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C Keane

Publications and source records attributed to C Keane.

At least 37 records · Page 2Linked to original sources
PubMed1996

Haemagglutination properties of Moraxella (Branhamella) catarrhalis.

The ability of 30 isolates of Moraxella (Branhamella) catarrhalis to haemagglutinate erythrocytes of five species was examined. Two haemagglutination phenotypes of M. catarrhalis were observed: phenotype I isolates (n = 10) agglutinated human erythrocytes, while phenotype II isolates (n = 7) agglutinated both human and rabbit erythrocytes. No haemagglutination was observed with chick, sheep or horse erythrocytes. Haemagglutination by both phenotype I and II isolates was abolished following treatment of these isolates with pronase and trypsin, while heat treatment at 70 degrees C markedly reduced the level of haemagglutination by both sets of isolates. Haemagglutination by phenotype II isolates was inhibited by galactose, whereas haemagglutination by phenotype I isolates was not inhibited by this carbohydrate. Transmission electron microscopy (TEM) studies showed that very close cell-surface interactions occurred when both phenotypes of M. catarrhalis adhered to the human erythrocyte. Fimbrial attachment was not apparent. Haemagglutinating isolates of both phenotypes had a trypsin-sensitive outer fibrillar coat when examined by TEM.

Animals↗
PubMed1995

Long-term prospective study of Helicobacter pylori in nonulcer dyspepsia.

Helicobacter pylori is present in up to 87% of patients with nonulcer dyspepsia. This study assessed the effect of eradicating Helicobacter pylori infection on the symptoms of nonulcer dyspepsia at four weeks and one year after treatment. Dyspepsia was assessed on the frequency and severity of six symptoms [epigastric pain (night and day), nausea and vomiting, upper abdominal discomfort, and regurgitation] where each symptom was scored from 0 to 4. Helicobacter pylori status was assessed before treatment and four weeks after treatment with histology and microbiology, and at one year with a carbon-13 urea breath test. Eighty-three patients (23 males, 60 females; mean age 56.3 years; mean symptom duration 3.6 months) with nonulcer dyspepsia and Helicobacter pylori infection entered the study. Seventy-five were available at one year follow-up. Four weeks after treatment, the mean symptom score improved in those with eradication (6.95-2.3, P = 0.01, N = 41) or persistent infection (6.69-3.0, P = 0.015, N = 42). At one year, those with persistent Helicobacter pylori infection (N = 38, score 5.24) had a higher score than those remaining clear of infection (N = 24, score 1.4, P < 0.0001) and those with reinfection (N = 13, score 2.2, P < 0.0001). In addition, persistent Helicobacter pylori infection was associated with more additional treatments than those with eradication (34/38 versus 4/37, P < 0.001). These results suggest that Helicobacter pylori plays an important role in the symptoms of nonulcer dyspepsia.

Adult↗
PubMed1994

Identification and intervention for urinary incontinence by community physicians and geriatric assessment teams.

OBJECTIVE: To determine the difference in the recognition and intervention/referral rates for urinary incontinence (UI) by out-patient Geriatric Assessment Units (GAUs) and private physicians in community-based practices (CMDs). DESIGN: A multi-site, randomized, controlled study where block randomization was utilized to assign subjects 65 years of age and older to either a GAU or a CMD for assessment. SETTING: One academic and three hospital-based GAUs and CMDs in private practice in a large metropolitan area. PARTICIPANTS: Three hundred sixty-four community-dwelling frail men (14%) and women (86%) with a mean age of 75 years. MEASUREMENTS: The independent variable was the type of out patient care, either CMD or GAU, to which the subjects were randomized. The dependent variables were recognition of UI by the health care providers and intervention or referral for the problem of UI once it was identified. Instruments included a structured in-home interview performed before randomization designed to uncover health problems such as urinary incontinence, as well as a medical record review form used post-assessment to ascertain recognition rates and intervention for UI by CMDS and GAUs. Both of the instruments were developed and piloted by the investigators in a preliminary study. MAIN RESULTS: Of the 364 subjects, 151 (41.5%) reported UI during the in-home interviews. Recognition rates for UI were significantly better for GAUs (48 of 81, 59.3%) than CMDs (11 of 70, 15.7%) (P < 0.001). This was true for mild (< 3 times/week) 44.2% vs 2.1% (P < 0.000005) as well as severe UI (> 3 times/week) 86.2% vs 43.5% (P = 0.00111) for GAUs and CMDs, respectively. There were no significant differences in the rate of referral/intervention for recognized cases of UI by GAUs or CMDs. GAUs referred/treated five (21.7%) cases of mild UI and 10 (40%) cases of severe UI while CMDs referred/treated three (30%) cases of severe UI but did not offer intervention for the one recognized case of mild UI. GAUs were more likely to refer to Continence Programs (12, 25%) compared with CMDs who were more likely to refer (3, 100%) to a urologist. A majority of the subjects with UI did not receive treatment or referral for their problem (8, 72.7% CMDs and 33, 68.6% of GAUs). CONCLUSIONS: GAUs out performed CMDs in the identification of subjects with both mild and severe UI. However, the intervention/referral rates were low for both GAUs and CMDs. The outcome of this study points to the need for increased emphasis on UI in curriculum preparing physicians and other health providers as well as the need for continuing education for those already in practice.

