Fat-soluble vitamin capsules as stereotactic markers.
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Biomedical subjects
Publications and source records attributed to T M Bailey.
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We surveyed members of the Ocular Microbiology and Immunology Group and reviewed laboratory requests at the Centers for Disease Control to determine better the epidemiology of Acanthamoeba keratitis in the United States. A total of 208 cases of Acanthamoeba keratitis were identified. The number of cases increased gradually between 1981 and 1984, with a dramatic increase beginning in 1985. Males and females were equally affected. Of the 208 patients, 85 (41%) resided in California, Texas, Florida, or Pennsylvania. Of 189 patients, 160 (85%) wore contact lenses, predominantly daily-wear or extended-wear soft lenses. Of the 138 patients who wore contact lenses and for whom information was available, 88 (64%) used saline prepared by dissolving salt tablets in distilled water. Patients aged 50 years and older were more likely to have had a history of trauma than younger patients, and males were more likely to have a history of trauma than females.
Trichinella spiralis is a parasite of carnivorous animals that causes the disease trichinosis. In the United States, people become infected by eating poorly cooked pork products or wild animal meat that is infected with the parasite. Although fewer than 100 cases per year are reported to CDC, trichinosis continues to persist as a public health problem in this country. Public health officials believe that the reported cases represent only a fraction of the total number of cases, since many of the mild or asymptomatic infections are undetected or are misdiagnosed unless they are related to more severe cases. In 1986, 51 cases of trichinosis were reported to CDC from 12 states and the District of Columbia. Thirty-six (71%) of these cases occurred in New Hampshire, Hawaii, Massachusetts, and Pennsylvania. Pennsylvania reported the largest number of cases, 15, or 29% of the total. In 1986, commercial pork products accounted for only three isolated cases of trichinosis. The other cases of trichinosis caused by pork included wild boar or pork purchased directly from a farm. Among those cases in which the food item was known or suspected, pork was incriminated in 26 (61%) cases, bear meat in 14 (33%), and other meat in three (7%) cases. Trichinosis is a preventable disease. The U.S. Department of Agriculture requires that ready-to-eat pork products be heat treated or frozen to kill the parasite before the products are sold to consumers.(ABSTRACT TRUNCATED AT 250 WORDS)
Acanthamoeba keratitis is a rare, serious protozoal infection of the cornea associated with wearing contact lenses. To identify risk factors in soft contact lens wearers, we interviewed 27 patients with Acanthamoeba keratitis and 81 uninfected matched controls to compare contact lens care practices, brands of contact lenses and associated solutions, and behavioral activities. Patients were significantly more likely than controls to use homemade saline instead of commercially prepared saline (21/27 [78%] vs 14/81 [17%]; odds ratio [OR], infinity), and wear their lenses while swimming (17/27 [63%] vs 24/81 [30%]; OR, 6.2). Contact lens disinfection schedules could be determined for 25 of the patients and all of the controls. Patients were significantly more likely than controls to disinfect their lenses less frequently than recommended by lens manufacturers (18/25 [72%] vs 26/81 [32%]; OR, 5.8). Microbiologic assay of contact lens solutions from controls showed frequent contamination with high levels of bacteria. Acanthamoeba species were isolated from homemade saline solutions from two controls. These findings emphasize adherence to recommended methods of soft contact lens care, especially when using nonsterile lens care solutions.
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The clinical and microbiological features of 31 cases of mycetoma seen in 8 years at a Riyadh hospital are described. Eighteen were due to Streptomyces somaliensis, 10 to Madurella mycetomatis and one each to Actinomadura madurae, Nocardia asteroides, and an unidentified species of Cladosporium. No immune defects were detected in the patients. Eleven had osteolytic lesions and 17 required surgery. Only seven patients were cured. Streptomyces infections were seen from all parts of Saudi Arabia outside the Rub Al Khali, but Madurella occurred mostly in highland regions where rainfall is higher.
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In Saudi Arabia, a native patient with no known risk factors for the acquired immune deficiency syndrome (AIDS) developed both clinical and laboratory evidence of AIDS 2 years after receiving transfusion of 11 units of blood obtained from a commercial distributor in the United States. This case suggests that a history of transfusions of blood components imported from areas where AIDS is prevalent should be elicited from patients in the Middle East with symptoms and physical findings suggesting AIDS.
Since 1947, the U.S. Public Health Service has recorded statistics on reported cases of trichinosis in humans. More complete clinical and epidemiologic data on cases became available after 1965, when trichinosis was officially made a notifiable disease. The numbers of reported cases declined markedly from an average of approximately 400, with 10-15 deaths reported each year in the late 1940s, to 57 per year, with three deaths in the 5 years 1982-1986. Although annual incidence was highest in sparsely populated Alaska, the highest numbers of cases are reported from the northeastern United States. Food sources of this infection vary in different geographic regions. The decline in annual incidence during the past 12 years appears to be accounted for largely by a decline in the number of cases attributed to commercially purchased pork, although pork products continue to be the major source of infections in humans. The number of cases due to ingestion of wild animal meat have remained relatively constant. Activities at the national and state level that have improved the prospects for control and prevention of trichinosis in commercial products are discussed.
Bacteriologic data and aspiration smears obtained by fine needle aspiration (FNA) biopsy for a series of 39 cases of tuberculosis were reviewed. Based on the morphologic features of the aspiration smears, the cases were divided into two groups: 18 cases in which distinct epithelioid granulomas were present and 21 in which no granulomas were found but large amounts of necrotic debris with variable numbers of polymorphonuclear cells, histiocytes and lymphocytes were present. Material from the FNA biopsy specimen was submitted for culture and fluorescence studies in 34 cases (15 with and 19 without granulomas). In the first group, auramine-rhodamine staining of smears was positive in 4 of 15 cases and Mycobacterium tuberculosis was isolated in 12 of 15 cases. In the second group, auramine-rhodamine staining was positive in 9 of 19 cases and culture was positive for M. tuberculosis in 16 of 19 cases. The results indicate that studying FNA smears by light microscopy and bacteriologic culture is an effective way of diagnosing tuberculosis.