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Biomedical subjects

B Romanowski

Publications and source records attributed to B Romanowski.

At least 19 recordsLinked to original sources
PubMed1994

Factors affecting urine EIA sensitivity in the detection of Chlamydia trachomatis in men.

OBJECTIVE: This study examined the effects of four variables on the detection of Chlamydia trachomatis in urine from men by enzyme immunoassay (EIA). These variables were: symptoms and signs of urethritis, urine polymorphonuclear leucocytes (PMN), inclusion counts from urethral chlamydia cell cultures and the time between testing and last voiding. METHODS: Included were patients with and without symptoms and/or signs of urethritis attending the Edmonton Sexually Transmitted Disease Clinic. Men were asked to submit a 20 ml volume urine sample. Urethral swabs were collected for gram stain, chlamydia and gonorrhea culture. RESULTS: A total of 318 men were evaluated of whom 47 had chlamydia. Excluding six men who were coinfected with gonorrhoea, sensitivities and specificities of the Microtrak, Chlamydiazyme and IDEIA systems were 78.1% and 99.6%, 75.6% and 100%, and 80.5% and 97.8% respectively. Last void time did not affect the sensitivity. However, sensitivity was best when applied to men with severe evidence of urethritis. CONCLUSION: There is evidence that urine EIA could be used to detect chlamydia in men with acute urethritis but not in those without signs of urethritis.

Chlamydia Infections↗
PubMed1993

Pelvic inflammatory disease. Current approaches.

Pelvic inflammatory disease is an important cause of acute and chronic morbidity among women of reproductive age, and PID rates are rising. Clinical diagnosis of PID is often inaccurate, but can be improved by knowledge of risk factors and use of simple investigations. Early diagnosis and the institution of appropriate treatment regimens, including evaluation and prompt treatment of sexual partners, are essential to prevent PID's devastating sequelae.

Adolescent↗
PubMed1992

Hospital-acquired infection with vancomycin-resistant Enterococcus faecium transmitted by electronic thermometers.

OBJECTIVES: To describe an epidemic of vancomycin-resistant Enterococcus faecium causing bacteremia and bacteriuria, to identify the source of infection, to delineate risk factors associated with acquisition of the organism, and to determine antibiotic sensitivities for the organism. DESIGN: Investigation of an epidemic, including a case-control study. SETTING: Medical-surgical intensive care unit and ward in a university medical center. PATIENTS: Nine patients infected or colonized with vancomycin-resistant Enterococcus faecium and 20 noninfected controls. MEASUREMENTS: Clinical data, environmental surveillance cultures, and in-vitro microbiologic studies. RESULTS: Colonization or infection by vancomycin-resistant E. faecium was associated with an increased duration of treatment with ceftazidime, 13.2 compared with 4.6 days, and a greater number of nonisolated days of hospitalization in the intensive care unit, 19.9 compared with 6.4 days for infected and noninfected patients, respectively (P less than 0.05). Environmental surveillance cultures recovered the organism repeatedly from the rectal probe handles of three electronic thermometers used exclusively on nonisolated patients in the intensive care unit. Restriction endonuclease analysis of plasmid DNA showed that all clinical and environmental isolates were identical. Infection control measures, including isolation of colonized or infected patients and removal of the rectal thermometer probes suspected to be responsible for transmission, resulted in termination of the outbreak. In-vitro, time-kill studies showed that the combination of ciprofloxacin, rifampin, and gentamicin resulted in bactericidal activity against the organism. CONCLUSIONS: This nosocomial outbreak of infection due to a highly vancomycin-resistant strain of Enterococcus is the first epidemic in which an electronic thermometer has been implicated as the vehicle of transmission for an infectious agent.

Adolescent↗
PubMed1991

Serologic response to treatment of infectious syphilis.

OBJECTIVE: To evaluate the serologic response to treatment of patients with infectious syphilis. DESIGN: Historical cohort study of all cases of infectious syphilis in Alberta from 1981 to 1987. PATIENTS: A total of 1090 patients were entered; 857 with primary syphilis, 183 with secondary syphilis, and 50 with early latent disease. Two hundred and eight patients were excluded who either were pregnant, had negative serologic results before treatment, had clinical relapse, were treatment failures, or were lost to follow-up. INTERVENTIONS: All 882 evaluable patients were treated with a recommended antibiotic regimen for infectious syphilis and returned for re-assessment including repeat serologic testing. MEASUREMENTS AND MAIN RESULTS: Seventy-two percent (95% CI, 66% to 77%) and 56% (CI, 43% to 70%) of patients with initial episodes of primary or secondary syphilis had seroreverted according to rapid plasma reagin (RPR) test results by 36 months. A 2- and 3-tube decline was seen by 6 and 12 months in primary and secondary syphilis. Early latent syphilis resulted in only a 2-tube decrease at 12 months. Serologic response was not affected by sex, age, race, or sexual orientation. Patients with their first infection were more likely to experience RPR seroreversal than those with repeat infections. The RPR reversal rates also depended on the pretreatment titer and stage of disease. At 36 months, 24% (CI, 20% to 28%) of patients had nonreactive fluorescent treponemal antibody absorption tests (FTA-Abs), and 13% (CI, 11% to 15%) had nonreactive microhemoglutination tests for Treponema pallidum (MHA-TP). CONCLUSIONS: Adequate therapeutic response for syphilis must be based on illness episode and the pretreatment RPR titer. Treponemal tests can demonstrate seroreversion after 36 months, and a negative treponemal test does not rule out a past history of syphilis.

Alberta↗
PubMed1990

High levels of Epstein-Barr virus in the oropharynx: a predictor of disease progression in human immunodeficiency virus infection.

