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Biomedical subjects

S T Brown

Publications and source records attributed to S T Brown.

At least 55 records · Page 3Linked to original sources
PubMed1984

A case-control study of stillbirths at a teaching hospital in Zambia, 1979-80: serological investigations for selected infectious agents.

Sera were obtained from 266 mothers of singleton stillborn babies (cases) and 266 mothers of live-born babies (controls), matched for parity, who delivered at the University Teaching Hospital, Lusaka, Zambia, between October 1979 and April 1980. Tests were performed on 262 samples from cases and 261 from controls. The microhaemagglutination assay for Treponema pallidum (MHA-TP) was reactive in 54% of cases and 29% of controls; the rapid plasma reagin (RPR) 18-mm circle card test was reactive at a dilution of 1:16 or greater in 29% of cases and in 3.5% of controls. Both these differences are highly significant.Sera from cases and controls were further examined for evidence of cytomegalovirus, human (alpha) herpesvirus, hepatitis B virus, toxoplasma, and plasmodium infections. The only difference between sera from cases and controls was that cytomegalovirus antibody titres >/= 1:1024 occurred more often among cases. There was no relationship between antibody titre and birth weight.The results of this study emphasize the importance of screening pregnant women for syphilis. Treatment of those found to be infected should help prevent stillbirths due to syphilis.

Antibodies↗
PubMed1983

Plasmid profile, serogrouping, and auxotyping of Neisseria gonorrhoeae isolates from Africa.

The plasmid patterns of 90 isolates of Neisseria gonorrhoeae (including 39 penicillinase-producing strains) originating from various countries in Africa were determined. Serogrouping by coagglutination and auxotyping were used to characterise the isolates. The 4.4-megadalton plasmid was present in seven isolates out of 39 penicillinase-producing strains, two of which occurred with a conjugative 24.5-megadalton plasmid. The African strains were predominantly serogroup WI and wild type. Arginine-dependent isolates were as common as proline-dependent types.

Africa↗
PubMed1981

Faculty and student perceptions of effective clinical teachers.

The following study has been conducted to discover the characteristics of an effective clinical teacher as described by faculty and students in a selected baccalaureate school of nursing. Through determination of these characteristics, clinical teachers can improve their teaching methodology and provide a more effective learning environment for the learner. The identification of these characteristics also has implications for graduate nursing education, as clinical teachers are being prepared in this arena to enter the teaching environment. Administrators should consider utilization of these characteristics for teacher evaluation purposes. Nursing educators must attempt to bridge the gap between what educators and students perceive as characteristics of the effective clinical teacher. The ultimate goal to be achieved from identification of effective clinical teacher characteristics, as determined in this study, is improvement in clinical teaching.

Clinical Competence↗
PubMed1981

Blinded proficiency testing of FTA-ABS test.

In 1976 and 1977, 28 state laboratories participated in a blinded proficiency testing study of syphilis serologic tests. The test considered of a battery of 50 duplicate reagin-positive sera; 12 specimens were obtained from syphilitic patients. The median reproducibility scores for the VDRL and FTA-ABS tests were the same, 92%, and the scores for the two tests were correlated. Given the relatively low prevalence of untreated syphilis in the United States today, serologic results that are highly predictive of syphilis are obtainable only from the most proficient laboratories, if unselected sera are tested. Reactivity in the VDRL and FTA-ABS tests does not prove the diagnosis of syphilis. Physicians must use clinical judgment to preselect patients for serologic testing.

Laboratories↗
PubMed1980

Problems and approaches to the control and surveillance of sexually transmitted agents associated with pelvic inflammatory disease in the United States.

The national gonorrhea control program has expanded since its inception in 1972 and now reflects new information and program evaluations. Initial program objectives to reduce the incidence of disease and the resistance of gonococci to antibiotics have been expanded to reduce the occurrence of pelvic inflammatory disease and to limit the sequelae of PID. The changes since 1972 in the national venereal disease control program have increased the number of people helping control programs and have enhanced our ability to control other sexually transmitted diseases.

Female↗
PubMed1980

Metronidazole for vaginal trichomoniasis. Seven-day vs single-dose regimens.

This randomized, double-blind evaluation of metronidazole therapy for trichomonal vaginitis compared the efficacy and side effects of a single 2-g dose and the standard seven-day regimen (250 mg three thimes daily). Eighty (86%) of the 93 women examined seven to 21 days after therapy with the 2-g regimen, and 76 (91.6%) of 83 examined after the seven-day regimen, were cured. These cure rates were not significantly different. In addition, symptom duration and the occurrence of side effects and yeast infection were not significantly different for the two treatment groups. Because the efficacy and side effects of the two regimens are comparable and the 2-g dose is easier to administer and less expensive, we recommend the 2-g dose as standard treatment for trichomoniasis.

Clinical Trials as Topic↗
PubMed1980

Imogene King's conceptual framework: a proposed model for continuing nursing education.

This paper presents a proposed model for continuing nursing education based on Imogene King's conceptual framework. The rationale for using King's conceptual framework as the foundation underlying this proposed model is three-fold: the concepts--social systems, health, perception, and interpersonal relationships--are relevant in every nursing situation; the interacting levels of operation--individuals, groups, and society--depict a reciprocal relationship between human behaviour and the environment; and the triad of elements--continuing nursing education, nursing practice, and nursing research--are interrelated in the nursing profession. The authors contend that this approach to continuing nursing education is beneficial to participating nurses, the health care consumer, and to the advancement of the nursing profession. Based on its simplicity and flexibility, the proposed intra-systems model described in this article is useful as a systematic guide for continuing nursing education. The authors believe that this proposed model provides an approach for stimulating continued learning, for establishing innovative foundations for nursing practice, and for generating inquiry through research. Utilizing this approach in maintaining the educational standards for professional practice will promote change for the advancement of the nursing profession.

