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Biomedical subjects

C Lewis

Publications and source records attributed to C Lewis.

At least 253 records · Page 14Linked to original sources
PubMed1984

Synthesis and antimicrobial activity of clindamycin analogues: pirlimycin, 1,2 a potent antibacterial agent.

The preparation of a series of analogues of clindamycin is described in which the naturally occurring five-membered cyclic amino acid amide portion of the molecule is replaced by a four-, six-, or seven-membered cyclic amino acid amide. The most interesting compound is pirlimycin (7e, U-57,930E), in which the (2S-trans)-4-n-propylhygramide portion of clindamycin is replaced by (2S-cis)-4-ethylpipecolamide. This structural modification results in significantly favorable changes in toxicity, metabolism, and antibacterial potency. Although the in vitro antibacterial activity of clindamycin and pirlimycin are nearly identical, the latter compound is 2-20 times more active than clindamycin when administered to mice experimentally infected with strains of Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae, Bacteroides fragilis, and Plasmodium berghei. Pirlimycin is absorbed in rats and mice following both subcutaneous and oral administration. It readily penetrates B. fragilis induced abscesses in mice and is sequestered within these abscesses. A drug concentration of at least 60 times the required inhibitory concentration is maintained for 6 h following a single subcutaneous dose of 200 mg/kg. Urinary excretion of total bioactivity consists only of intact pirlimycin with no other antibacterially active metabolites being detected. Pirlimycin is tolerated well in rats and mice at the administered levels.

Animals↗
PubMed1984

The syndrome of bulimia. Review and synthesis.

This comprehensive review of the syndrome of bulimia outlines treatment modalities including response prevention, cognitive behavioral and group interventions, and antidepressant pharmacotherapy. The authors propose an etiologic model that synthesizes available data indicating that young women who are at risk for developing bulimia appear to have a biologic vulnerability to affective instability, have family environments that are conflicted and disorganized, and a variety of personality traits that result in low self-esteem and self-regulatory difficulties.

Adolescent↗
PubMed1983

Compliance with cancer therapy by patients and physicians.

Although compliance with treatment regimens has been shown to be a significant problem in many areas of medicine, there are little data quantitatively describing the extent of the compliance problem for cancer patients. Traditionally, compliance has been understood as the degree to which a patient's behavior coincides with the prescribed medical regimen. However, patient behavior may be only one of several factors that determine compliance; other important components may include physician behavior, the patient-physician relationship, and the patient's support system, including family. In this report, we review the literature on cancer compliance in terms of the patient, the physician, and patient-physician relationships. Subgroups of patients are identified as appropriate for compliance research, and methodologic considerations and research strategies are explored.

Adolescent↗
PubMed1983

Influence of a "discharge interview" on patient knowledge, compliance, and functional status after hospitalization.

Physicians commonly assume that they can educate hospitalized patients to follow prescribed treatment plans after discharge. In a prospective, controlled study, we assessed the effectiveness of a discharge interview given to each of 545 hospitalized patients assigned to one of four groups: a group in which the physicians caring for the patients received a 35-minute tutorial on how to conduct a discharge interview (n = 181), a group that received a 15-minute discharge interview from an investigator (n = 53), a group that received both interventions (n = 63), or a control group (n = 248). One month after discharge, all patients were telephoned, and a standardized questionnaire was administered. Results revealed that, 1 month after discharge, there were no significant differences among the four groups in knowledge of diagnosis, symptom status, activity level, medication knowledge and compliance, appointment keeping, and rates of rehospitalization. These results suggest that effective inpatient education may require more than a discharge interview.

Evaluation Studies as Topic↗
PubMed1983

Pediatric viral gastroenteritis during eight years of study.

During the period January 1974 through July 1982, fecal samples from 1,537 pediatric inpatients with gastroenteritis were tested for enteric viruses by electron microscopic and rotavirus enzyme-linked immunosorbent assay techniques. Rotaviruses were detected in 34.5% of these patients, enteric adenoviruses were detected in 4.7%, approximately 27-nm viruses were detected in 1.6%, and at least one of these agents was found in 40.1% of the study subjects. Three infections were by an apparently new agent which morphologically is a rotavirus, but which failed to react in the rotavirus enzyme-linked immunosorbent assay. During the first 8 calendar years of study, rotaviruses were detected in 39.0% of 577 patients in the even-numbered years and 30.3% of 702 patients in the odd-numbered years. Adenoviruses were found in all calendar months. Rotaviruses were found in inpatients in November through July, whereas approximately 27-nm viruses were found in October through June. The percentage of patients who had a demonstrated viral infection rose steadily from 7.4% in September to 72.0% in January and then steadily declined to 2.9% in August. Viral infection was especially common in study subjects who were 7 through 24 months of age; 61% of such children had one or more enteric viruses. Rotavirus-infected patients tended to be younger during the months of greatest rotavirus activity than at the beginning and end of the rotavirus season, presumably because of a greater exposure to virus at the height of the rotavirus outbreak.

Adenoviridae Infections↗
PubMed1982

Metronidazole phosphate--a water-soluble prodrug for parenteral solutions of metronidazole.

To develop a parenteral solution of relatively water-insoluble metronidazole (2-methyl-5-nitro-1H-imidazole-1-ethanol), its phosphate ester was synthesized via two routes. One route utilized 2-cyanoethyl phosphate and the other utilized pyrophosphoryl tetrachloride. The first method used dicyclohexylcarbodiimide as a coupling agent and the cyanoethyl group was removed under mild alkaline conditions. The second method was a one-step procedure in which free acid of metronidazole phosphate was isolated as a crystalline solid. The solubility of metronidazole in various solvents was determined at 25 degrees. From the pH-dependence of its aqueous solubility, the pKa of the conjugate acid of metronidazole was estimated to be 2.62, which agreed well with the pKa values of other nitroimidazoles. Metronidazole phosphate behaved as a zwitterionic compound in an acidic medium with a minimum solubility at pH 2.0. At pH 7, its solubility was approximately 50 times that of metronidazole. The phosphate ester was so soluble at pH higher than 7 that it was difficult to measure the solubility accurately. In human serum, the hydrolysis of metronidazole phosphate followed zero-order kinetics at an initial concentration of 0.25 mg/ml or higher, presumably due to enzyme saturation (0.035 mg/ml/hr at 37 degrees). A reversed-phase HPLC procedure was adopted to monitor the appearance of metronidazole and the disappearance of metronidazole phosphate. Subcutaneous administration of metronidazole phosphate to rats produced a blood level of bioactivity comparable to that observed after administration of metronidazole.

Animals↗
PubMed1982

Management of stage I carcinoma of the uterus.

In an attempt to limit the use of adjuvant irradiation in the management of stage I endometrial carcinoma to high-risk patients only, a protocol was developed that utilizes grading and degree of myometrial invasion as indicators of high risk. From 1974 to 1977, 140 patients at Rochester General Hospital were treated according to this protocol. All patients had total abdominal hysterectomy and bilateral salpingooophorectomy. Adjuvant irradiation was given only to the patients who had grade 3 curettings or greater than one third myometrial invasion. In this series only 20.7% required irradiation. There were no vaginal or pelvic recurrences and the 5-year tumor-free survival rate was 93%.

Adenocarcinoma↗