PubMed Health⌕ Search

Biomedical subjects

T Madhavan

Publications and source records attributed to T Madhavan.

At least 19 recordsLinked to original sources
PubMed1991

Consanguinity and mental retardation.

Consanguinity among parents as a cause of mental retardation in their children is debatable. The present study was conducted to find out the effect of consanguinity on mental retardation where the causative factor is not established. A total of 517 mentally retarded persons and their families were studied out of which 160 were born of consanguineous marriage and 357 were of non-consanguineous marriage. The results indicated that, when there is a history of mental retardation in the family and if the parents are consanguineously married, the risk of mental retardation in the offspring is significantly high (chi 2 = 11.52; P less than 0.001). Among the consanguineously married families, the blood relationship of uncle-niece seems to have the highest risk of affecting the offsprings. The implications are discussed in detail.

Adolescent↗
PubMed1988

Protein patterns, serotyping and plasmid DNA profiles in the epidemiologic fingerprinting of Pseudomonas aeruginosa.

The epidemiological typing schemes based on serotyping, antibiotic susceptibility pattern, plasmid DNA profile, and protein patterns determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) were evaluated for their usefulness in typing clinical isolates of Pseudomonas aeruginosa. The serotypability was lower (45%) than reported in the literature (85-95%). The most commonly found serotypes were O:1 (19%), O:11 (25%), O:6 (35%). The electrophoretic analysis of plasmid DNAs showed plasmids (molecular weight = 1 to greater than 40 megadaltons). Two plasmids of Mr 2 and 38 megadaltons were found in various serotypes. The restriction enzyme analysis of plasmid DNA showed identical DNA fragment patterns among distinct serotypes. The SDS-PAGE protein banding patterns of whole-cell proteins showed homogeneity among the strains. However, analysis of the soluble protein patterns of the strains showed sufficiently distinct protein profiles that can be used to differentiate between various strains. The results of this study demonstrate that the electrophoretic patterns of soluble proteins, in combination with plasmid DNA profile or serotyping, can be of value in the epidemiologic fingerprinting of clinical isolates of Pseudomonas aeruginosa.

Anti-Bacterial Agents↗
PubMed1988

Plasmid profiles and klebocin types in epidemiologic studies of infections by Klebsiella pneumoniae.

The epidemiological methods of klebocin typing, antibiogram and plasmid DNA profile were evaluated using organisms isolated from a suspected epidemic of gentamicin-resistant Klebsiella pneumoniae and unrelated strains from different geographical areas as controls. The electrophoretic analysis of plasmid DNAs from Klebsiella pneumoniae showed the presence of at least one and up to as many as seven plasmids in each strain. The molecular weight of plasmid DNAs ranged from 1 to greater than 70 mega daltons. While none of the control Klebsiella pneumoniae strains showed identical plasmid profiles, 63% of the epidemic-related Klebsiella pneumoniae strains did. Klebocin typing and plasmid DNA profile gave different results for the same strains. Plasmid DNA profile was found to be a more valuable method than klebocin typing alone or klebocin typing in combination with antibiogram for differentiating epidemiologically related from unrelated isolates. Both plasmid DNA profile and klebocin typing methods were superior to antibiogram.

Anti-Bacterial Agents↗
PubMed1987

Characterization of self-transmissible plasmids determining lactose fermentation and multiple antibiotic resistance in clinical strains of Klebsiella pneumoniae.

The lactose fermentation (Lac+) and antibiotic resistance (R+) phenotypes were conjugally transferred from Klebsiella pneumoniae strains (K166, K182, K186, K218, and K220) to Salmonella typhi, S. typhimurium, Shigella flexneri, and Vibrio cholerae. The genes for lactose fermentation and antibiotic resistance were located on the plasmids. Further analysis of plasmid DNA from these isolates indicated the presence of multiple plasmids (Mr ranged less than 2.7 to 70 X 10(6)). The Lac+R+ plasmids p166 and p182 were members of the FII incompatibility group. The fertility inhibition property of plasmids, p182, p218, and p220 was fi+ type. Furthermore, phage typing experiments showed that plasmids p166 and p218 (Lac+R+) conferred the ability to inhibit the multiplication of bacteriophages 12 and 13 in S. typhimurium. However, the plasmids p182, p186, and p220 (Lac+R+) could inhibit the visible lysis of all the 30 phages in S. typhimurium. This study describes the characterization of Lac+R+ plasmids and the medical significance of an intergeneric transfer of lactose fermentation to non-lactose-fermenting pathogens.

Escherichia coli↗
PubMed1979

The increasing importance of polymicrobial bacteremia.

