Biomedical subjects

D P Sealy

Publications and source records attributed to D P Sealy.

5 recordsLinked to original sources

PubMed1995

An evaluation of the safety and efficacy of fluconazole in the treatment of onychomycosis.

Sixteen subjects were enrolled in this open-label noncomparative study to evaluate the safety and efficacy of fluconazole as a single daily dose for a period of 6 months. Liver function enzymes were monitored to assess safety. An adverse function questionnaire was used on a monthly basis to assess patient tolerance. A visual analogue scale was used to assess efficacy of treatment. After 6 months of fluconazole, all subjects experienced improvement in the appearance of their nails. None of the subjects evidenced any elevation in liver function enzymes. Adverse reactions were limited and consistent with other studies involving fluconazole. Fluconazole proved to be safe and efficacious in the treatment of onychomycosis. Further studies are needed to determine a cost-effective dosing regimen for the treatment of onychomycosis with fluconazole.

Adult↗

PubMed1994

Preeclampsia: progress and puzzle.

Preeclampsia is a major cause of maternal and fetal morbidity and mortality. It remains a management challenge despite recent advances in the understanding of the pathophysiology of this condition and its prevention, and it remains a major cause of maternal and fetal morbidity and mortality. The hallmarks of preeclampsia are proteinuria and edema in a woman who is hypertensive. Current theories suggest altered prostaglandin synthesis, inappropriate sensitivity to angiotensin II and immunologic factors as etiologies of preeclampsia. Low-dose aspirin therapy and high-dose calcium supplementation show promise in preventing preeclampsia and reducing its severity when it occurs. However, aggressive antenatal maternal and fetal assessment, magnesium sulfate therapy and early delivery are the standards of preeclampsia management.

Diagnosis, Differential↗

PubMed1993

The aseptic meningitis syndrome.

The diagnosis and treatment of acute meningitis is a challenge for the primary care physician. Differentiating between bacterial meningitis and aseptic meningitis is not always straightforward. The aseptic meningitis syndrome is usually viral in origin, and enteroviruses account for most cases. The aseptic syndrome also may be caused by unusual bacterial organisms such as Mycobacterium tuberculosis, Leptospira species, Brucella species, Borrelia burgdorferi and others. The classic presentation consists of the acute onset of meningismus, headache, fever, malaise with pleocytosis and normal glucose and slightly elevated protein in the cerebrospinal fluid. Cerebrospinal fluid lactate and serum C-reactive protein measurements may be helpful in differentiating aseptic meningitis from treatable bacterial meningitis. Aseptic meningitis of viral origin usually responds to expectant care. Other causes of aseptic meningitis must be searched for and treated if present.

Clinical Protocols↗

PubMed1983

Endemic giardiasis and day care.

Five surveys of 1,731 children for stool ova and parasites (1971 to 1981) in a rural county provide a unique perspective on naturally occurring, nonepidemic giardiasis. Currently white children in day care centers in Hampton County, South Carolina, experience attack rates of 26%. They enter the first grade with at least six times as much infection as those who do not attend day care. A trend toward more giardiasis linked to working mothers and day care is evident among white preschool children. This has not yet occurred among black preschool-aged children. These and other epidemiologic data indicate that as few as 100 children can maintain endemic levels of infection in a county of 18,000 residents. Person-to-person transmission in the day care setting is sufficient to explain this county's rising rate of stool positivity of infection (8% of all stool specimens submitted to the state laboratory).

Black People↗

PubMed1981

Giardiasis: a common and underrecognized enteric pathogen.

Until the early 1940s, Giardia lamblia was considered by virtually all to be a simple intestinal commensal that benignly fed on small amounts of ingested food, never to cause symptoms or invade tissue. In the past 35 years this organism has established itself, through epidemics in which other pathogens were ruled out, as a fairly common cause of human enteropathology. The most common forms of symptomatic giardial illness present initially to primary care physicians and invariably are diagnosed as "gastroenteritis" with a symptom complex of abdominal upset, diarrhea, cramping, flatulence, and belching. Unlike most enteritides, giardiasis may become chronic and cause severe weight loss, malabsorption, or generalized discomfort. Also, unlike most, the organism is quite sensitive to antimicrobials and may be simply eradicated. Therefore, it is crucial that the index of suspicion for this illness be raised among family physicians, since it may be treated at the primary care level instead of remaining unsuspected until eventually being referred for a major gastrointestinal evaluation.

Feces↗