Blood culture procedure and contamination with Klebsiella.
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Biomedical subjects
Publications and source records attributed to S L Baker.
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At the time of admission to treatment, 450 alcohol-dependent patients and 198 drug-dependent patients were asked to complete a brief questionnaire regarding their interest in 26 treatment goals. An analysis of the goal questionnaire data revealed that from the total sample of patients more than 70 percent wanted assistance, in addition to help with substance dependency, with medical problems, psychological problems, school or job counseling, and recreational guidance. Between alcohol- and drug-dependent groups, statistically significant (p less than .05) but small differences were found for numerous goal items, with drug-dependent patients wanting assistance for more goal items than alcohol-dependent patients.
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This study identified risk factors associated with readmission for postpartum endometritis. The study group consisted of 109 mothers (Group I) who were discharged after delivery and readmitted with endometritis. Control groups consisted of women who had endometritis immediately after delivery but who did not require readmission (Group II, n = 109), and women who had no intrapartum or puerperal infection and also were not readmitted (Group III, n = 109). Subjects in Groups II and III were matched to an index study subject for date of delivery and maternal age, race, and parity; and women in Groups I and III were also matched for route of delivery. Groups were compared in terms of demographic characteristics, intrapartum course, and clinical presentation. The data were analyzed with the t-test, chi2, and multiple logistic regression analyses, and a P value < .05 was considered significant. Women in Groups I and III delivered vaginally more often than mothers in Group II. In addition, mothers in Groups I and III had similar postpartum courses, no evidence of infection on discharge after delivery, and a similar period from delivery until postpartum discharge. Although women in Group I were more likely to have spontaneous rupture of membranes, a shorter latent period, and have fewer bilateral tubal ligations than mothers in Group II, multivariate analysis identified route of delivery as the only significant maternal variable associated with postpartum endometritis requiring readmission. Women who were readmitted for endometritis usually delivered vaginally, and the occurrence of late-onset postpartum endometritis was unrelated to the length of stay following delivery.
OBJECTIVE: To identify risk factors for the development of antepartum pneumonia and to describe maternal and perinatal outcome in pregnant women with pneumonia. METHODS: The study group consisted of 59 women with antepartum pneumonia. Pneumonia was defined by the presence of lower respiratory tract symptoms, radiographic findings, no other source of infection, and at least two of the following: oral temperature > or =38 degrees C, white blood cell count > or =15,000/ml, auscultatory findings, and/or positive sputum cultures. For comparison, a control group (n = 118) of pregnant women was formed by selecting the first mother who delivered immediately before and after an index study subject. RESULTS: Mothers in the study group were significantly more likely than women in the control group to have either a history of asthma (P = 0.022) or an admission hematocrit < or =30% (P < 0.001). Women with pneumonia were also more likely to receive a tocolytic agent (P < 0.001) and/or beta-methasone to enhance fetal lung maturity (P < 0.001). In addition, study subjects delivered at an earlier mean gestational age (P = 0.002) and had infants who weighed significantly less (P = 0.003) than mothers in the control group. Multivariate analysis indicated that women with asthma or anemia had more than a five-fold increase in the risk of developing pneumonia during pregnancy (P = 0.013), and mothers with pneumonia were significantly more likely to deliver before 34 weeks gestation (P = 0.04). CONCLUSIONS: Pneumonia during pregnancy was associated with maternal anemia and asthma. In addition, preterm labor with tocolysis and/or beta-methasone was more common in women with pneumonia, and these women were more likely to deliver preterm and have low birthweight infants compared to women without pneumonia.
Persons with heart failure (HF) experience impaired quality of life (QOL). However, the majority of research conducted on QOL in persons with HF has been with men. The purpose of this descriptive pilot study was to describe the impact of symptoms of HF and examine the relationships among symptom impact, perceived health status, perceived social support, and overall QOL in 30 women who had recently been hospitalized for HF. The women reported high physical symptom impact, poor perceived physical health status, and impaired QOL. Physical symptom impact, perceived physical health status, and QOL were moderately to highly correlated with one another. Perceived social support was significantly, though not strongly, correlated with physical symptom impact. Emotional symptom impact and mental health status were significantly and negatively correlated with each other but were not significantly correlated with QOL. In this group of 30 chronically ill women, QOL was lower in those women who reported greater physical symptom impact and poorer perceptions of their physical health status.
Chlamydia trachomatis infection is one of the most common sexually transmitted diseases (STD) among adolescents and is one of the most common causes of perinatal infection. We have screened 267 young nulliparous adolescent girls (12-17 years old) for cervical C. trachomatis infection during their pregnancy using tissue culture methods. The population was a cohort of pregnant teenagers who had limited sexual exposure (mean duration of sexual activity, 14.3 months, mean number of lifetime partners, 2.0 +/- 1.5). The initial screening was done at enrollment to a prenatal care clinic, and the third trimester examination at 32 to 36 weeks of gestation. According to clinical indications, additional interim STD examinations were carried out. The cervical C. trachomatis infection rate was 18.7% (50/267) at intake and 7.9% (14/178) in the third trimester. Three of the 40 interim STD examinations also were positive for cervical C. trachomatis infection. Prenatally, 64 of 267 (24.0%) girls were positive for C. trachomatis at one or more times. The repeat culture positive rate for C. trachomatis was 7.8% (17/218), and 14 of those that were negative on the initial screening were positive on the subsequent screening. One or more types of treatable STDs (chlamydial, gonorrhea, syphilis, or trichomonal) were identified in 38.6% (103/267) of the study population during pregnancy. These findings suggest that high-risk sexual behavior may continue in teen pregnancy, and repeated prenatal chlamydial and other STD screening and counseling are indicated in this population.