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Biomedical subjects

K Nye

Publications and source records attributed to K Nye.

12 recordsLinked to original sources
PubMed2004

Meningitis without a petechial rash in children in the Hib vaccine era.

AIMS: (1) To determine the causes of meningitis in children immunized with Hib vaccine, presenting without a non-blanching rash; (2) to review the use of dexamethasone in this group. METHOD: Retrospective review of all children with more then 10 white cells/mm(3) in their cerebrospinal fluid (CSF), admitted between January 1998 and August 2002. Children were excluded if they had a non-blanching rash on admission or if their discharge diagnosis was not meningitis. Local guidelines recommended dexamethasone to be given before antibiotics for children with meningitis and no rash. RESULTS: One hundred and eight children were identified. Causes of proven meningitis were: viral 41 (enterovirus 40), bacterial 22. CSF culture or PCR was the only diagnostic test in 31 children. Dexamethasone was given to 16 children. Length of admission was shorter in children with viral compared with bacterial meningitis (4 vs 8 days; P < 0.0001). SUMMARY: Viral meningitis is the commonest cause of meningitis without rash. Enteroviral PCR was the most useful test and needs to be widely available. Confirmation of enteroviral meningitis allowed early discharge. Few children were given dexamethasone, but only 5/108 may have benefited. CONCLUSIONS: The most common cause of meningitis without a rash in British children is enterovirus. The use of dexamethasone in children with meningitis without a rash should be reconsidered or, at least, individualised.

Adolescent↗
PubMed2002

Methods for detecting apoptosis in thyroid diseases.

Over the last few years, the importance of apoptosis in determining the fate of thyrocytes in autoimmune thyroid disease has been the topic of intense investigation. It is now clear that thyrocytes from patients with Hashimoto's thyroiditis are destroyed as a result of an apoptotic process. However, there is no general consensus on whether the intrathyroidal lymphocytes or the thyrocytes themselves are responsible for their death. The use of a wide range of techniques has contributed to the assessment of this process both in situ on thyroid sections and in vitro on thyroid cell preparations. The apoptosis field of research is rapidly evolving and as the pathways to cell death become unravelled, novel methods will emerge. As each technique offers some advantage, it is critical to know the most suitable method for a specific study. Equally, each method also has intrinsic limitations. Thus, to achieve reliable results, it is necessary to use more than one technique per study. In addition, techniques related to the measurement of the expression of pro-apoptotic and anti-apoptotic genes have been contributing to the study of the susceptibility of the cells to apoptosis and/or to their ability to kill themselves or neighbouring cells. In this review we will focus on the most relevant techniques.

Animals↗
PubMed2001

Cryptosporidium meleagridis from humans: molecular analysis and description of affected patients.

OBJECTIVES: To genetically characterize an unusual genotype of Cryptosporidium from the stools of humans with diarrhoea and to identify risk factors in the affected patients. METHODS: DNA was extracted from human faeces where Cryptosporidium oocysts were detected by light microscopy. Cryptosporidial gene fragments from six different loci were analysed by PCR alone, PCR/RFLP and by DNA sequencing. Oocysts were characterized by light and immunofluorescence microscopy and epidemiological data was collected from the affected patients. RESULTS: Analysis of the Cryptosporidium oocyst wall protein (COWP) gene amplified from > 2000 human faecal samples identified 19 patients all of which produced an unusual RFLP profile. Subsequent DNA sequence analysis of this and an additional four genetic loci (including 18S rRNA sequences) confirmed these as a homogeneous group which was genetically distinct from Cryptosporidium parvum. The isolates were identified as Cryptosporidium meleagridis since the gene sequences were identical to those from this species recovered from birds. Conventional microscopy showed oocysts indistinguishable from C. parvum and reacted strongly with two different commercially available anti-oocyst monoclonal antibodies. None of the patients showed risk factors unusual for cryptosporidiosis; however, ten of the cases occurred during the summer/autumn, six had a history of foreign travel, four were co-infected with Giardia, two were HIV positive, and six were without identifiable immunocompromising factors. CONCLUSIONS: This study further confirms that C. meleagridis, in addition to C. parvum, is involved in human disease. The study also highlights the lack of basic information on the host range of this genus of parasites, the complexity of the transmission routes involved in human cryptosporidiosis, and the value of molecular techniques in identify hitherto unrecognised differences in Cryptosporidium from human faeces.

