Nosocomial pneumococcal pneumonia in the elderly.

Among 35 elderly patients with transtracheal aspirate (TTA)-documented nosocomial pneumonia, 7 (20 percent) had Streptococcus pneumoniae infection. Clinical and epidemiologic data are reported on these 7 patients and on 2 others with nosocomial pneumococcal pneumonia documented by bacteremia. Malignancy and chronic obstructive pulmonary disease were the most common predisposing illnesses.

Transtracheal aspiration in the severely ill elderly patient with bacterial pneumonia.

Transtracheal aspiration was performed in 32 elderly hypoxic patients with bacterial pneumonia. No morbidity or mortality was associated with the procedure. Gram stains of the transtracheal aspirate provided rapid, accurate delineation of the etiologic pneumonic agent, and were particularly valuable in indicating mixed bacterial infections.

Meningitis caused by Acinetobacter calcoaceticus var anitratus. A specific hazard in neurosurgical patients.

Acinetobacter calcoaceticus var anitratus caused meningitis in five patients between 1968 and 1978 at two hospitals affiliated with Boston University School of Medicine. All patients had had head trauma or neurosurgical procedures prior to the development of meningitis. The course of the disease was relatively indolent in that fulminant disease did not occur even when initial therapy was inappropriate and bacteria persisted in CSF.

Pneumococcal pericarditis: a persisting problem in contemporary diagnosis.

We reviewed the clinical and laboratory features of six patients with pericarditis caused by Streptococcus pneumoniae who were admitted to Boston City Hospital. The diagnosis of pneumococcal pericarditis was delayed or missed entirely during life in all patients. The frequent absence of pericardial friction rubs and cardimegaly on chest roentgenograms contributed to the difficulty in recognizing this illness.

Mixed Streptococcus pneumoniae and gram-negative bacillary pneumonia in the elderly.

Of 24 elderly patients with Streptococcus pneumoniae pneumonia confirmed by transtracheal aspiration, six had concomitant infection with gram-negative aerobic bacilli. All six patients were elderly men with underlying cardiopulmonary disease. Three had had recent prior episodes of gram-negative pneumonia and four had previously received antibiotics.

An outbreak of type 1 pneumococcal pneumonia in a men's shelter.

A striking increase in blood culture isolates of Streptococcus pneumonia capsular type 1 was noted at Boston City Hospital in early 1978. The increased incidence of type 1 pneumococcal bacteremia was due, at least in part, to an outbreak of disease among alcoholic, male clients of Boston's largest shelter. Residents of the shelter also were found to have a high rate of nose and throat carriage of type 1 pneumococci.

Meningitis caused by gram-negative bacilli.

Thirty adults with meningitis caused by gram-negative bacilli were observed from 1968 to 1978 at four hospitals associated with Boston University School of Medicine. Equal numbers of two distinct types of gram-negative bacillary meningitis--spontaneously occurring meningitis and meningitis after neurosurgery--were found. Spontaneously occurring meningitis appeared to be caused most often by Escherichia coli and Haemophilus influenzae.

Thymoma and the nephrotic syndrome: a report of a case.

A 48-year-old male presented with the nephrotic syndrome 3 years after resection and irradiation of a thymoma. Renal biopsy revealed membranous glomerulonephritis by electron microscopy. IgA, IgG, and C3 deposition were present in the glomerular basement membrane by immunofluorescence.

Pneumococcal bacteremia diagnosed by peripheral blood smear in multiple myeloma.

A patient with multiple myeloma and a normal spleen died with high-grade pneumococcal bacteremia diagnosed by routine examination of a Wright-stained peripheral blood smear. In earlier reports, this finding has been described only in patients with abnormal or absent spleens. We review the proposed mechanisms of high-grade pneumococcal bacteremia in these patients and the immunologic abnormalities in patients with multiple myeloma that may result in increased susceptibility to this infection.

Effects of ingesting mercury-containing bacteria on mercury tolerance and growth rates of ciliates.

The ciliateUronema nigricans was found to acquire tolerance to mercury after being fed mercury-laden bacteria followed by exposure of washed suspensions of these ciliates to various concentrations of mercury in solution. Significant differences in percent mortality were observed for ciliates fed mercury-laden bacteria compared with control suspensions fed mercury-free bacteria. The phenomenon of acquired mercury tolerance was demonstrated within a single generation time.

Ciliates as a food source for marine planktonic copepods.

Copepods of the genusEurytemora, isolated from the Patuxent River, a tributary of Chesapeake Bay, were fed suspensions of the ciliateUronema isolated from the Rhode River, a subestuary of Chesapeake Bay. Grazing by copepods was determined by the decrease in numbers of ciliates, which were monitored by both direct counting and particle size analysis. Results from both methods of analysis showed significant reduction in the numbers ofUronema in the suspension whenEurytemora was present.

Noninvasive differentiation of cardiomyopathy from coronary disease; pulse transmission time and systolic time intervals.

Systolic time intervals and central pulse transmission time were compared in cardiomyopathy (CM) patients and age-and sex-matched patients with coronary artery disease (CAD). Significant differences were found in pulse transmission time (shorter in the CAD patients (p less than .001) and in the pre-ejection period (p less than .

Epidermal activity in annular dermatophytosis.

In five patients with annular tinea corporis, the tritated thymidine labeling indexes were determined in the rim, center, and intermediate areas of the lesion and compared with normal skin. Labeling indexes at the rim were much higher than those of normal skin (mean, 4.2 times).

Acupuncture for chronic shoulder pain. An experimental study with attention to the role of placebo and hypnotic susceptibility.

One half of 42 subjects treated for painful shoulders received classic acupuncture, and one half received a placebo in which the needles did not penetrate the skin. Half of each of these groups was treated in a positive setting to encourage the subject, and half in a negative setting designed to keep encouragement at a minimum. All patients were independently rated for susceptibility to hypnosis.

Separation of small ciliate protozoa from bacteria by sucrose gradient centrifugation.

Small ciliate protozoa of the genus Uronema were separated from labeled bacteria by means of a discontinuous sucrose gradient. More than 98% of the radioactivity associated with the bacteria was found in the upper portion of the gradient, whereas the remaining portion of the gradient contained the ciliates.

Neglected aspects of the quality of life.

Health status indexes have focused on physical function such as the activities of daily living, perhaps because the National Health Survey provides data of this sort or because it is the object of rehabilitation programs. In an attempt to elicit values concerning loss of function, 150 health workers were asked to assign weights from zero to 10 for 50 abilities or functions. Serious methodological problems were encountered in finding terms describing functional loss that were simple and meaningful to a wide range of workers.

The effects of chronic alcohol ingestion in mice on contractile properties of cardiac and skeletal muscle: a comparison with normal and dehydrated-malnourished controls.

In vitro isometric contractile tension was measured in heart and skeletal muscle in 3 groups of mice: 1. a control group, 2. a group maintained for 27 weeks on 20% alcohol, and 3.