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Biomedical subjects

C C Linnemann

Publications and source records attributed to C C Linnemann.

At least 55 records · Page 3Linked to original sources
PubMed1982

Methicillin-resistant Staphylococcus aureus: experience in a general hospital over four years.

From 1977 to 1981, 317 patients in a large general hospital became infected with methicillin- and gentamicin-resistant Staphylococcus aureus. The epidemic strain was characterized as bacteriophage type D11/83A/85, resistant to methicillin, cephalosporins and aminoglycosides, and contained a 24 megadalton plasmid which mediated gentamicin resistance. Spread within the hospital followed introduction of this organism into the general surgical and burn services and resulted from cross infection between patients. These services remained a reservoir of infection throughout the four-year period. Only 2% of hospital personnel carried methicillin-resistant S. aureus in their anterior nares, and only one of them was shown to be a long-term carrier. During the epidemic, there was no overall increase in serious staphylococcal infections, as reflected in bacteremias. As methicillin-resistant S. aureus increased, there was a reciprocal decrease in methicillin-sensitive S. aureus. Later, as methicillin-resistant S. aureus bacteremias decreased, methicillin-sensitive S. aureus bacteremias increased. Attempts to control the spread of the organism by containing infected patients on an isolation ward, or by placing all such infected patients in strict isolation, decreased the frequency of infections, but did not eliminate the organism. In 1980, the burn service was separated from the surgical service and moved into a new burn unit. Also, the five-bed rooms in the hospital were being converted to two-bed rooms. With only routine isolation precautions, the epidemic resolved over the next year, although the epidemic strain persists in the hospital.

Cross Infection↗
PubMed1982

The epidemiology of genital colonization with Staphylococcus aureus.

The prevalence of genital colonization with Staphylococcus aureus, including strains that have been associated with toxic shock syndrome, was studied in 600 women. Nine percent of these women were colonized with S. aureus, 5% of whom had positive vaginal cultures, and 1% were colonized with toxin-producing strains. Black women were colonized with S. aureus, including toxin-producing strains, as frequently or more frequently than white women. The highest colonization rates occurred in postpartum women. Trends toward increasing colonization occurred in relation to decreasing age and socioeconomic status. There were no statistically significant relationships between genital colonization with S. aureus and the use of tampons, oral contraceptives, or a variety of other personal habits and health problems. Genital cultures taken in consecutive menstrual cycles indicated that 35% of women with S. aureus were persistent carriers, and the rest either intermittent or transient carriers. Toxin-producing S. aureus was also identified in family members of women carrying the same organism. This report defines the prevalence of genital colonization in a large population of women, characterizes the women with S. aureus, and describes epidemiologic features of genital carriage.

Adolescent↗
PubMed1982

Measles immunity after revaccination: results in children vaccinated before 10 months of age.

Measles immunity was studied in children in a private pediatric practice who had been revaccinated because they had received their primary measles vaccination before 1 year of age. Antibody was measured in 72 of these children who had received the first injection of live measles virus vaccine at less than 10 months of age, and the second at greater than 1 year of age. Of the 72 children, 29 (40%) had no detectable antibody and the geometric mean titer for the group was approximately 1:4. Of the children with low antibody titers, 15 were given a third injection of measles vaccine and five (33%) still did not respond. Cell-mediated immunity as indicated by lymphocyte transformation to measles antigen was measured in 11 of the children. Five (45%) had responses to measles antigen, but the responses did not correlate with the presence or absence of antibody. This study confirms the observation that revaccination is unsuccessful in many children who received measles vaccine in the first year of life, and shows that even a third injection of vaccine may fail to produce a significant antibody response.

Age Factors↗
PubMed1981

Viral infections in pediatric burn patients.

