Biomedical subjects
C S Bryan
Publications and source records attributed to C S Bryan.
Bacteremia in obstetrics and gynecology.
Surveillance of all episodes of bacteremia in the four major hospitals of a metropolitan area of 400,000 population between 1977 and 1981 revealed that bacteremia was documented in only 92 patients on obstetrics and gynecology services. Death was attributed to bacteremia in only four of these patients, three of whom had severe underlying diseases. These data confirm that death due to bacteremia in present-day obstetric and gynecology practice is extremely uncommon.
The hospital tuberculosis registry: an aid to infection control.
Maintenance of a "central tuberculosis registry" has been proposed to facilitate communication between hospital personnel and other persons such as members of health departments and practicing physicians involved in the care of patients. A 5-year experience revealed additional benefits: (1) recognition, and partial correction, of deficiencies in tuberculin testing; (2) recognition and termination of a pseudoepidemic of false positive acid-fast bacilli smears; (3) increased frequency with which patients were placed in respiratory isolation at the time of admission to the hospital; and (4) decrease in the indicence of tuberculin conversions among hospital employees. It is suggested that such a registry should be included in all hospital infection control programs.
Ocular syphilis. Acute and chronic.
We describe our experience over the past 2 years with the ocular manifestations in 32 patients with acute and chronic syphilis. We urge that syphilis be considered in evaluating those patients with recurrent iritis, chorioretinitis, papillitis, optic atrophy, or abnormal pupillary findings. Specific serologic testing (FTA-ABS) must be obtained. Screening serologies (VDRL) are inadequate. We suggest that patients with evidence for CSF involvement or active ocular disease be treated by continuous intravenous infusion of 24 million units penicillin G daily for 10 days.
Comparison of cefamandole and cefazolin during cardiopulmonary bypass.
In a randomized comparison, concentrations of cefazolin were found to exceed those of cefamandole in serum, atrial appendage, and sternal bone in patients undergoing cardiopulmonary bypass. No postoperative infections and no antibiotic-related complications occurred in either patient group.
Bacteremia associated with decubitus ulcers.
We studied 104 episodes of bacteremia in 102 patients with decubitus ulcers observed over five years in the hospitals of one metropolitan area. The ulcers were considered to be the "probable" source of bacteremia in 49% of episodes. Another site of infection was documented in 86% of patients. Proteus mirabilis, Staphylococcus aureus, and Escherichia coli were the most frequent blood isolates in these patients, but only Bacteroides species correlated with "probable" origin of bacteremia from the ulcers. The overall mortality was 55%, with 51% of deaths being attributed to infection. These findings emphasize the importance of decubitus ulcers as potential sources of bacteremia in hospitalized patients.
Whither primary care?
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AIDS in South Carolina.
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Cure of anaerobic brain abscess with minimal surgical intervention.
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Chiropractic legislation: two broken records.
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Implementing control measures.
Implementation is the means by which a favorable infection control policy leads to a favorable result (low infection rate). Determination of endemic infection rates by traditional surveillance (outcome surveillance) may, in many situations, be a relatively insensitive method for identifying suboptimal implementation practices. Surveillance of the practices themselves (process surveillance) may identify situations likely to lead to unfavorable results and thus provide early feedback to personnel. Innovative approaches to process surveillance are needed in order to enhance motivation.
Eosinophiles in sputum.
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"Wellness" - new catchword or novel concept?
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Broussais in Columbia, South Carolina - 1831.
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Unread tuberculin tests.
Serial audits of tuberculin skin testing at a community teaching hospital indicated an ongoing need for standardization and quality control.
Petriellidium boydii infection of the sphenoid sinus.
Petriellidium boydii infection of the sphenoid sinus in a previously healthy woman was initially diagnosed by immunofluorescent staining of biopsy tissue sections. The diagnosis was confirmed by demonstrating P. boydii precipitins in serum and by isolating the infecting fungus. Despite surgical drainage and intensive therapy with miconazole nitrate, the outcome, because of intracranial extension, was fatal.
Communicating hydrocephalus caused by Aspergillus flavus.
A patient with a past history of sporadic parenteral drug abuse had communicating hydrocephalus associated with arachnoiditis over the lumbar spinal cord. The diagnosis of aspergillosis was made by a newly described immunofluorescent staining procedure and was later confirmed by culture. The spectrum of central nervous system aspergillosis associated with drug abuse is reviewed.
Drug-resistant bacteria: implications for community hospitals and practicing physicians.
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