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Biomedical subjects

R W Lyons

Publications and source records attributed to R W Lyons.

14 recordsLinked to original sources
PubMed1989

Mycobacterium avium intracellulare as a marker of human immunodeficiency virus disease.

Between January 1981 and December 1986, 4,178 patients were cultured for mycobacteria at a community teaching hospital in Hartford. The number of patients with positive cultures totaled 278 (6.65%). Mycobacterium other than tuberculosis (MOTT) was isolated from 228 (82%). MOTT isolation increased yearly from 1.5% of the patients in 1981 to 14.5% of the patients in 1986. Mycobacterium avium intracellulare (MAI) was the most common MOTT species isolated (197/228). Fifty-nine patients were under the age of 50, but 23 had predisposing factors for MOTT. Of the 36 who did not have an underlying condition, 25 had the human immunodeficiency virus (HIV). The isolation of MAI preceded the diagnosis of AIDS/ARC in nine patients, in 10 others it coincided with their diagnosis and in six it followed the diagnosis. Isolation of MAI in a patient under the age of 50 with no predisposing factors may suggest concommitant HIV disease.

Acquired Immunodeficiency Syndrome↗
PubMed1988

A nosocomial outbreak of ampicillin-resistant Haemophilus influenzae type b in a geriatric unit.

A nosocomial outbreak of Haemophilus influenzae type b (Hib) bronchitis occurred in a geriatric unit. The three infected patients were grouped together in an isolation unit and treated. A prevalence survey was done by obtaining pharyngeal cultures from patients and staff in the unit. One patient and a nurse were asymptomatic pharyngeal carriers of Hib. One infected patient was bedridden, and his only known Hib contact was the nurse. Geographic clustering was the only significant risk factor, as determined by a case-control study. Carriers were treated with rifampin. The isolates were characterized for strain relatedness by using three methods. All produced beta-lactamase and all were serotype b. Plasmid profiles and restriction endonuclease analysis of bacterial DNA were performed; chromosomes were digested with the restriction endonucleases HindIII and HaeIII. Strains were confirmed as identical by using these methods and were different from two Hib control strains producing beta-lactamase. This study documents nosocomial transmission of Hib, by using molecular typing methods.

Aged↗
PubMed1986

Fungal infections of the CNS.

Most CNS fungal infections can be divided into those that occur in normal hosts and those that occur in the immunosuppressed host. Cryptococcal infection, however, is common in both groups. The usual clinical presentation of a CNS fungal infection is chronic headache and mental status change. The CSF shows a lymphocytic meningitis with low sugar and high protein. Amphotericin B remains the drug of choice for most CNS fungal infections.

Acquired Immunodeficiency Syndrome↗
PubMed1977

Pseudobacteremia: false-positive blood cultures from mist tent contamination.

In the seven-month period from July 1975 through January 1976, 11 pediatric patients had Acinetobacter calcoaceticus var. anitratus cultured from blood; this organism had not been isolated from pediatric patients in the previous six months. In 10 of 11 patients, only the first of two cultures was positive. All patients recovered uneventfully, although only two were treated with appropriate antibiotics. Nine of 11 had been in mist tents at the time of the culture. Mist cultured from one tent contained the same organism found in the patient's blood culture. Eight of 10 patients, however, had blood for culture drawn from the same needle as samples for other blood work, compared with only three of 13 controls (p = .013); this represented a deviation from proper blood culture technique, and a mock trial confirmed contamination of blood cultures when technique was broken. Contamination by this organism occurred in the tent water reservoir and mist, and the nose and skin of the children were colonized. The hands of respiratory therapy technicians and blood-drawing personnel became contaminated while handling the mist tents. Thorough attention to hand-washing, tent sterilization, and technique in drawing blood cultures stopped the pseudo-epidemic.

Acinetobacter↗
PubMed1977

Effect of inline filtration of intravenous infusions on the incidence of thrombophlebitis.

The effect of inline filtration on the incidence of infusion phlebitis was examined in a community hospital. Two general surgical units, comparable in their patient populations, were studied during a one-month period. On one unit, an extension set with a 45 micrometer filter was attached to every i.v. catheter; no inline filtration was instituted on the second unit. The use or nonuse of a filter was not blinded. The filter was replaced every 24 hours or sooner if blockage occurred. A total of 49 patients (107 i.v.s) were studied in the group with filters and 40 patients (84 i.v.s) without filters. Phlebitis was graded on a scale of 0 to 4. The proportion of patients with phlebitis in the filter group was 86%; in the no-filter group, 75%. In the filter group, 67% of the catheterizations ended in phlebitis; in the no-filter group, 63%. Upon first catheterization, phlebitis developed in 63% of the filter group and 58% of the no-filter group. None of these differences was significant (p = 0.05). There was also no significant difference between the two groups in the severity of phlebitis and the incidence of phlebitis following the administration of irritating solutions containing cephalothin sodium or potassium chloride. Based on this study, the value of inline filtration in routine clinical conditions appears to be questionable.

Connecticut↗
PubMed1976

Haemophilus paraphrophilus endocarditis in a prolapsed mitral valve.

A case of Haemophilus paraphrophilus endocarditis successfully treated with ampicillin is described. The patient, a 24-year-old woman, had a prolapsed mitral valve. The organism was initally misidentified as H. parainfluenzae, which it closely resembles. H. paraphrophilus is distinguished by its requirement of 10% CO2 for growth on NaCl-free medium and its inability to ferment xylose.

Adult↗
PubMed1976

Combined serotyping and biotyping of Serratia marcescens.

The API (Analytab Products, Inc., New York, N.Y.) biotypes of 117 clinical isolates of Serratia marcescens were determined and fell into 13 different patterns. The O and H antigens were determined by tube agglutination, and 27 serotypes were identified. The biotype and serotype appeared to vary indepently. Serotyping and biotyping combined divided these isolates into 56 different types. There was a problem interpreting the end points for inositol fermentation and urease production, which could affect reproducibility of API biotypes. Biotyping is a simple way of screening for possible nosocomial outbreaks of S. marcescens.

Bacterial Infections↗