PubMed Health⌕ Search

Biomedical subjects

C C Linnemann

Publications and source records attributed to C C Linnemann.

At least 37 records · Page 2Linked to original sources
PubMed1989

Acute febrile cerebrovasculitis. A non-spotted fever group rickettsial disease.

In December 1985, a patient was seen with an illness that was clinically compatible with the recently described clinical syndrome of acute febrile cerebrovasculitis, including fever, headache, altered mentation, multifocal neurologic signs, and cerebrospinal fluid pleocytosis. An extensive medical evaluation failed to reveal a cause, until, retrospectively, she was shown to have antibodies to Rickettsia typhi. Detailed serologic analysis with enzyme immunoassays and protein immunoblots indicated that she was infected with a non-spotted fever group Rickettsia, most likely either R typhi or Rickettsia canada. Serum samples from a mouse trapped at her home contained antibody only to R canada. Evaluation of patients with acute febrile cerebrovasculitis in the future should include rickettsial blood cultures to attempt specific identification of the species involved.

Adult↗
PubMed1989

Pneumococcal endophthalmitis after corneal transplantation: control by modification of harvesting techniques.

Between January and September 1986, 61 patients underwent corneal transplantation at a university hospital, and three (4.9%) of the patients developed endophthalmitis. Cultures of the donor cornea were positive for Streptococcus pneumoniae. The transplant program was stopped and an investigation begun. Review of corneal transplants in 1985 showed that S pneumoniae was recovered from only 1 (1.5%) of 66 donor corneas compared with 6 (9.8%) of 61 in 1986 (P = 0.045; Fisher's exact test). Investigation showed that major changes had occurred in the corneal transplant program in 1986 as a result of a new state law. Coroner's cases had become the source of most corneas; younger donors were available, and corneas, instead of whole eyes, were collected in the coroner's office, often by part-time technicians. All of the infected corneas had been harvested by part-time technicians, instead of the regular eye bank technician, and came from younger donors (mean age 11.8 years v 27.2; P less than or equal to 0.02). Based on these observations, collection techniques were modified to reduce contamination of corneas during harvesting. This included the use of surgical drapes and gloves, collecting the cornea without interruption, saline irrigation of the eye, and inversion of the eye chamber to ensure complete contact of the cornea with the antibiotic-containing media. The program was restarted, and there were no corneal infections with S pneumoniae during a one-year follow-up period.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Recovery of human immunodeficiency virus and detection of p24 antigen in bronchoalveolar lavage fluid from adult patients with AIDS.

Published reports indicate that HIV is recovered from BAL fluid of patients with AIDS who have LIP but not with other AIDS-related pulmonary disease. Our experience has been different. Ten BAL specimens from nine patients with AIDS were cultured directly in peripheral blood mononuclear cells, and all ten cultures were positive for HIV as indicated by examination of the culture supernatant by reverse transcriptase assay and enzyme immunoassay for HIV antigen. Five of the specimens were also positive for Pneumocystis carinii, and other pulmonary diagnoses included histoplasmosis, lymphoma, Kaposi's sarcoma, and aspiration pneumonia. Five additional BAL specimens were cultured after freezing at -70 degrees C, but only two were culture-positive for HIV (p = 0.022; FET). This study indicates that HIV can be recovered from the BAL fluid in most patients with AIDS, unrelated to the type of pulmonary disease. In contrast to cultures, HIV antigen was detected in the BAL fluid of only one patient, and that patient had LIP with noncaseating granulomas. Therefore, HIV culture is not useful in the diagnosis of LIP, but HIV antigen detection should be studied further. All BAL fluids should be considered potentially infectious.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Increasing incidence of toxic shock syndrome in the 1970s.

To determine if there was a true increase in the incidence of toxic shock syndrome (TSS) or just increasing recognition of an old problem, we reviewed 2,145 charts of patients between the ages of 10 and 30 years with discharge diagnoses compatible with signs and symptoms of TSS. No cases were identified in 1970 and 1975, but eight cases were found in 1979 and 1980. The data suggest that an increase of TSS in this age group occurred in the late 1970s.

Adolescent↗
PubMed1986

Revaccination of renal transplant and hemodialysis recipients with pneumococcal vaccine.

Two years after pneumococcal vaccine was given to patients on a university renal transplant and hemodialysis service, vaccine failures began to occur. Serologic studies showed a threefold decrease in antibody levels during this period, from 913 ng of antibody nitrogen per milliliter to 315 ng/mL. The decrease was greater in patients undergoing hemodialysis than in renal transplant recipients (879 to 215 ng/mL vs 932 to 385 ng/mL). The lowest antibody levels were to types 4, 6A, and 19F. Patients were revaccinated, without serious reactions, and pneumococcal infections decreased as they had after the original vaccination program. After revaccination, there was a twofold increase in antibody levels (315 to 602 ng/mL), but the levels did not reach those seen after primary vaccination. The increase was greater in hemodialysis than in renal transplant recipients (215 to 757 ng/mL vs 385 to 536 ng/mL). This experience indicates that pneumococcal vaccines may be effective in patients undergoing hemodialysis and in asplenic renal transplant recipients, but these groups will require revaccination sooner than normal subjects to maintain immunity.

