Search PubMed⌕ Search

Biomedical subjects

A Neuman

Publications and source records attributed to A Neuman.

67 records · Page 4Linked to original sources

Post-meningitic hearing loss: report on three cases.

Three children with post-meningitic hearing loss were seen for evaluation and aural rehabilitation over a 4-yr period. Fluctations in hearing levels during that time period were noted. The hearing of one child improved, while that of the other two children decreased. Changes in sensitivity were documented and discussed with reference to the habilitation process. The need for frequent monitoring and for otologic intervention in the post-meningitic child is emphasized.

Child, Preschool↗

Cryopreserved cadaveric allografts for treatment of unexcised partial thickness flame burns: clinical experience with 12 patients.

Partial thickness burns (PTB) usually heal within 3 weeks. Prevention of infection and desiccation of the wounds are crucial for optimal healing. Early tangential excision of the burn eschar and allografting prevent deepening of the burns, and are therefore advocated for treatment with the best functional and aesthetic results. For superficial partial thickness burns (SPTB) conservative use of topical antimicrobial agents with frequent dressing changes are implemented. We compared the conservative treatment for PTBs and SPTBs to grafting cryopreserved cadaveric allografts with no prior excision. Twelve patients with flame PTB areas were allografted after mechanical debridement without excision of the burn wounds. The allografts were cadaveric skin cryopreserved by programmed freezing and stored at -180 degrees C for 30-48 months. Matching burns for depth and area were treated with silver sulfadiazine (SSD) one to two times daily until healing or debridement and grafting were required. It was found that 80 per cent of the cryopreserved allografts adhered well and 76 per cent of the treated areas healed within 21 days, whereas only 40 per cent of the SSD-treated burns healed within 21 days. Partial thickness burns can be treated successfully with viable human allografts (cryopreserved cadaveric skin) with no prior surgical excision. The burn wounds heal well within 3 weeks. For deep partial thickness burns (DPTB) treatment with allografts has no advantage if they have not been previously excised.

Adolescent↗

Late onset of extensive brain damage and hypertension in a patient with high-voltage electrical burns.

An 11-year-old boy sustained high-voltage electrical and flame burns over 85% of his body surface area, 75% of which were full-thickness burns. After 4 months of treatment and multiple operations and skin graftings before his discharge from hospital, he exhibited irritability, hallucinations, and eventually, seizures and respiratory and cardiac arrest. He was resuscitated successfully. Diffuse bilateral brain damage was observed by means of computerized tomography and magnetic resonance imaging. Acute hypertension (up to 290/220 mm Hg) developed the following day. Recovery began 48 hours later. Most clinical symptoms and the hypertension resolved within 1 week. However, the computerized tomographic scans and magnetic resonance imaging findings persisted but were resolved within 2 months. Irritability and low tolerance for frustration were the only remaining symptoms at the time of a 12-month follow-up examination.

Brain↗

Silver-sulfadiazine eschar pigmentation mimics invasive wound infection: a case report.

A 3-year-old girl with 52% TBSA scalds, mostly partial thickness, was treated topically with 5% mafenide acetate solution and 1% silver sulfadiazine cream. All blood cultures and wound swabs were negative for the first 5 days. On day 6 gram-negative bacteria and yeast forms were isolated from her wounds. High fever and leukocytosis were present and the child was treated with intravenous ampicillin and gentamicin according to sensitivity bacteriogram. The bacteria were identified as Pseudomonas aeruginosa and the yeast was Candida tropicalis. On day 7, Escherichia coli was identified in blood cultures and intravenous cefixime was added. Amphotericin B was added on day 9 when blood cultures grew Candida tropicalis and Burkholderia cepacia. On day 13 dark pigmentation foci developed on some areas of partial-thickness burns in the back, resembling invasive wound infection. White blood cell count was 14,300 cells/mm3, and her body temperature reached 39.7 degrees C. Cultures from the pigmented areas were negative, and biopsies revealed deposits of silver. Most of the areas healed uneventfully, and only about 8% TBSA needed grafting, including some of the pigmented areas. No residual pigmentation remained on discharge.

Anti-Infective Agents, Local↗