloxacin against Haemophilus influenza including [5-1actamaseproducing isolates range from 0.004 to 0.008 mg/1 and MIC values against Streptococcus pneumoniae and Klebsiella pneumoniae range from 0.5 to 4 mg/1 and 0.008 to 0.12 rag/l, respectively (7, 8). Thus, H. influenzae and K. pneumoniae are vel 3' sensitive to ciprofloxacin, whereas S. pneumoniae is less susceptible and MIC values may exceed actual lung tissue concentrations. However, It. influenzae and S. pneumoniae, accounting for a large percentage of lower respiratory tract infections (RTI), become increasingly resistant against well-established antibiotics (9, 10). Thus, in spite of the limited in vitro activity against S. pneumoniae, ciprofloxacin may be an alternative drug for treatment of RTI. Comprehensive clinical studies with ciprofloxacin in the treatment of RTI (n = 985) revealed that \"eradication of causative organisms was particularly good for S. pneumoniae, H. infIuenzae and K. pneumoniae\" (11). In the course of another cooperative study on RTI, eradication rates were 90.2% for H. inftuenzae, 80% for S. pneumoniae and 86% for K. pneumoniae (12). These data indicate that MIC data are not necessarily indicative of therapeutic activity of ciprofloxacin and that it seems appropriate to determine the efficacy of ciprofloxacin in the treatment of RTI. D. Schlenkhoff, A. Dalhoff, J. Knopf; W. Opferkuch

Pregnancy in renal transplant recipients: a review.

Abstract: Although pregnancy in renal transplant patients was looked upon with skepticism in the past, it is no longer an insurmountable barrier to successful pregnancy. Gestation in these patients, once quite rare, is increasing markedly and obstetricians expect to encounter problems such as immunologic, genetic, teratogenic, and infectious disease during the course of pregnancy in these patients. The purpose of this paper is to review various maternal and fetal aspects of pregnancy in renal transplant recipients.

Bacterial Infections of Nonhuman Primates

Abstract: A variety of bacterial infections can be expected to occur with considerable frequency in nonhuman primate colonies. These infections continue to be significant causes of morbidity and mortality and can have a serious impact on colony maintenance and management, domestic breeding programs, and research projects, if not actively pursued and controlled. Certain microbial agents, e.g., Shigella, Salmonella, pneumococcus and other streptococci, Staphylococcus, Hemophilus, and Yersinia, are encountered on almost a daily basis in nonhuman primate colonies. In addition, adequate microbial support will reveal numerous other bacterial pathogens that have been infrequently or rarely isolated in nonhuman primates, e.g.,Chromobacterium, Vibrio, and Listeria. The correct clinical or postmortem diagnosis is often dependent upon the results of bacterial cultures. Adequate bacteriologic support is, therefore, required in order to provide the appropriate therapy for clinical cases and to arrive at a definitive diagnosis in necropsy cases. Information provided by bacterial cultures is particularly useful in the clinical situation in three important ways. First, if bacterial cultures are available for most of the cases of infectious disease, it gives the clinician a historical data base for the relative incidence of the more common infectious conditions that occur in the colony. Since identification of the etiologic agent may take from one day to several weeks, the data base from previous culture results is an invaluable source of reference data that is specific for the colony in question and often for the species in general.

When should we use urine cultures

Abstract: Medicine and infectious disease textbooks have traditionally advised physicians to obtain urine cultures routinely before the initiation of therapy for presumed urinary tract infection. In practice, however, many physicians treat patients empirically, without doing a culture, and a recent cost-effectiveness analysis has supported this approach, at least in selected patients. What, then, are trie pros and cons of diagnostic urine cultures, and in which situations does current evidence favor their use?

Wastewater disinfection and infectious disease risks

Abstract: Under certain conditions, direct exposure to wastewater effluents during swimming or indirect exposure via consumption of shellfish taken from contaminated waters or drinking water produced from contaminated supplies may cause human infectious disease. Prior data on outbreaks associated with such cases will be reviewed along with relevant epidemiological and dose‐response studies. The relationship between these data and policy setting for microbial effluent criteria will be discussed.

