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Biomedical subjects

J K Ferguson

Publications and source records attributed to J K Ferguson.

At least 19 recordsLinked to original sources
PubMed1999

A population-based study of children with cerebral tuberculosis in New South Wales.

OBJECTIVE: To determine the incidence of childhood cerebral tuberculosis (tuberculous meningitis [TBM] and tuberculoma) in a defined population. DESIGN: Retrospective, population-based study. SETTING AND PARTICIPANTS: All resident children aged up to 14 years in New South Wales diagnosed with cerebral tuberculosis, from 1982 to 1996. MAIN OUTCOME MEASURE: Population-based incidence of childhood TBM. RESULTS: 10 children with TBM and one with tuberculoma were identified in the 15 years. The incidence of TBM was 0.053 (95% CI, 0.025-0.097) per 100,000. Eight of the 10 TBM patients were born in Australia and five were of white European origin. Only one had been vaccinated with BCG vaccine. Three of the children died. CONCLUSIONS: The incidence of childhood TBM in New South Wales is low, and comparable with that in other First World countries.

Adolescent↗
PubMed1999

Pulsed-field gel electrophoresis is a useful tool in the monitoring of methicillin-resistant Staphylococcus aureus epidemic outbreaks in the intensive care unit.

We wished to determine how pulsed-field gel electrophoresis may be of use in monitoring methicillin-resistant Staphylococcus aureus (MRSA) outbreaks in the intensive care unit (ICU). A retrospective epidemiological analysis was conducted. All 27 ICU patients and 11 patients from other hospital wards from whom MRSA was isolated over a one year period were included in the study. Seventeen of the 27 ICU MRSA isolates were analysed by pulsed-field gel electrophoresis for clonality and compared with the 11 other hospital isolates genotypes over the same period. During three MRSA outbreaks, five MRSA genotypes were identified in ICU whilst the same five genotypes and three additional were found in the rest of the hospital. Pulsed-field gel electrophoresis analysis was useful in identifying clonality of ICU MRSA infections and establishing that they were imported from hospital wards, rather than arising de novo in ICU. We were further able to identify clonal clusters within the unit linked by temporal and geographical proximity, suggestive of cross-infection. Pulsed-field gel electrophoresis typing might be additionally useful in tracing the source of human and/or environmental factors if a genotype were persistently identified.

Adolescent↗
PubMed1998

Should third-generation cephalosporins be the empirical treatment of choice for severe community-acquired pneumonia in adults?

The choice of empirical treatment for community-acquired pneumonia (CAP) is highly controversial. Our survey of 42 Australian emergency department doctors showed that monotherapy with a third-generation cephalosporin was the preferred regimen for severe CAP (14/42; 33%). We argue that cheaper regimens with a narrower spectrum are likely to be just as effective as third-generation cephalosporins and will have fewer adverse effects on the microbial ecology of hospitals. We suggest penicillin or ampicillin (to cover pneumococci--even if penicillin "resistant"--and Haemophilus influenzae), plus a macrolide (e.g., azithromycin or erythromycin; to cover Legionella and other "atypical" pathogens), plus a single large dose of an aminoglycoside (e.g., gentamicin; to cover gram-negative bacilli such as Klebsiella pneumoniae) as empirical therapy for severe CAP.

Adult↗
PubMed1997

Progressive vaccinia treated with ribavirin and vaccinia immune globulin.

A 67-year-old man with metastatic melanoma and chronic lymphocytic leukemia was inadvertently given a vaccinia melanoma oncolysate vaccination. He developed progressive vaccinia at the site of inoculation. The lesion started to heal only when he was treated with ribavirin. Vaccinia immune globulin was administered and appeared to help control the initial lesion and limit the development of satellite lesions.

Aged↗
PubMed1997

Primary cryptococcal cellulitis caused by Cryptococcus neoformans var. gattii in an immunocompetent host.

