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Biomedical subjects

R Hone

Publications and source records attributed to R Hone.

At least 19 recordsLinked to original sources
PubMed1992

Teenage girls attending a Dublin sexually transmitted disease clinic: a socio-sexual and diagnostic profile.

Over a 12 month period, 32 teenage girls attended the sexually transmitted disease clinic in the Mater Misericordiae Hospital, Dublin for the first time, accounting for 17.8% of all first visits. Their mean age was 18.2 years (range 15-19 years). Twenty-four (75%) were from social class V. Five (15.6%) were abusing drugs. The mean age of first coitus was 16.1 years (range 13-19 years). The mean number of sexual partners was 1.8 (range 1-5). Four (12.5%) had been sexually abused in the past. Fourteen (43.8%) had never used contraception. Twenty-three (71.9%) were nulligravidae: 2 were diagnosed as being pregnant in the clinic. Twelve (37.5%) were unaware of cervical cytology screening. Of 29 having intercourse without condoms, none considered themselves to be at risk of contracting HIV from their present partner. A total of 26 diagnoses were made in 23 patients (71.9%). The most common diagnosis was ano-genital condylomata acuminata (6, 18.8%); Chlamydia trachomatis was located in 2 patients and Neisseria gonorrhoea in one. Mild to moderate dyskaryosis was reported in 4 cervical smears (12.5%). This data highlights the need for priority targeting of this high risk group.

Adolescent↗
PubMed1991

Skeletal tuberculosis.

Skeletal tuberculosis is an uncommon form of tuberculosis. During the period 1977-87, the number of cases diagnosed in two Dublin hospitals has remained at a constant level. The present study reports on 36 adults with skeletal tuberculosis and shows more frequent extraspinal involvement than other studies. The long duration of symptoms prior to diagnosis of 10.79 (+/- 8.8) months suggests that tuberculosis is not being considered early in the course of unexplained inflammatory arthritides especially in the elderly patient. The under utilisation of the Mantoux test in diagnosis is also a matter of concern.

Adolescent↗
PubMed1990

Legionella in Dublin hospital water supplies.

An environmental survey was carried out which consisted of periodic and random sampling of water tanks and showers in two large Dublin hospitals. Of the samples 5.3% yielded Legionella bacteria. Legionella pneumophila of serogroups 3, 5 and 6 were isolated from these sites with viable counts ranging from 3.0 x 10(2) - 2.5 x 10(3) c.f.u./litre. The implementation of periodic sampling may, however, not be a worthwhile exercise unless an environmental site has been associated with cases of legionellosis. Emphasis should be placed on the prevention of contamination of environmental sites with legionellae and on the development and implementation of protocols and procedures for the isolation of legionellae to gain the necessary expertise should an epidemiological survey be required.

Hospitals↗
PubMed1990

Kerion--clinical spectrum in nine cases.

The clinical features, microbiology and outcome of nine cases of kerion are reviewed. The aetiology of this uncommon condition, and the role of various therapeutic modalities are discussed. Clinicians need to be aware of the varying presentations of inflammatory fungal disease to avoid misdiagnosis as bacterial infection.

Adult↗
PubMed1989

Legionella: an infrequent cause of adult community acquired pneumonia in Dublin.

The commonest infectious agents identified in community acquired pneumonia (CAP) amongst 50 patients admitted to a Dublin hospital were Streptococcus pneumoniae and Haemophilis influenzae. Legionella pneumophila pneumonia occurred in only one patient who acquired infection abroad. A serological screen of blood bank donors and renal transplant recipients failed to detect antibody to Legionella pneumophila supporting the clinical findings of a low prevalence of infection in this community. It is concluded that initial antibiotic therapy for patients with CAP need not routinely include cover for Legionella.

Adult↗
PubMed1989

Enterotoxin production by Staphylococcus aureus isolates from cases of septicaemia and from healthy carriers.

In a prospective study, 52 Staphylococcus aureus isolates from individual patients with septicaemia and 27 nasal strains from separate, healthy carriers were compared for production of a range of extracellular proteins and toxins. Whereas there was no difference (p greater than 0.05) between septicaemic and nasal isolates with respect to incidence of alpha, beta, gamma and delta haemolysins, toxic shock syndrome toxin-1 or staphylokinase production, the incidence of enterotoxin A, B, and C production was higher among isolates from septicaemia (p less than 0.01). Of the isolates from septicaemia, 33 (63%) produced enterotoxins A, B, C or D alone or in combination. Only three (11%) of the nasal isolates produced a single enterotoxin, enterotoxin D. Of the isolates from septicaemia, 67% were hospital-acquired and greater than 25% of these were endemic, methicillin-resistant (MRSA) strains. All MRSA strains produced either enterotoxin A, or enterotoxin B, or both. These findings suggest a possible role for enterotoxins in the pathogenesis of S. aureus disease other than food poisoning.

Bacterial Toxins↗
PubMed1988

Sources and outcome for methicillin-resistant Staphylococcus aureus bacteraemia.

Eighty-eight episodes of MRSA septicaemia occurring in 82 patients were studied prospectively. In 15 episodes bacteraemia was transient, in 36 non-fatal, in 33 fatal, while in four septicaemia was a major contributory factor in the patient's death. There were more patients aged over 60 years in the septicaemia groups compared to the transient bacteraemia group (P = 0.01), and patients with septicaemia were usually recently postoperative and/or suffering from severe underlying disease. Circulation access sites were the commonest source of the bacteraemic organisms with non-surgical wounds including burns, varicose ulcers and bed sores as the next most common. In four of the 16 burns patients, fatal septicaemia followed surgical debridement of infected burns. In only eight episodes was there no apparent source of bacteraemia.

Adolescent↗
PubMed1987

To tunnel or not to tunnel catheters for parenteral nutrition.

The effect of subcutaneous catheter tunnelling on the incidence of catheter sepsis and on catheter life span in the absence of a nutrition team was determined in a prospective controlled clinical trial. Eighty one patients who received 92 courses of parenteral nutrition had 110 catheters inserted. Alternate catheters were tunnelled. Four patients who received parentheral nutrition for less than 48 hours were excluded from the study. Catheter related sepsis occurred in one tunnelled (1.8%) and 4 non-tunnelled catheters (7.6%) (P greater than 0.05 NS). Mean life span of tunnelled catheters was 21 days (range 5-37 days) compared to 12.6 days for non-tunnelled (range 3-19 days) (P less than 0.05). Six non-tunnelled catheters became displaced, a complication which did not occur with tunnelled catheters (P less than 0.01). In conclusion subcutaneous tunnelling of silicone catheters prolongs catheter life span but does not significantly influence catheter sepsis.

Bacterial Infections↗