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L V Rhodes

Publications and source records attributed to L V Rhodes.

10 recordsLinked to original sources
PubMed1993

Rapid assessment of human immunodeficiency virus seroprevalence in a community-based hospital.

BACKGROUND: To aid in development of patient testing policy, in-service education, and resource planning, it is necessary to have a useful and meaningful tool for determining the population-specific HIV seroprevalence rate for our hospital patients. We were offered by the Centers for Disease Control a newly developed survey tool: "Rapid Assessment of HIV Seroprevalence in Hospital Patients." We subsequently served as one pilot site for this tool. METHODS: A population-based sample of 1000 patients (500 inpatients, 500 outpatients) was stratified into age and sex groups on the basis of admission statistics from the previous year in a general community hospital system in southeastern Pennsylvania that consists of two clinical campuses: an urban site with 343 beds and a suburban site with 506 beds. The study was conducted as an anonymous, unlinked screening for HIV antibody in 1000 serum samples. RESULTS: We found our overall seroprevalence rate to be 2.60% (Poisson 95% confidence interval, 1.77% to 3.81%), or 1 in 38 patient specimens. The highest rates for both sexes were found in the age range 25 to 44 years. CONCLUSIONS: This protocol is a useful survey tool for community hospitals to determine the HIV seroprevalence rate in patient populations, a practical necessity for planning and education. Survey results would aid in implementation of current Centers for Disease Control guidelines for HIV testing of inpatients and outpatients in the acute care hospital setting.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Nosocomial herpes simplex virus infection associated with oral endotracheal intubation.

BACKGROUND: To determine by culture the frequency of herpes simplex virus reactivation complicating oral endotracheal intubation. Additionally, clinical appearance and recognition of patient infection by attendant health care workers were studied. Last, evidence of any occupational acquisition of herpes simplex virus infection was sought. METHODS: In a prospective, non-randomized study, three serial viral cultures were taken of oro-facial or mucosal sites on the day of oral endotracheal intubation and in the subsequent 3rd and 5th or 7th days from 51 consecutive adults undergoing oral endotracheal intubation in a suburban community hospital. Clinical variables including appearances of lesions and therapeutic interventions were noted during serial assessments by study authors. Employee health records were reviewed for evidence of health care worker occupational herpes simplex virus infection associated with these cases. RESULTS: Of 51 patients, 4 were culture positive on the day of oral endotracheal intubation. Of the remaining 47 patients, serial cultures during the first week post intubation revealed herpes simplex virus in 25 (53.2%) patients. Of cohort variables studied, a history of prior oral herpes simplex virus was significantly associated with a subsequent positive viral culture for herpes simplex virus (relative risk, 2.29; 95% confidence interval, 1.48 to 3.56). Typical or atypical lesions were visible in only 52% of the herpes simplex virus culture-positive cases. No occupational transmission of herpes simplex virus was detected. Tape-securing practices appeared to contribute to the morbidity of herpes simplex virus eruptions. CONCLUSIONS: Nosocomial reactivation of herpes simplex virus infection complicated oral endotracheal intubation in our patient population in approximately one half of the patients who were intubated for more than 48 hours during the first week after the procedure. Clinically, the infection was recognizable in only one half of the virus culture-positive cases. Increased awareness of this infection is needed by health care workers, patients, and families. More information is needed on optimal therapy and prevention.

Aged↗
PubMed1992

Impact of human immunodeficiency virus on medical and surgical residents.

