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Biomedical subjects

W M McCormack

Publications and source records attributed to W M McCormack.

At least 163 records · Page 9Linked to original sources
PubMed1969

Report of the 1966-67 cholera vaccine field trial in rural East Pakistan. I. Study design and results of the first year of observation.

A controlled cholera vaccine field trial was carried out in rural East Pakistan during the 1966-67 cholera season. A commercial cholera vaccine of average potency was tested in 40 000 children aged 3 months to 14 years in 1- and 2-dose schedules. In the cholera season extending for 8 months following immunization, a single dose produced an over-all protection of 46%; 2 doses at an interval of 1 month provided 64% protection. The single dose was virtually ineffective in children under 5 years, but provided significant protection in older children. The enhanced effect of the 2-dose schedule was primarily due to the boosting of protection in children under the age of 5 years. The duration of significant protection, even with the 2-dose schedule, did not appear to extend beyond the first 3 months of the 8-month cholera season.

Adolescent↗
PubMed1969

Report of the 1966-67 cholera vaccine field trial in rural East Pakistan. 2. Results of the serological surveys in the study population--the relationship of case rate to antibody titre and an estimate of the inapparent infection rate with Vibrio cholerae.

The 1966-67 cholera vaccine field trials in East Pakistan tested 1- and 2-dose schedules of a commercial cholera vaccine in 40 000 children aged 3 months to 14 years. Randomsample serological surveys, made prior to the inoculations and 3 months and 6 months after the inoculations, demonstrated that there was a rise in the vibriocidal titres of the vaccinated children during the first 3 months after inoculation and a subsequent fall by the end of the second 3 months. The antibody response to 2 doses of cholera vaccine was better than the response to a single dose in children under 5 years of age. In children aged 5-14 years, the antibody response was similar for both inoculation schedules. Since the majority of the older children had vibriocidal antibodies before inoculation, the data suggest that the single dose acted as a booster, and this effect was not enhanced by a second inoculation.Serological studies of the hospitalized cholera patients indicated that the majority had low vibriocidal titres on admission to hospital. By comparing the distribution of admission titres of the hospitalized patients with the distribution of titres found in the population survey, it was possible to demonstrate a progressive reduction in the cholera case rate for the population with high levels of vibriocidal antibody.The sample surveys from the control population revealed a rise in titre following the peak of the cholera season, and a fall 3 months later. The data suggest that the rate of infection with V. cholerae for the 10 000 children in the control group during the cholera season may have been as high as 27%, while the clinical case rate was only 0.26%.

Adolescent↗
PubMed1969

Report of the 1966-67 cholera vaccine field trial in rural East Pakistan. 3. The lack of effect of prior vaccination or circulating vibriocidal antibody on the severity of clinical cholera.

In a controlled study, it has been shown that the prior administration of cholera vaccine had no beneficial effect on the clinical course of cholera as measured by either the condition of the patient on admission to hospital or the subsequent course of the disease. In fact, the disease was, if anything, more severe in those who had received cholera vaccine. Although the presence of a high vibriocidal titre is associated with protection from cholera, pre-existing antibody had no effect on the clinical course of the disease in those patients who developed cholera.

Adolescent↗
PubMed1968

Tetracycline prophylaxis in families of cholera patients.

The evaluation of tetracycline as a chemoprophylactic agent for cholera is described. Families of cholera patients were divided into 4 groups by strict rotation. The first group received multivitamin preparations and served as the control. The second received 1.0 g of tetracycline, divided into 4 doses, daily for 5 days, the third received 1.0 g of tetracycline in a single dose daily for 5 days, and the fourth received a single dose of 1.0 g of tetracycline. All families were visited daily for 10 days, a rectal swab being taken from each family member on each occasion. Tetracycline given daily for 5 days, either in divided doses or in a single daily dose, was effective in preventing subsequent infection. A single dose of tetracycline was less effective. The indications for chemoprophylaxis in cholera are discussed.

Adolescent↗
PubMedDate not supplied

Epidemiology of sexually transmitted diseases in rape victims.