Antibodies, Bacterial↗
PubMed1985

Prolonged hospital epidemic of salmonellosis: use of trimethoprim-sulfamethoxazole for control.

The occurrence of a foodborne outbreak of Salmonella drypool, an uncommon serotype, led to the recognition of hospital-acquired cases occurring over a 5-year period. In late 1981, a catered luncheon resulted in an epidemic of S. drypool, and in retrospect, cases were found to have been occurring in hospital patients from 1977 until 1981. Over the next 4 months, patients, employees, and 50% of the kitchen workers became infected, despite repeated culture surveys of the staff and removal of all infected workers. Food and environmental cultures failed to reveal the source of infection, but infected workers were observed to have multiple negative cultures over several months and then to become positive again. Closing of the kitchen for 2 weeks failed to stop the epidemic. Finally, all kitchen employees, both infected and uninfected, were treated with trimethoprim-sulfamethoxazole for 2 weeks. After treatment, no new kitchen workers became infected, although two workers who had had positive cultures earlier in the epidemic began to excrete S. drypool again, and the epidemic ended.

Carrier State↗
PubMed1985

Serologic survey of rotavirus, Norwalk agent and Prototheca wickerhamii in wastewater workers.

Analysis of paired sera from 48 wastewater workers and controls who reported gastrointestinal illness did not reveal any excess of seroconversions to Norwalk agent or to rotavirus. Inexperienced wastewater-exposed workers had higher levels of antibody to Norwalk agent than did experienced and control workers and those with high and medium aerosol exposure had higher titres than those in the low aerosol category. Analysis for Prototheca antibody titres was essentially negative.

Adult↗
PubMed1984

Prevalence of cytomegalovirus antibody in nursing personnel.

To evaluate the risk to nurses of childbearing age of acquiring cytomegalovirus (CMV) infection during the care of patients at high risk of the infection, 374 female hospital employees (288 nursing personnel) were interviewed and screened for antibody to CMV. Fifty-six percent of the population surveyed had antibody to CMV as measured by an immunofluorescent assay. Among nursing personnel, analysis of antibody prevalence by job title, work area, and duration of work showed no association between seropositivity and either current or past exposure to "high-risk" patients, such as infants and immunosuppressed individuals. Age, race (non-white), and the number of pregnancies reported by participants were significantly associated with the presence of antibody. Among 73 employees of a children's hospital, the prevalence of CMV antibody was 41%. This survey suggests that hospital nursing is not a major risk factor for acquiring CMV infection. However, this finding needs further evaluation in a prospective study of seroconversion rates among seronegative nurses.

Adult↗
PubMed1984

Familial clustering of hepatitis B infections in gorillas.

Two families of gorillas, comprising 13 animals, were studied in 1980-1982 for hepatitis virus infections. It was found that 27% of them had evidence of hepatitis B infection, and 23% evidence of hepatitis A infection. The four parents had been born in the wild and all of them had been infected with hepatitis B. The two patriarchs were positive for hepatitis B surface antigen (HBsAg) and one had hepatitis Be antigen (HBeAg). The two matriarchs had antibody to hepatitis B surface antigen. Three of the four parents had antibody to hepatitis A virus. The two gorillas with HBsAg were retested two years later and shown to be chronic carriers of HBsAg, subtype adw. Both were HBeAg positive at this time. Six of the nine children in the first generation born in captivity had antibody to hepatitis B, but none of them had antibody to hepatitis A. Two gorillas were documented by seroconversion to become infected with hepatitis B, indicating gorilla-to-gorilla transmission. During the course of this study, a recently employed keeper who had the most direct contact with the gorillas experienced an asymptomatic seroconversion to hepatitis B. This study indicates that hepatitis B in gorilla families in captivity may be a model of its behavior in human families, and that close, continuing contact with gorillas may be an occasional source of human infection.

Animals↗
PubMed1984

Risk of infection associated with a wastewater spray irrigation system used for farming.