Primary cutaneous cryptococcal infection is uncommon. The cutaneous manifestations are most often the result of dissemination from the central nervous system or lung, usually in an immunocompromised host; cellulitis is regarded as the rarest cutaneous form. Primary cutaneous cryptococcosis has occasionally been reported in the immunocompetent, the causative organism being Cryptococcus neoformans var. neoformans. We present a case of cellulitis of the right arm in a 75-year-old man caused by Cryptococcus neoformans var. gattii, a fungus which is endemic in Australia and an important cause of infection in the immunocompetent. This is the first case described of a primary cutaneous infection due to Cryptococcus neoformans var. gattii. The interesting ecology of this organism is discussed.

Aged↗
PubMed1996

Risk-stratified nosocomial infection surveillance in a neonatal intensive care unit: report on 24 months of surveillance.

OBJECTIVE: To document the nosocomial infection rate in a single neonatal intensive care unit (NICU) in terms of patient workload and device utilization. METHODOLOGY: Nosocomial infections have been identified and documented by the methodology described by the National Nosocomial Infection Surveillance System (NNIS), Centres for Disease Control, Atlanta. In addition, antibiotic usage has been surveyed in the NICU and standardized measures of patient exposure to antibiotics stratified by birthweight and gestational age have been described. RESULTS: Overall nosocomial infection rates compared favourably with the published NNIS figures at 6.2 infections per 100 admissions or 4.8 per 1000 patient days. Infection rates were significantly higher in lower birthweight groups. Device-related infection rates in each birthweight cohort were also very close to published figures and varied less with birthweight group. Antibiotic exposure averaged 12% of total admission days, less than previously published data. CONCLUSIONS: The NNIS system is applicable to Australian NICU and provides an effective tool for monitoring infection episodes.

Anti-Bacterial Agents↗
PubMed1995

Prospective study of diarrhoeal outbreaks in child long-daycare centres in western Sydney.

OBJECTIVE: To investigate outbreaks of diarrhoeal illness in children attending long-daycare centres (LDCs), to characterise parasitic, bacterial and viral isolates from the children's faeces and to identify individual and LDC risk factors for diarrhoea. DESIGN: Eleven-month prospective case-control study of diarrhoeal outbreaks among children in LDCs. SUBJECTS: 2368 children attending 35 LDCs in the western Sydney area. MAIN OUTCOME MEASURES: Frequency of diarrhoeal outbreaks, rate of attack and spread to family members; pathogens isolated from stools; and individual and LDC risk factors. RESULTS: The overall incidence of diarrhoeal disease was low (0.28 outbreaks per centre per year and 0.056 outbreak-associated cases per child-year). Attack rates during outbreaks varied widely (4%-55%; mean, 15%), as did secondary spread rates to family members (1%-15%; mean, 9%). Pathogens were isolated from 7% of symptomatic children and 7% of controls; no outbreak was shown to be caused by a recognised pathogen. Children with outbreak-associated diarrhoeal illness were more likely to have suffered vomiting, poor appetite, lack of energy, fever and to have taken antibiotics in the previous week than other children. Hygiene practices varied widely among centres. CONCLUSIONS: We found low incidence and morbidity from diarrhoeal illness in Australian urban LDCs. Diarrhoea in children in LDCs may be caused predominantly by non-infectious factors such as diet and antibiotic exposure. Current hygiene measures in LDCs seem adequate to prevent and contain outbreaks of infectious diarrhoea.

Child↗
PubMed1995

Prostate-specific antigen detected prostate cancer: pathological characteristics of ultrasound visible versus ultrasound invisible tumors.

