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J T Howell

Publications and source records attributed to J T Howell.

31 records · Page 2Linked to original sources

Nosocomial transmission of group B streptococci.

Group B streptococci are an important cause of infant septicemia and meningitis. A prospective study of group B streptococcal colonization in a 300-bed community hospital disclosed rates of 29% of 297 third-trimester women, 37% of 242 newborn infants, and 45% of 22 hospital personnel. Colonized parturients were more frequently black and anemic on admission for delivery. Infant colonization was statistically associated with a positive maternal genital culture, low birthweight, and prematurity. Nosocomial transmission of group B streptococci was strongly suggested by observations that 41% of colonized infants were born to culture-negative women and such infants became colonized later in their hospital stay than did colonized infants born to colonized women. Furthermore, hospital personnel working in the labor-delivery and nursery areas had a significantly higher prevalence of the organism than did personnel from other areas. Clearly, more information is needed about the epidemiology of group B streptococcal disease before appropriate and rational control measures can be recommended.

Adult↗

Hyperpyrexia due to air-conditioning failure in a nursing home.

During the period August 9--13, 1976, 21 of 89 residents of a nursing home in southeastern Florida had sudden onset of fever--temperature greater than 38.1 degrees C (100.6 degrees F) with no accompanying symptoms. Five residents, whose temperatures ranged from 39.4 degrees C (103 degrees F) to 41.3 degrees C (106.4 degrees F), died. No viral or bacterial pathogens were isolated. None of the nursing home's 123 employees and volunteers had similar illness. The air-conditioning system was shut down for repairs from August 9 through August 12, a time when recorded peak temperatures outdoors ranged from 30.6 degrees C (87 degrees F) to 32.2 degrees C (90 degrees F). The only recorded temperature inside the nursing home for that period was 31.7 degrees C (89 degrees F). Laboratory and epidemiologic data were consistent with the theory that the illness was due to hyperpyrexia, secondary to environmental conditions, rather than to an infectious agent. The episode was considered analogous to the nonspecific increased mortality of elderly and chronically ill persons during an urban heat wave. The episode points up the need for prompt recognition and intervention when there is the potential for heat stress in elderly and chronically ill patients. Buildings housing such patients must be designed so that alternative ventilation can be provided when the central air-conditioning system fails.

Aged↗

Characteristics of recipients in Florida's long-term program of insulin distribution.

Since 1935 the State health agency has provided insulin to medically indigent diabetics in Florida. During 1980, data were collected on 9,429 recipients regarding their age, race, sex, height, weight, and type and dosage of insulin. The mean age was 55 years; 47 percent were white and 52 percent were black. Seventy-two percent of the recipients were females and 28 percent were males. The utilization rate was much greater for blacks than for whites in all age-sex groups. Seventy-two percent of the estimated number of insulin-requiring black females used insulin supplied by the health agency, compared with 9 percent of insulin-requiring white females in the State. For black males, the proportion was 37 percent and for the white males, it was 5 percent. Obesity was defined as a Body Mass Index (BMI) of greater than 25 for females and greater than 27 for males. The mean BMIs were 30.9 for females and 27.7 for males. In all age groups, women were more obese than men, and blacks were more obese than whites except for the oldest age group, those 65 and older. The mean total daily dosage of insulin was 46 units, and 95 percent of recipients used NPH or Lente insulin. Insulin dosage per kilogram of body weight showed some decrease as weight increased. The authors concluded that the Florida program reaches a significant proportion of its target population.

Adult↗