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P J Wand

Publications and source records attributed to P J Wand.

14 recordsLinked to original sources
PubMed2001

Chlamydia trachomatis and Pap testing from a single, fluid-based sample. A multicenter study.

OBJECTIVE: To determine the potential for both Pap testing and the Chlamydia direct fluorescence assay (DFA) from a single sample using the fluid-based ThinPrep Pap Test method (Cytyc Corporation, Boxborough, Massachusetts). STUDY DESIGN: Conventional DFA was compared to ThinPrep DFA in a direct-to-vial, double-blinded, multicenter protocol. Cervical scrapings were collected for the ThinPrep Pap Test, and then a second swab was used to collect an endocervical sample for a conventional DFA test. The DFA slide prepared from the ThinPrep Test and the conventional DFA sample prepared from the endocervical swab were evaluated independently. Discrepant cases were adjudicated by testing residual specimens using a Chlamydia direct DNA method. RESULTS: Combining 636 adequate cases (94% of the total collected), 582 (91.5%) were negative on both slides, 43 (6.8%) positive by both and 11 (1.7%) discrepant. The prevalence of Chlamydia was 7.9% based on the conventional DFA method (range, 4.3-10.9%). McNemar's two-tailed test indicated the results not to be statistically different (P > .05). Adjudication favored ThinPrep 45% of the time and conventional 55%. Specimen adequacy favored ThinPrep with high statistical significance (McNemar's test, P > .01). CONCLUSION: A second slide prepared from the same vial of cells as that used for the ThinPrep Pap Test can be used for Chlamydia testing by DFA. Fluid-based collection could allow multiple tests from a single sample.

Adolescent↗
PubMed1997

Interlaboratory comparison of test results for detection of Lyme disease by 516 participants in the Wisconsin State Laboratory of Hygiene/College of American Pathologists Proficiency Testing Program.

In 1991, we reported that 55% of laboratories participating in the Wisconsin Proficiency Testing Program could not accurately identify serum samples from Lyme disease patients containing antibody against Borrelia burgdorferi. The purpose of this study was to determine whether the accuracy of Lyme disease test results reported by approximately 500 participants in the Wisconsin State Laboratory of Hygiene/College of American Pathologists Lyme Disease Survey had improved. From 1992 through 1994, 50 serum samples were sent to participants of the survey. Each laboratory received 28 serum samples from individuals with Lyme disease according to the case definition of the Centers for Disease Control and Prevention and 22 serum samples from healthy individuals. Unfortunately, the serodiagnosis of Lyme disease by participants had not improved. The specificity of the Lyme disease assays steadily decreased from approximately 95% to approximately 81% during the 3-year period of the survey. False-positive test results approached 55% with some of the serum samples from healthy donors. A serum sample containing antibody against Treponema pallidum was reported as positive by 70% of the participants. In addition, the sensitivity fluctuated between 93 and 75%, depending upon the conjugate used by the laboratories. These results suggest that stronger criteria must be applied for approving and continuing to approve commercially available kits for the serodiagnosis of Lyme disease.

Antibodies, Bacterial↗
PubMed1989

Community-acquired Legionnaires' disease associated with a cooling tower: evidence for longer-distance transport of Legionella pneumophila.

In the period August 10-29, 1986, 29 confirmed cases of Legionnaires' disease occurred in Sheboygan, Wisconsin; two cases were fatal. No common source of indoor exposure was identified. Water specimens were obtained from all known cooling tower units in Sheboygan; Legionella pneumophila serogroup 1 was isolated at 1 x 10(6) colony-forming units per liter from a specimen obtained August 27 at plant A. This isolate was identical to the only clinical isolate by monoclonal antibody and isoenzyme subgrouping. Of 29 persons with Legionnaires' disease, 21 lived or worked within one mile (1.6 km) of plant A; seven of the remaining eight visited within one to two miles (1.6 to 3.2 km) of plant A from three to seven days before onset of illness. Attack rates were highest for persons living within 0.5 mile (0.8 km) of plant A. These findings associate a cooling tower with community-acquired Legionnaires' disease and suggest that dissemination of Legionella may occur over longer than previously recognized distances.

