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Biomedical subjects

W C Duncan

Publications and source records attributed to W C Duncan.

At least 73 records · Page 4Linked to original sources
PubMed1978

Febrile neutrophilic dermatosis in acute myelogenous leukemia.

A 50-year-old woman with acute myelogenous leukemia on two occasions had fever and exquisitely tender, warm, erythematous, indurated to frankly bullous plaques on the face and upper extremities. Histologically, the lesions showed rather dense dermal infiltrates of mature polymorphonuclear leukocytes; special stains for bacteria and fungi were negative, as were all cultures for infectious agents. The lesions did not respond to antibiotics but cleared rapidly with systemic steroid treatment. Febrile neutrophilic dermatosis of acute myelogenous leukemia is believed to be a nonspecific reaction to the underlying malignant disease process. By prompt recognition of this entity, prolonged expensive courses of antibiotics may be avoided.

Female↗
PubMed1977

Cutaneous microflora of patients with repeated skin infections.

The microflora of normal skin in 16 patients with repeated staphylococcal and streptococcal skin infections was examined to determine whether abnormalities existed which would indicate a protective role for the indigenous flora against colonization by pathogens. Five sites-hands, feet, axilla, groin and back-were examined quantitatively and qualitatively and compared with a control group. Total populations of indigenous flora were significantly higher from patients with repeated skin infections of the back, axillae and feet. The frequency of isolation of different species from normal skin was comparable between the control and experimental groups, with the exception of the incidence of Staphylococcus aureus and Proteus species which were isolated only from patients with repeated skin infections. Gram-negative bacteria were isolated with comparable frequency between the two groups, but patients with repeated skin infections tended to carry gram-negative bacteria on multiple sites. It was concluded from the high population of indigenous flora and the types of microogranisms present that the microflora of normal skin did not appear to protect patients with repeated skin infections against colonization by pathogens. The presence of high populations of Staphylococcus aureus on the normal skin of patients with repeated skin infections would appear to be the most important contributing factor.

Bacteria↗
PubMed1977

The environment and the microbial ecology of human skin.

Microbial flora of the skin of three human population groups representing different natural environments was examined quantitatively and qualitatively to determine whether environmental differences in temperature and humidity can influence the microbial flora of normal skin. Five anatomical skin sites - hands, back, axillae, groin, and feet - were sampled from 10 subjects working in a high-humidity, high-temperature environment, 10 subjects from a low-temperature, high-humidity environment, and 10 subjects working in a moderate-temperature and low-humidity environment. Bacterial populations were significantly larger from the back, axillae, and feet in individuals from the high-temperature and high-humidity environment as compared to the moderate-temperature, low-humidity environment. High humidity and low temperature had no significant effect on total populations, but this group showed a higher frequency of isolation of fungi, and gram-negative bacteria from the back and feet. Although there was an indication that increase in the environmental humidity could result in an increased frequency of isolation of gram-negative bacteria, there was no evidence that an increase in either temperature or humidity altered the relative proportions of gram-negative bacteria in the predominantly gram-positive microbial flora found on normal skin. It was concluded that, although climatic changes may cause fluctation in microbial populations from certain sites, they are not a major influence on the ecology of the microbial flora of normal skin in the natural environment. The variables introduced by studying individuals in their natural environment and the influence of these on the results are discussed.

Journal Article↗
PubMed1977

Twenty-nail dystrophy of childhood.

Twenty-nail dystrophy is an idiopathic nail dystrophy that begins insidiously in early childhood. All 20 nails are uniformly affected with excessive longitudinal striations and loss of nail luster. The skin and its ectodermal derivatives are otherwise normal. Twenty-nail dystrophy is believed to be a self-limited abnormality that resolves slowly with age.

Age Factors↗
PubMed1976

Surgical treatment of hidradenitis suppurativa.

Hidradenitis suppurativa is a chronic, recurrent, suppurative inflammation of apocrine glands. Morbidity is high and serious complications may occur. A technique of surgical treatment utilizing an electrosurgical unit to provide cutting current is described. This allows rapid unroofing and cauterization of extensive cysts and sinus tracts.

Adolescent↗
PubMed1976

Microbial skin flora of selected cancer patients and hospital personnel.

