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Biomedical subjects

G J Parell

Publications and source records attributed to G J Parell.

22 records · Page 2Linked to original sources

Cefazolin prophylaxis in head and neck cancer surgery.

This study evaluated the prophylactic use of cefazolin in reducing the incidence of infection in patients undetgoing cancer surgery where the upper aerodigestive tract was entered from the neck. A prospective, randomized, double-blind design was conducted in a single hospital. The patient was given placebo or cefazolin, 1 gm intramuscularly with the preoperative medications, then 0.5 gm every six hours for four doses. Of 55 determinate patients, 32 received antibiotics and 23 placebo. Infection rate was 38% (12/32) and 87% (20/23) respectively, representing a statistically significant reduction in infection (P less than 0.001/. There were 30 wound and two nonwound (sinusitis and pneumonia) infections. In conclusion, the perioperative use of cefazolin in patients undergoing cancer surgery where the oral cavity or pharynx has been entered from the neck is useful in reducing the incidence of wound infection.

Adult↗

Otolaryngologic aspects of scuba diving.

Among the most common injuries encountered by the 700,000 active sport scuba divers in the United States are sinus and otitic barotrauma. The management of these injuries and the identification of high-risk patients during their required pretraining physical examination are discussed.

Athletic Injuries↗

Prediction of lymph node metastases by lymphoscintigraphy of the neck after peri-cancer injection of a radiocolloid.

Radionuclide imaging is used to evaluate the status of neck nodes preoperatively in small group of patients with oral squamous cell carcinoma. An area adjacent to the carcinoma, and a similar area on the opposite side of the oral cavity, are injected with Technetium (Tc) 99m labeled sulfur minicolloid. Differences in imaging intensity between both sides of the neck is used to predict the presence of metastases. Neck dissection confirms the histologic status of the nodes. The scan correctly predicts the presence of metastases in 100% (2/2) of patients with palpable nodes, and the absence of metastases in 75% (3/4) of patients with clinically tested negative necks.

Carcinoma, Squamous Cell↗

Anaerobic and aerobic bacteriology in head and neck cancer surgery.

A prospective study of wound infections following major head and neck cancer surgery was undertaken to define a rational approach to trials of antibiotic prophylaxis and initial therapy of these infections. Preoperative aerobic cultures were taken from the planned site of skin incision and from the oropharynx. Both aerobic and anaerobic cultures were obtained from all wound infections. Patients receiving prophylactic antibiotics were excluded from the study. The data indicate that preoperative cultures are not usually predictive of the bacteriology of subsequent wound infection. Mixed aerobic and anaerobic flora were cultured from most wound infections, and usually reflected normal anaerobic oropharyngeal flora, exogenously acquired Staphylococcus aureus, or both. Bacteroides fragilis was not cultured in this series. Antibiotics selected for trials of prophylaxis or initial treatment of these infections should cover both the resident oral aerobic and anaerobic flora and S aureus. Coverage for B fragilis does not appear necessary. Antibiotic choices might include penicillin G plus a penicillinase-resistant penicillin or a parenteral cephalosporin.

Anaerobiosis↗