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Biomedical subjects

C W Lewis

Publications and source records attributed to C W Lewis.

At least 37 records · Page 2Linked to original sources
PubMed1996

A pityriasis rosea-like eruption secondary to bacillus Calmette-Guérin therapy for bladder cancer.

The use of bacillus Calmette-Guérin (BCG) for the treatment of bladder cancer has been followed by reports documenting adverse reactions. Eruptions of the skin have been included (although not well described) in the list of side effects. We report a pityriasis rosea-like rash secondary to BCG therapy for bladder cancer. Although the treatment was interrupted because of this reaction, the medication was restarted later with only a mild transient recurrence of the eruption.

Adjuvants, Immunologic↗
PubMed1995

Drug-nutrient interactions in three long-term-care facilities.

OBJECTIVE: To assess the risk of drug-nutrient interactions (DNIs) in three long-term-care facilities. DESIGN: Retrospective audit of charts. SETTING: Three long-term-care facilities in central New York State. SUBJECTS: Fifty-three patients selected randomly from each facility. MEASUREMENT: Data were collected from the medical record of each patient for a period of 6 months. A computerized algorithm was used to assess the risk for DNIs. Mean drug use, most frequently consumed drugs, incidence of potential DNIs, and the most commonly observed potential DNIs are reported. RESULTS: In facilities A, B, and C, respectively, patients consumed a mean of 4.86, 4.04, and 5.27 drugs per patient per month and were at risk for a mean of 1.43, 2.69, and 1.43 potential DNIs per patient per month. The most commonly observed potential DNIs were gastrointestinal interactions affecting drug bioavailability and interactions affecting electrolyte status. CONCLUSIONS: Patients in long-term-care facilities, who are primarily elderly and chronically ill and who consume multiple medications, are at notable risk for certain DNIs. Efforts need to be made to ensure appropriate pharmacologic and nutrition therapies as well as adequate and timely monitoring of patients in these facilities. Dietitians can play an important role in training other health professionals and in designing policies to prevent DNIs.

Aged↗
PubMed1995

Management of pseudofolliculitis barbae.

Pseudofolliculitis barbae is a common dermatologic conditions primarily affecting black men who shave closely on a regular basis. Figures cited in the literature indicate 10 to 83% of black men have some form of it. Commonly encountered in the military, pseudofolliculitis barbae has caused significant problems in all commands, both medically and administratively. This article will review the pathogenesis of pseudofolliculitis barbae and provide a variety of treatment modalities. Proper treatment is essential to avoid unnecessary scarring, pigmentation, and keloid formation.

Barbering↗
PubMed1993

The effects of local ventricular pacing on recovery from regional myocardial ischemia.

After surgical revascularization of ischemic myocardium, temporary ventricular pacing is often used, yet no data exist to indicate whether pacing ischemic versus nonischemic myocardium affects myocardial recovery. Therefore, chronically instrumented conscious dogs were studied with segment length transducers in the left anterior descending (LAD) distribution, left ventricular and pericardial micromanometers, pneumatic occluders on the LAD and venae cavae, and bipolar ventricular pacing wires, one pair in the LAD zone and one pair in the nonischemic (LCX) zone. Six dogs underwent a total of twelve 15-min LAD occlusions, each followed by 48 hr of reperfusion. Just after reperfusion, either the LAD or LCX zone was paced at 150 bpm for 45 min. LAD versus LCX pacing decreased regional stroke work (6 +/- 5 versus 19 +/- 5 kerg.cm-2) and produced contractile asynchrony. Myocardial contractile function was assessed using preload recruitable work area (PRWA), the area under the regional stroke work versus end-diastolic length relationship. Relative to LCX pacing, LAD pacing significantly delayed the recovery of PRWA after 4 hr of reperfusion (54 +/- 9 versus 83 +/- 9% control PRWA, P < 0.05). Perhaps by increased contractile asynchrony despite the decreased regional stroke work, ventricular pacing of ischemically injured myocardium delays functional recovery and should be avoided in clinical settings where the ventricular pacing site may be chosen.

Animals↗
PubMed1993

Regional geometry and function during myocardial ischemia and recovery.

To define the effects of altered left ventricular (LV) geometry on regional myocardial function during ischemia and recovery, regional and global LV geometry and transmural pressure (P) were measured in seven conscious dogs with sonomicrometry and micromanometry. Data were obtained at steady state and during rapid vena caval occlusion (VCO) under control conditions, after 15 min of left anterior descending occlusion, and after 1, 4, and 24 hr of reperfusion. Regional midwall minor axis (MA) Lagrangian strain (epsilon) and stress (sigma) were calculated from measured MA segment length (L), MA midwall radius, and wall thickness. Unstressed regional geometry was quantified using L0, the value of L at P = 0 during maximal VCO. Conventional (SWL) and normalized (SW sigma epsilon) regional MA stroke work were calculated for each cardiac cycle as the area of P vs L and sigma vs epsilon relationships, respectively. Regional Frank-Starling mechanisms corrected for changes in unstressed LV geometry were quantified as the slope (M sigma epsilon) of the linear end diastolic epsilon vs SW sigma epsilon relationship for data obtained during VCO (mean r = 0.98). M sigma epsilon returned to baseline levels within 1 h of reperfusion (P = 0.314 vs control). In contrast, 15 min of ischemia increased L0 by 15.2 +/- 2.5% (P < 0.05), which remained increased 5.7 +/- 1.7% above control values after 1 hr of reperfusion (P < 0.05). Both steady-state SWL and SW sigma epsilon decreased with ischemia and slowly returned towards baseline, remaining 28.7 +/- 7.5% and 26.4 +/- 6.3% below control values after 1 hr of reperfusion (both P < 0.05). Therefore, late functional recovery from reversible ischemic injury is primarily correlated with reversal of changes in regional geometry, specifically the reversal of diastolic creep. As a result, adequate quantification of postischemic regional myocardial performance requires characterization of changes in regional geometry as well as indicators of Frank-Starling mechanisms.

Animals↗