PubMed Health⌕ Search

Biomedical subjects

B L Mann

Publications and source records attributed to B L Mann.

10 recordsLinked to original sources
PubMed2000

Clostridial bacteremia in the community hospital.

Anaerobic infections are not commonly studied in the community hospital. The aim of this study was to determine demographic factors, the portals of entry and underlying disorders for clostridial bacteremia and to determine whether appropriate (recommended) treatment is effective. Medical records were reviewed for 42 patients with clostridial bacteremia at 1 Florida, USA, hospital and 4 Dayton, Ohio, USA, hospitals. Fourteen (33.3%) of the patients had clostridial micro-organisms that were isolated in cultures with polymicrobial isolates. Only about half of the patients had fever at the onset of their bacteremia and only slightly more than half had elevated leukocyte counts. The most common portals of entry for the micro-organisms were gastrointestinal (42.9%), unknown (35.7%) and skin (16.7%). The most common underlying disorders were advanced malignancy (31.0%), diabetes mellitus (14.3%), none determined (12.0%) and acute cholecystitis (9.5%). The mortality rate was 23.8%. Timely appropriate treatment was started in only about half of the instances. Appropriate (recommended) treatment did not significantly affect survival (p = 0.469). Clostridial infections and bacteremia exist in the community hospital most commonly in severely ill patients. The fact that clostridia are commonly cultured in blood cultures positive for other bacterial pathogens and that appropriate treatment for clostridia did not affect patient survival, call into question the significance and pathogenicity of clostridial organisms. On the other hand, if clostridial bacteremia was not considered in half these patients with bacteremia, it is possible that more indolent clostridial infections are being overlooked.

Acute Disease↗
PubMed1998

Factors influencing the clinical diagnosis of sinusitis.

BACKGROUND: This study was conducted to determine the influence of various clinical factors on the physician's diagnosis of sinusitis. Although the "clinical impression" appears to be a valid method of diagnosis in the literature, the specific factors that influence it have not been explored. METHODS: Seven factors selected from the literature were incorporated into 128 simulated case histories of patients with possible sinusitis. These cases were presented to 40 local family physicians who were asked to assess whether sinusitis was present and whether antibiotic therapy would be prescribed. Logistic regression was performed to determine the influence of each factor. These results were compared with a 30-item Likert-type scale that asked the physicians to rate a variety of factors in terms of their importance to the diagnosis of sinusitis. RESULTS: The diagnosis of sinusitis and the decision to prescribe antibiotics were strongly influenced by the number of factors present. Physicians placed the most emphasis on purulent drainage seen on examination and sinus tenderness, and the least emphasis on smoking history and the failure to respond to decongestants. Transillumination and x-ray examinations were less useful to these physicians in establishing the diagnosis. CONCLUSIONS: The surveyed physicians based their diagnosis of sinusitis on the number of symptoms present, especially if the presentation included purulent drainage seen on examination or sinus tenderness. These results are consistent with studies that have approached the question using other designs.

Anti-Bacterial Agents↗
PubMed1996

Nosocomial infection in the community hospital: severe infection due to Serratia species.

BACKGROUND: Serratia bacteremia is an uncommon illness in hospitalized patients. The aim of this study was to determine how frequently this disease occurs nosocomially and to discover the most common portals of entry and the underlying disorders. METHODS: Fifty-six cases of Serratia bacteremia documented by blood culture (17 cases over a 4-year period in a community hospital in Gainesville, Florida, and 39 cases over a 3-year period in three community hospitals in Dayton, Ohio) were reviewed. Comparison was made with 60 control cases of general bacteremia from three Dayton hospitals. RESULTS: Of the 56 study cases of Serratia bacteremia, 45 (80.4%) were classified as nosocomial, compared with 13 (21.7%) of the controls. Twenty-seven (48.2%) of the 56 Serratia cases occurred in intensive care units. The cases were evenly distributed over the two study periods, and no outbreaks on specific units were noted. The most common portals of entry for Serratia organisms were, in descending order, lung, genitourinary tract, unknown, intravenous line, gastrointestinal tract, and skin. The most common underlying disorder for Serratia bacteremia was malignancy, followed by renal failure (acute or chronic) and diabetes mellitus. Most of the Serratia organisms tested were sensitive to carbenicillin, trimethoprim/sulfamethoxazole, ceftizoxime, ceftriaxone, ceftazidime, cefotetan, aztreonam, ticarcillin/clavulanate, and ciprofloxacin. The organisms were largely resistant to ampicillin, tetracycline, cefazolin, cephalothin, and cefuroxime. Twenty-five percent of the patients with Serratia bacteremia died, compared with 13.6 of the bacteremic controls. CONCLUSION: Serratia bacteremia is often acquired nosocomially. The mortality rate among the study population was surprisingly low for this opportunistic bacteremia, but was higher (though not significantly so) than that of the controls.

