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Biomedical subjects

K D Allen

Publications and source records attributed to K D Allen.

At least 19 recordsLinked to original sources
PubMed1992

Metronidazole-resistant Bacteroides fragilis wound infection.

We report the isolation of metronidazole-resistant Bacteroides fragilis from a post-operative wound abscess in a 72-year-old woman who had not been treated with metronidazole during the preceding 9 months. The case illustrates the need for caution when identifying anaerobes on the basis of metronidazole sensitivity.

Aged↗
PubMed1992

Costs of an outbreak of wound infections in an orthopaedic ward.

An outbreak of serious wound infections occurring in an orthopaedic ward is reported. The outbreak involved 10 patients, all of whom had undergone clean, orthopaedic operative procedures. The outbreak was eventually terminated by discarding five damaged and contaminated mattresses. The costs incurred during this outbreak were calculated using a retrospective comparative study. The infected patients had an average increased hospital stay of 17 days and average increased costs of 2220 pounds. The outbreak demonstrated the high costs of hospital-acquired infection and the need for further investment in infection control programmes.

Beds↗
PubMed1992

In-vitro activity of ten antimicrobial agents against penicillin-resistant Streptococcus pneumoniae.

The minimum inhibitory concentrations (MICs) of ten antibiotics were determined by the agar dilution method for 40 strains of penicillin-resistant Streptococcus pneumoniae, all of which were clinical isolates from this laboratory. The antibiotics tested were clarithromycin, erythromycin, teicoplanin, vancomycin, ceftriaxone, cefodizime, azithromycin, ramoplanin, ciprofloxacin and MDL 62873. Of these agents, clarithromycin, vancomycin, teicoplanin, ceftriaxone, ramoplanin and MDL 62873 were the most active. The role of these antibiotics as alternatives to penicillin for the treatment of infections caused by penicillin-resistant S. pneumoniae is discussed.

Anti-Bacterial Agents↗
PubMed1992

Dentist-implemented contingent escape for management of disruptive child behavior.

We evaluated the effectiveness of a dentist-implemented intervention in which brief escape from dental treatment was provided to manage disruptive child behavior during restorative dental treatment. Within a multiple baseline design across subjects, 4 children, aged 3 to 7 years, were provided temporary escape from dental treatment contingent upon brief periods of cooperative behavior. Disruptive behavior decreased when the appropriate escape contingency was used at least 80% of the time. The escape contingency required no more time than traditional management procedures (e.g., tell-show-do, reprimands and loud commands, restraint) to bring disruptive behavior under control. Independent ratings by two dentists provided social validation of the efficacy of the escape contingency.

Child↗
PubMed1991

Resolution of 16 to 20 chlorophyll-protein complexes using a low ionic strength native green gel system.

Conventional native "green gel" systems resolve at most 10 chlorophyll-protein complexes from thylakoid membranes of higher plants and green algae. Such analyses suggest a simplicity of the thylakoid membrane that is not supported by a growing body of evidence on the heterogeneity of photosystems I and II (PSI and PSII) and their associated antennae (LHCI and LHCII). We report here the development and characterization of a low ionic strength native "green gel" system that resolves from 16 to 20, mostly large chlorophyll-protein complexes from a variety of higher plant and green algal species with very little release of free pigment. In Chlamydomonas, this system resolves multiple PSI-LHCI complexes, multiple PSII-LHCII complexes, four oligomeric LHCII complexes, as well as several low electrophoretic mobility reaction center complexes, and a number of small complexes. We have obtained similar resolution with a large number of higher plant and green algal species. We also demonstrate how this system can be used as a sort of "fingerprinting" technique to distinguish thylakoids of different species, and for the analysis of photosynthetic mutants, using the chlorophyll b-less chlorina f2 mutant of barley as an example.

Chlorophyll↗
PubMed1991

EMG biofeedback treatment of pediatric hyperfunctional dysphonia.

A 9-year-old boy with a long history of impaired communication resulting from hyperfunctional dysphonia and vocal nodules had proven to be unresponsive to traditional voice therapy. In this study, he engaged in biweekly visual EMG biofeedback training to reduce laryngeal muscle tension. In a multiple baseline design across two responses with changing criteria, results demonstrated sequential stepwise reductions in muscle tension with each new criterion. Concomitant improvements were found in laryngeal aerodynamic functioning and in voice quality. The treatment also resulted in the elimination of the vocal nodules without surgical intervention. These effects were maintained at 6 month follow-up.

Biofeedback, Psychology↗
PubMed1991

Penicillin-resistant pneumococci.

