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Biomedical subjects

D B Louria

Publications and source records attributed to D B Louria.

At least 55 records · Page 3Linked to original sources
PubMed1988

Comparison of ticarcillin plus clavulanic acid with clindamycin and gentamicin in the treatment of postcesarean endomyometritis.

The efficacy of a single antibiotic--Timentin (ticarcillin with clavulanic acid)--was compared with a standard two antibiotic regimen (clindamycin and gentamicin) for the treatment of endomyometritis after cesarean delivery. The regimens were 3 grams of ticarcillin plus 100 milligrams of clavulanic acid given intravenously every four hours, or 600 milligrams of clindamycin given intravenously every six hours plus 3 to 5 milligrams per kilogram per day of gentamicin given intramuscularly. The diagnosis of endomyometritis was based upon an oral temperature of 100.4 degrees F. or higher on any two occasions, excluding the first 24 hours post partum, uterine tenderness and the absence of another focus of infection. Ninety-one patients were treated. Treatment failure rates were three of 49 in the clindamycin and gentamicin group and four of 42 of the ticarcillin plus clavulanic acid group. Treatment failures did not appear to be different from successes demographically or in risk factors for endomyometritis. The results of this study suggest that ticarcillin with clavulanic acid is as effective in the treatment of postcesarean endomyometritis as the standard regimen of clindamycin and gentamicin.

Adult↗
PubMed1987

Zinc and immunocompetence in the elderly: baseline data on zinc nutriture and immunity in unsupplemented subjects.

Zinc nutriture and immune function were studied in 100 subjects, age 60-89 yr. Mean (+/- SD) zinc concentrations found were 84.8 +/- 15.5 micrograms/dL (13.0 +/- 2.4 microM) for plasma, 1.04 +/- 0.24 micrograms (0.016 +/- 0.004 mumol)/10(9) cells for erythrocytes, 4.06 +/- 1.85 micrograms (0.062 +/- 0.028 mumol)/10(9) cells for mononuclear cells, 3.91 +/- 1.77 micrograms (0.060 +/- 0.027 mumol)/10(9) cells for polymorphonuclear leukocytes, 0.53 +/- 0.39 micrograms (0.0081 +/- 0.0060 mumol)/10(9) cells for platelets, and 222 +/- 101 micrograms (3.39 +/- 1.54 mumol)/g for hair. Zinc ingestion was below the RDA in more than 90% of study subjects. The incidence of anergy to a panel of seven skin test antigens was 41%; responses to these antigens were significantly associated with the plasma zinc concentration. Subjects with depressed lymphocyte responses to mitogens had significantly lower platelet and significantly higher mononuclear cell zinc concentrations than those with normal responses.

Aged↗
PubMed1986

Single-dose trimethoprim-sulfamethoxazole prophylaxis for cesarean section.

Single-dose trimethoprim-sulfamethoxazole prophylaxis after clamping of the umbilical cord decreased the rate of endomyometritis in high-risk patients by 50% when compared with placebo. This drug combination may affect the normal flora of the cervix the least so that superinfections should be rare.

Adolescent↗
PubMed1986

Staphylococcal infections in aging mice.

Aging (17 to 22 months old) and young (1 1/2 to 2 months old) mice were infected with 5 X 10(7) staphylococci. Twenty-eight-day mortality was 70% in senescent mice and 14.3% in young mice. Phagocytosis and intracellular killing of staphylococci by polymorphonuclear leukocytes and mononuclear cells and leukocyte mobilization were studied after intraperitoneal infection. Intracellular killing by polymorphonuclear leukocytes was slightly more effective in young mice but older mice mobilized about twice as many polymorphonuclear leukocytes in a 4-hour period. In older mice the lethality of intraperitoneally-administered staphylococcal toxins and salmonella endotoxin was markedly increased, the mortality rates in old and young mice being virtually identical to those found after intravenous infection with living staphylococci.

Aging↗
PubMed1985

Comparative clinical evaluation of ticarcillin plus clavulanic acid versus clindamycin plus gentamicin in treatment of post-cesarean endomyometritis.

