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Biomedical subjects

I Phillips

Publications and source records attributed to I Phillips.

At least 19 recordsLinked to original sources
PubMed1992

Controlled trial of a Y-set dialysis delivery system to prevent peritonitis in patients receiving continuous ambulatory peritoneal dialysis.

Peritonitis rates were compared in patients receiving continuous ambulatory peritoneal dialysis (CAPD) via either a Y-set dialysate delivery system or a standard system. Forty patients in each arm of the trial were matched for age (range 20-67 years, mean 49 years), and remained in the study for similar periods (range 3-36 months, mean 14.1 months). The observation time was 564 patient-months for each arm of the trial. There were 22 episodes of peritonitis in nine out of 40 patients using the Y-set and 57 episodes in 21 out of 40 patients using the standard system (P = 0.005 Wilcoxon signed rank test for episodes, P = 0.02 McNemar's chi 2 test for patients). Peritonitis rates were one episode per 25 patient-months in the Y-set group, and one episode per 9.7 patient-months in the standard group. In the Y-set group there were significantly fewer episodes caused by coagulase-negative staphylococci and Acinetobacter spp. There was no difference in the rate of episodes caused by Staphylococcus aureus, streptococci, enterococci, corynebacteria, enterobacteria or pseudomonads. There was no difference in the incidence of catheter exit wound infections. The Y-set dialysis delivery system is effective in reducing peritonitis rates in CAPD patients caused by organisms derived from the commensal skin flora, principally coagulase-negative staphylococci, but does not reduce peritonitis caused by other organisms.

Acinetobacter↗
PubMed1992

Detection of ciprofloxacin resistance in gram-negative bacteria due to alterations in gyrA.

Two plasmids containing the cloned Escherichia coli wild-type gyrA gene were used to transform ciprofloxacin-resistant Gram-negative clinical isolates to screen for DNA gyrase A-mediated quinolone resistance. The results show that the technique is simple and applicable to a wide range of Gram-negative species including E. coli, Enterobacter cloacae, Klebsiella aerogenes, Morganella morganii, Proteus mirabilis, Pseudomonas aeruginosa, Campylobacter jejuni and Neisseria gonorrhoeae. The use of an arithmetical MIC series of dilutions (as opposed to standard geometrical ones) was found to be essential during screening for the detection of altered gyrase A. The observations were consistent with the suggestion that DNA gyrase is highly conserved among different species of bacteria and that gyrase A-mediated resistance can occur in all.

Ciprofloxacin↗
PubMed1979

Phenylethylamine in paranoid chronic schizophrenia.

Phenylethylamine (PEA) is an endogenous amine that is structurally and pharmacologically related to amphetamine. Urinary PEA excretion is significantly higher in paranoid chronic schizophrenics than in nonparanoid chronic schizophrenics and normal controls. Diet, hospitalization, and medication do not account for differences in PEA concentrations. These findings offer some indication that PEA may be an endogenous amphetamine.

Chronic Disease↗
PubMed1979

Prophylactic peroperative intravenous metronidazole in elective colorectal surgery.

In a prospective double-blind randomised trial 83 patients undergoing elective colorectal surgery were given either preoperative intravenous metronidazole or intravenous normal saline. No other antimicrobials were given. Bowel preparation was the same for both groups. Deep post-operative wound sepsis occurred in 6 of 44 (13-6%) patients on metronidazole but in 20 of 39 (51-2%) control untreated patients. Anaerobes were responsible for all cases of deep sepsis in the metronidazole group (in 5 of the 6 cases aerobes were also isolated), and for 16 of the 20 cases of deep sepsis in the control group (all with aerobes). Superficial infection in the metronidazole group was caused by aerobes. Anastomotic leakage occurred in 5 of the 6 patients who developed deep sepsis on metronidazole and in 10 of 20 patients on placebo. Peroperative intravenous metronidazole dramatically reduced postoperative sepsis but failed to prevent infection in the presence of anastomotic breakdown.

Bacterial Infections↗
PubMed1979

Anaerobic axillary abscess.

Fifty-two patients with axillary abscesses were seen during two years. Staphylococcus aureus was isolated from 34, anaerobic bacteria from 12, and skin flora from five; in one case the pus was sterile. Seven patients with hidradenitis suppurativa had recurrent infection with abscess formation, which was bilateral in three. Anaerobes were isolated in five of these cases and skin flora alone in two. Anaerobes are secondary invaders in this condition, and histological examination shows that the primary abnormality is obstruction of pilosebaceous follicles and apocrine glands, associated with keratin plugging of the follicles. Chemotherapy offers little hope of cure, although metronidazole removes the offensive smell of the discharge. Radical surgery is usually indicated.

Abscess↗
PubMed1979

Anaerobic subareolar breast abscess.

15 non-puerperal women with breast abscess were seen during one year. In 8, anaerobes were cultured from pus obtained from the abscess, in 6, Staphylococcus aureus was grown, and in 1 the pus was sterile on culture. All 7 breast abscesses in puerperal women seen during the same period were staphylococcal. The anaerobic abscesses were all subareolar; they were recurrent in 4 patients and were associated with retracted nipples in 7. The anaerobes isolated were those found as normal commensals in the oropharynx and vagina but did not include the colonic commensal Bacteroides fragilis. Squamous metaplasia with keratin plugging of the breast ducts was identified histologically in the 2 non-puerperal patients in whom duct excision was performed. Surgical treatment of the underlying duct abnormality is important in the management of recurrent non-puerperal subareolar breast abscess.

Abscess↗
PubMed1979

Reassessment of histone gene expression during cell cycle in human cells by using homologous H4 histone cDNA.

