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Biomedical subjects

L D Gruer

Publications and source records attributed to L D Gruer.

At least 19 recordsLinked to original sources
PubMed1992

Estimates of HIV infection among injecting drug users in Glasgow, 1985-1990.

OBJECTIVE: To use research and surveillance studies in Glasgow (Scotland, UK) to estimate the number of current injectors infected with HIV, the total number of injectors infected up to the end of 1990 and the recent incidence of infection. DESIGN: (A) Prevalence of injecting drug use was estimated using log-linear modelling. (B) Prevalence of HIV infection was determined from voluntary testing of a community-wide sample of injectors. (C) The number of infected current injectors was predicted by combining the distributions generated by (A) and (B). (D) Data on known HIV-positive injectors were used in conjunction with (C) to forecast the cumulative number of infected injectors. RESULTS: The number of current injectors was estimated to be 9400; the prevalence of HIV infection among 447 injectors recruited to the HIV prevalence study during 1990 was 1.1%. From these data, the number of HIV-positive current injectors in 1990 was estimated to be between 52 and 138. Between 1985 and 1990, 110 known HIV-positive injectors were registered or received treatment in Glasgow for HIV-related diseases; the total number of cases estimated to have occurred during this period was between 110 and 300. The incidence of infection in Glasgow during 1990 was likely to have been low in light of the finding that only one case in the prevalence study had not previously been diagnosed HIV-positive. CONCLUSIONS: Linkage of datasets from a variety of sources and studies has enabled the substantial refinement of estimates of the number of injectors and the proportion infected with HIV in Glasgow up to 1990.

Adolescent↗
PubMed1992

Knowledge of HIV and condom use among heterosexual patients at a Glasgow genito-urinary medicine clinic.

Knowledge of HIV and knowledge of, attitudes to and use of the condom were assessed by a survey of a sample of 778 heterosexual patients attending the genito-urinary medicine clinic at the Glasgow Royal Infirmary. The mean age was 27.4 years for men and 24.5 years for women. Over two-thirds of the men and about half of the women reported more than one sexual partner during the previous year. More than 70% reported having intercourse at least three times each week. Knowledge about HIV transmission and the condom was generally good. Over three quarters of the respondents approved of the use of the condom. However, only 27% male and 24% female respondents reported using the condom, with 11% and 8% respectively using it always. Condom use was associated with a positive attitude to the condom, having received information from the media about the condom, educational status, a belief that condoms prevented sexually transmitted diseases, and having had sex education in school. It was unrelated to age, marital status, the number of sexual partners or the frequency of sexual intercourse. The most common reported reason for not using the condom was use of another form of contraceptive.

Adult↗
PubMed1991

Sexual behaviour and use of the condom among Ugandan students.

HIV infection is widespread in Uganda. Have its university students, the country's leaders of tomorrow, taken appropriate action? A questionnaire was completed by 661 men and 270 women in a one-in-four sample of Makerere University undergraduates (93% response rate). More than 60% of the men and 36% of the women reported at least two sexual partners in the past year. Over 18% of respondents reported at least one episode of sexually transmitted disease in the past year. Most respondents correctly identified the main routes of HIV transmission but risk was also often incorrectly associated with non-penetrative sex. Only a minority saw the condom as an effective preventive method: most saw it as unsafe or an encouragement to promiscuity. Condoms had been used by 35% of men and 24% of women but were currently always used by only 9% of men and 11% of women. The condom was approved of by only one quarter of respondents. Condom use increased with the number of sexual partners but was less likely if the respondent had seen official publicity about the condom. Whilst there were some encouraging signs of behaviour change, opportunities for the spread of HIV continued to abound in this important group. More positive promotion of the condom is urgently required.

Adult↗
PubMed1985

Prophylaxis of infective endocarditis for dental procedures. Report of a working party of the European Society of Cardiology.

Bacterial endocarditis still remains a serious disease with significant morbidity and mortality. In patients with known valve disease, most cases are caused by oral viridans streptococci. These organisms are present in vast numbers on the gum margins and in gum pockets. They cause transient bacteraemia during eating and tooth brushing. More substantial, but short-lived bacteraemia can occur during dental treatment such as extraction and scaling. Bacteria may then become attached to abnormal endocardium leading to the development of infective endocarditis. Prophylaxis of endocarditis during dental procedures in patients with known valve disease should thus be aimed at reducing the number of bacteria entering the blood stream and eliminating those that get there. This can be sought first by good oro-dental hygiene and secondly by the use of prophylactic antibiotics. In this paper, we set out simple guidelines for practitioners in those countries that do not already have recommendations of their own. They are based on guidelines already in use in the United Kingdom, France, Switzerland and the United States.