Aged↗
PubMed1992

Short report: short-term triple therapy for H. pylori-associated duodenal ulcer disease.

Thirty consecutive patients with endoscopically proven duodenal ulceration who had Helicobacter pylori infection on culture and histology, were treated with tripotassium dicitrato bismuthate (1 tablet q.d.s., 400 mg metronidazole t.d.s. and 500 mg tetracycline t.d.s. for one week, followed by the bismuth salt for a further 3 weeks. All patients were endoscoped at entry and 4 weeks after cessation of treatment, to check for ulcer healing and H. pylori eradication. Two antral biopsies were taken at each endoscopy for histological and microbiological evidence of H. pylori infection. Complete healing of duodenal ulcers was observed in 27/30 patients (90%). Gastritis improved or completely resolved in 26 patients. Eradication of H. pylori was achieved in 27 patients. Of the three patients who failed to heal, two were H. pylori-positive at follow-up and one was H. pylori-negative.

Adult↗
PubMed1992

Evaluation of different solid media used for cultivation of Helicobacter (Campylobacter) pylori.

The ability of nine blood containing media to support the growth of H. pylori was compared. Eighteen strains of H. pylori isolated from antral biopsies were cultivated in two dilutions, for colony counts on the media to be tested. Columbia base chocolate agar without additives was found to be the best medium for growth of H. pylori. However, all other fresh blood containing media also supported the growth of this organism satisfactorily.

Blood↗
PubMed1992

Helicobacter pylori and duodenal ulcer recurrence.

Preliminary evidence suggests that eradication of Helicobacter pylori (H. pylori) may lead to prolonged remission of duodenal ulcer (DU). The aim of this study was to assess the long-term effect of eradication of H. pylori on the natural history of DU. Fifty-one patients with endoscopically proven duodenal ulcers, who were found to have H. pylori infection on histology and culture, and who were successfully eradicated of H. pylori with combination treatment of colloidal bismuth subcitrate and antibiotics, were studied. All patients were endoscoped at entry, 4 wk after cessation of treatment and again at 1 yr or sooner, if symptoms recurred. At each endoscopy, two antral biopsies were taken and assessed histologically and microbiologically for evidence of H. pylori infection. Recurrence of H. pylori infection occurred in 18/51 patients (35.3%) and, of these, 12 patients had evidence of recurrent peptic disease (five DU, seven duodenitis). In contrast, of the 33 who remained negative for H. pylori at 1 yr, none developed evidence of recurrent DU. Overall, DU recurrence occurred in 5/51 patients (11.7%), and occurred only in patients reinfected with H. pylori. This relapse rate compares favorably with patients on maintenance H2-receptor antagonist treatment. These results lend further support to the hypothesis that antral reinfection with H. pylori is associated with relapse of DU.

Drug Therapy, Combination↗
PubMed1991

Eradicating Helicobacter pylori and symptoms of non-ulcer dyspepsia.

OBJECTIVE: To examine the effect of eradication of Helicobacter pylori on symptoms of non-ulcer dyspepsia. DESIGN: Four week prospective study. SETTING: One hospital outpatient and endoscopy department. PATIENTS: 90 adults with persistent symptoms typical of non-ulcer dyspepsia but no clinical or endoscopic evidence of other peptic, biliary, pancreatic, or malignant disease; all had histological and microbiological evidence of infection with H pylori. 83 patients completed the treatment regimen. INTERVENTION: Colloidal bismuth subcitrate 120 mg four times a day for four weeks (27 patients); metronidazole 400 mg and amoxycillin 500 mg each three times a day for one week (27); and bismuth subcitrate 120 mg four times a day for four weeks, metronidazole 400 mg three times a day for one week, plus amoxycillin 500 mg three times a day for the first week (29). MAIN OUTCOME MEASURES: Change in symptom scores determined with questionnaire; histological evidence of gastritis and microbiological evidence of presence of H pylori in biopsy specimens. RESULTS: Overall, H pylori was eradicated in 41 (49%) patients. Although gastritis scores improved significantly in only patients in whom H pylori had been eradicated (from 1.56 to 0.61, p less than 0.01 v from 1.83 to 1.07, p = 0.52) mean symptom scores after treatment were similar in patients in whom H pylori had or had not been eradicated (3.0 v 2.3, NS). Similarly the mean symptom score improved whether or not gastritis improved (2.8 v 3.1 respectively, p = 0.72). The observations were similar for treatment groups analysed individually. CONCLUSION: Antral infection with the organism does not seem to have an important aetiological role in non-ulcer dyspepsia short term.

