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Biomedical subjects

J W Holmes

Publications and source records attributed to J W Holmes.

4 recordsLinked to original sources
PubMed1991

Intraoperative colonic lavage: failure to decrease mucosal microflora.

Few data exist concerning the ability of intraoperative colonic lavage to decrease colonic bacterial counts, and nothing is known about its effect on the recently described mucosa-associated bacteria. The goal of our study was to determine the impact of intraoperative colonic lavage on both the intraluminal and mucosal microflora. After intraoperative colonic washout in 10 adult male Sprague-Dawley rats, quantitative and qualitative aerobic and anaerobic cultures of the intraluminal and mucosal bacteria were obtained. Tissue was also removed for scanning electron microscopic examination of the colon wall. Whereas 1000-fold to 10,000-fold reductions of aerobic and anaerobic intraluminal flora were achieved with mechanical lavage, reductions of aerobic or anaerobic mucosal bacteria were not significant. Failure to diminish bacterial colonization in this ecologic niche may be partly responsible for the persistently high infection rate after emergency colorectal surgery.

Anastomosis, Surgical↗
PubMedDate not supplied

Suppression of the human mucosal-related colonic microflora with prophylactic parenteral and/or oral antibiotics.

The purpose of this investigation was to assess the effects of preoperative administration of parenteral antibiotics with or without concomitant preoperative administration of oral antibiotics on the colonic mucosal-related microflora. Thirty-one patients were studied in a prospective fashion. Group A patients (n = 8) had colonoscopic mucosal biopsies performed after mechanical bowel preparation. Group B patients (n = 5) received neomycin and erythromycin (NE), 1 g each following mechanical bowel preparation, at 1, 2, and 11 p.m. the evening prior to either elective colon resection (n = 2) or prior to colonoscopic biopsy (n = 3). Emergent trauma patients who had left colon or sigmoid perforations due to gunshot wounds requiring segmental resection comprised group C (n = 7). These patients received cefoxitin or cefotetan 2 g intravenously preoperatively. Individuals in group D (n = 11) all had elective left hemicolectomies or sigmoid resections due to nonobstructing malignancies. These patients underwent the same regimen as group B patients in addition to receiving intravenous cefoxitin perioperatively. Quantitative and qualitative bacterial cultures as well as scanning electron microscopy (SEM) were used to study the mucosa-associated flora. Tissue for culture and SEM were obtained from the pathologic specimen immediately after removal. The interval between the dosage of parenteral antibiotics to tissue removal was 3 hours in both groups. Anaerobic and aerobic counts were suppressed the greatest in patients receiving both oral and parenteral antibiotics (p = 0.0001). Mean anaerobic counts decreased from 3.4 X 10(7) in group A to 1.8 X 10(2) (mean cfu/g) in group D patients. Mean aerobic counts in group A decreased from 3.7 X 10(6) to 64 (mean cfu/g) in group D.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMedDate not supplied

Intractable diarrhea from carbamazepine.

Diarrhea has been reported as an early, mild, and uncommon complication of carbamazepine (CBZ) therapy. We report three cases of intractable diarrhea induced by CBZ necessitating discontinuation of the drug.

Carbamazepine↗