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Biomedical subjects

M L French

Publications and source records attributed to M L French.

At least 37 records · Page 2Linked to original sources
PubMed1983

Immunoglobulin M and G histoplasmal antibody response in histoplasmosis.

Radioimmunoassays for IgM and IgG histoplasmal antibodies were developed and proved to be specific for their respective immunoglobulin classes, sensitive, and reproducible. Elevated IgM antibodies were detected in 59.8% of patients with histoplasmosis and 7.9% of control subjects. Elevated IgG antibodies occurred in 80.4% of patients with histoplasmosis but in only 12.9% of control subjects. Radioimmunoassay was nearly twice as sensitive as complement fixation for identifying patients with mild, presumably asymptomatic, infection. Of 13 patients with serologic follow-up at least 1 yr later, elevated IgM antibodies cleared, whereas IgG antibodies persisted in 7. In an epidemiologic investigation of a recurrent histoplasmosis outbreak, only the radioimmunoassay was able to prove the hypothesis that construction for a swimming complex was the source of exposure. These assays promise to be useful for clinical and epidemiologic investigations.

Antibodies, Fungal↗
PubMed1983

The use of TORCH titers.

Of 603 patients undergoing serologic tests for Toxoplasma, syphilis, rubella, cytomegalovirus, and herpes simplex (TORCH tests) during a 4-year period, 381 (63%) were infants younger than 6 months and 110 (18%) were either the mothers of those infants or pregnant women. The remaining 112 (19%) were older infants and children, male adults, or nonpregnant female adults. Of 381 infants less than 6 months of age who were tested, 323 (85%) had only a single TORCH test. Of 35 (9%) infants who had follow-up titers, 16 (46%) had a specific titer requested whereas in 19 (54%) the entire TORCH battery was repeated. Follow-up titers were infrequently (25%) requested when initial titers were elevated. Infection with a TORCH agent was not confirmed serologically in any of the 603 patients. The pattern of TORCH test use has a poor diagnostic return.

Adult↗
PubMed1982

Comparative evaluation of media for isolation of ureaplasma urealyticum and genital mycoplasma species.

Two media systems were compared for isolation of Ureaplasma urealyticum and genital Mycoplasma sp. System 1 (S-1) consisted of arginine agar and an arginine biphasic medium for isolation of Mycoplasma sp. and urea agar and urea broth for isolation of U. urealyticum. System 2 (S-2) utilized Boston broth, which is a urea-containing broth, and A7 agar, both of which support the growth of both species. Urine samples, some freshly collected and some known-positive frozen samples, were used as inocula for the two media systems. With S-1, U. urealyticum was recovered in 68% of U. urealyticum-positive cultures: 58% were detected in urea broth, and 60% were identified on urea agar. When the S-2 system was used for culture of the same samples. U. urealyticum was recovered in 98% of the cultures, with 94% detected in Boston broth and 92% identified on A7 agar. Mycoplasma sp. was recovered in S-1 and S-2 in 97 and 100% of Mycoplasma sp.-positive cultures, respectively. The S-1 arginine broth gave positive results for 89% of the cultures, and the arginine agar was positive for 97% of the cultures. The S-2 Boston broth and A7 agar gave positive results for 92 and 97% of the cultures, respectively. For the isolation of U. urealyticum, colony counts were higher, growth was seen sooner, and colonies were larger when the S-2 media system was used. Overall, the cost per test of the S-2 system was less both in technologist time and in reagent costs.

Culture Media↗
PubMed1982

Immunoglobulin M antibody titers in the diagnosis of Legionnaires disease.

The purpose of this study was to determine whether measurement of immunoglobulin M (IgM) antibodies against Legionella pneumophila serogroup 1 can aid in the diagnosis of Legionnaires disease. On the basis of measurements of antibody levels in 1,942 control sera, we used an IgM titer of 1:256, observed in 2.3% of the controls, as presumptive evidence of Legionnaires disease. Measurement of IgM titers permitted us to presumptively or definitively diagnose Legionnaires disease in 13 of 34 patients earlier than we would have if only IgG titers had been measured. Of the 13 patients, 5 were diagnosed serologically only by IgM antibody determination. IgM titers were presumptively diagnostic in week 1 of clinical symptoms in 4 of the 13 patients. We conclude that conjugates used for antilegionella indirect fluorescent-antibody tests should be capable of detecting IgM antibodies so that the value of serological results in diagnosing and managing Legionnaires disease will be maximized.