Bacterial and fungal infections are frequent complications of burns, but the frequency of viral infections has not been defined. In a retrospective survey of serum for viral antibodies in pediatric burn patients, 22% had fourfold increases in antibodies to cytomegalovirus (CMV); 8% had increases to herpes simplex virus and to Epstein-Barr virus; and 5% had increases to varicella-zoster virus. None of the patients had evidence of adenovirus or hepatitis B virus infection. On the basis of these observations, a prospective study of viral infections, using both serologic and viral culture techniques, was performed. This study showed that in 33% of the children CMV infection developed; in 25%, herpes simplex infection; and in 17%, adenovirus infection. In all of the most severely burned children CMV infections developed, and both primary and reactivation infections were observed. Unexplained fevers are common in pediatric burn patients, and this study shows that some of these may be due to CMV infection.

Adolescent↗
PubMed1981

Chlamydia trachomatis cervical infections in female adolescents.

To determine the prevalence of Chlamydia trachomatis cervical infection in an urban adolescent population, 100 sexually active female adolescents were screened with endocervical cultures for Chlamydia, in addition to bacterial cultures, Gram stains, wet mounts, and Papanicolau smears. C. trachomatis was isolated from 22% of these patients. Neisseria gonorrhoeae was isolated from only 3% of this population. No historical or clinical features were specific to those with positive chlamydial cultures, although cervical inflammations was noted more frequently. Treatment with tetracycline or erythromycin produced bacteriologic cure in 95% of culture-positive patients.

Adolescent↗
PubMed1981

Reye's syndrome simulacra in liver of mice after treatment with chemical agents and encephalomyocarditis virus.

In children with Reye's syndrome, liver specimens exhibit the following characteristics: mitochondrial dysfiguration, fatty infiltration, decreased activity of carbamyl phosphate synthetase and of ornithine transcarbamylase, histochemically reduced activity of succinic dehydrogenase and cytochrome oxidase, and depletion of glycogen. We intended to create an animal model for Reye's syndrome by treating mice with encephalomyocarditis virus, and/or salicylate, fructose, Atlox, butylated hydroxytoluene, pentachlorophenol, and an equal mixture of butylated hydroxytoluene and monosodium stearate. Liver specimens were then examined for the listed characteristics as well as for the activity of argininosuccinic lyase, arginase, phosphorylase, and glucose-6-phosphatase. Results of interest in regard to the experimental intention were obtained in livers of mice treated with virus and Atlox (A) or virus and butylated hydroxytoluene (B). In these specimens, we found a significant reduction (p less than 0.05)--except for ornithine transcarbamylase (A)--to the following levels (in percentage of normal mean): carbamyl phosphate synthetase (A, 79 per cent; B, 57 per cent); ornithine transcarbamylase (A, 91 per cent; B, 75 per cent); glycogen (A, 26 per cent; B, 37 per cent). Simultaneous morphologic analysis of these liver specimens indicated mitochondrial dysfiguration, absence of dense granules, fatty infiltration, and normal activity of succinic dehydrogenase and cytochrome oxidase. The induction of Reye's syndrome-like features in mouse liver may be useful for the study of disease mechanisms and therapy.

Animals↗
PubMed1981

Response to pneumococcal vaccine in renal transplant and hemodialysis patients.

Because of the risk of serious pneumococcal infections in patients receiving a renal transplant, a study was undertaken to determine if pneumococcal vaccine could be administered before or after transplantation. Vaccine was given to recipients of transplants and to patients who were undergoing dialysis. Both groups responded to the vaccine, and although the mean antibody levels were lower than those reported for normal populations, the levels were in the range thought to be protective for most pneumococcal types. Antibody levels, both before and after vaccination, were substantially lower in patients with recent transplants than in patients who were undergoing hemodialysis. Patients who are awaiting renal transplantation can be immunized while they are undergoing hemodialysis. Further study is needed to determine how long antibody levels will persist after vaccination in both patients undergoing hemodialysis and those receiving a transplant.

Adolescent↗
PubMed1980

Pathogenesis of varicella-zoster angiitis in the CNS.