Breast-Feeding and Host Defense

Abstract: Articulo cientifico -- Universidad de Costa Rica. Instituto de Investigaciones en Salud, 1986

Current therapy in infectious diseases-2

Abstract: Current therapy in infectious diseases-2 , Current therapy in infectious diseases-2 , کتابخانه الکترونیک و دیجیتال - آذرسا

Stress, the Immune System, and Cancer

Abstract: A casual linkage between stress and susceptibility to infectious disease and cancer has been suggested for some time. It has further been proposed that such a relationship, if it is a meaningful one, probably involves the influence of stress on immune system function.

Pyogenic liver abscess by haemophilus influenzae complicating hydatid cysts.

Abstract: The patient, a 42-year-old man, came to our hospital because of daily fever and right upper abdominal pain beginning 40 days before. Physical examination showed a febrile patient with a non-tender, enlarged liver. The erythrocyte sedimentation rate was 118 mm/h. The alkaline phosphatase was 328 U/1 (n: 70-t70 U/I) and the gammaglutamyltranspeptidase was 69 U/1 (n:6-28 U/l). All other biochemical investigations were within the normal range. Three blood cultures yielded 11. influenzae. A 99 m Technetium liver scan revealed a filling defect in the right liver lobe. Ultrasonography showed two lesions, 4 cm and 7 cm in diameter, without clear differentiation between solid and cystic. Anti-echinococcus antibodies were detected by indirect hemagglutination at a titer of 1:102,400. A laparotomy was performed. Two abscesses, 4 cm and 8 cm in diameter, were found in the right hepatic lobe, without communication with the biliary tract. Culture of the pus yielded H. influenzae. Morphologic examination of one of the lesions showed a cystic structure with a white capsule containing calcifications and gelatinous membranes. The patient followed a good course and is doing well six months later.

Survey for antibodies against various infectious disease agents in muskoxen (Ovibos moschatus) from Jamesonland, Northeast Greenland.

Abstract: these hosts and the persistence of such infections. The observations of Locke et al. (1974, op. cit.) on salmonellosis in a captive heron colony suggest that these possibilities are likely. The extent to which Sulmonellu spp. infections may limit natural populations of wading birds requires further study. I thank Ms. Maria Mikovsky and Ms. Michaele Mikovsky for assistance in the field and Ms. Harriet Izenberg for performing the tests for antibiotic resistance.

Training, Cost Containment, and Practice: Effect on Infectious Diseases

Abstract: In 1978 the statement was made that if any more infectious disease specialists were trained they would be culturing one another. The increase in infectious disease consultants continues unabated. The number of training programs in infectious disease is rising in proportion to the number of fellows being trained; one-third of these training programs are in New York, California, and Texas, and a number of them are not associated directly with medical schools. It is often argued that there is no reason to restrict the number of infectious disease consultants because there is plenty for them to do. There are an equal number of arguments against unbridled growth, including the fact that the existence of specialists in most community hospitals with lead to fewer referrals to the teaching centers and the resulting lack of patients will lead training programs to atrophy. Infectious disease is destined to function best as an academic specialty whose trainees should pursue careers primarily as investigators. The number of clinicians leaving training should be reduced and not further glut the marketplace; they should be based in academic divisions and devote their clinical time and effort to the care of complex referral and to indigent patients.

Disease and Pest Outbreaks

Abstract: Until recent times, the periodic irruptions of infectious diseases have been significant factors in the lives of humans and in the history of civilized society. Today many of the serious infectious diseases of humankind have been controlled. However, the increased control of human infectious disease has not lessened the importance of studying and understanding infectious diseases, because agricultural crops as well as forest resources are continually damaged by outbreaks of pests and disease. Strategies for their elimination or control are urgently needed.

Toxic effects of food-borne fluoride in silver foxes.

Abstract: Chronic ingestion of excessive amounts of fluoride from commercial fox food is associated with agalactia in vixens resulting in the starvation deaths of large numbers of kits in three fox herds. Evidence of infectious disease or poor management could not be found and a causal relationship between fluoride and high kit mortality is suggested.