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Biomedical subjects

A Josephson

Publications and source records attributed to A Josephson.

27 records · Page 2Linked to original sources
PubMed1985

The relationship between intravenous fluid contamination and the frequency of tubing replacement.

Medical patients receiving IV therapy were randomly assigned to one of two IV tubing change groups. One group had a 48-hour tubing change and the other had no tubing change for the remainder of the cannula placement. A daily IV fluid specimen was processed microbiologically. To complete the study, a minimum of 3 continuous days of therapy and three fluid specimens was required. There were two contaminated specimens, one in each tubing change group. The contamination rate in the 48-hour change group was 0.87% and 0.96% in the no change group. The rate difference of 0.09% has a 95% confidence interval (-0.035 to +0.036) which includes zero. Survival analysis also revealed no significant difference in the cumulative probability of survival, however the mean duration of continuous tubing use of 4.3 days in the no change group and 1.8 days in the 48 hour change group were significantly different (p less than 0.05). The cumulative probability of surviving contamination free was 0.988 in the 48-hour group and 0.987 in the no-change group. We conclude that it is safe to change IV tubing at intervals up to but not exceeding 4 days.

Catheterization↗
PubMed1984

Cavitary Legionnaires' pneumonia: nosocomial infection in renal transplant recipients.

Cavitation is an unusual manifestation of legionnaires' pneumonia. Mortality rates range from 24 to 58 percent with effective therapy. Antibiotic therapy is not standardized and is largely based on anecdotal reports. This report has described nosocomially acquired cavitary legionnaires' pneumonia in five renal transplant recipients. The diagnosis was made by seroconversion and immunofluorescent staining of lung tissue or transtracheal aspirates. Frequently seen associated symptoms were not present. All patients were successfully treated with 2 to 4 g of erythromycin for at least 4 weeks.

Adult↗
PubMed1984

An epidemiologic study of postcesarean infection.

Cesarean section (CS) is associated with increased postpartum infectious morbidity, predominantly endometritis. In this prospective cohort study, endometritis was found in 28% of 229 patients who underwent consecutive CS from September 1979 to May 1980 at a university hospital. When the occurrence of bacteremia and wound infection was considered, the study found 31% of the patients were infected. Among the 20 potential epidemiologic and operative risk factors for infection that were studied, the most important were primary CS, membrane rupture, labor, and meconium staining (p = 0.0001). Failure to progress, breech presentation, and fetal distress were also significantly associated with infection (p = 0.001). Another factor correlated to the rate of infection was attendance by physician in training (p = 0.002). Discriminant function analysis was used to develop an equation that correctly classified, as infected or noninfected, 76% of a sample of CS patients (p = 0.004). This sample was not part of the original sample from which the discriminant function equation was developed. Finally toward the end of the study period, we observed a decrease in the infection rate among patients of house staff physicians. This decrease has resulted in similar infection rates for patients of attending physicians and patients of house staff physicians, which have continued to the present.

Bacterial Infections↗
PubMed1981

Infection complicating intrapericardial steroid instillation in uremic pericarditis.

Short-term, indwelling, percutaneous pericardiocentesis for drainage with local steroid instillation has been advocated for refractive uremic pericarditis. It is reported to be almost universally successful and to cause only minor complications. We describe a patient in whom this technique lead to purulent pericarditis (Staphylococcus aureus) requiring pericardiectomy.

Adult↗