The role of Epstein-Barr virus (EBV) on the progression of human immunodeficiency virus (HIV) infection is not well defined. The objective of this prospective study was to determine the prevalence of EBV excretion and the role that EBV might have on HIV disease progression. Fifty-two homosexual males were studied, all of whom had positive EBV serology. Twenty-four of the 27 HIV-seropositive and 14 of the 25 HIV-seronegative subjects had detectable levels of EBV DNA in oropharyngeal cells. In addition to a greater prevalence of detectable EBV, the level of excretion was higher among HIV-seropositives than among HIV-seronegatives, and higher among group III than among group II HIV-seropositive men. These results are consistent with earlier studies showing a relationship between immunosuppression and EBV reactivation. The EBV excretion levels in a control group of 52 age-matched heterosexual males were substantially lower than those found in the homosexual group. In a proportional hazards regression analysis EBV excretion was found to be the best single predictor of progression of HIV infection (P less than 0.001). HIV p24 core antigenemia (P = 0.048) and low EBNA (P = 0.024) were significant predictors independent of EBV excretion. Whether EV directly accelerates the time to progression or is merely a marker of underlying subclinical immunosuppression remains an open question.

Antigens, Viral↗
PubMed1986

Norfloxacin in the therapy of uncomplicated gonorrhea.

In an open study, 70 patients with uncomplicated anogenital Neisseria gonorrhoeae infection were evaluated to determine the efficacy and safety of a single oral dose of norfloxacin (800 mg). Norfloxacin cured all 31 male urethral and 25 endocervical infections. All 63 isolates of N. gonorrhoeae tested were inhibited by 0.05 microgram of norfloxacin per ml.

Child↗
PubMed1986

Norfloxacin in the therapy of gonococcal infections.

Norfloxacin is a quinolone derivative with demonstrated activity against Neisseria gonorrhoeae. The MIC90 against penicillinase- and non-penicillinase producing N. gonorrhoeae is 0.06 mg/l and 0.015 mg/l respectively. The drug is rapidly absorbed with a single oral dose of 800 mg producing peak serum levels of 2.45 mg/l. In this open, uncontrolled study, 70 patients with laboratory confirmed, uncomplicated infections with N. gonorrhoeae were entered to determine the efficacy and safety of a single oral dose of norfloxacin 800 mg. Thirty-one males and 27 females were evaluated for efficacy with 34 males and 25 females evaluated for safety. Norfloxacin cured all 31 urethral and two pharyngeal infections in men. All 25 females with endocervical infections and six with rectal involvement were also cured. The single treatment failure occurred in a woman who had persistent pharyngeal infection. All isolates of N. gonorrhoeae were inhibited by 0.05 mg/l of norfloxacin. The incidence of adverse effects was 23.7% but all were mild, required no specific therapy and cleared without sequelae. In this study, norfloxacin proved to be an effective agent in the therapy of uncomplicated gonococcal infection in males and females. It has previously been proven to be useful in the therapy of gonococcal infections due to penicillinase-producing N. gonorrhoeae and the value of this drug as a first line choice in the treatment of gonococcal infections is discussed.

Administration, Oral↗
PubMed1984

Rosoxacin in the therapy of uncomplicated gonorrhea.

In this randomized, multicentered study, 157 males and 130 females with laboratory-confirmed, uncomplicated anogenital Neisseria gonorrhoeae infections were evaluated to determine the efficacy and safety of a single 300-mg oral dose of rosoxacin versus 3.5 g of ampicillin plus 1 g of probenecid. A total of 130 males and 101 females were evaluated. Rosoxacin cured 90.3% (P = 0.053) and 94.1% (P = 0.62), respectively, whereas ampicillin was effective in 98.5 and 98% of males and females, respectively. All 39 patients with anorectal infections were cured. One penicillinase-producing N. gonorrhoeae strain was isolated and was eradicated with rosoxacin. Of 212 pretreatment isolates tested, 201 were inhibited by 0.06 micrograms or less of rosoxacin per ml. The MICs of rosoxacin for the remaining 11 isolates ranged up to 0.5 micrograms/ml. The incidence of adverse effects was relatively high (29% for the rosoxacin group versus 18% for the ampicillin group), but none of the reactions required medical intervention nor did they result in serious sequelae.

4-Quinolones↗
PubMed1983

The latency period of carcinoma-in-situ of the cervix.

The age-specific incidence figures for gonorrhea and cervical carcinoma-in-situ in Alberta, Canada, have been correlated. The findings suggest that when reliable population-based data are available, changes in incidence and age distribution for gonorrhea can be regarded as predictive for comparable changes in incidence and age distribution for carcinoma-in-situ of the cervix with a delay in presentation of approximately five years. The latency period of carcinoma-in-situ of the cervix does not seem to vary considerably among different age groups. The results of the present study support the theory that a sexually transmitted infectious agent could be an etiologic factor in cervical cancer. Because gonorrhea rates in younger women indicate that they are engaging in earlier sexual activity with more partners, regular cervical screening should be encouraged to prevent a potential major increase of invasive cervical cancer.

Adolescent↗
PubMed1983

Treatment of neurosyphilis with chloramphenicol. A case report.

Although penicillin is the drug of choice in syphilis, treatment failures with benzathine and procaine penicillin have occurred in neurosyphilis. Patients allergic to penicillin have traditionally been treated with tetracycline but, since this drug diffuses poorly into the cerebrospinal fluid, its use in neurosyphilis is uncertain. In the case reported here, a penicillin allergic patient with general paresis of the insane was successfully treated with chloramphenicol. This drug has been used in the treatment of syphilis and achieves high concentrations in the cerebrospinal fluid. Thus chloramphenicol may be a more appropriate agent than tetracycline in treating patients with neurosyphilis who are allergic to penicillin.

Chloramphenicol↗