The bacterial flora of the skin from five anatomical sites on 10 leukemia patients, 10 patients with malignant melanoma, and a control group of 10 medical personnel was examined quantitatively and qualitatively. This was done to determine whether malignant disease results in changes in skin flora and to establish carrier rates of gram-negative bacteria on the skin of personnel in hospital environments. Gram-negative bacteria were isolated more frequently (74 isolates from 100 cultures) from the skin of leukemia patients than from either patients with malignant melanoma (8 isolates from 100 cultures) or the medical personnel (9 isolates from 100 cultures). Klebsiella pneumoniae and Pseudomonas aeruginosa were isolated exclusively from leukemia patients. Relative proportions of gram-negative bacteria in total populations were determined. The axilla was the only site with a uniformly high proportion of gram-negative bacteria. From all other sites cultured, gram-negative populations were low (1 to 5 bacteria/cm2 of skin), although a high proportion of gram-negative populations occurred randomly throughout all subject groups. It was concluded that leukemia patients tend to carry gram-negative bacteria on the skin. The factors permitting colonization of skin by gram-negative bacteria are discussed.

Adolescent↗
PubMed1976

Oral carbenicillin treatment of uncomplicated gonorrhea in men and women.

In a prospective controlled study of 290 men and women with uncomplicated gonorrhea, carbenicillin was shown to be less than 90% effective. Positive cultures were the basis for initial diagnosis and therapeutic failure in both sexes. Carbenicillin was evaluated in three different schedules: 5gm p.o., 10 gm p.o, and 2gm IM Plus 5GM p.o. The three schedules were equally effective. Eleven of 20 failures in women occurred in infection of the rectum. MICs of carbenicillin ranged from 0.025% to 1.0 mug/ml with a mean of 0.29 mug/ml.

Administration, Oral↗
PubMed1975

Comparison of trimethoprim-sulfamethoxazole with penicillin and tetracycline in the treatment of uncomplicated gonorrhea in women.

In a collaborative prospective study 327 women with uncomplicated gonococcal cervicitis or proctitis were randomly assigned to one of four treatment groups: (1) aqueous procaine penicillin G, 4.8 million units IM in one session plus 1.0 g probenecide; (2) tetracycline HCI, 9 g over 4 days; (3) trimethoprim, 80 mg-sulfamethoxazole, 400 mg (TMP-SMX) six tablets once daily for 3 days; (4) TMP-SMX, six tablets wtice on 1 dat at a 6-hour interval. They were re-examined 4 to 8 days and 10 to 15 days after completion of therapy. There was no significant difference between the results of the four regimens in the 4- to 8-day period (P greater than 0.36). However, at the 2-week point the results of TMP-SMX given for 3 days were less effective (P smaller than 0.05) than those obtained by penicillin plus probenecid. There was no significant difference between the results of the other regimens at this latter period.

Administration, Oral↗
PubMed1975

Trimethoprim-sulfamethoxazole in the treatment of gonorrhea: comparison with standard treatment schedules.

Several treatment regimens of trimethoprim-sulfamethoxazole (TMP-SMZ) were compared to the USPHS-recommended schedules for treatment of uncomplicated gonorrhea with ampicillin plus probenecid, tetracycline, or aqueous procaine penicillin G in both men and women. TMP-SMZ, six tablets as a single oral dose daily for 3 days, was as effective as the ampicillin or tetracycline schedules. The drug was well tolerated.

Ampicillin↗
PubMed1975

Physiological and environmental control of Gram negative bacteria on skin.

The relative importance of the environment versus the physiology of the host in the control of Gram negative bacteria on skin has been examined by two experimental designs. (I) The changes in incidence of Gram negative carriage from three skin sites in a climate controlled chamber at 35 degrees C and 90% humidity for 64 h were determined. Following 2 weeks of tetracycline treatment the above experiment was repeated. High temperatures and humidity increased the overall frequency of isolation of Gram negative bacteria although there were individual differences. This effect was reversed 24 h after a return to the natural environment. Tetracycline inhibited the increase in isolation of Gram negative organisms in six subjects, enhanced it in three and had no effect on one subject. Gram negative populations were less than 10 colony forming units/cm2 of skin in most instances but ranged up to 10,000/cm2 skin. No residual effect occurred after return to natural environment and at no time was there a loss of normal flora. (2) Klebsiella pneumoniae, Proteus vulgaris and Pseudomonas aeruginosa were inoculated on normal skin of ten volunteers and survival determined during a 24 h period. Viability was lost between 2 and 6 h on most subjects as compared to 24 h or longer for K. Pneumoniae and P. vulgaris on an inert surface and between 8 and 24 h for Ps. aeruginosa. It was concluded that extremes of environment can affect Gram negative skin carriage but under normal conditions in healthy individuals there is evidence of physiological control of Gram negative flora.

Adult↗