Rape is a violent crime that is increasing rapidly in incidence. Victims can include male and female adults and children. These victims may be at risk for the acquisition of many sexually transmitted conditions. The risk will vary with the sex and socioeconomic status of the assailant as well as with the nature of the sexual contact. Infections with Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, herpes simplex virus, human papillomavirus, and Treponema pallidum have all been found to occur following sexual assault of female adults or children. Although data are lacking, male victims of homosexual rape are presumably at risk for the acquisition of the above infections as well as hepatitis B, the acquired immunodeficiency syndrome, and other infections prevalent among homosexual men. All victims of sexual assault should undergo a comprehensive physical examination with a complete history. Baseline and follow-up laboratory tests should be performed. In some instances, prophylactic administration of antimicrobial agents may be warranted.

Female↗
PubMedDate not supplied

Orogenital contact and the isolation of Neisseria gonorrhoeae, Mycoplasma hominis, and Ureaplasma urealyticum from the pharynx.

Men and women who came to clinics in Boston underwent pharyngeal examinations, and pharyngeal specimens were obtained for cultures for Neisseria gonorrhoeae, Mycoplasma hominis, and Ureaplasma urealyticum. Fifty-one (4.9%) of 1,037 participants had gonococcal pharyngeal infection. M. hominis and U. urealyticum were recovered from the pharynges of 149 (14.3%) and 154 (14.8%) of 1,044 participants, respectively. The history of ever having performed fellatio was associated with pharyngeal infection with N. gonorrhoeae (P less than 0.02), M. hominis (P less than 0.05), and U. urealyticum (P less than 0.006). A history of fellatio was also associated with a history of a recent sore throat. There was, however, no association between pharyngeal infection with N. gonorrhoeae, M. hominis, or U. urealyticum and a recent sore throat. Cunnilingus was not associated with symptoms or signs or pharyngitis or with the isolation of gonococci or genital mycoplasmas from the pharynx. The pharyngitis associated with fellatio remains a microbiologic enigma.

Female↗
PubMedDate not supplied

Isolation of Neisseria meningitidis from anogenital specimens from homosexual men.

By use of the fluorescent antibody technique, the authors examined 663 consecutive anogenital isolates from men that satisfied the presumptive criteria for Neisseria gonorrhoeae of the Center for Disease Control (Atlanta, Ga.). Most urethral isolates (364 of 368; 98.9%) from men presumed to be heterosexual were confirmed as N. gonorrhoeae. In contrast, urethral (98 of 114; 86%) and anal (136 of 175; 78%) isolates from homosexual men contained N. gonorrhoeae significantly less often (P less than 0.001). Most the isolates with negative results in the fluorescent antibody test for N. gonorrhoeae were shown to be Neisseria meningitidis by use of sugar fermentation reactions. Homosexual men sampled at two bathhouses for gay men were more likely to have oropharyngeal Neisseria isolated from anogenital cultures than were homosexual men screened in a clinic for gay men. Reliance on presumptive criteria for the identification of N. gonorrhoeae in anogenital cultures taken from homosexual men is inappropriate.

Anal Canal↗
PubMedDate not supplied

Cefoxitin vs. penicillin in the treatment of uncomplicated gonorrhea.

Four hundred six men and women with gonorrhea were randomly assigned to receive either 2 g of cefoxitin or 4.8 X 10(6) units of aqueous procaine penicillin G intramuscularly. All patients also received 1 g of probenecid orally. There was no statistically significant difference in the failure rate between patients treated with penicillin (4.3%) and those treated with cefoxitin (5.1%). Twelve (92%) of 13 homosexual men with gonococcal proctitis who received penicillin and 19 (95%) of 20 who received cefoxitin were cured. Adverse reactions were infrequent and mild in the cefoxitin-treated group. Three patients who received penicillin developed reactions consistent with procaine toxicity. It is concluded that cefoxitin is a safe and effective alternative to penicillin for treating uncomplicated anogenital gonorrhea in men and women.

Adult↗
PubMedDate not supplied

Nonspecific vaginitis among women attending a sexually transmitted diseases clinic.

We studied 33 women who presented to the sexually transmitted disease clinic at Boston City Hospital (Boston, Massachusetts); most of the women attended the clinic for management of uncomplicated anogenital gonococcal infection. A clinical diagnosis of nonspecific vaginitis was based on the finding of three or more of the following: homogeneous vaginal discharge, vaginal pH of greater than 4.5, abnormal odor on the addition of 10% KOH to vaginal secretions, and the presence of "clue cells." This diagnosis was assigned to 21 (64%) of the 33 women; it was confirmed by use of gas-liquid chromatographic analysis of vaginal secretions (succinate:lactate ratio of greater than 0.4 or detection of priopionate or butyrate) in 20 of the 21 women. About two-thirds of the women with nonspecific vaginitis were symptom-free. We conclude that nonspecific vaginitis is exceedingly common among women attending an inner-city clinic for sexually transmitted diseases and that most of the infected women are asymptomatic.

