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Biomedical subjects

R Freeman

Publications and source records attributed to R Freeman.

At least 343 records · Page 19Linked to original sources
PubMed1981

Catheter tip cultures on open-heart surgery patients: associations with site of catheter and age of patients.

The results of culture of 668 catheter tips from 422 patients are analysed with relation to the site of the catheter and the age of the patient. Coagulase-negative staphylococci were the most common bacterial isolate, but Gram-negative bacilli were found in the venous lines, femoral artery lines, and peripheral lines. Isolations of Gram-negative bacilli were associated with age, being found mainly in those under 1 year and those over 40 years of age. Typing of coagulase-negative staphylococci revealed that Staphylococcus epidermidis is the only variety found in peripheral lines and in lines inserted after operation for complications (central venous, sub-clavian, and long lines), whereas other types occur (along with Staphylococcus epidermidis) in the other lines (left atrial, arterial, and venous). Use of extra lines for the management of postoperative complications thereby increases the risk of Staphylococcus epidermidis gaining access to the circulation. A subgroup of venous lines used to administer inotropic agents was found to be sterile on culture, and this was the result of the anti-oxidant (sodium metabisulphite) in the inotrope solution acting as an antiseptic.

Adolescent↗
PubMed1981

Improved contrast in cytochemistry of dehydrogenases by scanning transmission electron microscopy.

A scanning transmission electron microscope (STEM) was used to examine ultrathin sections of rabbit white skeletal muscle. Lactic dehydrogenase (LDH) activity was localized in the tissue using the tetra-nitro blue tetrazolium (TNBT) method. For most specimens postfixation was omitted in order to avoid reoxidation and solubilization of the formazan by osmium tetroxide. The STEM image revealed sufficient contrast of the intracellular structures and apparently electron-dense reaction product in the sarcoplasmic reticulum and mitochondria. Substantially less contrast was obtained when the same areas were observed by conventional transmission electron microscopy (CTEM). In material postfixed with osmium tetroxide, although the tissue contrast was improved, the TNBT reaction product was focally leached out, exhibiting lower contrast than in unosmicated sections. These results indicate that the fine structural visualization of dehydrogenases with TNBT, the STEM technique as used in the present study is superior to that obtained by CTEM.

Animals↗
PubMed1980

Miconazole as a treatment for Candida septicaemia.

Two case histories are presented illustrating the difficulties of treating candida septicaemia. The factors which may have predisposed to its development are reviewed. Miconazole a new antifungal agent was used with dramatic response.

Aged↗
PubMed1980

Serological studies on 40 cases of mumps virus infection.

The results of serological study of 40 cases of mumps virus infection are presented. Mumps virus was isolated from 20 of the patients studied and antibodies to the V antigen, the S antigen, and the haemagglutination antigen were performed in all cases. Analysis of these results shows that estimation of all three types of antibody is necessary to confirm the diagnosis in the maximum number of instances and that the long-accepted view that a characteristic pattern of antibody response is typical of the acute illness (namely, anti-S appearing earlier and in greater titre than anti-V) is questionable.

Acute Disease↗
PubMed1980

A new selective medium for Streptococcus pneumoniae.

The development and evaluation of a new selective medium for Streptococcus pneumoniae is described. It is shown that the new medium (crystal violet-nalidixic acid-gentamicin agar:CVNG) is highly selective for Strep. pneumoniae in sputum specimens containing other organisms and is also sensitive, being only marginally inhibitory when compared to Columbia blood agar. The advantages of the medium in routine use are presented, based on 206 consecutive sputum specimens. It is concluded that CVNG medum is a useful adjunct to sputum bacteriology, especially in combination with digestion of the sputum samples by Cleland's reagent.

Agar↗
PubMed1980

Bacterial culture of perfusion blood after open-heart surgery.

The results of routine culture of 595 consecutive specimens of perfusion blood are presented. Ten per cent of the specimens yielded bacteria overall, but it was found that the isolation rate was increased to 17.7% when the prophylactic antibodies being given during the bypass were specifically neutralised. Coagulase-negative staphylococci and diphtheroids formed the majority of organisms isolated, but Gram negative bacilli or "coliform" type were also occasionally found. A comparison of the relative findings in patients receiving prophylactic flucloxacillin or cephradine showed that the isolation rates of coagulase-negative staphylococci and diphtheroids were lower in the group receiving flucloxacillin. The origin of the bacteria isolated from perfusion blood remains uncertain but speciation of coagulase-negative staphylococci from perfusion blood and similar organisms isolated subsequently from catheter tips in the same patients revealed no evidence that the two sources of organisms were linked. Although organisms are easily and commonly found in perfusion blood, the relevance of this phenomenon to post-operative endocarditis is not clear.

Bacteria↗
PubMed1980

Short-term adverse effects of antibiotic prophylaxis for open-heart surgery.

A study was made of the incidence of postoperative endocarditis and of septicaemia in early convalescence in 814 consecutive patients undergoing open-heart surgery. The results were related to the prophylactic antibiotic given to "cover" the operation. A subgroup of 150 patients was studied more intensively and the bacterial flora of the tracheal aspirates and catheter tips from these patients have been related to the antibiotics used. The results demonstrate that the use of a narrow spectrum agent (flucloxacillin) is associated with a modest change in bacterial flora at the two sites sampled, but that much more pronounced shifts in flora are found with a more broad spectrum agent (cephradine). The changes in flora have been related to the incidence of septicaemia in early convalescence, which was higher (7.7%) in the cephradine group than in the flucloxacillin group (0.9%). Since the overall incidence of prosthetic infection using flucloxacillin was acceptably low (0.49% of perfusions; 0.56% of valve insertions), it is concluded that narrow spectrum prophylaxis offers the better overall choice, at least until more objective comparisons are made.

Adolescent↗
PubMed1980

Species of coagulase-negative staphylococci isolated from catheter tips from open-heart surgery patients.

Coagulase-negative staphylococci isolated from the tips of catheters used in open-heart surgical patients were classified into species and the results compared with those obtained by speciation of coagulase-negative staphylococci isolated as blood culture contaminants. Staphylococcus epidermidis was the most common species in both populations, but other species occurred more often in the catheter tip group. Staphylococcus saprophyticus was found in 17% of the catheter tip series and was not found at all in the blood cultured contaminants. Species other than S epidermidis, and particularly S saprophyticus, were isolated more often from catheters which had been in situ some days. These findings suggest that speciation of coagulase-negative staphylococci from catheter tips may point to some species being better adapted to colonise and survive on prosthetic materials. In this study such evidence suggested that S saprophyticus might be such a species. It is concluded that if the initial results presented here are confirmed, a more logical approach to the chemoprophylaxis of prosthetic implant surgery would be possible.

Blood↗
PubMed1979

The relationship between long-distance running, plasma progesterone, and luteal phase length.

The chronic effects of long-distance running upon the menstrual cycle were studied in a healthy, ovulatory 30-year-old woman. Luteal phase plasma concentrations of follicle-stimulating hormone, luteinizing hormone, 17beta-estradiol, and progesterone were compared during a control and a training cycle. The luteal phase was shorter in cycles of greater mileage. Mid-luteal phase plasma progesterone concentrations were significantly lower during training.

Adult↗