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Biomedical subjects

I M Baird

Publications and source records attributed to I M Baird.

64 records · Page 4Linked to original sources
PubMed1970

Role of occult blood loss in anaemia after partial gastrectomy.

The present investigation is a study of occult gastrointestinal blood loss in 20 anaemic postgastrectomy patients and 14 control subjects. One patient in the postgastrectomy group was found to be bleeding from undetected haemorrhoids. One patient in each group showed sensitivity to aspirin with greatly increased occult blood loss. The mean blood loss in 18 postgastrectomy patients with unexplained anaemia was 0.6 +/- 0.5 ml/day compared with 0.5 +/- 0.5 ml/day in 13 control subjects. Only two of the 19 anaemic postgastrectomy patients studied lost more than 2 ml blood/day. Aspirin blood loss in 18 postgastrectomy patients was 2.4 +/- 2.1 ml/day, compared with 2.6 +/- 2.7 ml/day in 13 controls. The pattern of aspirin blood loss is identical in both groups. All gastric biopsies obtained from nine patients with Polya gastrectomies showed changes of gastritis; some showed complete gastric atrophy and intestinal metaplasia. Occult gastrointestinal bleeding is not an important factor in the pathogenesis of anaemia after partial gastrectomy unless there is either stomal ulceration or a lesion completely unrelated to the partial gastrectomy. If occult bleeding is present after partial gastrectomy a careful search for the site of bleeding is indicated. Excessive intake of aspirin or increased sensitivity to aspirin was not shown to be a significant factor in the pathogenesis of the anaemia in this group of patients. However, because of the inability to augment iron absorption to compensate for blood loss, it would be inadvisable for the patient with a partial gastrectomy to take a high dosage of aspirin for long periods of time, unless aspirin-induced blood loss is measured and shown to be very low. Aspirin administered in low dosage is not contraindicated after partial gastrectomy.

Adult↗
PubMedDate not supplied

Multicentered study of cefoperazone for treatment of intraabdominal infections and comparison of cefoperazone with cefamandole and clindamycin plus gentamicin for treatment of appendicitis and peritonitis.

Cefoperazone was evaluated for efficacy and safety in the treatment of known or suspected intraabdominal infections. Initially, 59 patients were enrolled in an open, noncomparative study. Of the 35 patients in whom the efficacy of treatment could be evaluated, 32 had a satisfactory clinical response. In this open study, cefoperazone eradicated 62 of 71 pathogens. The safety of the drug was evaluated in all 59 patients. Adverse reactions were seen in nine patients. In the second part of the study, 144 patients were enrolled. Fifty-seven of these patients received cefoperazone, 35 received cefamandole, and 52 received clindamycin plus gentamicin. Therapeutic efficacy could be evaluated in 20 patients who received cefoperazone, 20 who received cefamandole, and 16 who received clindamycin-gentamicin. Satisfactory clinical responses were seen in 90%, 80%, and 100% of these patients, respectively; satisfactory bacteriologic responses were seen in 100%, 95%, and 100%, respectively. A 5% incidence of adverse reactions was observed among the 57 patients who received cefoperazone; in contrast, the rate of adverse reaction to cefamandole was 11%, and that to clindamycin-gentamicin was 11.5%. No differences were seen among the patients in the three groups. Thus, cefoperazone appears to be safe and effective for the treatment of intraabdominal infections of bacterial etiology.

Abdomen↗
PubMedDate not supplied

Prognostic factors in Staphylococcus aureus endocarditis and results of therapy with a penicillin and gentamicin.

