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Biomedical subjects

J L Stephens

Publications and source records attributed to J L Stephens.

At least 19 recordsLinked to original sources
PubMed2001

Successful treatment of an infant with Chromobacterium violaceum sepsis.

Chromobacterium violaceum sepsis, a rarely reported phenomenon, has a high mortality rate. We report a unique case of C. violaceum sepsis in an infant. A 4-month-old girl presented to our institution with fever, pustular skin lesions, and distended abdomen, as well as diminished activity and mental status. Radiological investigation revealed brain, lung, and hepatic abscesses. The infant was successfully treated with trimethoprim-sulfamethoxazole and ciprofloxacin.

Anti-Bacterial Agents↗
PubMed2001

Isolated septic arthritis caused by penicillin-resistant Streptococcus pneumoniae.

Streptococcus pneumoniae is a common cause of infection in the pediatric population, as well as an important cause of septic arthritis. The increased prevalence of drug-resistant S pneumoniae in North America has renewed interest in the use of pneumococcal vaccines. We describe the case of a child with isolated acute septic arthritis caused by infection with penicillin-resistant S pneumoniae.

Acute Disease↗
PubMed2000

Tuberculous enteritis: a case report.

Tuberculous enteritis is an unusual diagnosis in the United States. Because this entity is rare and the symptoms are not specific, the physician must have a high index of suspicion. We report the case of a young man with tuberculous involvement of the gastrointestinal tract who required surgical intervention for small bowel obstruction.

Adult↗
PubMed2000

The relationship between volume status, hydration, and radiographic findings in the diagnosis of community-acquired pneumonia.

BACKGROUND: Many clinicians believe the radiographic expression of community-acquired pneumonia (CAP) is affected by the fluid volume status of the patient. However, there are very few data to support or refute this concept. With this study we began to examine the relationship between admission fluid volume status and the radiographic expression of CAP. METHODS: Using a retrospective chart review, we examined 376 consecutive inpatient encounters with the diagnosis of pneumonia at discharge from a community teaching hospital. Patients were evaluated by age, sex, admission serum sodium, blood urea nitrogen (BUN) level, creatinine, and fluid administered in the first 48 hours of treatment. We classified these patients as either showing radiographic progression (P) or no radiographic progression (NP) by comparison of admission and follow-up radiographs. RESULTS: A total of 125 patient encounters satisfied inclusion criteria for the study. Using the Student t test we noted a statistically significant difference between the P and NP groups for BUN level (P=.02), volume of fluid administered during the first 48 hours (P=.04), and marginally for age (P=.05). The P group had higher BUN levels (mean=34 vs 24), more 48-hour fluid intake (mean=5824 mL vs 4764 mL), and younger age (mean=59 years vs 66 years) than the NP group. Logistic regression poorly predicted which patients would have worsening infiltrate on the second radiograph. CONCLUSIONS: Elevated admission BUN level and higher fluid volume administered in the first 48 hours of admission were associated with worsening radiographic findings of pneumonia after hydration. Prospective studies are needed for confirmation of our results.

Aged↗
PubMed1999

FISH landmarks for barley chromosomes (Hordeum vulgare L.).

Barley metaphase chromosomes (2n = 14) can be identified by fluorescence in situ hybridization (FISH) and digital imaging microscopy using heterologous 18S rDNA and 5S rDNA probe sequences. When these sequences are used together, FISH landmark signals were seen so that all 7 chromosomes were uniquely identified and unambiguously oriented. The chromosomal location of the landmark signals was determined by FISH to a barley trisomic series using the 18S and 5S probes labeled with different fluorophores. The utility of these FISH landmarks for barley physical mapping was also demonstrated when an Amy-2 cDNA clone and a BAC clone were hybridized with the FISH landmark probes.

Aedes↗
PubMed1998

Flexor tenosynovitis due to Mycobacterium asiaticum.

Mycobacteria other than tuberculosis infections of the hand are seen with increasing frequency. A case of Mycobacterium asiaticum flexor tenosynovitis is described. Successful management included radical flexor tenosynovectomy and therapy with oral minocycline and clarithromycin.

Adult↗
PubMed1997

The risk of peripheral vein phlebitis associated with chlorhexidine-coated catheters: a randomized, double-blind trial.

OBJECTIVE: To evaluate the risk of phlebitis associated with chlorhexidine-coated polyurethane catheters in peripheral veins. DESIGN: A randomized, double-blinded trial comparing chlorhexidine-coated polyurethane catheters with uncoated polyurethane catheters. SETTING: A university hospital. PATIENTS: Adult medicine and surgery patients. INTERVENTIONS: Certified registered nurse anesthetists or an infusion team consisting of nurses and physicians inserted the catheters. Catheter insertion sites were scored twice daily for evidence of phlebitis. At the time catheters were removed, a quantitative blood culture was performed, and catheters were sonicated for quantitative culture. RESULTS: Of 221 evaluable catheters, phlebitis developed in 18 (17%) of 105 coated catheters, compared to 27 (23%) of 116 uncoated catheters (relative risk [RR], 0.74; 95% confidence interval [CI95], 0.43-1.26; P = .32). By survival analysis, chlorhexidine-coated catheters had a lower risk of phlebitis during the first 3 days (P = .06), but not when all catheters were considered in both patient groups (P = .31). In the absence of catheter colonization, the incidence of phlebitis was 21% (16/76) and 24% (20/86) for coated and uncoated catheters, respectively (P = .85), whereas in the presence of catheter colonization, the incidence of phlebitis was 14% (1/7) and 80% (4/5) for coated and uncoated catheters, respectively (RR, 0.18; CI95, 0.03-1.15; P = .07). CONCLUSION: The risk of phlebitis in the presence of catheter colonization was 82% lower for chlorhexidine-coated polyurethane catheters compared to otherwise identical uncoated catheters.

