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Biomedical subjects

M H Wansbrough-Jones

Publications and source records attributed to M H Wansbrough-Jones.

At least 19 recordsLinked to original sources
PubMed2000

In vitro activity of ciprofloxacin, sparfloxacin, ofloxacin, amikacin and rifampicin against Ghanaian isolates of Mycobacterium ulcerans.

MICs of ciprofloxacin, sparfloxacin, ofloxacin, amikacin and rifampicin were determined for 14 primary clinical isolates and three reference isolates of Mycobacterium ulcerans by modifying a standard agar dilution method for testing Mycobacterium tuberculosis sensitivity. All these antimicrobials were active against every isolate of M. ulcerans. Sparfloxacin exhibited the highest activity and ofloxacin was the least effective. Rifampicin exhibited the broadest range of activity.

Amikacin↗
PubMed1996

Alveolar macrophage activation in HIV infection.

Alveolar macrophage function is critical to the pulmonary immune response to infection. It is not known whether alveolar macrophages from HIV-infected individuals function normally in vivo. We have measured neopterin concentration, a marker of macrophage activation, in induced sputum, serum and saliva samples from control and HIV-infected subjects, with and without intercurrent lower respiratory tract infection (LRTI). Induced sputum (IS) neopterin concentration was increased in non-AIDS HIV positive (NAHIV) subjects (mean 3.5 nmol/l) compared to controls (mean 0.6 nmol/l) (P = 0.01) and it was further increased in patients with AIDS (mean = 27.7 nmol/l) (P = 0.002). When only those without LRTI were considered, the difference between the NAHIV and AIDS groups remained significant (P = 0.007). Those with LRTI had a significantly higher IS neopterin concentration (mean 53.2 nmol/l) than those without LRTI (mean 3.9 nmol/l) (P = 0.001). Contamination of the sample with saliva was not significant as there was no correlation between IS and saliva neopterin concentration (R = 0.1) and the concentration of neopterin was not related to the proportion of alveolar macrophages in IS samples (R = 0.2). Similarly there was no correlation between IS and serum neopterin concentration (R = 0.1). These results indicate that alveolar macrophages from NAHIV and AIDS subjects were in an activated state in vivo and that LRTI caused further stimulation (reflected in higher IS neopterin concentrations).

Adult↗
PubMed1996

Cutaneous and pharyngeal diphtheria imported from the Indian subcontinent.

We report the case of a 32-year-old woman who presented upon returning from India with cutaneous ulcers on the feet and pharyngitis. Microbiological testing showed the causative organism to be a toxigenic strain of Corynebacterium diphtheriae. She was treated successfully with penicillin and diphtheria antitoxin. This case emphasises the importance of maintaining a high index of suspicion for such rare but significant infectious diseases.

Adult↗
PubMed1995

Treatment of native valve Candida endocarditis with fluconazole.

Candida endocarditis of native valves is difficult to diagnose and treat. The majority of cases require valve replacement and long term amphotericin treatment. We describe a case of Candida endocarditis which was successfully managed with fluconazole without valve replacement. The patient has now been reviewed for 4.5 years from the time of diagnosis and 39 months since treatment was discontinued.

Antifungal Agents↗
PubMed1995

Cytomegalovirus viraemia in HIV infection: association with intercurrent infection.

The aim of this retrospective study was to investigate the clinical significance of cytomegalovirus (CMV) viraemia in HIV-infected subjects (with or without AIDS) who had attended this hospital during a 45 month period. They were reviewed regularly and, when clinically indicated, tested for CMV viraemia. The blood of 105 subjects was cultured for CMV and 34 had at least one episode of CMV viraemia during the review period. The viraemia was present during CMV disease in nine of the 34 positive patients and was the only detectable infection in another two. In the remaining 23 patients, CMV viraemia occurred in association with intercurrent opportunistic infection. Among these 23 patients, the viraemia resolved in 12 after treatment (or natural resolution) of the intercurrent infection and only one of these 12 developed CMV disease (mean review period: 8 months). In another seven patients, CMV viraemia persisted despite treatment (or natural resolution) of the intercurrent infection and four subsequently developed CMV disease (mean review period: 4 months) (P = 0.08, Fisher's exact test). From the remaining four patients, no specimens for CMV culture were obtained after treatment of the intercurrent infection. The CD4 count was higher in the 12 patients in whom there was resolution of the viraemia [mean CD4 60 x 10(6)/l] compared with the seven in whom the viraemia persisted [mean CD4 45 x 10(6)/l]. These findings suggest that in some HIV-positive patients, CMV viraemia was potentiated by intercurrent infection with another micro-organism and that its treatment was sufficient to mitigate the CMV disease.