Adult↗
PubMedDate not supplied

Vaginal colonization with mycoplasma hominis and ureaplasma urealyticum.

Vaginal cultures obtained from unselected young women who consulted the gynecologist in a student health service were examined for Ureaplasma urealyticum and Mycoplasma hominis. Each participant completed a confidential questionnaire. Multiple logistic regression analysis was used to determine which variables, of a large number ascertained, were associated with mycoplasmal colonization. U. urealyticum was isolated from 273 (56.8%) of 481 participants. The following variables were significantly predictive of colonization with U. urealyticum: black race, absence of antibiotic use, cigarette smoking, and number of sexual partners during the last year. Lifetime number of sexual partners was significantly predictive only in women who used nonbarrier methods of contraception. M. hominis was isolated from 85 (17.7%) of the 481 participants. Independent variables that were significantly predictive of colonization with M. hominis included black race, young age, and, for users of nonbarrier methods of contraception, lifetime number of sexual partners.

Black or African American↗
PubMedDate not supplied

Prevalence of genital pathogens among female prostitutes in New York City and in Rotterdam.

The authors studied the prevalence of genital microorganisms among 300 female prostitutes in brothels in New York City and 60 female prostitutes attending a sexually transmitted diseases clinic in Rotterdam, The Netherlands. Rates of isolation of Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticum in the two cities were 9.3% and 8.3%, 25.3% and 16.6%, 57.3% and 74.9%, and 73% and 79%, respectively. Trichomonas vaginalis was detected in 3.6% of New York prostitutes and in 16.6% of those in Rotterdam. Nonspecific vaginitis was found in 33% of prostitutes examined in New York. In New York, Asian prostitutes were more likely to be infected with C. trachomatis (33 of 102; 32.3%) than were prostitutes of other ethnic backgrounds (44 of 194; 21.5%; P less than .05.

Adult↗
PubMedDate not supplied

Colonization of sexually abused children with genital mycoplasmas.

Although sexually abused children are usually evaluated only for the presence of infections with Neisseria gonorrhoeae and Treponema pallidum, they are also at risk for acquiring other sexually transmitted organisms prevalent in the adult population. Accordingly, we examined pharyngeal, anorectal and genital specimens from 50 children who had been sexually abused and from 40 healthy children who served as controls; these specimens were cultured for Mycoplasma hominis and Ureaplasma urealyticum. M. hominis was isolated from the anorectal and vaginal cultures of 11 (23%) and 16 (34%), respectively, of 47 abused girls as compared with three (8%) and six (17%), respectively, of 36 controls. U. urealyticum was isolated from the anorectal and vaginal cultures of nine (19%) and 14 (30%), respectively, of the abused girls as compared with one (3%) and three (8%), respectively, of 36 controls. Colonization with genital mycoplasmas was not associated with any symptoms.

Adolescent↗
PubMedDate not supplied

Evaluation of ofloxacin in the treatment of uncomplicated gonorrhea.

In an open study, a single oral dose of 400 mg of ofloxacin was administered to 40 men and 20 women who required treatment for uncomplicated gonococcal infection. Thirty-six men and 13 women were evaluable. Ofloxacin eradicated 49 of 49 urethral or endocervical gonococcal infections and 1 of 1 pharyngeal infection. There were 55 pretreatment isolates of Neisseria gonorrhoeae available for antimicrobial susceptibility testing. Twenty-four (43.6%) produced penicillinase. Eighteen (32.7%) isolates that did not produce penicillinase had penicillin MICs greater than or equal to 1.0 micrograms/mL. Twelve (21.8%) isolates had tetracycline MICs greater than or equal to 16 micrograms/mL. The geometric mean minimal inhibitory concentrations (range) for 55 pretreatment N. gonorrhoeae isolates were: ofloxacin, 0.014 (.0078-.03) micrograms/mL; penicillin, 6.30 (.125-128) micrograms/mL; and tetracycline 1.61 (.03-128) micrograms/mL. There were few side effects. Ofloxacin appears to be an effective and safe oral therapy for the treatment of infections caused by N. gonorrhoeae including infections due to penicillin- and tetracycline-resistant strains.

Adult↗