Search PubMed⌕ Search

Biomedical subjects

D R Graham

Publications and source records attributed to D R Graham.

At least 55 records · Page 3Linked to original sources
PubMed1986

The electrophysiological effects of intravenous xamoterol in man.

The electrophysiological effects of xamoterol were studied in ten patients with suspected coronary artery disease by intracardiac electrography. Sino-atrial and atrioventricular conduction times were both slightly shortened by 0.1 mg/kg of xamoterol. The atrioventricular nodal refractory periods were shortened without consistent change in atrial refractoriness. This dose raised mean blood pressure by only 3 mmHg and resting heart rate by only 4 beats/min. The effects suggest a beta 1 agonist activity closer to that of prenalterol than that of pindolol under conditions of rest.

Adrenergic beta-Agonists↗
PubMed1985

Disk diffusion antimicrobial susceptibility testing for clinical and epidemiologic purposes.

Antimicrobial susceptibility testing is one of the most important and useful tests performed by the clinical microbiology laboratory. The value of disk susceptibility testing in epidemiology is enhanced by its simplicity of performance, reproducibility of results, and ability to indicate whether a single strain is likely to be the cause of many infections. By using a specific set of antimicrobials for either gram-positive or gram-negative bacterial susceptibility testing and by following recommended testing procedures, laboratories can reliably identify similarities and differences in strains. We propose a list of antimicrobial agents chosen specifically for their value in disk susceptibility testing for clinical and epidemiologic purposes and describe the recommended methods of testing.

Anti-Bacterial Agents↗
PubMed1984

Nosocomial meningitis due to Citrobacter diversus in neonates: new aspects of the epidemiology.

Two term neonates born within four days of each other at a small hospital developed sepsis and meningitis caused by a unique strain of Citrobacter diversus not previously reported to cause meningitis. Eleven (27.5%) of 40 other infants admitted to the nursery during the epidemic period developed rectal or umbilical colonization by C. diversus. Contact soon after birth with either of two nurses was more common among infected or colonized infants than among infants who were not infected or colonized. Hand cultures of both nurses and a rectal culture of one of the nurses yielded the epidemic strain. C. diversus may have been introduced into the nursery by the rectal carrier and spread person to person. Six weeks later continued surveillance identified a second cluster (of four colonized infants) associated with a mother who was a carrier of C. diversus and whose newborn infant became colonized at birth. The outbreak ended after strict control measures were used.

Carrier State↗
PubMed1983

Outbreak of pyrogenic reactions at a dialysis center. Association with infusion of heparinized saline solution.

Twenty-three pyrogenic reactions occurred in 16 patients undergoing hemodialysis at a private dialysis center in the south central United States between November 23 and December 2, 1978. No deaths were attributed to reactions; however, 10 patients were hospitalized for observation after experiencing a reaction. Cultures of all blood specimens obtained from the patients gave negative results. Chills (75 percent), nausea and/or vomiting (30 percent), and fever (90 percent) were the most common signs and symptoms, with mean times of onset after starting dialysis of 1.1, 1.6, and 3.6 hours, respectively. An epidemiologic and laboratory investigation documented that reactions occurred only in patients who had anticoagulation with a dilute solution of heparin. Analyses of heparinized saline solution used during the outbreak revealed a bacterial count of 7.4 X 10(5)/ml and a bacterial endotoxin level of 1,300 ng/ml. Acinetobacter calcoaceticus var. Iwoffi was isolated from the solution. Diluted heparin solution was prepared at the dialysis center by adding commercially supplied sodium heparin to 0.9 percent sodium chloride infusion fluid. Bacteria and endotoxin were not detected in vials of stock heparin and bags of unopened 0.9 percent sodium chloride infusion fluid. We concluded that contamination of the solution occurred at the dialysis center. After changes in the preparation and use of heparin were instituted on December 4, 1978, no pyrogenic reactions occurred in more than 400 subsequent dialyses.

Acinetobacter↗
PubMed1982

Streptococcal wound infections caused by a vaginal carrier.

During a four-month period, ten cases of group A streptococcal (GAS) postoperative wound infection occurred among patients in a community hospital. Bacteremia developed in two patients, and one patient died. Group A streptococcal surgical wound infections were associated with exposure to a circulating nurse and duration of surgery. Prophylactic antibiotic reduced the risk of infection. Vaginal, perineal, and anal cultures from nurse A yielded GAS, serotype M-4, T-4, as did the blood of two infected patients. Penicillin eradicated GAS colonization of nurse A, and she returned to work. Five months later, two additional cases of GAS postoperative wound infections occurred and were associated with recolonization of the same nurse with GAS, serotype M-nontypeable, T-12. She was relieved of patient-care duties, and no further cases have occurred.

Anal Canal↗
PubMed1982

Toxic shock syndrome associated with surgical wound infections.

In 13 cases of toxic shock syndrome (TSS) associated with postoperative wound infections, clinical findings were similar to those observed in cases of TSS in menstruating women. While local signs of a surgical wounds infection were minimal, Staphylococcus aureus was recovered from cultures of wounds in 12 of 12 patients; multiple blood cultures were negative for 11 of 11 patients. Toxic shock syndrome due to surgical wound infections accompanied a wide variety of surgical procedures in both men and women and was not necessarily associated with menstruation in women. The median interval between surgery and onset of TSS was two days. Toxic shock syndrome can develop in association with surgical wound infections caused by S aureus and should be considered in the differential diagnosis of postoperative fever and hypotension.

Adolescent↗
PubMed1981

Citrobacter diversus brain abscess and meningitis in neonates.

Brain abscess is an infrequent complication of meningitis, including cases caused by Gram-negative enteric bacteria in neonates. Because brain abscesses recently developed in four of five neonates with Citrobacter diversus meningitis at one institution, we reviewed cases of C diversus meningitis reported in the literature and those enrolled in the Neonatal Meningitis Cooperative Study Groups and reported to the Centers for Disease Control. Seventy-four cases in neonates were identified, and a brain abscess had developed in 41 (77%) of 53 patients for whom the information was available. This high frequency indicates the need for rapid diagnosis of this complication of C diversus meningitis.

Brain Abscess↗