Adolescent↗
PubMed2000

Guidelines for the microbiological quality of some ready-to-eat foods sampled at the point of sale. PHLS Advisory Committee for Food and Dairy Products.

These guidelines for the microbiological quality of ready-to-eat foods represent a revision and expansion of guidelines first published by the PHLS in September 1992 and revised in March 1996. The latest guidelines incorporate many of the constructive comments received from food examiners and other microbiologists within and outside the PHLS and from environmental health officers throughout the United Kingdom. This document reviews the changes and the reasons they were made and sets out the new guidelines. It also clarifies the role of food examiners in interpreting the microbiological results of formal samples.

Colony Count, Microbial↗
PubMed1990

Mycobacterium chelonei isolation from broncho-alveolar lavage fluid and its practical implications.

Mycobacterium chelonei was isolated from the broncho-alveolar lavage fluid of seven patients on eight occasions over a 6-month period. The same bacterium was identified in the hospital water supply. Despite the use of a recommended disinfection procedure, it proved impossible to eradicate the organism until the bronchoscopes were treated with ethylene oxide and the use of tap water in rinsing was abandoned.

Aged↗
PubMed1990

Pharmacokinetics and tissue penetration of cefprozil.

The pharmacokinetics of cefprozil after a single 500 mg oral dose were studied, measuring plasma, inflammatory fluid and urine concentrations. Mean peak plasma concentrations of 9.6 mg/l (measured by bioassay) were achieved at a mean time of 1.9 h after administration. The mean plasma elimination half-life was 1.4 h; 63.6% of the dose was eliminated in urine by 24 h. Mean peak levels in inflammatory fluid reached 4.9 mg/l after 3.5 h. Mean plasma levels remained 2 mg/l for almost 5 h post dose and more than 6 h in inflammatory fluid. These data suggest that infections caused by highly susceptible pathogens might respond to a twice daily dosing regimen and less susceptible pathogens might require a higher dose or more frequent administration.

Adult↗
PubMed1990

The pharmacokinetics and inflammatory fluid penetration of orally administered azithromycin.

The pharmacokinetics of azithromycin were determined during a 24 h period following oral administration of a single 500-mg dose to each of six male volunteers. Concentrations in serum, urine and cantharides-induced inflammatory fluid were determined by microbiological assay. The mean peak serum concentration of 0.45 mg/l was obtained at a mean time of 2.6 h post-administration. The elimination half-life from serum was seen to increase with time post-dose; the mean elimination half-life at 16 h post-dose was 9.6 h. Inflammatory fluid was penetrated rapidly, with the mean peak concentration of 0.13 mg/l achieved at a mean time of 3.25 h post-dose. After this peak, levels initially decreased, but after 8 h from drug administration until the end of the trial period, inflammatory fluid concentrations remained relatively constant. The mean inflammatory fluid penetration up to the end of the study period was 74%. The mean urinary recovery of azithromycin, during the initial 24 h post-dose, was 6%.

Administration, Oral↗
PubMed1990

Pharmacokinetics and inflammatory fluid penetration of cefpodoxime proxetil in volunteers.

The pharmacokinetics of cefpodoxime were determined after a single oral dose of 261 mg of cefpodoxime proxetil, equivalent to 200 mg of cefpodoxime, was given to each of six healthy male volunteers. Concentrations in serum, urine, and cantharidin-induced inflammatory fluid were measured by a microbiological assay. The mean peak level in plasma was 2.1 micrograms/ml, attained at a mean time of 2.9 h. The mean half-life of elimination from serum was 2.2 h. The inflammatory exudate was penetrated moderately rapidly, the mean peak level being 1.7 micrograms/ml at 3.5 h. The mean percent penetration of the inflammatory exudate was 103.7. The mean 24-h urine recovery of cefpodoxime was 32.2%. This study suggests that cefpodoxime proxetil taken once or twice daily will be sufficient to treat urinary or systemic infections caused by susceptible pathogens.