Adult↗
PubMed1991

Prospective hospital study of community acquired lower respiratory tract infection in the elderly.

A prospective study of community acquired lower respiratory tract infection in the elderly was carried out over a 15-month period. During this time 127 consecutive admissions to two acute geriatric medical wards were studied. An aetiology was established in 77 (61%) of cases. Streptococcus pneumoniae was identified in 37% of patients. Haemophilus influenzae in 18% and Branhamella catarrhalis in 10%. Infection with Mycoplasma pneumoniae was found in only one episode and no cases of Legionella pneumophilia were diagnosed. A significant number of patients had multiple bacterial pathogens isolated: 18% of all bacterial pathogens isolated were ampicillin resistant. Fourteen patients died (11%). Lower respiratory tract infection is a frequent cause of hospital admission for those aged over 65 and is often regarded as a preterminal event. Adequately treated however, mortality is no higher than in the general population. Knowledge of the likely pathogens allows early and appropriate antibiotic therapy for these patients whether at home or on admission to hospital.

Aged↗
PubMed1990

Dosage of colloidal bismuth subcitrate in duodenal ulcer healing and clearance of Campylobacter pylori.

Sixty consecutive patients with endoscopically proven duodenal ulcers were given colloidal bismuth subcitrate tablets either as 120 mg q.d.s. or 240 mg b.d., in a randomized single-blind study. The efficacy of each regimen was determined by endoscopic examination and antral biopsy at 4 weeks; if the ulcer remained unhealed, treatment was continued and endoscopy repeated at 8 weeks. The ulcer-healing efficacy of the two regimens was identical; however, in the four times daily group only 27% remained Campylobacter pylori positive after 8 weeks of treatment compared with 58% of the twice-daily group. Similarly, only 21% of twice daily patients were free of histological gastritis compared with 42% of the four times daily patients.

Anti-Ulcer Agents↗
PubMed1990

Adjuvant antibiotic therapy in duodenal ulcers treated with colloidal bismuth subcitrate.

Persistence of Helicobacter pylori after duodenal ulcer healing is associated with high rates of ulcer relapse. We compared colloidal bismuth subcitrate alone with CBS combined with one of four antibiotic regimens in the treatment of duodenal ulcers. Endoscopy and antral biopsies were performed before treatment and four weeks afterwards. Biopsy specimens were examined for histological evidence of gastritis and by Gram stain and culture for H pylori infection. Altogether 141 patients were allocated to one of five treatment groups. Giving CBS and metronidazole (400 mg tid for 7 days) with and without amoxycillin (500 mg tid) achieved higher clearance rates of H pylori than treatment with CBS alone (p less than 0.01). These two combinations also achieved higher rates of antral gastritis healing than CBS alone (p less than 0.01 and p less than 0.05 respectively). Susceptibility to metronidazole was tested in 29 isolates before and in seven isolates after treatment with metronidazole by disc diffusion test and minimum inhibitory concentration assay. Twenty seven (93%) of the isolates were sensitive before treatment while six of seven (86%) were resistant afterwards. Four of the six resistant strains had acquired resistance during treatment and one of these had acquired metronidazole resistance despite concomitant treatment with amoxycillin, to which it remained sensitive. CBS with adjuvant metronidazole at a dose of 400 mg tid for seven days significantly improves the eradication of H pylori compared with CBS alone. Acquired metronidazole resistance, however, seems to be an important cause of failure to eradicate H pylori.

Amoxicillin↗
PubMed1989

Effect of age on adherence of Branhamella catarrhalis to buccal epithelial cells.

The role of adherence in the pathogenicity of Branhamella catarrhalis in lower respiratory tract infection in the elderly was investigated. Differential adherence of this organism to buccal epithelial cells of elderly inpatients, outpatients, and young controls was measured. The mean number of bacteria adherent per cell was 36.9 +/- 11.2, 40.2 +/- 6.1 and 16.5 +/- 12.8 for inpatient and outpatient elderly and young controls respectively (significantly different p less than 0.01, Student's t test). This significantly higher level of adherence in the elderly subjects suggests that increased adherence may contribute to the incidence of respiratory tract infection due to B. catarrhalis seen in this group.

Adult↗
PubMed1987

Campylobacter pylori and recurrence of duodenal ulcers--a 12-month follow-up study.

In 39 patients with endoscopically healed duodenal ulcers repeat endoscopy and two antral biopsies after 1 year showed a relapse rate of 59%. Only post-treatment Campylobacter pylori status was a significant predictor of endoscopic relapse. 79% of patients who remained culture positive had a relapse, compared with 27% of culture-negative patients. Relapse was more likely (66%) in patients with a recurrence of C pylori after apparent eradication of the organism than in those who remained negative for C pylori (10%). No patient who remained negative for C pylori had histological gastritis, whereas all with recurrence of C pylori showed histological gastritis. These findings suggest an important role for C pylori in duodenal ulcer relapse in the year after treatment.

Adult↗