Anti-Bacterial Agents↗
PubMed1985

Septicemia caused by Agrobacterium sp.

Agrobacterium radiobacter biovar 2 was repeatedly grown from the blood of an elderly patient receiving artificial ventilation and broad-spectrum antibiotics. No source of the organism was found, but the septicemia ceased when cefotaxime was given. Sera from the patient showed a fourfold rise in antibody against the organism and higher titers than sera from all but 1 of 50 healthy blood donors. The organism did not contain the plasmid associated with plant oncogenicity. This case may be only the second in which Agrobacterium sp. has been clearly linked with human infection.

Aged↗
PubMed1985

Vancomycin and tobramycin in the treatment of CAPD peritonitis.

Seventy-five episodes of continuous ambulatory peritoneal dialysis (CAPD) peritonitis were studied during a 1 year period at the Queen Elizabeth Hospital, Birmingham. When two simple culture methods were used in parallel, the causative organisms were identified in 97% of cases. Nearly two thirds of episodes of peritonitis were caused by coagulase-negative staphylococci (C-NS), many of which were multiply antibiotic-resistant. On the basis of detailed antibiotic sensitivities, intraperitoneal vancomycin and tobramycin were chosen for the initial treatment of CAPD peritonitis. With this regime, a cure was achieved in 32 of 38 episodes, compared with 15 of 27 episodes when cefuroxime was used. All but 1 of 24 episodes caused by C-NS were cured by vancomycin.

Adolescent↗
PubMed1984

Disinfection of hands and tubing of CAPD patients.

During a 3 month study the effectiveness of two methods of handwashing was assessed in a group of 31 patients undergoing continuous ambulatory peritoneal dialysis. A defined, double rinse with alcohol, prior to bag exchange, was found to be more convenient and significantly more effective than povidone-iodine alone or povidone-iodine followed by alcohol. Spraying the tubing around the bag connector with 70 per cent ethanol reduced the numbers of adherent skin organisms so reducing the likelihood of bacteria being drawn into the dialysate. Although there was no difference in the overall incidence of peritonitis in the two groups of patients studied, there was an unexpected drop in the incidence of peritonitis caused by coagulase-negative skin staphylococci. This was attributed to an overall awareness of the importance of handwashing and aseptic procedures during bag exchange. Monitoring the bacteriology of the catheter exit site may give some prior indication as to the likelihood of subsequent peritonitis especially with Staphylococcus aureus and Gram-negative bacilli.

Catheters, Indwelling↗
PubMed1984

Indices of effectiveness of medical and surgical treatment in 40 cases of prosthetic valve endocarditis.

Forty patients with prosthetic valve endocarditis (PVE) presenting during a 12-year period at a single hospital were studied. Twenty-six were male and 14 female and ages ranged from 19 to 67 years. During the first six post-operative months, most episodes were caused by staphylococci (38%) and Gram negative bacilli (24%). Between 6 and 11 months no episodes were seen, but thereafter streptococci predominated (50%). The overall mortality was 58% (66% during first six months; 36% thereafter). Nine of 23 patients undergoing re-operation died, most deaths occurring in patients in cardiac failure prior to surgery. Eleven deaths occurred in the 17 patients treated with antibiotics alone. Six of these were pyrexial at death and all but one was infected by a virulent organism. The remaining five were apyrexial at death and all had staphylococcal PVE. Our findings suggest: (1) all cases occurring during the first six months should be initially treated as 'early' PVE; (2) in staphylococcal PVE, apyrexia may not mean cure; (3) the principal guides to prognosis in PVE are the patient's cardiac status and the nature of the infecting organism.

Adult↗
PubMed1984

Evaluation of the API 20 STREP system for species identification of streptococci associated with infective endocarditis.

A rapid commercial system (API 20 STREP gallery, API System, France) for the identification of streptococci was compared with conventional biochemical or serological methods. 77 clinical isolates from patients with infective endocarditis and six reference strains were tested. Biochemical tests showing differences between conventional methods and the API gallery were the acidification of inulin and the Voges-Proskauer reaction, but these differences did not affect the final identification of any strain. 75 strains were identified by the API system and 70 by conventional methods. 69 strains (25 groupable and 44 of 51 non-groupable streptococci) were given the same identity by both methods. One S. morbillorum was only identified by the conventional method. Seven S. sanguis I strains were identified only by the API system and confirmed by additional biochemical tests. The API gallery is a useful method for identifying streptococci associated with infective endocarditis, agreeing with conventional methods in 90% of strains. Results are usually available in 24 h.

Bacteriological Techniques↗