Adult↗
PubMed1990

Pharmacokinetics and tissue penetration of ceftibuten.

The pharmacokinetics of the cephalosporin ceftibuten were determined after the fifth and final dose of 200 mg given every 12 h. Concentrations in plasma and cantharidin-induced inflammatory fluid were determined by a microbiological assay. Samples for three volunteers were assayed by a high-performance liquid chromatographic procedure to determine levels for both cis and trans ceftibuten. The mean peak level of ceftibuten in serum was 10.9 micrograms/ml at a mean time of 1.8 h after administration, and the mean elimination half-life from plasma was 2.5 h. Penetration into the inflammatory fluid was good, the mean peak level being 9.2 micrograms/ml at a mean time of 3.7 h. The mean percent penetration into the inflammatory fluid was 113.4%. High-performance liquid chromatography analysis showed that the mean peak level of the trans isomer was 5.7% that of the cis isomer. This study suggests that twice-daily doses of ceftibuten should be sufficient to treat urinary or systemic infections caused by susceptible pathogens.

Adult↗
PubMed1989

The in-vitro activity, pharmacokinetics and tissue penetration of temafloxacin.

The in-vitro activity of temafloxacin compared with other quinolone antibiotics was evaluated using 579 bacterial strains and three isolates of Chlamydia trachomatis. The MICs of temafloxacin for 90% of Haemophilus influenzae, Neisseria spp., Enterobacteriaceae, Bacteroides fragilis and Ch. trachomatis were all less than or equal to 1 mg/l, an activity comparable with or superior to that of ofloxacin and superior to those of fleroxacin and norfloxacin. Temafloxacin, although more active against anaerobes, was in general slightly less active than ciprofloxacin. Against Streptococcus pneumoniae and Staphylococcus aureus (including MRSA) temafloxacin was twice as active as ciprofloxacin. The pharmacokinetics of temafloxacin were studied in six volunteers, following a single 400 mg oral dose, measuring concentrations in plasma, inflammatory fluid and urine. Mean peak plasma levels of 3.3 mg/l were achieved. The mean plasma elimination half life was 6.8 h and the percentage penetration into blister fluid was 104.5%. Of the administered dose 51.8% was excreted in urine by 26 h. Serum and blister fluid levels in excess of 1 mg/l were present for at least 8 h post dose, suggesting that a once or twice daily dosing regimen would be suitable for the treatment of infections caused by susceptible organisms.

4-Quinolones↗
PubMedDate not supplied

Microbial flora on doctors' white coats.

OBJECTIVE: To determine the level and type of microbial contamination present on the white coats of doctors in order to assess the risk of transmission of pathogenic micro-organisms by this route in a hospital setting. DESIGN: Cross sectional survey of the bacterial contamination of white coats in a general hospital. SETTING: East Birmingham Hospital, an urban general hospital with 800 beds. SUBJECTS: 100 doctors of different grades and specialties. RESULTS: The cuffs and pockets of the coats were the most highly contaminated areas. The level of bacterial contamination did not vary with the length of time a coat had been in use, but it increased with the degree of usage by the individual doctor. Staphylococcus aureus was isolated from a quarter of the coats examined, more commonly from those belonging to doctors in surgical specialties than medical specialties. Pathogenic Gram negative bacilli and other pathogenic bacteria were not isolated. CONCLUSIONS: White coats are a potential source of cross infection, especially in surgical areas. Scrupulous hand washing should be observed before and after attending patients and it may be advisable to remove the white coat and put on a plastic apron before examining wounds. There is little microbiological reason for recommending a more frequent change of white coat than once a week, nor for excluding the wearing of white coats in non-clinical areas.

Bacteria↗