A 20-year-old man with Hodgkin's disease experienced ophthalmic zoster with dissemination and CNS involvement. At autopsy, he was found to have granulomatous angiitis involving the basilar artery, and electron microscopy revealed virus-like particles in the outer layers of the vessel walls, but not the endothelium. This suggests that granulomatous angiitis of the CNS in varicella-zoster infections results from direct viral invasion of blood vessels, perhaps by contiguous spread from cranial nerves.

Adult↗
PubMed1980

Rocky Mountain spotted fever in Clermont County, Ohio. II. Distribution of population and infected ticks in an endemic area.

The epidemiology of Rocky Mountain spotted fever (RMSF) in relation to the distribution of the human population and infected ticks has not been defined. A study was undertaken in Clermont County, Ohio, to describe the distribution of population in a highly endemic focus of RMSF and to determine the prevalence of ticks infected with rickettsiae of the spotted fever group. This area was compared to another area of similar size in the same county where the incidence of RMSF was much lower. The population in the highly endemic area was distributed diffusely throughout the area, allowing maximum interfacing of the human population and the tick vector. The population distribution in the other area differed from the endemic area in that most of the population was concentrated in one town. Of 1168 Dermacentor variabilis collected in the endemic area, 18 (1.5%) were infected, compared to four (1.2%) of 339 ticks in the other area. Past studies of infected ticks have not identified the specific strains or species of spotted fever group rickettsiae. In this study, 11 rickettsiae were serotyped by microimmunofluorescence. Four were Rickettsia rickettsii, five were R. montana, and two were unclassified rickettsiae of the spotted fever group.

Animals↗
PubMed1980

Lung punctures.

Explore the source record for details and available documents.

Biopsy, Needle↗
PubMed1979

Risk of pneumococcal infections in renal transplant patients.

Because of the recent licensing of pneumococcal vaccine, the risk of pneumococcal infections on a renal transplant service was determined. The overall risk of infection was 7% (14 of 197 patients) over a six-year period, or 1% per year. In patients with functioning allografts, this represented a risk of 28 infections per 1,000 patient-years of follow-up. Clinically, the major presentations of pneumococcal infection were pneumonia in the patient who was rejecting his kidney and pneumococcemia of sudden onset that was often fatal. Five of the pneumococci isolated from bacteremic patients were typed; three of the isolates were types that are in the vaccine. The frequency and seriousness of pneumococcal infections in renal transplant patients suggest that pneumococcal vaccine should be given to these patients, probably before transplantation.

Bacterial Vaccines↗
PubMed1979

Cytomegalovirus encephalitis associated with thymoma and immunoglobulin deficiency.

The clinical and immunologic findings in an elderly woman with thymoma and immunoglobulin deficiency in whom cytomegalovirus (CMV) encephalitis developed are described. The patient had absent serum immunoglobulins and no circulating immunoglobulin-bearing lymphocytes. Complement receptor-bearing lymphocytes were present in the peripheral blood, and circulating T lymphocyte numbers were within normal limits. She was anergic to a battery of skin test antigens, and her lymphocytes in vitro showed a selective unresponsiveness to CMV antigen while responding normally to phytohemagglutinin and streptokinase. The course of the encephalitis was progressive with quadriplegia, aphasia and coma developing within six months of onset of symptoms. This is the fifth reported case documenting an association between CMV infection and the syndrome of thymoma with immunoglobulin deficiency, but the first report of fatal CMV encephalitis in a patient with thymoma and immunoglobulin deficiency.

Agammaglobulinemia↗
PubMed1979

Salicylate intoxication and influenza in ferrets.

A model of salicylate intoxication was developed in ferrets to permit the evaluation of the interaction with viruses isolated from patients with Reye's syndrome. Salicylate intoxication produced a mild elevation of the serum glutamic oxaloacetic transaminase and fatty changes in the liver, but these changes differed from those seen in Reye's syndrome on light and electron microscopy. Salicylates were associated with decreased activity of hepatic phosphorylase and a slight depression of activity or ornithine transcarbamylase, a mitochondrial urea cycle enzyme. Infection with influenza viruses produced mild fatty changes in the liver, but did not significantly potentiate the effects of salicylate intoxication on the over-all mortality, the degree of fatty changes, or the hepatic enzymes. Influenza infection alone was not associated with decreased hepatic phosphorylase activity, but was associated with decreased activity of ornithine transcarbamylase. Influenza A was isolated from the livers of two of four animals cultured in embryonated eggs.

