Autoimmune islet damage mediated by insulin-specific T cells.
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Animals↗
Biomedical subjects
D Daniel
Publications and source records attributed to D Daniel.
The fetid foot: lower-extremity infections in patients with diabetes mellitus.
Infections of the lower extremities in patients with diabetes mellitus have been attributed to Staphylococcus aureus and other facultatively anaerobic bacteria. However, a review of 30 consecutive diabetics who required surgery for lower-extremity infections revealed that 17 had mixed infections due to both obligate and facultative anaerobes; only six had infections due to S. aureus. Mixed infections often had characteristics of anaerobic suppuration and responded poorly to therapy. Patients with mixed infections required more operations than did those with staphylococcal infections, and their surgical wounds healed more slowly. Seven patients had infections with mixed enteric bacteria (neither anaerobes nor S. aureus), and their response to therapy was intermediate between that of the patients with mixed anaerobic infections and those with staphylococcal infections. Nine additional patients with mixed anaerobic infections were treated with cefoxitin; three required amputations at a level above the ankle, but six patients improved and required only limited surgery that preserved foot function. Bacteroides fragilis was the anaerobe isolated most often. Cefoxitin (less than or equal to 20 micrograms/ml) inhibited all of the anaerobes isolated from the nine patients and 97% of an additional 135 consecutive clinical isolates of B. fragilis; 98% of 54 strains of Bacteroides oralis and all of 34 strains of Bacteroides melaninogenicus were also inhibited. These in vitro results and the results of our clinical study show that cefoxitin is a promising antibiotic for therapy of foot infections due to a mixed flora of anaerobes in diabetics.
Aged↗
The effect of continuous passive motion on anterior cruciate ligament reconstruction stability.
This study was undertaken to examine the immediate effect of continuous passive motion (CPM) on anterior cruciate ligament (ACL) reconstruction stability. Cadaver knees were tested with a knee arthrometer with the anterior cruciate intact and then with the anterior cruciate sectioned. One of three anterior cruciate reconstructions was then performed and stability was restored to the knee and it was again tested with the knee arthrometer. Stability was defined as being within 2 mm of the intact measurement. The three operations selected were the Marshall-MacIntosh "over-the-top," (OTT) a patellar bone-patellar tendon-tubercle bone (BTB) graft, and a semitendinosis reconstruction. The specimens were placed on a CPM device in a cooler at 38 degrees F and put through a range of motion of 20 to 70 degrees at 10 cycles per minute for 3 days. A success was less than a 2 mm increase in the post-CPM measurement compared to pre-CPM. All three bone-tendon-bone operations failed. The semitendinosis operation was successful in only three out of eight specimens. The OTT operation was successful in eight out of nine specimens. The possible reasons for success and failure are discussed. Because of the potential problems with failure of an ACL with CPM it is suggested that the particular technique being used for an anterior cruciate reconstruction be tested prior to it being used with CPM clinically.
Humans↗
Treatment outcomes in acute exacerbations of chronic bronchitis: comparison of macrolides and moxifloxacin from the patient perspective.
Moxifloxacin, a new respiratory quinolone, was compared with the macrolides azithromycin, clarithromycin and roxithromycin in a cohort study to assess clinical, safety and health-related outcomes of these antimicrobials in general practice settings. In total 332 patients with acute exacerbations of chronic bronchitis (AECB) each received one of the antimicrobial agents for a standard short course of therapy. Random allocation of therapeutic agents occurred by centre, not individuals, and the drugs were prescribed in an open manner. In addition to clinical evaluation by their physicians, all patients kept daily diaries to assess AECB symptoms over the study period, therapy received and quality of life. The overall clinical response rate was 96% and all four regimens were well tolerated. After 14 days there were no significant differences between the study groups, but analyses of patients' daily evaluations of certain AECB specific symptoms showed a faster response rate in the moxifloxacin group.
Acute Disease↗
The documentation dilemma: an integrated solution.
Every home healthcare manager must contend with the demands of documentation. One approach to ensure quality and address staff concerns is presented.
Aged↗
The variable effects of LSD-25 on the behavior of a heterogeneous group of childhood schizophrenics.
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Adolescent↗
Effect of salicylate therapy on cartilage destruction in experimental pyarthrosis.
An experimental rabbit pyarthrosis model was utilized to investigate the effects of sodium salicylate therapy on cartilage destruction. Animals were innoculated with 10(3) organisms of Staphylococcus aureus 502A. The opposite knee was injected with sterile saline. Infection was documented 48 hours post innoculation, procaine penicillin therapy initiated, and the adequacy of therapy evaluated at sacrifice. One half of the animals began salicylate feedings one week prior to injection and this continued until sacrifice at 14 or 49 days. Salicylate levels were 12.5 +/- 6.9 mg %. There was a significant loss of cartilage in both the salicylate treated and untreated animals. The levels of salicylate obtained in this study were not protective to cartilage in a septic joint.
Animals↗