Polymicrobial bacteremia increased from 6% in 1970 to 13% in 1975 in patients with bloodstream infections. This type of serious infection most commonly complicated genitourinary (27%) and gastrointestinal (26%) conditions, frequently followed invasive procedures (68%), was more common in hospitalized patients (73%), and was often associated with malignancies (25%) or immunosuppressive or cancer chemotherapy (34%). Although polymicrobial endocarditis was more commonly encountered in recent years, this infection accounted for only 4.5% of patients with multiple organism bacteremias. Gram-negative aerobic bacteria were isolated from 62% and anaerobic bacteria in 39% of patients with polymicrobial bacteremia compared with 37% and 14%, respectively, in patients with monomicrobial bacteremia. In the 88 patients with polymicrobial bacteremia, the mortality was 44.5%, compared with 18.0% in patients with monomicrobial bacteremia.

Adolescent↗
PubMed1979

Ceforanide: in vitro and clinical evaluation.

Ceforanide, a new cephalosporin antibiotic with a long half-life (3 h), can be administered twice daily. We evaluated its antimicrobial activity, pharmacology, and clinical efficacy. Twenty-seven patients with infections due to susceptible organisms received ceforanide, 0.5, 1, or 2 g, intramuscularly or intravenously every 12 h for 6 to 28 days. In vitro studies with the clinical isolates from 27 patients treated plus 263 additional isolates showed that ceforanide was active against cephalothin-susceptible gram-positive and gram-negative microorganisms. In addition, ceforanide inhibited 65% of cephalothin-resistant Escherichia coli and 65% of Enterobacter spp. at </=12.5 mug/ml. After a single 1-g intramuscular dose, the mean peak plasma concentration at 1 h was 48.9 mug/ml and that at 12 h was 4.7 mug/ml. Plasma accumulation occurred in some patients. The infections included 10 pneumonias, 3 with bacteremia and 1 with empyema; 11 soft tissue infections, 4 with abscesses and 3 with sepsis; and 3 urinary tract infections. One case each of endocarditis, osteomyelitis, and septic thrombophlebitis, all due to Staphylococcus aureus, were treated. Clinical response was satisfactory in all patients; bacteriological response was satisfactory in 26 of 27 patients. Ceforanide was well tolerated. Three patients developed mild increases in liver enzymes, and one developed slight eosinophilia. In another case, the antibiotic was discontinued because of a fivefold rise in serum glutamic-oxalacetic transaminase (aspartate aminotransferase) and serum glutamic-pyruvic transaminase (alanine aminotransferase) and a twofold rise in lactic acid dehydrogenase and alkaline phosphatase.

Adult↗
PubMed1979

The compromised host and Legionnaires' disease.

Pneumonia caused by Legionnaires' disease bacterium was recognized in eight patients during a 7-month period. The patients were immunosuppressed by their underlying illness, corticosteroid therapy, and other exogenous immunosuppressive agents. Five of the patients had received immunosuppressive therapy for less than 16 days. Clinical presentation was similar to that of other bacterial pneumonias in compromised patients. Legionnaires' disease progressed to necrotizing pneumonia with abscess formation and respiratory failure in two patients. Diagnosis was made by [1] culture of lung tissue and bronchial washings; [2] direct fluorescent antibody staining of lung tissue, sputum, and bronchial washings; and [3] serologic evidence of infection. Therapy with oral erythromycin was ineffective. Intravenous erythromycin was given to six patients, with a good response. However, two patients showed further clinical improvement after rifampin was added. Because this illness may be more severe in compromised hosts, open lung biopsy and special microbiologic tests should be done when Legionnaires' disease is suspected.

Adrenal Cortex Hormones↗
PubMed1978

Polymicrobial infective endocarditis: an increasing clinical entity.

Polymicrobial endocarditis was very uncommon until ten years ago. However, since that time, at least 21 cases were reported, and 10 patients with this mixed infection were seen at our hospital. All, except one of these infections, occurred in patients who had undergone heart surgery or abused intravenous drugs. Although, generally clinically indistinguishable from mono-microbial endocarditis, these mixed infections carried a very high mortality rate (greater than 30 per cent), and an unusually large number of the patients (greater than 50 per cent) needed heart surgery either to control the infection or to repair cardiac defects resulting from the infection. The prognosis depended on the species rather than the number of organisms isolated and on aggressive antimicrobial and surgical therapy.

Adult↗
PubMed1978

Parenteral cephalothin therapy for pelvic gonococcal infections.

The efficacy of intravenous cephalothin was studied prospectively in 20 patients with acute pelvic inflammatory disease, all of whom presented with lower abdominal pain, cervical and adnexal tenderness, fever, and leukocytosis. Blood, cervical, and cul-de-sac cultures were obtained on admission. The latter was transported anaerobically and inoculated in routine and prereduced medium. Transgrow medium with trimethoprim was used for endocervical cultures. Neisseria gonorrhoeae was isolated from the endocervix in 15 patients and from the cul-de-sac in four patients. All received intravenous cephalothin, 2 gm every four hours for seven days. Clinical improvement was observed in 48 to 78 hours. The cervical cultures were negative for N. gonorrhoeae after 48 hours, at the completion of treatment, and two weeks post-treatment. The drug was well tolerated. It was concluded that cephalothin intravenously is an acceptable alternative antibiotic for the treatment of gonococcal pelvic infection.