AIDS-Related Opportunistic Infections↗
PubMed1991

Characterisation of a series of human immunodeficiency virus isolates derived sequentially from a single patient.

Five HIV-1 isolates were obtained sequentially from a single seropositive individual during the later stages of AIDS. Four of these isolates were adapted to grow in a continuous human T-lymphocytic cell line. Comparative biological and biochemical studies of the virus isolates were made using persistently infected cultures or virus derived from these systems respectively. The data obtained clearly shows that viruses with different biological properties can be isolated from the same individual at different times during the course of clinical AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Bronchoalveolar lavage in the prediction of post-thoracotomy chest infection.

A prospective study was carried out on 75 patients undergoing pulmonary surgery to determine the relationship between perioperative lung flora and postoperative infections. Seventy-five patients having pleurectomy or pneumonectomy received cefuroxime prophylaxis; 1.5 g i.v. at induction followed by 6 further doses of 0.75 g i.v. over 48 h. Bronchoalveolar lavage samples were taken perioperatively via bronchoscopy in pleurectomy patients and from excised lung in patients undergoing lung resection. Patients were monitored for development of chest infection during the first 10 days after operation. Bacterial pathogens were cultured from 12 out of 54 lavage samples. The most common pathogen was Haemophilus influenzae and all the organisms were sensitive to cefuroxime. Eight patients (10.7%) developed postoperative chest infection. The likelihood of developing postoperative chest infection was 42% (5 out of 12 patients) in those patients whose lavage culture was positive for bacterial pathogens compared to 4.8% (2 out of 42 patients) for those whose culture was negative (chi 2 test, p less than 0.001). These results suggest that the culturing of bacterial pathogens from lavage samples from resected lung is a significant predictor of postoperative chest infection in patients undergoing pulmonary resection.

Bronchoalveolar Lavage Fluid↗
PubMed1990

Q fever encephalitis.

Encephalitis is a rare but documented complication of acute Q fever. We report here the case of a 48-year-old lady who presented with an acute illness characterised by influenza-like symptoms, pneumonia and neurological disturbance but in whom the serology was suggestive of chronic rather than acute Q fever.

Canada↗
PubMed1988

Chickenpox pneumonia: experience with antiviral treatment.

Of 13 patients with chickenpox pneumonia (12 of them adults) treated during 1979-87, 10 received antiviral drugs--nine acyclovir and one vidarabine. Three died despite intensive treatment. Serious secondary infections occurred in six cases. There were no clear indications that antiviral treatment altered the natural history of the condition. Acyclovir may at present be used too late in the course of chickenpox pneumonia to alter its outcome.

Acyclovir↗
PubMed1986

Complement activation and spleen function in erythema multiforme associated with herpes simplex virus reactivation.

Plasma C3d concentrations were measured in patients with erythema multiforme (EM) complicating herpes labialis. C3d levels were raised during cold sores but not during EM. Heat damaged red cell clearance was prolonged during EM. These observations support the concept that immune complexes disseminate herpes simplex virus (HSV) antigens to skin before the onset of EM.

Adult↗
PubMed1984

Gallbladder abnormalities in acute infectious hepatitis. A prospective study.

We have studied the gallbladder and its contents by ultrasonography in 31 patients with acute viral hepatitis and 23 age-matched controls. Liver cell necrosis was assessed by raised transaminase levels within 24-48 hr of ultrasonography in all patients. Gallbladder wall (GBW) measured 5.16 +/- 0.4 mm (mean +/- SEM) in patients and 2.0 +/- 0.06 mm in controls (P less than 0.001). GBW was thickened (greater than 3 mm) in 21 patients (68%), with double wall appearance in 5 (16%), and sludge was seen in the gallbladder cavity in 7 (23%). GBW thickness was significantly related to serum albumin (r = -0.45, P less than 0.01) and bilirubin (r = 0.50, P less than 0.004), but not to the serum transaminase levels. On repeat measurements after recovery in 13 patients, GBW thickness fell from 5.84 +/- 0.49 mm during acute hepatitis to 2.46 +/- 0.21 mm (P less than 0.001).

Acute Disease↗