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Biomedical subjects

W J Hierholzer

Publications and source records attributed to W J Hierholzer.

At least 55 records · Page 3Linked to original sources
PubMed1982

Hospital infection control for varicella zoster virus infection.

More than 500 hospital employees and 209 patients were exposed to varicella zoster virus (VZV) as a consequence of 22 uncontrolled hospital introductions that occurred over a period of 34 months. Five introductions of varicella were by hospital employees who acquired the infection outside the hospital. Successful infection control of VZV requires an accurate definition of the susceptible population and the limitation of transmission. Individuals with prior VZV infection are epidemiologically not at risk for developing clinical illness. Serologic screening of hospital employees with uncertain prior VZV history is effective in identifying those at risk of developing the infection. A prior history of intimate exposure to VZV does not imply immunity in the absence of clinical illness.

Chickenpox↗
PubMed1980

Background prevalence of microagglutination antibodies to Legionella pneumophila serogroups 1, 2, 3, and 4.

The background prevalence of microagglutination antibodies to Legionella pneumophila was determined by testing the sera of 517 individuals who lived or worked in a small Iowa town. In this population, the upper limit of normal microagglutination titer for serogroups 1, 3, and 4 was 1:16, and that for serogroup 2 was 1:8. The prevalence of microagglutination titers of greater than or equal to 1:32 against any serogroup of L. pneumophila was only 7.4% and did not vary significantly with age or sex.

Antibodies, Bacterial↗
PubMed1980

Indirect immunofluorescence antibodies to Legionella pneumophila: frequency in a rural community.

The background prevalence of indirect immunofluorescence antibody to Legionella pneumophila in a rural community was determined by testing sera from 517 volunteers. The upper limit of normal antibody titer was found to be 1:64 with L. pneumophila serogroup 1 (Philadelphia 1) used as antigen. High titers (greater than or equal to 1:128) were found in 13.2% of the sera and occurred with similar frequencies in males and females. In individuals 40 years of age and older, however, high titers were 2.7 times as prevalent in males as females.

Adolescent↗
PubMed1979

Legionnaires' disease in pneumonia patients in Iowa. A retrospective seroepidemiologic study, 1972-1977.

The frequency of Legionnaires' disease among 586 cases of pneumonia that occurred in Iowa between fiscal years 1972 and 1977 was studied retrospectively on the basis of paired sera. The frequency of confirmed Legionnaires' disease was 4.1% and of presumptive Legionnaires' disease was 11.4%. Infections with the Legionnaires' disease (LD) bacterium were most frequent in the summer. Of the 22% of pneumonias for which a cause could be defined, Legionnaires' disease was third in frequency behind Mycoplasma pneumoniae and influenza A virus infections. Infections with the LD bacterium occurred in association with pneumonias in most age groups. The youngest patient with LD infection was a 5-year-old boy with pneumonia. The disease occurred 3.2 times more often in males than in females. In males, the frequency of confirmed and presumptive Legionnaires' disease increased steadily to plateau after the fourth decade at about 12% and 28%, respectively. In females the frequency of presumptive Legionnaires' disease was 7% to 16%, relatively evenly distributed over all age groups. Pneumonias associated with LD bacterium infection should be considered in the differential diagnosis of community-acquired pneumonias in most age groups.

Adolescent↗
PubMed1979

Prophylactic antibiotics in gynecologic surgery.

A 2-year prospective double-blind study of prophylactic antibiotics in 317 patients undergoing elective total abdominal or vaginal hysterectomy was conducted. Patients randomly received placebo, penicillin, or cefazolin 30 minutes prior to surgery and at 6-hour intervals thereafter for 48 hours. Rigid criteria for postoperative morbidity were established. Vaginal hysterectomy patients given either penicillin or cefazolin prophylaxis had fewer postoperative infections (P less than 0.01) compared to those given placebo. A similar trend was noted among women undergoing abdominal hysterectomy; however, this trend was not statistically significant (P greater than 0.05). Despite continuous surveillance, no change in nosocomial flora or antibiotic sensitivity of bacterial isolates was noted. Adverse drug effects and antibiotic-resistant secondary infections were encountered with similar frequency in all treatment groups.

Bacterial Infections↗
PubMed1978

Endometrial and vaginal cuff bacteria recovered at elective hysterectomy during a trial of antibiotic prophylaxis.

The utility of culturing the cut edge of the vaginal cuff and endometrium of the uterine specimens of patients undergoing elective hysterectomy and receiving antibiotic prophylaxis has been critically examined. Subjects for this study represent a randomized subpopulation of patients participating in a larger controlled, prospective, double-blind study of antibiotic prophylaxis which has been conducted at Yale-New Haven Hospital during the past five years. On the basis of the organisms recovered, speculation is raised concerning the existence of an endometrial flora and the mechanisms of postoperative vaginal cuff infection in patients treated and not treated with antibiotic prophylaxis at the time of hysterectomy.

Aerobiosis↗
PubMed1978

A novel pattern of treponemal antibody distribution in isolated South American Indian populations.

Serologic surveys for treponemal disease were carried out in 1970-1976 among three linguistically distinct and isolated population groups in the Brazilian Amazon Region and among the Mapuche Indians of southern Chile. Three patterns were found: 1) no evidence for treponemal infection in two very recently contacted groups; 2) sporadic positive individuals in groups with long periods of contact with non-Indian populations; and 3) a high prevalence of positive tests in one cultural group with limited exposure to non-Indians. The seroepidemiology and clinical manifestations of a possible treponemal infection in those villages with a high prevalence of positive tests were unlike those of the classically described human treponematoses.

Adolescent↗
PubMed1977

Epidemiology of infectious disease: the example of measles.

The situation of unacculturated Brazilian Amazon tribes is described. The isolation of these populations has been sufficiently tight that they have been free of most epidemic diseases of the cosmopolitan world, although diseases associated with persistent infection have a high prevalence. The history of measles epidemics in Amerind populations is reviewed and it is concluded that most deaths can be prevented by basic nursing care but that there is a residual excess mortality characteristic of these populations. Three Brazilian virgin-soil populations and one experienced tribe in Chile, the Mapuche, were vaccinated against measles. Elevated febrile responses were observed in the three virgin-soil populations relative to the fevers seen in the Mapuche and in cosmopolitan populations. Nutritional status, immunological experience, humoral immune response and genetic characters have been examined for an explanation of this phenomenon. The most pronounced correspondence detected so far is a high degree of homozygosity in HLA loci of the virgin populations.

Adolescent↗
PubMed1976

Yale studies of patient care. I. The evaluation of the febrile patient.

Observations are reported on the variation in evaluation and management of 216 episodes of fever in 690 patients on four services of a university hospital. Twenty-two percent of febrile episodes were not commented upon in the medical record. Thirty percent of all fevers and 14% of antibiotic-treated fevers were not evaluated with microbiologic cultures. The extent of evaluation varied with service and varied directly with the height of the fever and the clinical recording of abnormality in temperature.

Adolescent↗