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Biomedical subjects

C K Avent

Publications and source records attributed to C K Avent.

10 recordsLinked to original sources

Clinical evaluation of moxalactam.

We investigated the clinical efficacy of moxalactam for treatment of a variety of infectious disorders in 50 patients (38 males and 12 females). Patient ages ranged from 8 days to 98 years, with a median of 66 years. Infectious disorders were confirmed by isolation of etiological bacteria in all patients. Thirty-eight patients had gram-negative bacillary disease, nine had pneumococcal infection, and three had disorders caused by staphylococci or streptococci. Twenty-three patients had pneumonia, 17 had bacteremic diseases other than pneumonia, and 10 had miscellaneous infectious diseases. The overall efficacy of moxalactam was excellent. Forty-eight patients were cured by clinical criteria, and 45 were cured by bacteriological criteria. A total of 19 adverse reactions were associated with the use of moxalactam in 18 patients, but none were severe and only one necessitated discontinuation of treatment. Moxalactam promises to be an important addition to our therapeutic armamentarium, especially for therapy of gram-negative bacillary infections.

Adolescent↗

Penetration of spectinomycin into cerebrospinal fluid duirng experimental meningitis.

The concentration of spectinomycin in serum and cerebrospinal fluid was compared in rabbits with and without experimental pneumococcal meningitis. When injected intravenously, spectinomycin could not be detected in the cerebrospinal fluid of normal rabbits. In rabbits with meningeal inflammation, however, spectinomycin penetrated the blood-brain barrier and produced significant cerebrospinal fluid concentrations, equal to or well above spectinomycin minimal inhibitory concentrations for many bacterial species.

Animals↗

Simple primary tuberculosis in an elderly woman.

The diagnosis of primary tuberculous infection was made in a 78-year-old woman. The chest roentgenographic findings were remarkably similar to those often seen in children and adolescents with primary infection. Like the majority of adults with this entity, the patient was asymptomatic; the diagnosis was suspected epidemiologically and was confirmed by culture of M. tuberculosis from the sputum. As the incidence of new tuberculosis cases declines, the diagnosis of primary tuberculosis in the adult may be made more frequently.

Age Factors↗

Ketoacidosis.

The pathogenesis and treatment of diabetic ketoacidosis has been discussed. Insulin deficiency leads to increased rates of hepatic ketogenesis and gluconeogenesis with resultant hyperglycemia and ketonemia. Treatment consists of insulin and fluid replacement. Insulin therapy is titrated against the change in blood glucose concentration. Isotonic saline is the initial replacement fluid, and potassium is administered as required. Bicarbonate is employed in extreme acidosis, but its administration may contribute to the development of hypokalemia, CSF acidosis, and tissue hypoxia. It is hoped that a better understanding of the biochemical basis of ketoacidosis will permit the physician to develop a rational therapeutic regimen which will decrease the mortality associated with this condition.

Bicarbonates↗

Ampicillin and tetracycline in the treatment and prophylaxis of chronic bronchitis.

Ampicillin and tetracycline, in doses of 2 g a day, were compared in the treatment of acute exacerbations of chronic bronchitis. Seventy-nine patients were followed for 3 to 29 months and were treated for 118 exacerbations. Clinical improvement occurred after 10 days of treatment with either drug in over 80% of the cases. Haemophilus influenzae and Diplococcus pneumoniae were eradicated from the sputum more than 60% of the time, but in general there was a poor correlation between bacteriological clearing and clinical response. The effect of chemoprophylaxis with ampicillin and tetracycline in doses of 1 g a day on the frequency of acute exacerbations of bronchitis was compared with that of a placebo. Seven hundred eighty prophylactic regimens, consisting of one capsule every 12 hr for 5 days beginning with the first sign of a cold, were prescribed for 76 patients. Irrespective of the regimen, an acute exacerbation of bronchitis was encountered at approximately 13% of the follow-up visits to the clinic.

Ampicillin↗

Bacterial contamination of tube-feeding formulas.

Bacterial cultures were made on tube-feeding formulas provided to 35 unselected adult patients on termination of the infusion. Bacteria were counted and identified using routine procedures. Formulas were classified as nonmanipulated, manipulated, or locally prepared. Medical records were reviewed to determine if diarrhea was present during the period that included 2 days on either side of the sampling day. A significant association was observed between the extent of bacterial contamination and the presence of diarrhea (p = 0.027). Locally prepared and manipulated formulas contained a significantly greater number of organisms when compared to nonmanipulated formulas (x2 = 17.81, p less than 0.001). Counts for two baseline and four termination cultures on locally prepared formulas exceeded the acceptable limit for coliform organisms in pasteurized milk according to public health standards. Eight additional cultures on commercial feeding formulas which were presumably sterile initially, exceeded these standards at the end of the administration period. Thus 12 of 35 formulas (34%) would not meet public health standards applicable to pasteurized milk. Use of sterile nonmanipulated formulas in a closed administration set is recommended, along with routine, periodic bacteriologic surveillance of enteral feeding programs.

Adult↗