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T L Gustafson

Publications and source records attributed to T L Gustafson.

30 records · Page 2Linked to original sources

Protective effect of anticholinergic drugs and psyllium in a nosocomial outbreak of Norwalk gastroenteritis.

An outbreak of Norwalk agent gastroenteritis occurred in a chronic-care hospital in Tennessee in April 1981. Fifty-five per cent of the elderly psychiatric patients and 61 per cent of the nursing employees on one floor became ill. Infection was most likely to have spread from patient-to-patient by nursing employees. Certain chronic medications seemed to protect patients from symptomatic infection. Anticholinergic drugs appeared to mask the symptoms of this disease; psyllium ('Metamucil') may have prevented infection in some patients. We suggest that prospective studies be undertaken to confirm the possible value of psyllium in averting infection with Norwalk agent.

Aged↗

Invasive aspergillosis in renal transplant recipients: correlation with corticosteroid therapy.

During a 31-month period in 1979-1981, nine patients at a renal transplant center in Tennessee developed invasive infections with Aspergillus species. Despite an extensive search, no common environmental source of contamination was found. A matched case-control study of host risk factors showed that leukopenia, prior administration of antibiotics, and treatment with azathioprine and antilymphocyte serum were not significantly related to the development of aspergillosis. In contrast, the administration of high-dose corticosteroids posed a significant risk. An average daily dose of greater than or equal to 1.25 mg of prednisone/kg per day for the entire interval studied was the best predictor of subsequent invasive infection with Aspergillus.

Adrenal Cortex Hormones↗

An outbreak of foodborne hepatitis A: the value of serologic testing and matched case-control analysis.

In April 1981, an outbreak of hepatitis A occurred among state legislators in Tennessee. Although the number of cases was small, we traced the source to a food handler who served cold meats and cheese. This investigation demonstrates the value of rapid serologic testing using a radioimmunoassay technique and matched case-control analysis to identify small foodborne outbreaks of hepatitis A.

Cheese↗

The epidemiology of heat-related deaths, Texas--1950, 1970-79, and 1980.

A study of the deaths during a 1980 heat wave in Texas revealed death rates that were highest in males, the elderly, Blacks and those engaged in heavy labor, the latter two factors perhaps reflecting socioeconomic status. The data suggest that persistent high temperatures were related to death to a greater degree than the temperature peaks reached. Higher heat death rates in earlier years are believed to be attributable to the limited availability of air conditioning in those years.

Black or African American↗

Survey of tampon use and toxic shock syndrome, Tennessee, 1979 to 1981.

Thirty-eight cases of toxic shock syndrome were reported in Tennessee between January 1, 1979, and March 31, 1981. Thirty-one of these cases (82%) occurred in white women less than 30 years of age; none occurred in black women. We suspected that age and racial differences in tampon use could contribute to the relatively high risk of toxic shock syndrome in young white women. In March, 1981, we surveyed 1,136 Tennessee women regarding their past and current used of tampons. Age and race were related, not only to whether or not tampons were used but to the way tampons were used. "Continuous" tampon use during the most recent menstrual period was most common among young white women (61%), less common among older white women (42%), and least common among black women (23%). On the other hand, the brands, absorbency types, numbers, and usage patterns did not vary greatly with respect to age or race. Comparing each woman's tampon habits in March, 1981, with her usual habits in June, 1980, suggested a striking effect of publicity about the toxic shock syndrome. We estimate that 23% to 39% of the women surveyed changed their tampon habits in an attempt to reduce their risk of toxic shock syndrome.

Adolescent↗

An outbreak of airborne nosocomial varicella.

An outbreak of nosocomial varicella was traced to airborne spread from an immunocompromised child hospitalized from Nov 11-19, 1980. Seventy potentially susceptible children were hospitalized on the ward during that period. Although the index patient remained in strict room isolation throughout his hospital stay, eight of these patients contracted varicella. The afternoon of November 12 was the period of highest risk for acquiring varicella. Eight of 36 patients (22%) present that afternoon, compared to none of 34 patients not present that afternoon, acquired the infection. A patient's risk of contracting varicella was significantly related to how near he/she came to the index patient's room that afternoon. Airflow studies, using the tracer gas, sulfur hexafluoride (SF6), demonstrated that patient rooms on this ward were at positive pressure with respect to the corridor. Despite isolation procedures, SF6 released in the index patient's room achieved concentrations in the corridor as high as 10% of those inside the room. Airborne spread of varicella has rarely been reported, but it may be a common mode of transmission in hospitals. We suggest that patients hospitalized with varicella be placed in strict isolation in negative-pressure rooms to reduce the risk of nosocomial transmission.

Adolescent↗

Outbreak of acute pulmonary histoplasmosis in members of a wagon train.

In August 1980, an outbreak of acute pulmonary histoplasmosis occurred among participants in a wagon train as it traveled through eastern Tennessee. Of the 85 people on the train 69 (81 percent) had evidence of infection with Histoplasma capsulatum. Fifty-four people had symptomatic disease. The source of infection was traced to the site of a former winter blackbird roost in Charleston, Tennessee, that had been partially cleared five years earlier to make a park. Fourteen of 25 soil samples from this site were culture-positive for H. capsulatum. This is the first reported outbreak to involve a large migrant group. The outbreak is unusual in that exposure occurred without excavation, construction or tree-cutting at the site.

Adult↗

Pseudomonas folliculitis: an outbreak and review.

In November 1980, an outbreak of folliculitis due to Pseudomonas aeruginosa occurred in members of a health spa in Tennessee. The source of infection was traced to the health spa swimming pool, which had not been chlorinated for two days due to equipment malfunction. Thirty-seven (62%) of 60 members who used the swimming pool on these two days developed a papulopustular rash within eight hours to five days after swimming in the pool. The rash had a characteristic distribution, predominantly involving the buttocks, hips, and axillae. Other manifestations of infection included otitis externa (49%) and mastitis (11%). P. aeruginosa serogroup 0-11 was isolated from pustules of six people. A swab from the edge of the swimming pool also grew P. aeruginosa serogroup 0-11. With the rising popularity of home whirlpools and hot tubs, physicians may expect to encounter this disease with increasing frequency.

Disease Outbreaks↗

Statewide survey of the antimicrobial susceptibilities of Haemophilus influenzae producing invasive disease in Tennessee.

Between October 1, 1980, and September 30, 1981, a prospective statewide study of Haemophilus influenzae infections identified 220 culture-proved systemic infections. Of these, 92% were caused by H. influenzae type b. Antimicrobial susceptibility testing of the type b isolates showed that 17% were resistant to ampicillin, but virtually all were susceptible to chloramphenicol, trimethoprim-sulfamethoxazole, cefaclor and rifampin. Ampicillin resistance is common in all parts of Tennessee and chloramphenicol remains the drug of choice for initial therapy of systemic H. influenzae infections.

Ampicillin↗

Nosocomial transmission of hepatitis A from a hospital-acquired case.

An outbreak of hepatitis A occurred in a pediatric hospital in Texas. The index case had been admitted during the incubation period for cardiac surgery and developed symptoms while hospitalized. A child in a nearby bed acquired hepatitis A, as did three staff members. The second child was still hospitalized when she developed symptoms and infected 12 nurses, 3 physicians, 2 medical students, 2 patients and 1 respiratory therapist. Children with diarrhea can effectively disseminate this virus even when normal hospital routines and rules of hygiene are observed.

Child↗