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Biomedical subjects

H C Smitherman

Publications and source records attributed to H C Smitherman.

2 recordsLinked to original sources

Altered bleeding time associated with ibuprofen and zidovudine use.

The purpose of this article is to describe a patient who was HIV-positive, had a massive venous ulcer, and developed a prolonged bleeding time with marked blood loss from the ulcer. The patient underwent a workup to rule out possible causes for this prolonged bleeding time; all studies were negative. A review of his history identified that he was self-medicating with ibuprofen while taking zidovudine. A potentiated effect of these two medications on the bleeding time has been reported in the literature. This case illustrates the importance of revisiting a patient's history while working up an acute problem as well as clinically monitoring for blood loss if a person takes ibuprofen and zidovudine.

Adult↗

Diskitis in children.

Thirty-six patients diagnosed with diskitis from 1978 to 1988 and followed for an average of 29.2 months were reviewed. The study included 23 boys and 13 girls with an average age of 5.3 years. The initial symptoms varied, but distinct clinical patterns emerged and were identifiable in different age groups. Both the leukocyte count and sedimentation rate were elevated. Routine roentgenograms were positive for intervertebral disk space narrowing in 82% of cases, technetium bone scans positive in 72%, and magnetic resonance imaging positive in all recent cases. Treatment consisted of bed rest for all patients, plaster casts for 50%, antibiotics for 40%, and traction for 23%. Regardless of the treatment combination, the course of the disease in most children is benign. At the completion of the study, all patients were asymptomatic including three children who had recurrences. In spite of being asymptomatic, 74% had persistent roentgenographic changes. The administration of antibiotics appears to be appropriate when indicated, i.e., failure to respond to immobilization. Disk space aspiration or biopsy should be reserved for those cases that are refractory to immobilization and antibiotics.

Adolescent↗