The representation of H4 histone mRNA sequences in RNAs isolated from G1 and S phase HeLa cells was assessed by use of a homologous H4 histone cDNA. S phase cells were obtained by double thymidine block, and G1 cells were obtained by double thymidine block or mitotic selective detachment. Nuclear and cytoplasmic RNAs from S phase cells hybridized with H4 histone cDNA as did nuclear and cytoplasmic RNAs from G1 cells synchronized by double thymidine block. In contrast, significant levels of hybridization were not observed between H4 histone cDNA and nuclear, polysomal, or postpolysomal cytoplasmic RNAs of G1 cells synchronized by mitotic selective detachment. Double thymidine block yields a G1 cell population containing 20-25% S phase cells whereas the G1 population obtained by mitotic detachment contains less than 0.1% S phase cells. The ability of H4 histone cDNA to hybridize with the RNAs from G1 cells obtained after release from double thymidine block can therefore be explained by the presence of S phase cells in such a G1 population--an artifact of the synchronization procedure. We interpret these results to be consistent with the presence of H4 histone mRNA sequences during the S but not G1 phase of the cell cycle in continuously dividing HeLa S3 cells.

Cell Cycle↗
PubMed1979

A taxonomic study of clinical isolates of Pseudomonas pickettii, 'P. thomasii' and 'group IVd' bacteria.

On the basis of cluster analysis, average similarities within and between groups, and DNA base composition of selected strains, Pseudomonas pickettii appeared to be a distinct species comprising several biotypes. Although some or all of these biotypes, represented by subclusters in our computer study, may ultimately warrant recognition as separate species, our results were not conclusive enough to warrant such a proposal at present. Most strains tentatively named 'P. thomasii' could be included in P. pickettii so that the name P. pickettii, which was validly published whilst 'P. thomasii' was not, takes priority over 'P. thomasii'. Strains of Group Va (Tatum et al., 1974) examined were also included in P. pickettii. Group IVd (King, 1964) did not appear to be a natural group but some of the strains could also be included in P. pickettii.

Base Composition↗
PubMed1979

An assessment of the Microcult-GC culture test.

Microcult-GC, a miniaturised culture test, was compared with an established selective culture method for laboratory confirmation of gonorrhoea. Microcult-GC correlated 94% with the control method in identifying gonococci in male urethral specimens. Microcult-GC testing of 130 gonococci-negative vaginal swabs gave only 4.6% false-positive oxidase results, which could probably have been readily refuted by Microcult Gram stain. The test may be difficult to interpret for rectal specimens and is not appropriate for pharyngeal cultures.

Adult↗
PubMed1979

Assessment of a selective medium for the isolation of Neisseria gonorrhoeae.

Specimens of urethral pus from 312 men with gonorrhoea were diluted and inoculated on to non-selective and selective media, the latter containing vancomycin, colistin, nystatin, and trimethoprim. Although three (1%) isolates of Neisseria gonorrhoeae were inhibited by trimethoprim 4 mg/1 and 10 by vancomycin 2 mg/1, only two failed to grow on a selective medium from large inocula but eight strains sensitive to vancomycin failed to grow on a selective medium from a light inoculum. These few failures do not appear to negate the value of the selective medium.

Culture Media↗
PubMed1979

Antibiotic sensitivity of anaerobic bacteria.

Antibiotic sensitivity tests on most anaerobic organisms isolated from a given patient are seldom of use to that individual. This is because both isolation and sensitivity testing of this group of bacteria take so long. It is thus vital that the microbiologist should be able to supply to the clinician the cumulated results of past experience, ideally his own, but if not, then the experience of others, taking into account geographical variations whenever possible. Because of the possibility of geographical variation, it is important that every institution should carry out sensitivity testing on easily isolated and rapidly growing bacteria. Bacteroides fragilis is probably the most common of these, and because it is among the more resistant anaerobes and is present in the majority of anaerobic infections, it is often used as an "indicator" both of the diagnosis and of the likely response to a given drug regimen.

Aminoglycosides↗
PubMed1978

Gonorrhoea in women. Diagnostic, clinical, and laboratory aspects.

Examination of the case-notes of all women seen at a large metropolitan clinic during 1976 showed 607 episodes of gonorrhoea (92.3% of all such cases seen in the hospital), of which 3 were in prepubertal girls. Gonorrhoea occurred more often and at an earlier age in Negroids than in Caucasians. In about 30% of patients gonococci could be found in only one of the sites tested (cervix 18%, urethra 6%, rectum 4.8%, and throat 1.5%). Microscopical examination of gram-stained cervical and rectal samples was of value, but that of urethral samples made no significant contribution to the diagnosis. 31% of the gonococcal isolates showed diminished sensitiivty to penicillin, but none showed significant resistance to spectinomycin, kanamycin, or sulphamethoxazole. The complication rate was lower than that reported from the United States. Overall, 40% of patients were symptom-free. The presence of other infection significantly increased the probability of a patient with gonorrhoea having symptoms. "Epidemiological" treatment would have led to the unnecessary treatment of 142 females and would have included only 4 of 16 patients with gonorrhoea who defaulted before treatment could be given.

Adult↗
PubMed1978

Epidemiological patterns of Klebsiella colonization and infection in an intensive care ward.

Twenty-four per cent of 2315 patients admitted to the intensive care unit of St Thomas's Hospital in the 4 year period from November 1969 became colonized or infected with Klebsiella species. Capsular typing of 986 klebsiella isolates from 551 patients showed that there were 695 patient-isolates, mostly derived from the respiratory tract. Capsular types 47 and 21 were the commonest types and together accounted for 19.9% of the patient-isolates. The 14 commonest types accounted for 47.3% of all patient-isolates and all these strains showed clustering, strongly suggesting a changing common source, cross infection, or both.

Cross Infection↗