Adult↗
PubMed1987

Evaluation of a quantitative fluorescence immunoassay (FIAX) for detection of serum antibody to Borrelia burgdorferi.

A quantitative, indirect, fluorescence immunoassay (FIAX; Whittaker Bioproducts, Inc.) was compared with the conventional indirect fluorescent-antibody test for detection of serum antibody to Borrelia burgdorferi. FIAX correlated well with the indirect fluorescent-antibody test (r = 0.72). FIAX is a convenient and dependable means of measuring serum antibody to B. burgdorferi.

Antibodies, Bacterial↗
PubMed1985

Development of serum antibody to toxic shock toxin among individuals with toxic shock syndrome in Wisconsin.

The presence of Staphylococcus aureus producing toxic shock toxin (TST) and the absence of antibody to TST (anti-TST) in acute-phase sera are markers for toxic shock syndrome (TSS). We used radioimmunoassay methods to examine 133 acute-phase and 277 convalescent-phase serum specimens from 181 patients with TSS for anti-TST. Among confirmed menstrual cases, nine (9.5%) of 95 patients had demonstrable anti-TST in acute-phase sera obtained during the first seven days of illness; patients with probable or non-menstrual TSS had a higher prevalence of anti-TST in acute-phase sera. Five (33.3%) of 15 individuals with confirmed menstrual TSS developed anti-TST as early as seven to nine days after TSS onset; 32 (62.7%) of 51 patients had demonstrable anti-TST in sera obtained more than one year after their episode of TSS. This study demonstrates a gradual rate and low magnitude of development of anti-TST after TSS and supports the diagnostic usefulness of measuring anti-TST levels in sera from patients suspected of having TSS.

Acute Disease↗
PubMed1982

Recovery of staphylococcal enterotoxin F from the breast milk of a woman with toxic-shock syndrome.

At 22 hr after an uncomplicated delivery of a healthy full-term infant, a 26-year-old woman developed toxic-shock syndrome (TSS). A vaginal culture yielded a coagulase-positive Staphylococcus that produced staphylococcal enterotoxin F (SEF) but no other enterotoxins. Breast milk specimens obtained on postpartum days 5, 8, and 11 contained 3.0, 2.5, and 2.0 ng of SEF/ml, respectively. Sera obtained from the mother on postpartum days 4 and 38 had titers (by radioimmunoassay) of antibody to SEF of 1:5 and less than 1:5, a result demonstrating a persisting lack of antibody to SEF after the first episode of TSS; the infant's serum titer of antibody to SEF on day 38 was also less than 1:5. Further longitudinal monitoring of SEF and antibody to SEF in breast milk from this patient is presented. This case is the first isolation of SEF from a body fluid obtained from a patient with TSS further strengthens the association between SEF and TSS.

Adult↗
PubMed1982

Toxic shock syndrome: management and long-term sequelae.

Little information is available on the optimal management of toxic shock syndrome and on its sequelae. The most appropriate antibiotic treatment, the efficacy of colloid infusions, and the potential role of gamma globulin preparations have not yet been completely ascertained. Coagulase-positive staphylococci associated with toxic shock syndrome had minimal inhibitory concentrations of 0.06 microgram/mL or less to rifampin, 0.25 microgram/mL or less to gentamicin, and 0.50 microgram/mL or less to both nafcillin and clindamycin. In the 36 patients studied abnormal chest roentgenograms were commoner in those who had received albumin than in those who had not. Radioimmunoassay showed antibody titers to staphylococcal enterotoxin F, a marker protein in toxic shock syndrome, of 1:4000 or more for intravenous gamma globulin (12/15 lots) and 1:40 000 or more for intramuscular gamma globulin. Major sequelae of toxic shock syndrome include late-onset rash, compromised renal function, cyanotic extremities, and prolonged neuromuscular abnormalities.

Adolescent↗
PubMed1982

Toxic shock syndrome: a critique of the 1980 Wisconsin case-control study.

