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Biomedical subjects

L C Vogel

Publications and source records attributed to L C Vogel.

At least 37 records · Page 2Linked to original sources
PubMed1980

Metastatic complications of Fusobacterium necrophorum sepsis. Two cases of Lemierre's postanginal septicemia.

We have recently encountered two instances of septicemia due to Fusobacterium necrophorum in adolescents. The presence of severe exudative pharyngitis in both patients pointed to the upper respiratory tract as the probable portal of entry. In one case, metastatic infection was manifested by multiple septic pulmonary emboli with associated pleural effusions. In the other case, diffuse encephalopathy and septic arthritis of the left shoulder and hip occurred. Unilateral neck pain, persistent bacteremia, and prolonged fever despite appropriate antibiotics were consistent with the presence of septic jugular thrombophlebitis in both patients. "Postanginal septicemia" caused by F necrophorum, described by Lemierre in the preantibiotic era, was undoubtedly the syndrome manifested by these patients. This condition, formerly uniformly fatal, can readily be diagnosed when anaerobic techniques are used for blood culture, but requires prolonged antibiotic therapy for cure.

Adolescent↗
PubMed1980

Murine resistance to type III group B streptococci.

We examined the role of serum, complement and the reticuloendothelial system in mouse resistance to type III group B streptococci (GBS). Normal serum obtained from 21 day-old mice failed to protect chick embryos against a lethal intravenous (IV) inoculation of GBS-III-SS620/50. Mice that were decomplemented using cobra venom factor remained resistant to intraperitoneal (IP) inoculation of 10(6) colony-forming units (CFU) of GBS-III-22620/50, GBS III-Bell and GBS-III-Minnesota. In contrast, mice prepared with IP oleic acid were killed with 10(4) CFU of GBS-III-SS620/50 IP. However, when mice were injected IV with oleic acid, they remained resistant to IP inoculation of GBS-III-SS620/50. These results suggest that peritoneal macrophages play a role in murine defense against IP infection with GBS-III-SS620/50.

Animals↗
PubMed1980

Prevalence of type-specific group B streptococcal antibody in pregnant women.

Immunoglobulin G antibody against the four major serotypes of group B streptococcus was measured by indirect immunofluorescence in the sera of 200 consecutive pregnant women seen in the obstetric screening clinic of an urban teaching hospital. Antibody was detectable in 26% of undiluted sera against serotype Ia, 52% against serotype Ib, 82% against serotype II, and 45% against serotype III. Only 9% had antibody against all four GBS types. When serotype-specific antibody prevalences in 108 women with GBS vaginal colonization were compared with prevalences in noncolonized women, only women colonized with GBS type Ia were more likely to have antibody against Ia than noncolonized women. Antibody prevalences in sera from 54 mothers whose infants developed invasive GBS disease were significantly lower than those in colonized or noncolonized women. Since low titers of IF antibody to GBS III were present in some sera from mothers of infected infants, the data were analyzed based on IF antibody titers associated with passive protection in a chick embryo model of GBS septicemia. None of the sera from mothers of infected infants had antibody levels associated with chick embryo protection. Less than 10% of women had titers associated with chick embryo protection. These data suggest that the majority of pregnant women lack immunity to GBS, regardless of colonization status.

Adult↗
PubMed1980

Protective value of gamma globulin preparations against group B streptococcal infections in chick embryos and mice.

The protective value of pooled human gamma globulin (GG) and a group B streptococcal immune globulin (GBSIG) was studiedf in a chick embryo and a murine model of group B streptococcal (GBS) infection. Chick embryos were protected by the IV administration of 0.4 to 0.8 mg of GG from three manufacturers against IV challenge with type Ia GBS. Two of three GG preparations at doses of 0.4 to 1.65 mg protected chick embryos against type III, but 1.65 mg of all three preparations failed to protect against GBS types Ib and II. MIce were protected from lethal IP challenges with types Ia and Ib by the prior IM inoculation of three and two of the three GG preparations at doses of 0.5 to 1.0 mg, respectively. Administration IM of 1 mg of GG failed to protect mice against types II and III. The IV administration of 0.2 mg of GBSIG protected chick embryos against IV inoculation with GBS types Ia, Ib, II, and III. Administration IM of 0.5 mg of GBSIG protected mice against IP challenges with types Ia, Ib, and II, but not with type III. The IP administration of 0.25 mg of GBSIG simultaneously with type III GBS protected mice, whereas GG was not protective. GBSIG should undergo clinical trials for the prevention of GBS infections and their recurrences and as a possible adjunct to antibiotic and supportive therapy of severe GBS infections.