Fluorescent Antibody Technique↗
PubMed1982

Risk factors for disseminated or fatal histoplasmosis. Analysis of a large urban outbreak.

An outbreak of histoplasmosis in Indianapolis involving 488 clinically recognized cases including 60 patients with disseminated or fatal infection permitted statistical analysis of risk factors. Being male, white, under 5 years of age, having chronic obstructive lung disease, and living near the presumed source of the outbreak were not risk factors for fatal or disseminated histoplasmosis. Age greater than 54 years and immunosuppression were the only risk factors for disseminated or fatal infection. Dissemination should be excluded in patients with histoplasmosis who are immunosuppressed or older than 54 years. Specific antifungal treatment is more likely to be required in those two groups rather than in patients without risk factors.

Adolescent↗
PubMed1982

The diagnostic laboratory tests for histoplasmosis: analysis of experience in a large urban outbreak.

Of 495 patients reported in a large urban histoplasmosis outbreak, we studied 276 whose serologic tests were done in a single laboratory. Serologic test results were positive in 96% of these patients (compared with less than 5% of controls from an endemic area), cultures were positive in 22%, and special stains in 19%. The immunodiffusion test results were negative in 13% of patients who had positive findings by complement fixation, and 1% had positive results only by immunodiffusion. The complement fixation test was almost twice as sensitive as the immunodiffusion test in patients with subclinical infection. The serologic response differed significantly among the clinical syndromes with higher titers in cavitary and lower titers in disseminated disease. Factors associated with titers of 1:64 or greater to both antigens were black race and immunocompetence. High mycelial titers were also associated with more intense exposure, and high yeast titers were associated with age less than 36 years. No prognostic significance could be proved for fourfold titer rises or falls or persistence of precipitins.

Adolescent↗
PubMed1981

Comparison of enzyme-linked immunosorbent assay for acute measles with hemagglutination inhibition complement fixation, and fluorescent-antibody methods.

An enzyme-linked immunosorbent assay (ELISA) using commercially available reagents was compared with standard serological tests for determination of antibody titers in patients with acute measles. The measles-specific ELISA was as sensitive as complement fixation, hemagglutination inhibition, and indirect fluorescent-antibody methods. The ELISA method used was simple, sensitive, inexpensive, and reproducible and may conveniently be used in a small clinical laboratory.

Antibodies, Viral↗
PubMed1981

A large urban outbreak of histoplasmosis: clinical features.

An outbreak of histoplasmosis estimated to involve more than 100,000 residents in Indianapolis, Indiana, occurred between September 1978 and August 1979. In the 435 cases evaluated, 52% of the patients were between 15 and 34 years old, and 63% were black. Fifteen patients died, and 46 progressive disseminated infection. Twenty-four patients had pericarditis, and 26 had rheumatologic syndromes. Unusual manifestations that occurred in 18 patients included esophageal and vocal cord ulcers, parotitis, adrenal insufficiency, uveitis, fibrosing mediastinitis, interstitial nephritis, intestinal lymphangiectasia, and epididymitis. The highest attack rate was in the central part of the city, which is a densely populated, disproportionately black section. The source of the outbreak has not been proved by positive culture results; two sites, however, were suspected on an epidemiologic basis.

Adolescent↗
PubMed1980

The antimicrobial effectiveness of operative-site preparative agents: a microbiological and clinical study.

Eight wound preparative agents (one triclosan compound, one hexachlorophene compound, and six iodophors) were evaluated under actual operating-room conditions for efficacy in de-germing the operative site prior to the performance of 310 total hip arthroplasties. All of the preparations tested achieved a significant reduction (p less than or equal to 0.001) of indigenous skin microflora compared with the pre-scrub level in both the post-scrub and the postoperative cultures. Two iodophors, when applied as sprays, demonstrated excellent bactericidal action, were less time-consuming and easier to use than the compounds that were applied as scrubs, and did not alter the low (0.42 per cent) infection rate that we have recorded over a period of four years.

Anti-Infective Agents, Local↗
PubMed1979

Serology of Legionnaires disease: comparison of indirect fluorescent antibody, immune adherence hemagglutination, and indirect hemagglutination tests.

An immune adherence hemagglutination (IAHA) test for the measurement of antibodies to Legionella pneumophila was developed and evaluated for the diagnosis of Legionnaires disease. Its sensitivity was compared to that of the indirect fluorescent antibody (IFA) test and a recently developed indirect hemagglutination (IHA) test. The sensitivity of the three tests appeared to be similar, with the IFA test giving slightly higher titers. Both the IHA and IAHA tests appear useful for the serodiagnosis of Legionnaires disease; the IAHA test has the advantage that it can be used with many other serological antigens.