A new single-antibiotic combination of ticarcillin and clavulanic acid was compared with the standard two-drug regimen of clindamycin and gentamicin in the treatment of post-cesarean endomyometritis. The regimens were as follows: 3 g of ticarcillin plus 100 mg of clavulanic acid intravenously every four hours; or 600 mg of clindamycin intravenously every six hours plus 3 to 5 mg/kg per day of gentamicin intramuscularly. The prospective randomized schedule was calculated such that half the patients were assigned to each treatment group. The diagnosis of endomyometritis was based upon an elevated oral temperature of 100.4 degrees F or higher on any two occasions, excluding the first 24 hours after delivery, uterine tenderness, and the absence of other foci of infection. Lochial discharge was foul in most cases. Forty-seven patients were treated. Treatment was successful in all patients who received clindamycin and gentamicin; ticarcillin plus clavulanic acid failed in two of 23 (9 percent) patients. Patients in whom treatment failed did not appear to be different from those in whom treatment was successful on demographic variables or in terms of risk factors for endomyometritis. The difference between the treatment failure rates was not statistically significant. This study suggests that the single-drug combination of ticarcillin plus clavulanic acid is effective in the treatment of post-cesarean endomyometritis when compared with the standard regimen of clindamycin and gentamicin.

Adolescent↗
PubMed1985

Clusters of cancer mortality in New Jersey municipalities; with special reference to chemical toxic waste disposal sites and per capita income.

The state of New Jersey (NJ), USA, has been thought to have an unusually high cancer mortality rate; this assumption has been based on 1950-1969 mortality data for NJ counties. This study presents an analysis of mortality from major cancers for NJ municipalities during 1968-1977, and correlates cancer mortality rates with several potentially relevant variables. Age-adjusted mortality rates for 13 major cancer sites for 194 municipalities of 10 000 or more people in 21 NJ counties were compared with cancer mortality in the US. Municipality rates were correlated with: distribution of chemical toxic waste disposal sites (CTWDS); annual per capita income; the rates of low birth weight, birth defects and infant mortality of NJ municipalities. Clusters of cancer mortality were observed in 23 municipalities in 10 counties in which a total of 98 age-adjusted cancer death rates were at least 50% above the national rate, and each of these municipalities had at least two race-sex-specific cancers in which the observed number of cancer deaths was greater than the expected number of deaths at the p less than 0.0005 level. Of these 98 excessive cancer death rates, 72% involved the gastrointestinal tract. Most of the municipalities are located in the highly industrialized densely populated northeastern part of the State. Correlation analyses showed a consistent and significant (p less than 0.05) negative correlation between income and cancer mortality in 11 of 12 cancers studied. These analyses also showed a significant positive association between 8 of 12 cancers studied and CTWDS in one or more subgroup populations and lesser associations with birth defects, low birth weight and infant mortality.

Breast Neoplasms↗
PubMed1985

Anterior thigh pain or tenderness. A diagnostically useful manifestation of bacteremia.

In four patients with putative infectious process, anterior, bilateral proximal thigh pain and tenderness unaccompanied by generalized myalgias developed. This unusual manifestation, observed in these and other patients, was associated with demonstrable bacteremia. Aside from tenderness, no local abnormalities were found and the pain and tenderness disappeared after appropriate therapy. Creatine kinase levels, measured in three of the four patients, were elevated in only one. This manifestation is useful clinically as it strongly suggests bacteremia; attention to this finding can be lifesaving.

Abdomen↗
PubMed1985

Comparative clinical evaluation of ceftizoxime with clindamycin and gentamicin and cefoxitin in the treatment of postcesarean endomyometritis.

New third generation cephalosporins have been recommended as single agent antibiotic therapy in the treatment of postoperative infections. This study compares the new third generation cephalosporin ceftizoxime with cefoxitin, clindamycin and gentamicin in the treatment of postcesarean section endomyometritis. The results indicate that the clindamycin and gentamicin regimen is more efficacious in the treatment of severe infection after cesarean section than either ceftizoxime or cefoxitin regimens. Therefore, the results of this study suggest caution in substituting single drug antibiotic therapy with cefoxitin or the third generation cephalosporins for the standard clindamycin and gentamicin regimen in the treatment of postcesarean section endomyometritis until more clinical data are available.

Adult↗
PubMed1984

Symposium on infectious complications of neoplastic disease (Part I). Introduction and epidemiology.

An approach to infections in cancer patients is outlined that divides such infections into those due to underlying disease, those related to underlying disease plus therapy, and those related to therapy alone. The incidence of such infections in each of the categories is discussed, together with a general outline of patterns and trends in regard to involved microorganisms. Several specific areas discussed include: problems of superinfection with newer antimicrobial agents; the current inadequacy of diagnostic techniques; the potential for early treatment with monoclonal antibodies; the potential for augmenting one or more host defenses prior to sundering other defenses during antitumor chemotherapy; the potential value of a variety of nutrients that either may be depleted or might be of benefit in enhancing host defense mechanisms.