Most studies examining the issue of 'early detection of prostate cancer' advocate the combined use of serum prostate-specific antigen (PSA) and digital rectal examination (DRE). As a result, a significant number of new prostate cancers are diagnosed on the basis of an elevated serum PSA when the DRE is unremarkable. The purpose of this study is to determine if the PSA-detected tumors that are visible on transrectal ultrasound (TRUS) have the same pathological characteristics as PSA-detected tumors that are invisible on TRUS. One hundred and ninety-four patients with an elevated serum PSA concentration and nonpalpable prostate cancer who underwent radical retropubic prostatectomy (RRP) at our institution between March 1988 and December 1991 were reviewed. The patients were divided into two groups: 97 (50%) had no identifiable lesion on TRUS, and 97 (50%) had at least one hypoechoic area consistent with adenocarcinoma of the prostate. The pathological characteristics of the RRP specimens from the two groups were compared. There was no significant difference in the age (p = 0.14) or the preoperative serum PSA values (p = 0.18) between the groups. Also, there was no significant difference between the groups with regard to tumor volume (p = 0.89), focality of the cancer (p = 0.43), Gleason score (p = 0.81), DNA ploidy status (p = 0.96), pathological stage (p = 0.92), surgical margin involvement (p = 0.27), and tumor location (p = 0.64). These findings suggest that the clinical TNM staging system for prostate cancer may be simplified by eliminating the distinction between PSA-detected cancers visible on TRUS and PSA detected cancers not visible on TRUS.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1994

Patient evaluation if prostate-specific antigen becomes elevated following radical prostatectomy or radiation therapy.

Prostate-specific antigen (PSA) is the most sensitive and clinically useful method for monitoring patients following definitive therapy for prostate cancer. A "detectable" value following radical prostatectomy and an increasing level following radiation therapy are both indicative of recurrent/residual disease. The persistent cancer may be local or distant; the rate of increase of serum PSA can be useful in distinguishing between local and metastatic disease. A computed tomography or magnetic residence imaging scan may be useful for evaluating abdominal and pelvic lymph nodes, and the radionuclide bone scan is an effective tool for assessing the skeleton when the serum PSA concentration becomes elevated following treatment.

Adenocarcinoma↗
PubMed1983

Skin thickness in patients with acromegaly and Cushing's syndrome and response to treatment.

Radiological assessment of skin thickness (ST) was assessed in 22 patients with acromegaly and 17 patients with Cushing's syndrome. The age ranges of the patients studied and the 55 individuals in the control group were comparable. The skin thickness in males was significantly greater than in females (P less than 0.01). Mean skin thickness in patients with acromegaly and Cushing's syndrome was significantly greater and less respectively than the mean skin thickness of the normal controls (P less than 0.02). Following successful treatment of acromegaly (growth hormone less than 5 micrograms/l) there was a significant reduction in skin thickness (P less than 0.02 males: P less than 0.01 females). The skin thickness declined at approximately 0.3 mm/year for the first two years and more slowly thereafter. A highly significant correlation was observed between the logarithm of the pre and post treatment plasma GH concentrations and ST values. With one exception, all patients with growth hormone (GH) levels greater than 5 micrograms/l had ST values above the normal range. At an average of 4.5 years after successful treatment of Cushing's syndrome the average increase in ST was 0.23 mm (P less than 0.01). It is concluded that the measurement of skin thickness is a useful screening test for both acromegaly and Cushing's syndrome and provides an objective assessment of the clinical response to treatment.

Acromegaly↗
PubMed1978

Prevalence of fungi during Skylab missions.

Samples for mycological analysis were collected from surfaces in the Skylab spacecraft before launch and during flight for each manned mission. Fungal contamination levels were low during the first two flights; however, the species recovered were different for each mission. On the third mission, widespread contamination of the Skylab spacecraft with Aspergillus and Pencillium spp. was detected. This contamination was traced to several contaminated space suit undergarments.

Aspergillus↗
PubMed1975

Microbiological sampling of the spacecraft atmosphere during a simulated skylab mission.

A skylab Air Sampler (SAS) has been developed for the use during Skylab missions. The SAS was used in the Skylab Medical Experiments Altitude Test (SMEAT) to gather baseline data which could be directly compared to data obtained during actual Skylab missions. The results obtained in the SMEAT gave no evidence of consistent change in either concentration or types of microorganisms in the SMEAT atmosphere over the 56-d test. Microorganisms found included some potential pathogens but were largely normal human microflora. Few typical soil microorganisms were found. These findings are related to commonly anticipated effects of long-term spaceflights on environmental microflora and to other closed environment studies.

Aerospace Medicine↗