Antibodies, Bacterial↗
PubMed1979

A microbiological in-use comparison of surgical hand-washing agents.

Seven different surgical hand-scrub agents (one triclosan compound, two hexachlorophene compounds, and four iodophors) were evaluated under in-use conditions by five persons for efficacy in degerming the hands and forearms prior to performing a total of 215 total hip arthroplasties. With all of the compounds tested there was a significant reduction (p less than or equal to 0.001) of indigenous skin microflora from prescrub levels at both the post-scrub and postoperative points. The two hexachlorophene compounds in general revealed a bacteriostatic effect whereas the triclosan compound and the four iodophors did not. A hexachlorophene compound applied as a foam demonstrated excellent bacteriocidal and bacteriostatic action, was less time-consuming and easier to use than compounds applied as scrubs, and did not alter a low (0.47 per cent) in-use infection rate over a period of three years.

Anti-Infective Agents, Local↗
PubMed1976

The plastic surgical adhesive drape: an evaluation of its efficacy as a microbial barrier.

A microbial evaluation was made of adhesive plastic surgical drapes and cloth surgical drapes. These studies were done both during surgery and in the laboratory. The plastic drape does not allow bacterial penetration, lateral migration does not occur, skin bacteria do not multiply under the drape within the time periods studied and the patient drapes are held in place with their use. When wet, cloth drapes showed profuse bacterial penetration. Dry cloth showed less bacterial penetration as compared to wet cloth. Lateral migration under cloth drapes was not possible to assess due to a high level of penetration. The surface of cloth showed a higher level of bacterial contamination during the surgical procedures. Deep wound cultures collected just prior to closing showed 60% contamination when cloth was used compared to 6% when plastic was employed. The micro-organisms recovered from the various sites sampled were identified. Finally, in addition to the positive aseptic benefits afforded by plastic adhesive drapes, aesthetic features such as a more delineated operative field and elimination of towel clips make this product a useful adjunct to the surgeon's armamentarium.

Air Microbiology↗
PubMed1976

The effect that time, touch and environment have upon bacterial contamination of instruments during surgery.

Hemostats were evaluated for frequency of contamination and such contamination was correlated with increasing operating room exposure time. The studies were performed under surgical conditions in operating rooms with and without laminar air flow. The study was also designed to show whether contamination of hemostats were influenced by the scrub nurse's handling. Hemostats were more frequently contaminated in the conventional operating room without laminar air flow (P less than 0.001). Handling by the scrub nurse's gloved hand statistically increased the number of contaminated hemostats (P less than 0.01). Laminar air flow reduced the frequency of contamination statistically (P less than 0.001) to a point where time and touch by a gloved hand of the scrub nurse were not important factors.

Air Movements↗
PubMed1976

Evaluation of microbial contamination of surgical gloves during actual use.

The contamination rate of gloves is about the same for all scrubbed personnel, be they single or double gloves (33%). More holes are noted in the gloves of personnel who use their hands more strenuously. A double pair of gloves does not reduce the amount of contamination but does reduce the number of holes. The contamination could not be associated with the hole in the glove in our study. The amount of contamination beneath the glove does not influence its exterior contamination. Contamination generally comes from somewhere else in the operative field environment.

Bacteria↗
PubMed1975

Bacterial contamination of the surgical knife.

Two hundred and eight skin knives and 374 deep knives were evaluated in 153 clean orthopedic cases with and without a horizontal wall-less laminar air-flow system. There was no statistical difference in contamination frequency between the skin and the deep knives with and without the laminar air-flow. However, the knife blades were found to be contaminated less than laminar air-flow was used than when it was not (P less than 0.005). No correlation could be made between the cultures of the wound edges and the depth of the wound with the contaminated knife blades.

Air Microbiology↗
PubMed1975

The operating room environment as affected by people and the surgical face mask.

The microbiological counts were determined in an operating room suite of 8 rooms and a hallway. The bacterial counts in an empty operating room jumped statistically from 13 CFU/ft2/hr (+/- 31) to 24.8 (+/- 58.8) when the doors were left open (people in the hallways) and 447.3 (+/- 186.7) when 5 people were introduced. The wearing of a surgical face mask had no effect upon the overall operating room environmental contamination and probably work only to redirect the projectile effect of talking and breathing. People are the major source of environmental contamination in the operating room.

Air Microbiology↗