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Biomedical subjects

J A Lowes

Publications and source records attributed to J A Lowes.

26 records · Page 2Linked to original sources

10 Years of infective endocarditis at St. Bartholomew's Hospital: analysis of clinical features and treatment in relation to prognosis and mortality.

A retrospective survey of patients with infective endocarditis at St. Bartholomew's Hospital in the decade 1966--75 showed a male/female ratio of 1.5/1. The commonest presenting features were malaise, fever, new cardiac symptoms, heart-failure, splenomegaly, and finger clubbing. The commonest problem during treatment was heart-failure. As in the two previous decades, viridans streptococci were the commonest causative organisms. Acute endocarditis was caused by Staphylococcus aureus. 6 patients' lives were saved by heart-valve replacement during medical treatment. Of 3 patients who relapsed, 1 died. The overall mortality at six months was 20%, compared with 40% in the two previous decades. Of the patients with proven subacute infective endocarditis thought to have received adequate antibiotic treatment, only 5 of 49 (10%) died; in a similar group of patients in the previous decade 19% died. Early surgical intervention probably accounts for the improved prognosis.

Acute Disease↗

Serratia marcescens in mixed aerobic infections of bone. A report of two patients.

Two patients with acute osteomyelitis of the foot caused by mixed aerobic organisms are described; sources of infection and predisposing factors are discussed. Serratia marcescens was isolated in each instance. Antimicrobial therapy which did cover this organism failed; a change to treatment directed against it succeeded.

Abscess↗

Intravenous feeding in a gastroenterological unit: a prospective study of infective complications.

We have assessed the bacteriological safety of a system of intravenous feeding by culturing catheters on removal, swabs taken from the catheter's skin entry sites, and samples of infusion fluid. Among 38 treatment periods using 51 catheters over 1551 patient days, septicaemia due to Staphylococcus aureus was observed in one treatment period and bacteraemias due to Staphylococcus albus and Diphtheroid species in two others. The Staph. aureus and the diphtheroids probably gained access via the skin entry site along the outside of the catheter. The origin of the Staph. albus was uncertain. Parenteral nutrition over extended periods can be a safe procedure if aseptic precautions are taken. The importance of the catheter's skin entry site as a source of contaiminating organisms is emphasised.

Adult↗