Animals↗
PubMed1979

Human immunity to group B streptococci measured by indirect immunofluorescence: correlation with protection in chick embryos.

An indirect immunofluorescence (IF) assay has been developed as a useful semiquantitative method for determination of type-specific IgG antibody in human sera to the five serotypes of group B Streptococcus. Antibody titers measured by IF correlated with passive protection in chick embryos, and antibody titers associated with chick embryo protection were delineated. Except for types Ia and Ic, IF antibody to each of the streptococcal types was completely absorbed by homologous strains, and antibody titers were unchanged by incubation with heterologous bacteria. For types Ia and Ic, IF antibody was absorbed by either the Ia or the Ic strain and by native Ia carbohydrate antigen. Antibody titers measured by IF and chick embryo protection against types Ia and Ic were similar, but were divergent for Ib and Ic, a finding suggesting that antibody is predominantly directed to the major carbohydrate determinants. In addition, 29 of 31 sera that had been tested in chick embryos yielded comparable results in mice against challenge with type Ia group B Streptococcus, a finding further validating the chick embryo assay. Sera from all of 43 mothers of infants infected with group B streptococci had antibody titers by IF that were less than titers associated with protection in chick embryos.

Absorption↗
PubMed1979

II. Operational experiments in the outpatient department (1970-1972).

Many of the recommendations, resulting from the previous study, to improve efficiency and to reduce waiting time and queueing, were put into practice in 1970 and evaluated in 1972. Most changes turned out to be improvements by all indicators, but some were not and several resulted in unforeseen sideeffects. Moreover the modified system proved to be vulnerable as it required rigorous coordination, greater motivation and stricter discipline among staff as well some extra material inputs.

Appointments and Schedules↗
PubMed1979

I. An operational study in the outpatient department of Machakos Hospital (1968).

The demand for outpatient services at Government Hospitals in Kenya increased considerably during the period 1962-1967. As a result a discrepancy developed between demand for services and the resources to meet these demands. An operational study, dealing with medical, technical and administrative aspects, was carried out at the outpatient department at Machakos Hospital in 1968. The study comprised: the arrival pattern of patients, work measurement of the activities of the medical assistant, diagnosis, prescriptions, the distribution of patients over the therapeutic units, waiting times and length of queues. Following the study recommendations, expected to improve the efficiency of the clinic and the service to the patients, were put forward to the Ministry of Health. The most important recommendations dealt with: the need for overall leadership; direction of traffic; the position and the role of the medical assistant; the organization procedures, in particular at the medical assistants' units and at the injection room and pharmacy. The present study does not include: the attitude of the staff; expectation and satisfaction of patients; the quality of care provided; the cost of service.

Appointments and Schedules↗
PubMed1979

IV. Health services research; the case of the outpatient department.

The main findings of the series of operational and satisfaction studies in the outpatient department of Machakos Hospital (1968-1972) were presented as a case study of evaluation research. The relevant theoretical aspects of evaluation research in the ambulatory care setting are reviewed. In an attempt to feed back the implications of the above studies for planning and management of services, for training of staff and for future research are presented.

Ambulatory Care↗
PubMed1976

An antenatal record for identification of high risk cases by axliliary midwives at rural health centres.

A prerequiste for effective and efficient medical care to be carried out by auxiliary staff at health centres in rural areas in developing countries is the standardization of the medical, technical and administrative procedures that they have to undertake. A record for antenatal care in rural health centres was designed to facilitate the selection of high risk cases. Several features of this record - which has been successfully used since 1972 in several rural health centres in Kenya - are described.

Female↗