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Biomedical subjects

E Keith

Publications and source records attributed to E Keith.

16 recordsLinked to original sources
PubMed1994

Management and control of a large outbreak of diarrhoea due to Clostridium difficile.

In the six-month period 1 November 1991 to 1 May 1992 175 patients developed diarrhoea due to Clostridium difficile in three hospitals in Manchester, UK. Most patients (90%) were over 60 years old and had been admitted to acute geriatric or medical wards with other illnesses. Infection is thought to have contributed to 17 deaths. Twenty-two patients relapsed clinically after antibiotic treatment. The outbreak began in one ward and affected 15 patients and two nurses. During the following months cases occurred on 34 wards. The pattern of spread suggested that a ward index case was followed by several secondary cases. Pyrolysis mass spectrometry showed that 79% of isolates of C. difficile belong to a single cluster and this putative outbreak strain also extensively colonizes the hospital environment. It was also responsible for a smaller outbreak in 1991 and many 'sporadic' cases in our hospitals before then. An outbreak control team was convened at an early stage and expert opinion co-opted. Infection control measures included: intensive education of staff; increased vigilance; strict enteric precautions; cohort nursing in a designated ward; rigorous cleaning procedures including emptying and 'deep' cleaning of wards where several cases had occurred; restriction of staff and patient movement; and restriction of antibiotic use. Subsequent to these measures there has been a substantial and sustained decrease in the number of new cases.

Aged↗
PubMed1991

Assessment of the relevance of zona pellucida antibodies in serum and cervical mucus in patients who have fertilization failure during in vitro fertilization.

OBJECTIVE: To assess whether antibodies to the zona pellucida can cause fertilization failure during in vitro fertilization (IVF). DESIGN: Two methods for detecting zona pellucida antibodies were used to assess 20 women undergoing IVF. Nine patients had failed fertilization during the treatment cycle. SETTING: Academic IVF department of a teaching hospital. PATIENTS: Infertile patients previously assessed as requiring IVF. INTERVENTIONS: Gonadotropin-releasing hormone analogue to achieve pituitary down regulation and human menopausal gonadotropin for superovulation. Transvaginal ultrasound directed oocyte recovery. Cervical mucus and serum samples were obtained. MAIN OUTCOME MEASURES: The presence of antizona pellucida antibodies in serum or cervical mucus in relation to fertilization. RESULTS: Seven of 20 patients had antizona antibodies in serum and 7 of 20 patients had antibodies in mucus. Only 1 patient had antibodies in both samples. No correlation between the presence of antibodies in either sample and failure of fertilization was found. CONCLUSION: Detection of antizona pellucida antibodies by the methods described have no role in the prediction of IVF.

Antibodies↗
PubMed1991

Evaluation of the risk of pelvic infection following transvaginal oocyte recovery.

The risk of introducing infection into the peritoneal cavity at the time of transvaginal ultrasound-guided recovery of oocytes in assisted reproduction techniques was assessed by culturing peritoneal fluid samples from 25 women with unexplained infertility. The samples were collected laparoscopically at the time of zygote intra-Fallopian transfer (ZIFT), 24-48 h after oocyte collection. High vaginal and endocervical specimens from 25 women treated by in-vitro fertilization (IVF) and transcervical embryo transfer were cultured for comparison. The peritoneal cultures were negative in all but one patient. High vaginal swabs grew Candida albicans in three cases and endocervical specimens were all negative. Seven and three pregnancies occurred in the ZIFT and IVF groups respectively. No pelvic damage was noted at laparoscopy in those women who had had previous treatment cycles with transvaginal oocyte recovery. This method of oocyte recovery, using prophylactic metronidazole and chlorhexidine for preoperative vaginal preparation, appears to be safe for treatment of women with no previous pelvic damage.

Adult↗
PubMed1990

Biotransformations of aromatic aldehydes by acetogenic bacteria.

Vanillin was subject to O demethylation and supported growth of Clostridium formicoaceticum and Clostridium thermoaceticum. Vanillin was also stimulatory to the CO-dependent growth of Peptostreptococcus productus. The aldehyde substituent of vanillin was metabolized by routes which were dependent upon both the acetogen and a co-metabolizable substrate (e.g. carbon monoxide [CO]). C. formicoaceticum and C. thermoaceticum oxidized the aldehyde group of vanillin to the carboxyl level, while P. productus reduced the aldehyde group of vanillin to the alcohol level. In contrast, during CO-dependent growth, C. thermoaceticum reduced 4-hydroxybenzaldehyde to 4-hydroxybenzyl alcohol while P. productus both reduced and oxidized 4-hydroxybenzaldehyde to 4-hydroxybenzyl alcohol and 4-hydroxybenzoate, respectively. These metabolic potentials indicate aromatic aldehydes may affect the flow of reductant during acetogenesis.

Aldehydes↗
PubMed1983

Outcome of very low-birth weight infants born at a perinatal center.

One hundred six infants with birth weights less than or equal to 1,000 gm were born at a Perinatal Center in 1979 and 1980. Eighty-three (78%) were born to women transferred to the Center because of antenatal problems. The most common obstetric problem was premature labor with or without premature rupture of the membranes. Seventy-two infants (68%) survived. The following perinatal factors were associated with increased survival: increased birth weight and gestational age, intrauterine growth retardation, antenatal steroids, absence of hyaline membrane disease, and absence of seizures or clinical signs of intraventricular hemorrhage. Of the 72 survivors, two were lost to follow-up and one died (sudden infant death syndrome). The most common general health problem was recurrent middle ear infection. Growth was satisfactory. Significant neurological or developmental handicap was found in nine infants (13% of the 69 evaluated).

Birth Weight↗
PubMedDate not supplied

Telomerase activity in normal human endothelial cells.

Telomerase, a ribonucleoprotein complex, adds hexameric repeats of 5' T T A G G G 3' to the ends of chromosomes called telomeres. Telomerase activity is present in germ cells but not in most somatic cells. An overwhelming majority of cancer cells show elevated levels of telomerase activity. Once thought to be cancer-cell specific, it is becoming apparent that many proliferating normal cells express telomerase activity. In this study, we demonstrate that normal human endothelial cells express telomerase activity: the activity is growth related. In quiescent, confluent cultures, the telomerase activity is repressed. Furthermore, the activity is lost upon subculturing of the endothelial cells in vitro. Finally, G2/M arrest induced by nocodazole treatment of endothelial cells abolished telomerase activity. Primary cultures of endothelial cells offer a powerful model to study the role, if any, of telomerase in normal cells.

Cell Cycle↗