Data on 40 patients with Staphylococcus aureus endocarditis treated with appropriate antibiotics in adequate dosage at the University of Cincinnati Medical Center hospitals between January 1961 and June 1975 were analyzed. The overall mortality was 40 per cent. The mortality was 11.1 per cent in patients under 50 years old and 63.6 per cent in patients over 50 years old (p less than 0.01). Seven patients were narcotic addicts who had no underlying disease and were under 50 years old; all survived. For patients without underlying diseases, the mortality was 0 per cent in those under 50 years old and 75 per cent in those over 50 years old. Patients who died had a greater number of major underlying diseases (pre-existing cardiac disease, diabetes mellitus, alcoholism and/or cirrhosis) than the survivors. Patients over 50 years old had significantly more major underlying diseases than patients under 50 years old (p less than 0.001). Among patients over 50 years old, those who died had more complications than the survivors while the number of underlying diseases were comparable. A group of patients treated with gentamicin during the first two to three weeks of therapy in addition to a penicillin was compared to a similar group treated with a single antibiotic. The mortality of both groups was 40 per cent.

Adolescent↗
PubMedDate not supplied

Case report. Clinical manifestations and treatment of Legionnaires' disease.

Eight patients with atypical pneumonia caused by the Legionnaires' disease organism were seen during the spring and summer of 1977. Two died of the acute illness. All patients were febrile and presented with symptoms of acute respiratory infection. Other symptoms included malaise, anorexia, chills, myalgia, and headache. Severe hypoxemia was a striking feature. Conventional methods to determine the etiology of these pneumonias were unsuccessful but subsequent serological studies confirmed the diagnosis of Legionnaires' disease. Seven patients were treated with beta-lactam antibiotics alone or with an aminoglycoside and all failed to respond. Six were subsequently treated with erythromycin and five who received this drug for at least 48 hours were markedly improved within this time period. We believe that erythromycin is effective in the treatment of Legionnaires' disease.

Adult↗
PubMedDate not supplied

Legionnaires' disease with acute renal failure.

We describe two patients with Legionnaires' disease (LD) and acute renal failure not associated with hypotension or therapy with nephrotoxic antibiotics. The first patient ran a fulminant course unresponsive to erythromycin therapy and intensive supportive care including mechanical assisted ventilation and peritoneal dialysis. The second patient recovered after erythromycin therapy and hemodialysis. The clinical course of both patients and the renal pathology of the first patient were compatible with acute tubular necrosis. LD is a disease with many extrapulmonary manifestations. The pathogenic mechanism of acute renal failure in LD is presently unknown.

Acute Kidney Injury↗
PubMedDate not supplied

Case report. Tularemia in Ohio: report of two cases and clinical review.

Although unusual, human tularemia continues to be reported from areas of the United States which are not heavily endemic for the disease. Two patients with ulceroglandular tularemia diagnosed in Ohio are described. The causative microorganism, Francisella tularensis, is a small, pleomorphic gram negative coccobacillus which requires special microbiological media for laboratory isolation. In nature, the organism is usually transmitted to man by the handling of infected animal tissues and body fluids or by an arthropod vector. There are several clinical forms of tularemia of which the ulceroglandular type is most common. Laboratory diagnosis is usually made by demonstrating a four-fold increase in the serologic agglutinating antibody titer to Francisella tularensis. Streptomycin is the drug of choice in the treatment of tularemia.

Adult↗
PubMedDate not supplied

The effects of dietary fibre on upper and lower gastro-intestinal transit times and faecal bulking.

A total of 10 obese patients (body mass index greater than 25) undergoing treatment with a very low-calorie (330 kcal/day) liquid diet were treated without and with 10.5 or 21 g/day dietary fibre. Mean (+/- SE) faecal bulking increased significantly (P less than 0.001) in a dose-dependent manner from 314.8 +/- 54.4 g on a fibre-free diet to 517.2 +/- 45.4 g and 748.9 +/- 78.5 g, respectively, over 5 days on diets containing 10.5 and 21 g/day dietary fibre. Total mean colonic transit time decreased from 53.9 +/- 3.6 h on a fibre-free diet to 25.8 +/- 44 and 17.3 +/- 4.6 h, respectively, on diets including 10.5 and 21 g/day dietary fibre. Both right and left colonic transit times were similarly affected but no effect on orocaecal transit time was detected.

Body Mass Index↗