Lipopolysaccharide-induced chorioamnionitis is confined to one amniotic compartment in twin pregnant sheep.

Background: Chorioamnionitis is a major risk factor for preterm birth in multifetal pregnancies. However, there is little clinical data whether chorioamnionitis is restricted to one amniotic compartment in multifetal pregnancies.

Objective: To explore whether chorioamnionitis is confined to the exposed compartment and does not cross to the unaffected fetus in twin pregnancy.

All-inclusive concurrent antibiotic usage review: a way to reduce misuse without formal controls.

During an 11-week period, all antibiotic usage on a 113-bed medical teaching service was reviewed concurrently in weekly sessions between house staff and a review team. Recommendations for change, based on accepted criteria, were communicated by the house officer to the attending physician. In one-half of the patients no change was suggested; in one-third, a recommended change was made; and in only one-sixth was a recommendation not followed.

Acceptability and cost savings of selective sputum microbiology in a community teaching hospital.

Our experience in introducing selective sputum microbiology into a clinical laboratory was recorded prospectively and analyzed. Based on low-power microscopy with determination of ratios of polymorphonuclear to squamous cells, 32% of specimens were discarded as unfit for culture. Speedy processing and prompt telephone calls afforded opportunities to replace these with better specimens, but only 29% of rejected specimens were resubmitted.

Unpredictable response of Pseudomonas aeruginosa to synergistic antibiotic combinations in vitro.

The combined activity of ticarcillin and each of three aminoglycosides, gentamicin, tobramycin, and amikacin, was studied with 45 clinical isolates of Pseudomonas aeruginosa. All strains individually were susceptible to each of these agents. Comparison of the results revealed highly variable interaction, both from strain to strain and from one aminoglycoside to another against the same strain.

Misinformation from sputum cultures without microscopic examination.

Only 13 of 38 hospital laboratories surveyed include a Gram stain routinely in microbiological sputum examination. In a prospective three-hospital study, 60% of over 1,200 "sputum" specimens consisted predominantly of saliva, as judged by cell composition. Compared with the results of cultures in which microorganisms presumptively identified on sputum smears were specifically sought ("directed cultures"), cultures of the same specimens processed in the routine manner missed pneumococci 61%, haemophili 23%, and yeasts 44% of the time.

Brucella suis infection in Philadelphia. A survey of hog fever and asymptomatic brucellosis.

Examination of hospital and public health records revealed 19 cases of brucellosis diagnosed in Philadelphia between 1968 and 1972. A serologic survey at Philadelphia's largest hog-processing plant, however, indicated infection in 39% of workers. If extrapolated industry-wide, the total would be several hundred in Philadelphia.

Herpes simplex encephalitis in Hodgkins disease. Isolation of drug-sensitive virus from brain following unsuccessful treatment with idoxuridine.

Herpes simplex encephalitis developed in a patient with Hodgkin's disease under therapy. Despite treatment with idoxuridine in a total dose of 280 mg/kg intravenously, he died without showing any clinical response. At autopsy, there was no gross or microscopic evidence of Hodgkin's disease, and virus isolated from the brain postmortem was inhibited in vitro by idoxuridine 0.

Carbenicillin in the first nine months of unrestricted use. A chapter in the natural history of an antibiotic.

During the first nine months following its release for general use, carbenicillin was administered to forty-two patients in Hahnemann Hospital. Thirty-nine available records of patients receiving the drug for other than urinary infection were reviewed. Among children, all but one had mucoviscidosis: most were given acceptable therapeutic regimens; survival rate was 80%, and their physicians were favorably impressed.