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Biomedical subjects

J E Bennett

Publications and source records attributed to J E Bennett.

At least 127 records · Page 7Linked to original sources
PubMed1980

Minimal deviation melanoma with epidermotropic metastases arising in a congenital nevus.

A congenital nevus removed from a 20-year-old woman was found to contain a minimum deviation melanoma. Subsequently, there were multiple nodular recurrences in the region of the excision as well as in the grafted skin. Microscopically the recurrent lesions closely resembled the original nevus, including the junctional activity and even the grafted skin. Lymph node metastasis occurred 5 1/2 years after excision of the nevus. This is the first report of a minimal deviation melanoma arising in a congenital nevus with epidermotropic metastases.

Adult↗
PubMed1980

Nasal obstruction as a complication of pharyngeal flap surgery.

In a series of 85 patients who had pharyngeal flap surgery at Indiana University Medical Center, We found an unusually high incidence of hyponasality with total or near total nasal obstruction. The nasal obstruction was often occult, detected only after careful questioning and examination. Nasal obstruction was associated with peri-operative infection or micrognathia as in the Pierre Robin Anomalad. Flap division or port revision yielded a significant relief of the nasal obstruction and achievement of normal nasal balance.

Adolescent↗
PubMed1980

The selective use of systemic antibiotics in the treatment of burns.

For the past ten years, we have followed a conservative program in using systemic antibiotics for the treatment of significant burns. Prophylactic antibiotics are not used except for scalds. Antibiotics are given selectively at the time of operation and, otherwise, are reserved for the treatment of specific infections. It has been unusual for a patient with a burn severity index, compatible with survival, to die of uncontrolled sepsis. Resistant bacteria and fungi have not been a problem. We attribute this to the selective use of antibiotics.

Anti-Bacterial Agents↗
PubMed1979

A comparison of amphotericin B alone and combined with flucytosine in the treatment of cryptoccal meningitis.

We compared amphotericin B therapy for cryptococcal meningitis with a newer regimen containing both amphotericin B and flucytosine. In 50 patients with 51 courses of therapy adherent to the protocol, 27 courses were with amphotericin B and 24 with the combination. Even though the combination regimen was given for only six weeks and amphotericin B for 10 weeks, the combination cured or improved more patients (16 vs 11), produced fewer failures or relapses (three vs. 11), more rapid sterilization of the cerebrospinal fluid (P less than 0.001) and less nephrotoxicity (P less than 0.05) than did amphotericin B alone. The number of deaths was the same (five) with each regimen. Adverse reactions to flucytosine occurred in 11 of 34 patients but were not life threatening. We conclude that combined flucytosine-amphoericin B therapy is the regimen of choice in cryptococcal meningitis.

Adolescent↗
PubMed1979

Surveillance of nosocomial infections by antibiotic monitoring.

Records of all patients receiving intravenous gentamicin sulfate during a 92-day interval were reviewed to detect nosocomial infections that had been missed by routine surveillance. Only 46 of 48 of the 99 treatment courses had been detected. In 96% of cases not detected by routine surveillance, use of gentamicin was considered justified. Of the patients missed by surveillance, 83% were in oncology wards, and 46% had severe neutropenia and fever of unknown origin. Antibiotic surveillance proved a useful adjunct in estimating the incidence of nosocomial infections in such patients.

Anti-Bacterial Agents↗
PubMed1979

Detection of Candida antigen in sera of patients with candidiasis by an enzyme-linked immunosorbent assay-inhibition technique.

A total of 37 serum samples from 27 cancer patients were tested by an enzyme-linked immunosorbent assay-inhibition technique for the detection of Candida antigen. In 20 randomly chosen sera from patients without clinical evidence of candidiasis and in 10 sera from patients proven by autopsy not to have candidiasis, the inhibition ranged up to 17%; in contrast, inhibition ranged from 22 to 56% in all seven patients proven by autopsy to have systemic candidiasis, indicating the presence of Candida antigen in the sera of these patients. This technique appears promising in diagnosing disseminated candidiasis in cancer patients.

Antigens, Fungal↗
PubMed1978

Amphotericin B pharmacokinetics in humans.

The pharmacokinetics of amphotericin B were studied in two patients at the conclusion of long-term therapy for disseminated histoplasmosis. The distribution kinetics of this drug were adequately described by a three-compartment mamillary model with a total distribution volume averaging 4 liters/kg. The elimination phase half-life of amphotericin B was approximately 15 days, reflecting slow release of amphotericin B from a peripheral compartment. In accordance with previous reports, renal excretion accounted for only 3% of total amphotericin B elimination. The pharmacokinetic model for one of the patients also was used to compare the simulated amphotericin B serum levels that would be expected if initial therapy followed two recommended regimens.

Aged↗
PubMed1978

Factors influencing susceptibility of Nocardia species to trimethoprim-sulfamethoxazole.

Demonstration of synergism between trimethoprim and sulfamethoxazole against 10 Nocardia isolates was found to be critically dependent upon the isolate, the duration of incubation, and the trimethoprim-sulfamethoxazole ratio. Inoculum effect was not significant. The trimethoprim-sulfamethoxazole ratio in the commercial, fixed-dose combination was found to contain too little trimethoprim to be optimal for Nocardia.

Drug Combinations↗
PubMed1978

Erythropoietin concentration in amphotericin B-induced anemia.

Amphotericin B was given to six patients with systemic fungal infections. A dose averaging 1.78 g, administered from 42 to 144 days, was associated with a fall in hematocrit to a mean value of 25.8%. Despite this degree of anemia, no elevation of erythropoietin concentrations in urine or serum could be detected. Thus, amphotericin appears to cause anemia by inhibiting erythropoietin production rather than by suppressing bone marrow activity directly.

Adult↗
PubMed1978

Evidence for conversion of 5-fluorocytosine to 5-fluorouracil in humans: possible factor in 5-fluorocytosine clinical toxicity.

A gas chromatographic-mass spectrometric method for detecting 5-fluorouracil (5-FU) in serum at concentrations as low as 10 ng/ml was used to determine to what extent 5-FU was present in the serum of patients taking oral 5-fluorocytosine (5-FC). Preliminary studies in two patients and two healthy volunteers given an initial 2-g oral dose of 5-FC demonstrated sustained serum 5-FU levels (>100 ng/ml) during the 5 h after ingestion of drug. Pharmaceutical preparations of 5-FC used in these studies were shown to be insignificantly contaminated with 5-FU (<0.03%), suggesting in vivo conversion of 5-FC to 5-FU had occurred. Serum samples from seven patients with cryptococcal meningitis treated with amphotericin B and 5-FC were examined for 5-FU. Five of these patients had experienced hematological or other toxicity attributed to 5-FC at some time during the course of therapy. Of 41 serum samples, 20 were observed to have 5-FU levels greater than 1,000 ng/ml in the range observed with cancer chemotherapeutic doses of 5-FU known to be associated with hematological toxicity. It is concluded that conversion of 5-FC to 5-FU occurs in humans and furthermore that 5-FU may account for some of the toxicity observed with 5-FC.

Capsules↗