Cephalothin↗
PubMed1978

Retropharyngeal abscess after endoscopic retrograde cholangiopancreatography: an uncommon but potentially fatal complication.

Diagnostic cholangiopancreatography is a useful procedure which is attended by a relatively low incidence of immediate or delayed complications. Perforation of the esophagus or gut, myocardial infarction, hemorrhage, cholangitis, and pancreatitis are the most commonly reported morbid or fatal events. This paper reported a case of retropharyngeal abscess which led to tracheal compression requiring an emergency tracheostomy and antibiotic therapy after a routine ERCP procedure. This dramatic case pointed out an unusual but potentially fatal complication of diagnostic ERCP.

Abscess↗
PubMed1977

Focal glomerulonephritis and interstitial nephritis in methicillin-treated, heroin-related infective endocarditis.

A drug addict with staphylococcal endocarditis treated with methicillin, who developed massive proteinuria and acute nephritic syndrome is described. Discontinuation of methicillin therapy and appropriate antibiotic treatment of endocarditis led to clinical improvement, emphasizing the need to promptly discontinue potential nephrotoxic agents when abnormalities in renal function appear. The clinical course and results of renal biopsy studies suggest multiple causes of the renal lesions in this patient.

Adult↗
PubMed1977

Tuberculous meningitis in an urban general hospital.

We analyzed the clinical and laboratory findings of 19 patients with tuberculous meningitis seen between 1966 and 1974 at the Henry Ford Hospital. Eighteen patients were adults at the time of diagnosis. In eight patients, the history suggested that the infection with the tubercle bacillus had occurred in the remote past. Cerebrospinal fluid analysis was often typical for tuberculous meningitis; stains for Mycobacterium tuberculosis were usually negative. Of 16 patients who were treated, five died and five suffered permanent neurological sequelae. The addition to rifampin to isoniazid therapy did not improve either survival or permanent sequelae. We were not able to analyze the effect of steroids on the disease.

Adult↗
PubMed1976

Intramuscular clindamycin for therapy of infective endocarditis. Report of 23 cases and review of the literature.

Twenty-three patients with infective endocarditis received intramuscular clindamycin (Cleocin) for treatment. Thirteen had acute Staphylococcus (S.) aureus endocarditis but none had involvement of the aortic valve. Eleven of these 13 infections were heroin-related and involved the tricuspid valve.Twenty-one patients were successfully treated. Two patients with heroin-related S. aureus infection failed to respond to intramuscularly administered clindamycin, but responded to retreatment with methicillin. There have been 34 reported cases of endocarditis treated with clindamycin. Although 80 percent of all cases due to staphylococci responded favorably, almost all were heroin-related tricuspid valve infections. In addition 91 percent of cases due to aerobic streptococci responded but, surpisingly, treatment failed in three of four cases of anaerobic endocarditis. Although clindamycin can be useful in streptococcal endocarditis and in some cases of heroin-related S. aureus tricuspid endocarditis, caution should be exercised in its use. It is "less" bactericidal than the penicillins or cephalosporins, and organisms have become resistant during treatment. Furthermore, patients with anaerobic endocarditis have not responded well, and data are not available to recommend administration of clindamycin for acute S. aureus infections engrafted on the aortic or mitral valve.

Adolescent↗
PubMed1976

Effect of renal failure and dialysis on the serum concentration of the aminoglycoside amikacin.

Serum and dialysate levels of amikacin were determined at appropriate intervals after a 300-mg intravenous dose as a continuous infusion in six patients with end-stage renal failure undergoing hemodialysis and in three patients on peritoneal dialysis. The mean serum half-life of amikacin was 3.75 h during (or after) hemodialysis and 29 h during (or after) peritoneal dialysis. Although not on hemodialysis in the same six patients, the serum half-life was 28 h. The results indicate that the maintenance dose of amikacin should be markedly decreased in patients with severe renal failure even if they are treated with peritoneal dialysis, and that serial serum antibiotic concentrations are essential to prevent cumulative toxicity of the drug.

Adult↗
PubMed1975

Effects of renal failure and dialysis on cefazolin pharmacokinetics.

Serum and urinary levels of cefazolin were determined after a 500-mg parenteral dose in eight azotemic volunteers. The mean peak serum concentration was 1.5 to 5 times the levels obtained in nonazotemic patients. The serum half-life of cefazolin was increased significantly. In patients on dialysis, the mean serum half-life of cefazolin was 4.05 h during (or after) hemodialysis, and 32.1 h during (or after) peritoneal dialysis. There was a significant decrease in cefazolin removal when dialysate flow or membrane surface area of the dialyzer were decreased. It was also shown that one circuit through the dialysis unit caused measurable decrease in cefazolin concentration. These data and previously published reports suggest: (i) the maintenance dose of cefazolin can be decreased in azotemic patients; (ii) patients on hemodialysis will require an additional half dose after dialysis because of efficient removal during hemodialysis; and (iii) patients on peritoneal dialysis do not require an extra dose.

Cefazolin↗