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Biomedical subjects

J Wilkins

Publications and source records attributed to J Wilkins.

At least 91 records · Page 5Linked to original sources
PubMed1987

Surgical findings in clenched-fist injuries.

A total of 191 patients (representing 194 skin lacerations) hospitalized for clenched-fist injuries were evaluated for deep structure involvement. Tendon, joint, cartilage, and/or bone were damaged in 75%. Tendon involvement occurred in 28 of 138 (20.3%), joint capsule violation in 99 of 146 (67.8%), free articular cartilage fragments in 8 of 139 (5.8%) and articular-bone indentations in 23 of 139 (16.5%). All patients with clenched-fist lacerations or puncture wounds over joints should be treated by surgical debridement and exploration of the deep structures, including the joint, at the time they first seek medical care.

Adolescent↗
PubMed1986

Infection following intramedullary nailing of long bones. Diagnosis and management.

In 30 patients (23 femurs and 7 tibias) with infection of long bone fractures following intramedullary (IM) nailing, the follow-up study ranged from eight to 84 months (mean, 20 months). Six patients retained active infection at the time of follow-up examination. Ununited fractures were present in four and sequestra in two patients. Stabilization for fracture healing after irrigation and debridement with appropriate systemic antibiotic therapy was the critical factor in the orthopedic management of this series of patients.

Adult↗
PubMed1985

Cefotaxime in the treatment of female pelvic soft tissue infections.

Forty-six females with pelvic soft tissue infections (recurrent salpingitis [n = 14], salpingitis with intrauterine contraceptive device [IUD] [n = 9], salpingitis with adnexal mass [n = 14], post-partum endomyoparametritis [n = 9]) were randomized for three antibiotic treatment regimens: cefotaxime (CTX) (n = 23), clindamycin and gentamicin (C + Gen) (n = 13), and clindamycin, gentamicin and penicillin (C + Gen + P) (n = 10). Patients were evaluated by diagnosis for clinical response to the three regimens and by pre-treatment bacterial susceptibility to the individual as well as the combination antibiotics. All 14 recurrent salpingitis patients responded satisfactorily to the assigned antibiotic regimen (CTX, n = 8; C + Gen, n = 3; C + Gen + P, n = 3). One of four patients with the diagnosis of salpingitis/IUD treated with CTX was a treatment failure, while three of three patients treated with C + Gen and two of two patients with C + Gen + P responded satisfactorily. Two of three patients with the diagnosis of salpingitis/adnexal mass failed therapy with C + Gen while the seven patients treated with CTX and the four patients with C + Gen + P responded satisfactorily. All nine patients with endomyoparametritis responded to their treatment regimen. Overall, there were no statistically significant differences in the responses by diagnosis and regimen, with the exception that C + Gen was significantly different (p less than 0.05) from CTX and C + Gen + P for the treatment of salpingitis with mass. Of the 141 bacterial isolates in all groups, 57 were aerobic or anaerobic gram-positive organisms.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacterial Infections↗
PubMed1985

Comparison of injectable molindone and haloperidol followed by oral dosage forms in acutely ill schizophrenics.

The comparative efficacy of molindone and haloperidol, given by injection for the first 2-3 days of hospitalization and then continued orally for up to 4 weeks, is reported from an ongoing double-blind study. Efficacy and side effects were assessed by the Brief Psychiatric Rating Scale, Clinical Global Impressions, Treatment Emergent Symptom Scale, and Target Symptom Ratings. Analyses based on the first 35 patients who entered the study indicate that both drugs were effective and well tolerated. There were slight advantages for molindone early during the injectable phase of treatment and for haloperidol late during the oral portion of the study, but these differences were not clinically significant. No significant differences in side effects were found between the two drugs.

Acute Disease↗
PubMed1985

Activation of rat and human alveolar macrophage intracellular microbicidal activity by a preformed LGL cytokine.

