Pilot study of a point-of-use decision support tool for cancer clinical trials eligibility.

Many adults with cancer are not enrolled in clinical trials because caregivers do not have the time to match the patient's clinical findings with varying eligibility criteria associated with multiple trials for which the patient might be eligible. The authors developed a point-of-use portable decision support tool (DS-TRIEL) to automate this matching process. The support tool consists of a hand-held computer with a programmable relational database. A two-level hierarchic decision framework was used for the identification of eligible subjects for two open breast cancer clinical trials. The hand-held computer also provides protocol consent forms and schemas to further help the busy oncologist. This decision support tool and the decision framework on which it is based could be used for multiple trials and different cancer sites.

The selectivity of vancomycin and lincomycin in NYC medium for the recovery of N. gonorrhoeae from clinical specimens.

Varying concentrations of vancomycin and lincomycin were tested separately in NYC medium to determine the degree of their selectivity and sensitivity for isolation of N. gonorrhoeae from clinical specimens. Results indicate that 2 microgram/ml of vancomycin used in conjunction with colymycin, amphotericin B, and trimethoprim lactate provide adequate selectivity and reduce the possibility of losses of vancomycin-sensitive strains of gonococci seen with 3 microgram/ml of vancomycin. The same medium with concentrations of from 1 to 4 microgram/ml of lincomycin substituted for vancomycin permitted more contamination and fewer recoveries of gonococci as compared with 2 microgram/ml of vancomycin.

Field evaluation of New York City medium in the biological environment-CO2 chamber in recovery of Neisseria gonorrhoeae and urogenital mycoplasmas.

The biological environment-CO2 chamber containing New York City (NYC) medium was evaluated in a clinical field trial in comparison with Transgrow and NYC medium in plates for the recovery of Neisseria gonorrhoeae and with NYC medium for urogenital mycoplasmas. The results of the study indicated that the biological environment chamber-CO2 culturing system with NYC medium is an effective method for the handling, transport, and culture of N. gonorrhoeae, large-colony mycoplasmas, and T-mycoplasmas if the delay in transport and incubation does not exceed 24 h.

A comparison of horse, cow, and sheep blood in NYC medium: effect on recovery of N. gonorrhoeae and urogenital mycoplasmas.

NYC medium supplemented with cow blood (NYC-C) and sheep blood (NYC-S) were tested for the growth of N. gonorrhoeae and urogenital mycoplasma in comparison with standard NYC medium which contains horse blood. In situations where horse blood is not available, cow blood could be substituted in NYC standard medium, whereas the use of sheep blood was found unsuitable.

Asymptomatic urethral gonorrhea among men in public New York City Social Hygiene Clinics.

Cultures were made from the urethra of 2,370 male Social Hygiene Clinic patients who were not directly associated with gonorrhea by signs, symptoms or epidemiology were cultured for N. gonorrhoeae. Of these asymptomatic individuals, 37 or 1.6% were found to be urethrally infected. Gram stain smear examinations of urethral specimens from these men were positive in about one-half of the cases.

Isolation of nonsense suppressor mutants in Pseudomonas.

A strain of Escherichia coli harboring the drug resistance plasmid RP1 was treated with the mutagen N-methyl-N-nitro-N-nitro-N-nitrosoguanidine, and mutants were isolated in which ampicillin resistance had been lost due to an amber mutation in the plasmid. One of these mutants was again treated, and a strain was isolated in which tetracycline resistance was also lost due to an amber mutation in the plasmid. The plasmid containing amber mutations in the genes amp and tet was named pLM2. This plasmid could be transferred to strains of Pseudomonas aeruginosa, P. phaseolicola, and P. pseudoalcaligenes. Mutants resistant to ampicillin and tetracycline could not be obtained from P. phaseolicola carrying pLM2. However, strains of E. coli, P. aeruginosa, and P. pseudoalcaligenes carrying the plasmid did produce mutants simultaneously resistant to both antibiotics. All of the mutants of E. coli had developed nonsense suppressors since they became phenotypically lac+, although harboring a lac amber mutation, and formed plaques with amber mutants of phages PRR1 and PRD1 that attack organisms carrying RP1. Approximately 20% of the resistant mutants of P. aeruginosa and P. pseudoalcaligenes were sensitive to the amber mutant of PRD1. These mutants were of variable stability and grew somewhat more slowly than their parent strains. One of the suppressor mutants of P. pseudoalcaligenes, designated ERA(pLM2)S4, was used for the isolation of nonsense mutants of bacteriophage PHA6, a virus having a segmented genome of double-stranded ribonucleic acid and an envelope of lipids and proteins.

Isolation of Neisseria meningitidis from the Genito-urinary tract and anal canal.

During the first 3 months of 1975, a striking increase has been noted in the incidence of Neisseria meningitidis in cultures from the genito-urinary tract and anal canal of both males and females being screened for gonorrhea. The data for recovery of these organisms from these sites are presented and reviewed.

Carbohydrate fermentation plate medium for confirmation of Neisseria species.

A carbohydrate fermentation plate medium is described for rapid and reliable confirmation of Neisseria gonorrhoeae, N. meningitidis, and other Neisseria species. The medium is based on a modification of NYC (U.S. Patent 3,846,241) medium, originally designed for the isolation of pathogenic Neisseria (3). A total of 715 clinical isolates were tested for their carbohydrate fermentation reactions on the medium, in parallel with cystin-Trypticase agar medium. In 82% of the strains tested, results were in agreement on both media and 18% gave conflicting results. The NYC modification provides rapid and accurate fermentation patterns for use in routine confirmation procedures for Neisseria species.

Morphologic observations of mycoplasmas and Neisseria gonorrhoeae in associated growth patterns.

Mycoplasma hominis and T-colony mycoplasmas were observed growing among or developing within gonococcal colonies on primary isolation plates streaked for detection of N. gonorrhoeae in urogenital specimens. The frequency of such association of mycoplasmas with gonococci was as high as 84% among patients screened for gonorrhea in several Social Hygiene Clinics of the City of New York, Department of Health, Bureau of Venereal Disease Control. The individual morphology of both mycoplasmal and gonococcal colonies was characteristic when viewed through the light microscope, and their associated growth was maintained throughout numerous serial transfers on agar culture media. Electron microscopy of such interrelated colonies revealed nipple-like projections on the gonococcal cell walls, to which the mycoplasmas appeared to be firmly attached. These morphologic observations are presented and discussed.

NYC medium for simultaneous isolation of Neisseria gonorrhoeae, large-colony mycoplasmas, and T-mycoplasmas.

NYC medium, primarily designed for isolation of pathogenic Neisseria, also readily supports the growth of large-colony mycoplasmas and T-mycoplasmas. When compared with A-3 agar medium and PPLO agar in clinical field trials, NYC medium performed equally as well as these mycoplasma-specific media in providing recovery of Mycoplasma species from female genital specimens. The transparent, highly-selective NYC medium permits direct, microscopic observation and presumptive identification of mycoplasmas, as well as Neisseria gonorrhoeae, without interference from contaminating saprophytes. As a single medium it can therefore be doubly useful in the diagnosis of gonorrhea and in the recognition of active or asymptomatic mycoplasma infections. Used in gonorrhea screening programs, the medium can be valuable in establishing the frequency of association of mycoplasmas with urogenital tract infection.