Abscess↗
PubMed1984

Bladder cancer mortality in New Jersey counties, and relationship with selected environmental variables.

Age-adjusted mortality rates for bladder cancer were calculated for the 21 New Jersey (NJ) counties (USA) during the period 1968-1977, and compared with the period 1950-1969, with the Surveillance, Epidemiology and End Results (SEER) survey and with cancer mortality in the US 1973-1977. The county rates were also correlated with: the rates of low birth weight, birth defects, infant mortality; chemical waste disposal sites; annual per capital income; per cent of the population working in the chemical industries; density of population and urbanization indices of 21 NJ counties. Age-adjusted bladder cancer mortality rates in 95% of NJ counties were higher than national and SEER area rates. The overall NJ State rates for four subgroup populations were highly significantly (p less than 0.001) greater than the national rates. There was a statistically significant correlation between bladder and lung cancer mortality among females in 21 NJ counties which may suggest a common risk factor--namely cigarette smoking. There was no such correlation between bladder and lung cancer mortality among males. There was a statistically significant association between bladder cancer mortality in individual counties and the percentage of the adult population working in the chemical industries.

Adolescent↗
PubMed1984

Fungal and yeast infections of the central nervous system. A clinical review.

In the past 20 years, there has been a marked increase in the number of reported cases of meningitis and brain abscess due to fungi and yeasts. This increase is due in part to better diagnostic techniques and greater awareness of the possibility of fungal invasion of the nervous system; but the increase can also be attributed to a growing pool of severely compromised hosts, many of whom are undergoing treatment with adrenal glucocorticoids or immunosuppressive agents. The diagnosis and treatment of aspergillosis, blastomycosis, candidiasis, coccidioidomycosis, cryptococcosis, infections caused by dematiaceous fungi, histoplasmosis, paracoccidioidomycosis, petriellidosis, and sporotrichosis, as well as relatively rare infections of the central nervous system caused by other fungi, are discussed. The efficacy of amphotericin B and 5-fluorocytosine in the treatment of CNS fungal and yeast infections is also evaluated.

Adult↗
PubMed1983

Gastrointestinal cancer mortality in New Jersey counties, and the relationship with environmental variables.

The State of New Jersey (NJ) USA has been thought to have an unusually high cancer mortality rate; this assumption has been based on 1950-1969 mortality data for its 21 counties. This paper presents an analysis of gastrointestinal (GI) cancer mortality rates in New Jersey counties during 1968-1977, a comparison with the 1950-1969 rates, and associations between current GI cancer mortality rates and selected environmental variables. Age-adjusted mortality rates for GI cancers were calculated for the 21 NJ counties during the period 1968-1977, and were compared with the period 1950-1969, with the Surveillance, Epidemiology and End Results (SEER) survey and with cancer mortality in the US, 1973-1977. The county rates were also correlated with: the distribution of chemical toxic waste disposal sites; annual per capita income; the rates of low birth weight, birth defects, and infant mortality; chemical industry distribution; percentage of the population employed in chemical industries; the density of population; and the urbanization index for each of the counties. Some of the major findings are: Age-adjusted GI cancer mortality rates (all sites combined) were higher than national rates in 20 of 21 NJ counties. In comparison with national trends, NJ stomach cancer rates have declined less, oesophageal cancer rates have declined more, and pancreatic cancer mortality rates have followed similar patterns. Cancer mortality rates in NJ during the period 1968-1977 significantly (p less than 0.0001) exceeded national rates for cancer of the oesophagus (white male, non-white male), stomach (men and women), colon (white male, white female, non-white female), and rectum (whites only). In 18 of the 21 NJ counties, the observed number of cancer deaths for at least one GI cancer site was significantly greater than expected at the 0.0001 level for at least one population subgroup. Among white men, a significant (p less than 0.0001) excess of observed over expected cancer deaths was observed for three or more GI cancer sites in seven counties. The environmental variables that were most frequently associated with GI cancer mortality rates (except pancreatic cancer) were degree of urbanization, population density, and chemical toxic waste disposal sites. Some of the implications of the study findings are discussed and recommendations made for future investigations.

Adult↗