Adolescent↗
PubMed1991

Scanning electron microscopic examination of ultrasonic and effervescent methods of surface contaminant removal from complete dentures.

Dentures were examined by scanning electron microscopy to evaluate removal of surface contaminants such as plaque, calculus, microflora, and cigarette smoke. Ten complete dentures were obtained during patient appointments and prepared for SEM examination. Samples from 10 control surfaces, 10 surfaces cleaned with effervescent cleansers, and 10 surfaces ultrasonically cleaned were photographed at x5000. One photograph of each sample was evaluated in random order by five judges for a total of 150 observations. Photographs were compared with one of a clean denture sample. Statistical analysis of the results validated the superiority of the ultrasonic method for cleaning dentures.

Bacteria↗
PubMed1985

Subclassification of neurons in the ventrobasal complex of the dog: quantitative Golgi study using principal components analysis.

The neuronal architecture of the ventrobasal complex (VB) in dog is examined in coronal and horizontal brain sections processed by Golgi- and Nissl-staining methods. Presumed projection and intrinsic neurons are identified by differences in soma size and shape, dendritic branch pattern, the morphology and distribution of appendages, and the appearance of axons. Forty-five projection neurons are examined by quantifying (1) soma cross-sectional area, (2) dendritic field extent and shape, (3) appendages on the soma, primary dendrites, and in a defined major dendritic branch zone, and (4) location in the VB. When considered independently, each variable offers little evidence for separation into morphological classes. However, several of the variables have wide ranges and show significant correlation with other parameters. Using the multivariate descriptive methods of principal components analysis and cluster analysis, a separation of the projection neurons into three morphological classes designated as large, medium, and small neurons is indicated. The features most critical in distinguishing between the groups are, in descending order of importance: (1) dendritic field extent; (2) number of primary dendrites; (3) soma cross-sectional area; (4) number of appendages per major branch point (MBP); (5) number of appendages on the soma; and, (6) number of appendages on the primary dendrites. Dendritic field shape and neuron location have little influence in determining classification.

Analysis of Variance↗
PubMed1983

A Golgi study of the opossum ventral basal complex.

The morphology of neurons in the ventral basal complex (VBC) of the adult opossum (Didelphis virginiana) is described from thick coronal brain sections, using Golgi-, horseradish peroxidase (HRP)-, and Nissl-staining methods. Soma cross-sectional area, dendritic field shape, and the number of appendages (spines) in a defined major branch zone (MBZ) are quantified and statistically analyzed. Results indicate that neurons in opossum VBC have relatively large cell bodies, dendrites which branch in a tufted pattern, and numerous dendritic appendages. These neurons are designated as relay cells because of (1) their tufted dendritic branch patterns, considered characteristic of thalamic relay cells (Ramon-Moliner, '62), and (2) the similarity of their soma sizes with HRP-labeled somata after somatosensory cortical injections. Neurons with traditionally described interneuron morphology do not appear to be present in the VBC of this animal, and, in this respect, the neuronal morphology of opossum VBC is similar to that in rat (McAllister and Wells, '81). Based on statistical analysis of the structural features observed, the presumed relay cells in opossum VBC do not show significant differences in morphology, and consequently are not subdivided into classes. Opossum VBC neurons are recognized as forming a single category in which broad and continuous variations in morphology are indicated. Recognition of a singular class of relay cell is consistent with descriptions for rat and cat VBC (Scheibel and Scheibel, '66), but at variance with a previous report for the primate Galago VBC (Pearson and Haines, '80) subdividing thalamic relay cells into Types I, II, and intermediate categories.

