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Biomedical subjects

A M Geddes

Publications and source records attributed to A M Geddes.

At least 91 records · Page 5Linked to original sources
PubMed1980

Protection against pertussis by immunisation.

Review of all 126 children admitted to the communicable diseases unit with whooping cough during the epidemic in 1978 showed that two had received two doses of triple vaccine and only one had had full primary immunisation against the disease. None of these three children suffered complications of the disease. Of the 123 children who had not been immunised against pertussis, however, 66 had had one or more complications. In Birmingham the dramatic decline in immunisation against pertussis has been accompanied by a fall in acceptance rates for diphtheria and tetanus immunization. Nevertheless, of the 62 children aged over 1 year in this series, 41 had been so immunised. These findings suggest that the apparently positive decision by parents to omit pertussis immunisation was misplaced, since immunisation does protect against the more serious complications of the disease. Furthermore, there is no firm evidence that pertussis immunisation of children without specific contraindications is associated with serious adverse reactions.

Child↗
PubMed1980

Clavulanic acid and amoxycillin: a clinical, bacteriological, and pharmacological study.

Clavulanic acid is an inhibitor of certain beta-lactamases, notably those enzymes which inactivate the penicillins and cause resistance of important bacteria to these antibiotics. Microbiological, pharmacological, and clinical studies show that clavulanic acid in combination with amoxycillin is effective and safe in the treatment of urinary-tract infection caused by amoxycillin-resistant bacteria.

Administration, Oral↗
PubMed1979

Malaria in Birmingham and a London teaching hospital.

During the past five years the incidence of imported malaria increased among patients seen in East Birmingham Hospital and in St Thomas's Hospital, London. Plasmodium vivax was the predominant species in Birmingham, and was almost always acquired by Asian immigrants visiting the Indian subcontinent. In St Thomas's P falciparum was most commonly imported, usually by African immigrants visiting Nigeria and Ghana. Two patients (one Irish, one Japanese) died of falciparum malaria after visiting tropical Africa. In both hospitals the immigrant patients had seldom taken prophylactic drugs, and the few who had, ceased to do so on arrival in the UK and sometimes before leaving the malarious country. Apparently immigrants who visit their homeland do not consult their general practitioners before travelling, are given inappropriate advice, or do not take appropriate advice when given. Since the incidence of imported falciparum malaria in the UK is rising, the following points should be considered: the infection may be lethal, particularly in patients lacking immunity; it can mimic other diseases, which may lead to delayed diagnosis; severe disease may be associated with few parasites on a blood film, and even if the result is negative further tests should be performed; clinicians and hospital pharmacists should be aware of the need to keep permanent stocks of parenteral chloroquine and quinine preparations.

Adolescent↗
PubMed1979

Spread of Salmonella typhi in a maternity hospital.

An Asian patient with undiagnosed typhoid fever was admitted to a maternity hospital and delivered within 10 min. Salmonella typhi (phage type D5) was isolated from her blood and from the faeces of her baby. Another women in a different room of the labour suite at the same time acquired the same organism in her faeces; her brother was admitted to the Infectious Diseases Unit 5 weeks later with typhoid fever. Two babies, born over 60 h after the index case was delivered, became faecal excreters of the same strain and one of them also developed S. typhi osteitis of the hip. These two babies and their mothers were in the same ward as each other, but not that occupied by the infected mother and her baby. Nine other excreters in two of the families involved were identified. The index case and her baby were isolated immediately after delivery, and the relevant rooms in the labour suite were adequately disinfected. No evidence of undisinfected equipment used by the index case and the other infected patients was found, and no spread to staff was detected. The mode of spread remains unknown.

Adolescent↗
PubMed1979

Mezlocillin and azlocillin: an evaluation of two new beta-lactam antibiotics.

Mezlocillin and azlocillin are broad spectrum penicillins for parenteral administration. In this study it was shown that they were very active against a wide range of pathogenic bacteria. Thirty-five patients were treated with mezlocillin, and 5 patients were treated with azlocillin (in combination with cefoxitin in 3 cases). The serum, bile and CSF levels of the drugs were measured. Both antibiotics would appear to be safe and efficacious in treating serious infections by sensitive pathogens. Infections caused by unknown pathogens could be treated by one of these agents in combination with a broad spectrum beta-lactamase stable cephalosporin or cephamycin.

Adolescent↗
PubMed1979

Coagulation activation and hyperviscosity in infection.

A serial study of coagulation activation and whole-blood viscosity was performed on 37 patients with local or systemic bacterial infection, malaria, or a viral infection. Thrombocytopenia, without consumption of coagulation factors, was the main feature of benign tertian malaria and viral infection, whereas in septicaemia and malignant tertian malaria it was associated with activation of coagulation and fibrinolysis. Patients with evidence of intravascular coagulation showed the highest levels of factor VIII related antigen which did not correlate with fibrinogen and probably reflected vascular endothelial cell damage rather than an acute-phase protein reaction. Hyperviscosity, which has been implicated in the pathogenesis of endotoxic shock and cerebral malaria, occurred in parallel with the acute-phase rise in plasma fibrinogen. There was, however, no evidence to implicate hyperviscosity as a major causative factor in the pathogenesis of septic shock or severe infective illness.

Adolescent↗
PubMed1979

Serial changes in coagulation and viscosity during sickle-cell crisis.

Coagulation activity and whole-blood viscosity were measured in the steady state, and serially during painful crisis, in eight patients with sickle-cell anaemia. Platelet and coagulation activation occurred in the steady state and became more pronounced early in crisis. Whole-blood viscosity increased during crisis in parallel with plasma fibrinogen. Similar changes were found in a parallel study of 20 patients with localized bacterial or viral infection who did not have sickle-cell anaemia. Reports of platelet activation, hypercoagulability, and hyperviscosity during painful crisis therefore reflect secondary changes arising from vascular stasis, precipitating infection, and an acute-phase protein reaction. Although secondary, these changes may contribute to vascular occlusion by an additive effect in vessels already partially occluded by sickled cells.

Adolescent↗
PubMed1979

Neutrophil cytochemistry in bacterial infection.

A new cytochemical technique, sensitive to altered lysosomal membrane permeability of blood neutrophils, has been evaluated as a screening test for bacterial infection. This technique, for the lysosomal enzymes acid phosphatase and chloroacetate esterase, was compared with the neutrophil alkaline phosphatase and nitroblue tetrazolium tests. The mean score for each method was significantly higher in infected patients than in normal controls. There was, however, considerable overlap of individual scores between infected patients and ill, but uninfected, patients. This overlap limits the diagnostic value of existing cytochemical screening methods.

Acid Phosphatase↗