Animals↗
PubMed1978

Transmission of herpes-simplex virus type 1 in a nursery for the newborn. Identification of viral isolates by D.N.A. "fingerprinting".

The occurrence of herpes-simplex-virus type-1 infections in two newborn infants in a nursery within a one-month period suggested the possibility of transmission in the nursery. One infant may have been infected by his father, who had active herpes labialis at the time of the child's birth. The source of the second infant's infection was not apparent. Viruses isolated from the two infants were "fingerprinted" by cleaving the virus-specific D.N.A. with several restriction endonucleases and comparing the electrophoretic patterns. Isolates from the two infants were identical and differed from other isolates from epidemiologically unrelated cases. This observation confirmed the possibility of transmission of herpes-simplex virus type 1 in the nursery, but did not define the mode of transmission. Type-1 infections are serious in neonates: one of the infants died and an oesophageal stricture developed in the other. The "fingerprinting" technique provides a useful epidemiological technique for tracing the transmission of herpes virus infections.

Adult↗
PubMed1978

Tick-borne relapsing fever in the Eastern United States.

Tick-borne relapsing fever is endemic in the western part of the United States, but it has not been reported east of the Mississippi River. Sporadic cases have been reported in the eastern part of the United States, but travel to the West during the incubation period appeared to provide the source of infection. In the fall of 1975, a case of relapsing fever was diagnosed in Cincinnati in a child who had not traveled outside of Ohio, indicating the presence of Borrelia in this area. Serial serological studies indicated that B turicatae was the species involved. The occurrence of this case suggests that relapsing fever may exist in the eastern part of the United States, but its presence may not be appreciated because of the rarity of the disease and the difficulty in confirming the diagnosis.

Anti-Bacterial Agents↗
PubMed1978

Cellular immune response to cytomegalovirus infection after renal transplantation.

A prospective study of 15 patients who received renal transplants defined the effect of renal transplantation on the cellular immune response to cytomegalovirus infection. Of 15 patients, 14 developed cytomegalovirus infection, usually in the first 2 months after transplantation, and all infections were accompanied by a normal humoral immune response. After the initiation of immunosuppressive therapy and transplantation, there was a general depression of lymphocyte transformation, as reflected in the response to phytohemagglutinin, accompanied by a specific defect in cellular immunity, as indicated by lymphocyte transformation to cytomegalovirus antigen. Eleven patients had cellular immunity to cytomegalovirus before transplantation, and all of these became negative in the first month after transplantation. In subsequent months, only 6 of the 14 study patients with cytomegalovirus infection developed specific cellular immune responses to cytomegalovirus. This occurred most often in patients who had severe febrile illnesses in association with infection. The specific cellular immune response which developed in the posttransplant period did not persist in three of the patients. This study demonstrates the dissociation of the humoral and cellular immune response to cytomegalovirus infection in renal transplant patients and indicates the importance of the loss of cellular immunity in the appearance of infection. Previously infected patients lost their cell-mediated immunity and had reactivation infections despite the presence of serum antibody.

Adult↗
PubMed1978

The clinical presentations of Rocky Mountain spotted fever. Comments on recognition and management based on a study of 63 patients.

Rocky Mountain spotted fever continues to increase in the United States and the case-fatality ratio remains unchanged despite the availability of effective antibiotics. The apparent reason for the continuing deaths from this disease is the failure of physicians to consider the diagnosis in patients presenting with febrile exanthems in the late spring and summer months. A clinical diagnosis should be based on the history of tick exposure and the presence of fever and the typical exanthem. Serologic tests are useful mainly in retrospect. This article reviews the clinical experience with Rocky Mountain spotted fever in an endemic area in recent years and discusses problems in the diagnosis and management.

Adolescent↗