Adult↗
PubMed1984

Regulation of arylsulphatase A and sulphogalactolipid turnover by cortisol in myelinogenic cultures of cells dissociated from embryonic mouse brain.

Myelinogenic cultures of cells dissociated from embryonic mouse brain were used to study the regulation of myelination-associated molecules by cortisol. Cortisol in physiological concentrations (0.03 microM) caused an increased accumulation of myelination-associated sulphogalactolipids. It also stimulated the myelin- and oligodendroglia-specific cyclic nucleotide phosphohydrolase. The increase in sulphogalactolipid content was caused by a cortisol-concentration-dependent inhibition in arylsulphatase A activity and not by an increase in either cerebroside sulphotransferase activity or an increase in availability of adenosine 3'-phosphate 5'-phosphosulphate. Of several steroid hormones tested only the glucocorticoid types brought about these changes. The relationship between net sulphogalactolipid accumulation and arylsulphatase A inhibition induced by cortisol was confirmed by sulphogalactolipid turnover studies. Depending on whether a single-phase or a two-phase decay calculation is used, the turnover of sulphogalactolipid with cortisol present was decreased at 22 days in culture by either 62% or 65% respectively of that without cortisol. This decrease in turnover can be attributed completely to the decrease of arylsulphatase activity by cortisol to 63% of the value for normal cells grown under the same conditions.

2',3'-Cyclic Nucleotide 3'-Phosphodiesterase↗
PubMed1983

Serial enzyme-linked immunosorbent assays for antibody to Candida antigens during induction chemotherapy for acute leukemia.

Two or more sera were collected from 68 adult patients who received a total of 100 courses of induction chemotherapy for acute leukemia. Sera were tested by ELISAs for antibody to candidal mannan and a major cytoplasmic antigen. Twenty episodes of induction chemotherapy were accompanied by invasive candidiasis of skin, esophagus, or deeper organs. Levels of antibody to mannan rose more than 2.75 times normal activity in nine of these episodes and were already above this level in all sera in two episodes. Levels of antibody to mannan exceeded 2.75 times normal in only two of the remaining episodes in which invasive candidiasis was not observed. An eightfold increase in antibody to mannan occurred at some point in five of the 20 episodes complicated by invasive candidiasis but in only one of the remaining 80 episodes. Antibody to the major cytoplasmic antigen was detected infrequently in sera from episodes complicated by invasive candidiasis. Further studies of precise serial measurements of antibody to mannan therefore appear warranted.

Acute Disease↗
PubMed1983

Quantitation of antibody to Candida mannan by enzyme-linked immunosorbent assay.

Early clinical diagnosis of invasive candidiasis is difficult. To facilitate rapid diagnosis of Candida infections, we developed an ELISA to quantitate levels of antibody to Candida mannan. The test was standardized by analysis of a nonselected inpatient population to determine a cutoff point defining the upper 5% of such a population as test-positive. Passively acquired sera from patients in intensive care units, patients with neoplastic disease or recent renal allografts, and other patients were analyzed. There was no significant difference between the number of positive tests obtained from patients in whom candidiasis was considered but cultures were negative and from the nonselected inpatient population. Positive tests were obtained from 18.5% of patients with Candida mucocutaneous colonization or infection and 40% and 63.6% of patients with probable and proven invasive candidiasis, respectively. Patients with neoplastic disease had lower test sensitivity than patients in other test categories. These results demonstrate the usefulness of a simple, rapid, standardized test for quantitation of levels of antibody activity to Candida mannan in the serodiagnosis of candidiasis.

Antibodies↗
PubMed1979

Oral neomycin dosage schedules for suppression of ammonia production by bowel flora.

To better define a minimal but optimal dose of oral neomycin to suppress ammonia production by bowel flora, several dosage regimens were examined in normal healthy volunteers. Fecal urease activity was quantitatively determined and was used as an indirect measure of intrinsic ammonia production by bowel flora. Large doses of neomycin were found to exert inhibition of fecal urease for many days. There was considerable variation in enzymatic activity among subjects even after adjustments were made for protein content of the stool. Depending on the dose, there was a 1- to 3-day lag in neomycin effect on stool urease activity and several days of continued effect. The most effective regimen of those studied was a loading dose of 6 g of neomycin given in three divided doses on day 1, followed by 1 g twice daily.

Adult↗
PubMedDate not supplied

The reliability and validity of the Tekdyne hand dynamometer: Part I.

The purpose of this study was to evaluate the reliability of Tekdyne hand dynamometer in a controlled loading environment using the Instron 1331. Test-retest reliability, the intertool reliability of three different Tekdyne hand dynamometers, and the effects of surface area and the configuration of the forces applied to the Tekdyne hand dynamometer were studied. In addition, intertool reliability between a Jamar dynamometer modified with foam padding and the same Jamar dynamometer without padding was calculated to explore this device as an alternative measurement device. Intratool and intertool reliabilities of the three Tekdyne tools were high (ICC = 0.993-10.998, SEM = 0.106-0.045 psi and ICC = 0.995, SEM = 0.080 psi, respectively) when tested on the Instron. Both the surface area and the configuration of the force applied to the Tekdyne dynamometer appeared to influence the output reading of this device. The measurements obtained on the Tekdyne hand dynamometer correlated well with those obtained with the Jamar hand dynamometer when a controlled load was applied (r = 0.988). The Tekdyne hand dynamometer is a reliable tool in a controlled loading environment; however, further study is needed to determine its validity with respect to the Jamar dynamometer for testing human grip strength.

Equipment Design↗