Seven cases of toxic shock syndrome has been reported to the Wisconsin Division of Health by 6 January 1980; all seven cases were in female patients, six of whom had onset of illness during active menstruation. Through passive reporting of cases by physicians and patients themselves, a total of 38 patients with confirmed cases of toxic shock syndrome had been identified by the Division of Health by 30 June 1980. Thirty-five patients with menstrual toxic shock syndrome were each age-matched to three menstruating control subjects as part of a case-control study to identify potential risk factors associated with menstrual toxic shock syndrome. Statistically significant findings included increased tampon usage by patients as compared with controls, and fewer patients than controls were using any method of birth control. Numerous other health and hygiene variables were examined and found not to be statistically significant. We critically review the potential biases inherent to the study design. The conclusions and experience gained in this study were crucial to the designing of later case-control studies.

Adolescent↗
PubMed1982

An enterotoxin-like protein in Staphylococcus aureus strains from patients with toxic shock syndrome.

An enterotoxin-like protein, tentatively labeled enterotoxin F, was isolated from Staphylococcus aureus strains taken from patients with toxic shock syndrome. Antibodies specific for enterotoxin F were prepared in rabbits. Use of these antibodies showed that 130 (91.5%) of 142 S. aureus strains from patients with toxic shock syndrome produced enterotoxin F. Strains from toxic shock patients in eight other countries were identified as enterotoxin F producers. Only a small number of S. aureus strains from sources other than patients with toxic shock syndrome were found to produce enterotoxin F. Twenty-one of 111 controls had low antibody titers (less than 1:100) to enterotoxin F whereas 86 of 92 toxic shock patients had low acute phase antibody titers (less than 1:100) to enterotoxin F. Eight of 52 patients had serum conversion as shown by an increase in antibody titer to enterotoxin F in sera taken 21 to 60 days after onset of the illness. It may be possible to identify persons susceptible to toxic shock syndrome by measuring their antibody titer to enterotoxin F.

Bacterial Toxins↗
PubMed1981

Clinical manifestations of toxic shock syndrome.

Twenty-two women aged 13 to 44 years (mean, 22 years) with toxic shock syndrome (TSS) were hospitalized in Madison, Wis, between Aug 1, 1977, and Sept 1, 1980. Disease onset occurred during menses in 21 patients; all recovered. Notable sequelae included vocal cord paralysis and impaired finger sensation in two patients and recurrent disease in three. Coagulase-positive staphylococci were grown from the cervix or vagina in 11 of 12 women cultured. Previously undescribed features included vulvar cellulitis, hypocalcemia, hypophosphatemia, hypocholesterolemia, hyponatremia, lymphocytopenia, hypoferrinemia, and late convalescent hair and nail loss. Patients requiring dopamine hydrochloride had worse renal function, longer hospitalizations, and higher total serum bilirubin levels, and clinical onset earlier in menses. Originally reported in children, TSS now appears to be primarily a disease of menstruating women in whom recurrences are possible.

Adolescent↗
PubMed1980

Toxic-shock syndrome: epidemiologic features, recurrence, risk factors, and prevention.

Surveillance for toxic-shock syndrome (TSS) in Wisconsin detected 38 cases with onsets from September 1975 through June 1980. Thirty-seven of the cases occurred after January 1, 1979; 37 of the patients were women, 35 cases occurred during menses; 38 patients were white; and one patient died. Cervical or vaginal cultures were obtained before antibiotic therapy in 23 patients, and 17 cultures were positive for Staphylococcus aureus. Ten patients had at least one recurrent episode during subsequent menstrual periods. The recurrence rate was lower in patients who had been treated with beta-lactamase-resistant antibiotics. Thirty-five patients were matched for age and menstruation to 105 controls: 34 of 35 cases (versus 80 of 105 controls) used tampons during every menstrual period (P < 0.01); nine of 35 cases (versus 64 of 105 controls) practiced contraception (P < 0.001). In Wisconsin the minimum incidence of TSS as defined by clinical criteria is 6.2 cases per 100,000 menstruating women per year. The rate of TSS among menstruating women younger than 30 years was 2.4 to 3.3 times the rate among those who were 30 or older.

Adolescent↗