Animals↗
PubMed1983

Cardiac function monitored by impedance cardiography during changing seatback angles and anti-G suit inflation.

Impedance cardiography (IC) appears to be a promising noninvasive technique for monitoring small changes in pilot cardiovascular status during conditions simulating flight. Heart rate (HR), stroke volume (SV), cardiac output (CO), ventricular ejection time (VET), and thoracic impedance (Zo) were monitored in ten volunteers for 5 min at each of four seatback angles from vertical: 12 degrees, 30 degrees, 45 degrees, and 60 degrees. Data were also obtained at three seatback angles (12 degrees, 30 degrees, 60 degrees) for 6 min each before, during, and after inflation of the standard USAF anti-G suit to 1.5 psi. Significant differences (p less than 0.05) in HR, SV, CO, VET and Zo were observed among the four positions. Inflation of the standard anti-G suit to 1.5 psi at 1.0 +Gz did not significantly alter HR, SV, or CO; whereas, 1 min of deflation of the anti-G suit significantly altered HR, SV, CO compared to inflation values. The results suggest IC can detect small differences in HR, SV, CO, VET, and Zo within subjects as a function of minor changes in body position.

Cardiac Output↗
PubMed1982

Exercise does not change high-density lipoprotein cholesterol in women after ten weeks of training.

Effects of a 10 wk, three times per wk individualized bicycle ergometer training program were investigated in 16 healthy sedentary women 19-29 yr-old who were not taking oral contraceptives or other medications. Twelve women were in an interval type program, 6 in a continuous program, all performing 30 min exercise per session at 70% maximum heart rate reserve. Conditioning responses did not differ between the training regimens. Training produced increases in maximum oxygen uptake and physical work capacity. Percent body fat determined by underwater weighing was significantly reduced as was resting heart rate, after the training program. Maximum heart rate was unchanged. Despite changes in "fitness" variables, post-training values of high density lipoprotein cholesterol and triglycerides did not differ from pretraining. High-density lipoprotein cholesterol was significantly reduced at 2 and 5 wk of training and returned to control levels at 10 wk. Exercise conditioning leading to improved physical fitness in healthy women may not be associated with increments in high density lipoprotein cholesterol levels.

Adult↗
PubMedDate not supplied

How family physicians distinguish acute sinusitis from upper respiratory tract infections: a retrospective analysis.

BACKGROUND: The purpose of our study was to examine how physicians diagnose sinusitis in practice. We addressed three specific questions: (1) what clinical factors do physicians look for in evaluating and caring for patients with suspected sinusitis, (2) to what extent do physicians use transillumination and radiograph evaluations in diagnosing sinusitis, and (3) how does the diagnosis of sinusitis influence the decision to prescribe antibiotic therapy? METHODS: We conducted a retrospective review using charts from 25 local family physicians who volunteered to participate in the study. After selecting a random sample of charts of adult patients treated for sinusitis and for upper respiratory tract infection (URI) by each physician, we reviewed the charts to determine the nature of the information collected to differentiate between sinusitis and URI. RESULTS: Rhinorrhea, sinus tenderness, visualization of purulent secretions, and a history of sinusitis were significant predictors of the diagnosis of sinusitis. Antibiotics were prescribed for 98.4% of patients with sinusitis and 13.1% of patients with URI. CONCLUSIONS: This sample of physicians based the diagnosis of sinusitis on three prominent clinical findings, which were also significant factors in diagnosing sinusitis in previous studies. The history of sinusitis might influence patient and physician expectations for the diagnosis.

Acute Disease↗