Penicillin-resistant pneumococci were first reported in Australia in 1967 and appeared in the UK in 1976. Their prevalence is increasing but varies greatly worldwide. The mechanism of resistance lies in the alteration of penicillin-binding proteins. Penicillin-resistant strains are often also resistant to a variety of non-beta-lactam antibiotics. Many different serotypes have been found to be penicillin resistant, type 23 being the most common resistant serotype in the UK. Use of oxacillin discs is recommended for penicillin sensitivity testing, otherwise resistant isolates may escape detection. Treatment of infected patients depends on several factors including the degree of resistance of the infecting strain, the sensitivity to alternative agents and the achievable concentration of antibiotic at the site of the infection. Carriage of penicillin-resistant pneumococci is more common in children, especially the recently hospitalized and those recently exposed to antibiotics. Outbreaks of infection have occurred and various control measures have been suggested in attempts to limit the spread of resistant strains.

Bacterial Proteins↗
PubMed1991

Penicillin-resistant pneumococci in a Merseyside hospital.

Strains of Streptococcus pneumoniae (N = 915) from clinical specimens were examined for penicillin resistance over a 2-year period. The prevalence of resistance [minimum inhibitory concentration (MIC) greater than 0.1 mg l-1] increased from 1.4 to 2.5% per year during this time. In addition, 83% of penicillin-resistant pneumococci (PRP) showed resistance to chloramphenicol. Most PRP were isolated from uninfected children colonized with the organism, but two out of the three adult cases were clinically infected, one by cross-infection between in-patients. In only two cases was there an association with foreign travel. Three children showed prolonged carriage providing a potential reservoir of infection for other members of the community. The percentage of strains showing high level resistance (MIC greater than 1 mg l-1) increased from 0.7% to 1.9% of all isolates during the 2-year study period. This high prevalence of high level resistance has not been reported previously in the UK and if the trend continues, it will have serious implications for the management of invasive pneumococcal infection, particularly meningitis.

Adult↗
PubMed1991

Home-based multicomponent treatment of pediatric migraine.

The present investigation examined a home-based multicomponent treatment program incorporating biobehavioral technology in the treatment of pediatric migraine. Twenty-one children ages 7-12 participated in home-based practice of thermal biofeedback while parents implemented guidelines designed to encourage the use of biofeedback and eliminate support for maladaptive pain behavior. Treatment was introduced sequentially across three groups of children in a multiple baseline design. When subjects and their families were complaint with treatment recommendations, 87% of the children experienced clinically significant reductions in headache activity, with these reductions maintained at 3 and 8 month followups. Treatment outcome was found to be closely related to frequency of home practice, parental support for the use of adaptive coping (biofeedback) rather than maladaptive coping (pain) behaviors, and ability to warm hands. Discussion is provided concerning potential mechanisms of action and directions for future research.

Behavior Therapy↗
PubMed1991

Evaluation of the Microring YT system for identifying clinical yeast isolates.

The Microring YT is a commercial system for identifying clinical yeast isolates. The system uses a series of discs impregnated with inhibitory agents mounted on a ring. The pattern of growth and inhibition produced provides a six digit code which can be compared with a table provided by the manufacturer. The performance of this system was compared with the API 32C in the identification of 606 yeast isolates (355 clinical and 251 environmental strains). The Microring YT system was in 72.6% agreement with the API 32C system. The sensitivity of identification of different species varied from 38% to 100%. The API 32C system has a more extensive database than the Microring YT and is thus more reliable for use, but it is considerably more expensive. It is concluded that although the Microring YT is cheap, easy, and convenient to use, it is inadequate for many common Candida species.

Candida↗
PubMed1990

Exercise as a treatment for hypertension in low-socioeconomic-status black children.

Low-socioeconomic-status (SES) Black children have a higher mean blood pressure than most other groups. The antihypertensive effects of a 12-week aerobic exercise program were examined on 11 low-SES Black children, ages 8-12, who had blood pressure above the 95th percentile. A multiple baseline across three groups of children with baseline and exercise conditions was conducted. After the introduction of the exercise program, there were significant decreases in diastolic and systolic blood pressure. Cardiovascular fitness improved concurrently. The results suggest that vigorous exercise can decrease the blood pressure of low-SES hypertensive Black children.

Black or African American↗
PubMed1989

An outbreak of Trichuris trichiura in a mental handicap hospital.

An outbreak of Trichuris trichiura in a ward for the severely mentally handicapped affected 22 of 29 patients. There was concurrent carriage of non-pathogenic Entamoeba histolytica in 59% of these patients. Heavy contamination of soil was found in the patients' recreation area. The management of the outbreak is discussed.

Adult↗
PubMed1989

Videotaped modeling and film distraction for fear reduction in adults undergoing hyperbaric oxygen therapy.

We used a combined videotaped coping model and film distraction technique to reduce the distress of patients undergoing hyperbaric oxygen (HBO) therapy. Five experimental patients ranging in age from 34 to 68 were shown a videotape that depicted a coping model and then viewed a feature film as a distraction during their first exposure to HBO. In comparison with 6 control patients ranging in age from 17 to 53, the experimental patients experienced less arousal and rated themselves as significantly more relaxed before treatment, completed significantly more prescribed treatments without complication, and required fewer days in the hospital. These results support the use of modeling and distraction techniques as a cost-effective means of reducing distress and improving patients' compliance with HBO therapy.

Adolescent↗