The use of wastewater for agricultural purposes involves the potential risk of infection from microorganisms in the wastewater. The application of partially treated wastewater on farms has been reported in one study to be associated with human illness, but this has not been confirmed. In the present study, workers at a land application system involving low-pressure spray irrigation of corn fields with wastewater were followed through a growing season to determine if they had an increased risk of infection as compared with a control population of the same socioeconomic group who had no direct exposure to wastewater. Enteroviruses were recovered from the wastewater used for irrigation, but not from the air during spraying. There was no increase in clinical illness among the workers and there was no evidence of an increased risk of infection. The workers who seemed at greatest risk, those who cleaned the spray nozzles, had higher antibody levels to one enterovirus, coxsackievirus B5, but acute symptomatic infections with viral excretion were not documented. This study indicates that there is very limited risk of infection among workers using partially treated wastewater for agriculture purposes.

Adult↗
PubMed1984

Etiological diagnosis of influenza A virus by enzymatic radioimmunoassay.

An enzymatic radioimmunoassay for influenza A virus was developed by using polystyrene beads coated with rabbit immunoglobulin G to capture viral hemagglutinins (H1 and H3). Captured hemagglutinin was detected with goat immunoglobulin G followed by affinity-purified rabbit anti-goat immunoglobulin G labeled with alkaline phosphatase. [3H]AMP was added to quantify alkaline phosphatase activity, and free [3H]adenosine was measured with a scintillation counter. The assay detected as little as 0.1 ng of purified hemagglutinin. It was specific for hemagglutinin subtype and, depending on the source of the goat immunoglobulin G used, detected either H1 or H3. There was no reaction with neuraminidase or core antigens of influenza strain WSN-33. The clinical efficacy of the assay was evaluated with sequential nasal washes from 33 patients with naturally acquired H1N1 influenza. In the first 3 days of infection, the assay was consistently less sensitive than the viral culture, although detectable antigen persisted in secretions longer than did the infectious virus. Testing of multiple samples greatly increased the number of individuals in whom an etiological diagnosis could be made by immunoassay (81% of patients were positive for viral antigens at some point in their illness), and such testing was necessary to achieve the sensitivity of a single culture. Mean antigen levels were highest in nasal washes with the highest titers of infectious virus.

Animals↗
PubMed1984

Enteric parasites in workers occupationally exposed to sewage.

To determine if parasitic infections occur more frequently among workers exposed to wastewater than among controls, parasitologic examinations were performed on stool specimens collected over a 12-month period from sewer and highway maintenance workers. Three of 56 sewer maintenance workers (5.4%) had at least one positive specimen compared with 10 of 69 highway workers (14.5%). The highest rate was found among highway workers engaged in street cleaning. Contrary to studies conducted outside the United States, the present study does not indicate that parasitic infections occur more frequently among sewer workers than among controls in the urban midwestern United States. The results of this study indicate that there may be a risk of parasitic infections among street cleaners.

Adult↗
PubMed1983

Polytetrafluoroethylene graft survival in hemodialysis.

Expanded polytetrafluoroethylene (PTFE) graft fistulas are widely used as secondary vascular access for patients receiving long-term hemodialysis treatment. Sixty-seven grafts were implanted in 48 patients and followed for 12 to 51 months. Cumulative patency for all grafts at 12 months was 67% +/- 6%, at 24 months 50% +/- 7%, and at 48 months 43% +/- 9%. Graft survival rates were different when considering graft configuration and location. Forearm straight graft survival at 12 months was 35% +/- 13%, upper arm curved grafts 60% +/- 19%, and forearm looped grafts 78% +/- 7%. Complications that decreased graft survival were related to thrombosis (21%), infection (25%), and intimal hyperplasia at the venous anastomosis (34%). After reviewing our experience, we believe that the challenge of secondary vascular access has not been solved by PTFE grafts. This should stimulate the search for better grafts and techniques.

Adult↗
PubMed1982

Bacteremia due to methicillin-resistant Staphylococcus aureus.

During a three-year period, Staphylococcus aureus phage type D11/83A/85 that was resistant to methicillin, cephalothin, and multiple aminoglycosides was recovered from 260 infected patients in an urban general hospital in Cincinnati, Ohio. This methicillin-resistant S. aureus (MRSA) was recovered from 30% of all blood cultures positive for S. aureus and represented 50% of all episodes of nosocomial bacteremia due to S. aureus. Bacteremia due to MRSA occurred most often in surgical patients (especially burn patients), occurred late in hospitalization, and was recovered frequently from wounds and intravascular catheters. Infection with S. aureus was the direct cause of death of 44% of the patients with bacteremia due to MRSA. Nine of 10 MRSA-infected patients who were treated with vancomycin alone responded to therapy compared with seven of 15 who were treated with other antistaphylococcal antibiotics (P less than 0.05). The present study defines the epidemiologic characteristics of bacteremia due to MRSA, demonstrates the virulence of MRSA, and proves that vancomycin is effective as therapy.

Cross Infection↗