Attitude to Health↗
PubMed1980

Accuracy of presumptive criteria for culture diagnosis of Neisseria gonorrhoeae in low-prevalence populations of women.

The accuracy of presumptive criteria for identification of Neisseria gonorrhoeae was assessed in two separate populations of women with a low prevalence of gonorrhea. Of the presumptively positive cervical isolates available for confirmation, 98.5% were identified as N. gonorrhoeae. Of 25 isolates that could not be confirmed, 20 failed to grow on subculture, and of the remaining 5, only 2 (0.6% of all viable recoveries) were identified as nongonococcal isolates (N. meningitidis). Our study confirms earlier findings that meningococcal isolates are rarely found in endocervical specimens. The benefits from early treatment and counselling of women for gonorrhea on the basis of presumptive criteria outweight the risks occasioned by the rarely encountered nongonococcal isolate.

Cervix Uteri↗
PubMed1977

Comparison of erythromycin base and estolate in gonococcal urethritis.

A randomized double-blind trial of 152 men with gonococcal urethritis compared the therapeutic efficacy of erythromycin estolate and erythromycin base. Twenty-one of 86 (24%) men treated with the estolate and 15 of 66 (23%) treated with the base had recurrent or persistent gonococcal infection when seen after a 9-g course of erythromycin. The serum erythromycin activity among estolate-treated patients (3.57 +/- 0.84 microgram/ml) was nearly twice that for base-treated patients (1.76 +/- 0.80 microgram/ml). Our findings do not support routine use of erythromycin for treatment of pregnant, penicillin-allergic patients.

Clinical Trials as Topic↗
PubMed1977

Spectinomycin-resistant Neisseria gonorrhoeae.

Neisseria gonorrhoeae resistant to high levels of spectinomycin (more than 2,048 microng/ml), were isolated from specimens obtained from a patient with urethritis. The bacterial resistance to spectinomycin is probably due to ribosomal changes that are a result of a chromosomal mutation. If spectinomycin fails to cure gonorrhea, spectinomycin resistance should be considered.

Adult↗
PubMed1977

Treatment of gonorrhea with trimethoprim-sulfamethoxazole.

The following regimens were randomly administered to 271 men with gonococcal urethritis: 4.8 X 10(6) units of aqueous procaine penicillin G intramuscularly plus 1 g of probenecid orally (APPG); nine tablets of trimethoprim-sulfamethoxazole (TMP-SMZ; 720 mg of TMP and 3,600 mg of SMZ), orally as a single dose (TMP-SMZ-9); and 12 tablets of TMP-SMZ (960 mg of TMP and 4,800 mg of SMZ) orally as two doses of six tablets taken at a 6-hr interval (TMP-SMZ-12). The failure rates of the APPG, TMP-SMZ-9, and TMP-SMZ-12 regimens were 4%, 23%, and 19%, respectively. APPG was significantly more effective (P less than 0.05) than TMP-SMZ-9 or TMP-SMZ-12. Isolates of Neisseria gonorrhoeae from treatment failures as compared to those from treatment successes were significantly more resistant to SMZ (P less than 0.01) and to the TMP-SMZ combination in a ratio of 19 parts SMZ to one part TMP (P less than 0.05). Minimal inhibitory concentrations of SMZ, TMP, TMP-SMZ, and penicillin G showed positive correlation coefficients.

Administration, Oral↗
PubMed1976

Treatment of secondary syphilis.

There are few studies of therapy for secondary syphilis which are adequate by modern standards of scientific design. Penicillin has been the best documented, effective antibiotic, although not all forms and regimens are equally effective. Although both aqueous penicillin G and procaine penicillin G in oil with aluminum monostearate (PAM) appear effective, these are not practical penicillin forms. The first requires injections every 2 to 4 hours for 7 to 10 days and the latter is no longer available in the United Sates. Aqueous procaine penicillin G (APPG) regimes have been evaluated in limited trials, but do appear effective. However, APPG requires daily injections and is impractical for widespread use in the treatment of secondary syphilis. The injection of 2.4 million units of benzathine penicillin G appears to be an effective single session regimen. Although tetracycline is widely accepted as the drug of choice for patients allergic to penicillin, this drug has been less rigorously evaluated for treatment of secondary syphilis. Other antibiotics have been even less well evaluated and none has been clearly shown to be highly effective.

Chloramphenicol↗
PubMed1976

Adverse reactions in syphilis therapy.

Reactions related to treatment of syphilis may be due to treponemal infection, therapy, or to the interaction of these. In this review I discuss the Jarisch-Herxheimer (J-H) reaction and the therapeutic paradox. Antibiotic side effects are not unique among patients treated for syphilis; therefore, readers are referred elsewhere for reviews of major antibiotic side effects. J-H reactions are acute, transient episodes with manifestations occurring both systemically and at local sites of treponemal concentration. These reactions are related to the rapid destruction of treponemes by various therapeutic agents. In this review, I suggest that J-H reactions may be significant only in syphilitic paresis, pregnancy complicated by syphilis, and when local inflammation can cause serious functional compromise, as with second or eighth cranial nerve involvement. Many workers use prednisone in conjunction with penicillin in some or all of these situations. However, the efficacy of corticosteroids has not been evaluated for such problems in clinical trials. Therefore, the use of prednisone can be supported only in very selected situations and for short duration (ie, 2 days). Therapeutic paradox, which is clinical worsening despite cure of infection, is said to result from scar formation after rapid treponemal destruction by therapeutic agents. The therapeutic paradox does not appear of great significance. Futhermore, no methods to prevent such reactions are generally advocated.

Anti-Bacterial Agents↗