BACKGROUND--Previous surveys of resident physicians on human immunodeficiency virus (HIV) matters have tended to focus on urban programs serving a patient population with an expected high prevalence of HIV infection. The objective of this study was to survey a community hospital residency program in a nonurban area with a perceived low HIV patient seroprevalence. METHODS--A 32-question survey was completed on an anonymous basis by the entire 74 member multidisciplinary resident physician group at a two-campus university-affiliated hospital program in southeastern Pennsylvania in May 1991. RESULTS--Residents perceived their patient population's HIV seroprevalence rate to be low although they believed their personal risk of occupational exposure to blood-borne infection was moderate to high. House staff most often complied with universal precautions for fear of acquiring a blood-borne illness and most often did not comply because of time constraints. Not perceiving the exposure as a health risk was the primary reason for nonreporting of exposures. Occupational exposure rates were alarmingly high, with suturing using a curved needle being the most common exposure method. Most residents were unfamiliar with HIV legislation. A majority of the house staff wanted improved HIV patient management training and life and disability insurance against occupationally acquired HIV. Many other important issues were addressed in this survey. CONCLUSION--Residents even in low seroprevalence environments do fear occupationally acquired HIV. A great need exists for improved training in universal precautions, acquired immunodeficiency syndrome legislation, and HIV patient management as well as for insurance against occupationally acquired HIV.

Acquired Immunodeficiency Syndrome↗
PubMed1980

Isolation of Legionella pneumophila from clinical specimens: salutary effects of lung tissue dilution.

Diagnosis of legionnaires' disease is seldom confirmed by isolation of Legionella pneumophila. In 2 cases, isolates were obtained using inoculums of diluted lung tissue suspension, even though no growth ocurred when undiluted suspensions were used. It is speculated that tissue dilution decreases the concentration of antimicrobial agents and antibacterial properties associated with lung host defense mechanisms, which allows improved recovery rates. This technique is recommended when attempting isolation of L. pneumophila from clinical specimens.

Adult↗
PubMed1979

Diagnostic specificity of immunoglobulin M (IgM) response in differentiation Legionnaires' disease from psittacosis.

Specific IgM and IgG antibody responses to Legionella pneumophila (LDB) and Chlamydia psittaci (PSI) in serum specimens from 22 cases of Legionnaires' Disease (LD) were examined by micro-immunofluorescence (IF) tests to explore the diagnostic significance of the IgM antibody response. Serial samples from 5 patients with LD showed greater than or equal to 4-fold changes in IgG antibody against LDB and PSI. All 5 patients possessed IgM antibodies against LDB but not against PSI. In single convalescent serum samples from 17 additional cases, 16 exhibited IgG and 15 showed IgM antibodies against LDB; all 17 exhibited IgG but not IgM antibodies against PSI. The IgM antibody response appears more specific than the corresponding IgG response in the serodiagnosis of LD, and may be valuable in differentiating LDB infections from those due to PSI.

Fluorescent Antibody Technique↗
PubMed1979

The Philadelphia epidemic of Legionnaire's disease: clinical, pulmonary, and serologic findings two years later.

Clinical, pulmonary, and serologic findings in Legionnaires who attended the 1976 American Legion Convention in Philadelphia were studied 2 years after the Legionnaires' disease epidemic there. All 31 survivors of Legionnaires' disease studied became ill within 2 weeks after the convention, and 18 had not fully recovered 2 years after the epidemic. Twenty-five (28%) of 90 additional Legionnaires exposed at the convention but not diagnosed as having Legionnaires' disease became ill during the same time interval; five of these had symptoms during the next 2 years. Survivors had decreased diffusion capacities measured by the carbon monoxide single-breath method. These differences could not be accounted for by ventilation abnormalities or concurrent illness. Significant levels of IgG or IgM antibodies persisted in 94% of survivors of Legionnaires' disease and in 53% of Legionnaires exposed at the convention, which suggests a high prevalence of subclinical infection. Persistence of IgM antibody raises the question of latency or subclinical infection as part of the natural history of Legionnaires' disease.

Adult↗
PubMed1978

Legionnaires' disease. Clinical findings and one-year follow-up.

The cases of six patients with Philadelphia Legionnaires' disease were studied during the acute phase and throughout the following year. This multisystems disease process developed abruptly with symptoms of chills, fever, myalgias, and headache. The unusual clinical association of fever with relative bradycardia was noted frequently. Pneumonia developed after the first few days and rapidly progressed to life-threatening respiratory failure despite penicillin and cephalosporin therapy. Improvement occurred within 48 hours after tetracycline or chloramphenicol was administered. No permament sequelae were noted on the one-year follow-up examination, and no secondary cases of infection occurred.

Acute Disease↗