An alveolar macrophage-activating factor was released from Percoll fractionated large granular lymphocytes (LGL) within minutes of contact with either the natural killer (NK)-sensitive K562 tumor or heat-killed Staphylococcus aureus. The factor enhanced the intracellular killing of S. aureus without altering the rate of phagocytosis. Factor release was blocked by treatment of LGL with monensin, a carboxylic ionophore that inhibits vesicular traffic, but was unaffected by actinomycin D and cycloheximide pretreatment, suggesting that the cytokine was performed. The cell producing the factor was found only in Percoll fractions containing high concentrations of lytic NK cells and LGL, and the phenotypes of the LGL were HNK-1+ and E rosette-. The macrophage activating factor was a small protein of 10,000 to 20,000 daltons, as determined by gel fractionation, and was sensitive to proteolytic enzymes and heat and pH labile. Active supernatants were devoid of antiviral (interferon; IFN) or interleukin 2 (IL 2) activity, and IFN-beta, IFN-gamma, IL 2, and interleukin 1 were unable to activate staphylococcidal activity, suggesting that the LGL macrophage activating factor was distinguishable from these cytokines.

Animals↗
PubMed1984

Hapten-Ficoll conjugates induce T-cell-dependent IgM anti-hapten responses and T cells mediating hapten-specific delayed-type hypersensitivity.

It was generally believed until recently that the B-cell IgM response induced by type-II "thymus-independent" antigens, that are not mitogenic for B cells, was T cell independent. Neither has it been possible in the past to demonstrate that these antigens activate specific T cells. This has led to the general belief that type-II thymus-independent antigens have the anomalous property of not being able to activate such cells. Recent evidence has shown that the IgM response to hapten-Ficoll conjugates, the prototype of type-II thymus-independent antigens, is T cell dependent in at least some circumstances. Here evidence that these antigens activate T cells mediating hapten-specific delayed-type hypersensitivity (DTH) is presented. Furthermore, the conditions under which they do so are similar to those that allow thymus-dependent antigens to activate DTH-mediating T cells.

Animals↗
PubMed1984

Single-dose cefotaxime versus 3 to 5 dose cefoxitin for prophylaxis of vaginal or abdominal hysterectomy.

We evaluated a single 1-g dose regimen of cefotaxime versus the standard three to five 2-g cefoxitin regimen for prophylaxis in vaginal or abdominal hysterectomy to determine whether acceptable rates of morbidity could be achieved. The antibiotics were administered as follows: cefotaxime, 1 g im or iv on call to the operating room; cefoxitin, 2 g im or iv on call to the operating room, followed by 2 g intravenously at 6 hourly intervals for up to 24 h. The patients received a povidone-iodine vaginal preparation immediately before surgery; vaginal packs, when used, contained no antimicrobial agents. Surgical procedures were comparable for each antibiotic and surgery group. The results showed that among cefotaxime treated subjects who underwent hysterectomy only 1 of 37 (2.7%) vaginal cases and 5 of 60 (8.3%) abdominal cases developed operative site infections requiring parenteral antibiotics. For cefoxitin, 3 of 41 (7.3%) vaginal cases and 6 of 41 (14.6%) abdominal cases, similarly, required antibiotics. The incidence of postoperative infections was not different between regimens, irrespective of the type of hysterectomy, but considerable cost-savings by reduced drug and administration expenses were realized with the single-dose cefotaxime regimen.

Adult↗
PubMed1984

The question of lithium/neuroleptic toxicity.

The question of lithium-haloperidol incompatibility has been debated for a number of years now. The difficulty remains in distinguishing a combined toxicity syndrome, rather than toxicity to either agent alone. The authors reviewed a further case of adverse drug response following the concomitant use of lithium and haloperidol. It is their conclusion that a combined toxicity syndrome does exist, although it remains for future investigations to determine whether this effect is additive or synergistic. Finally, the possibility of underlying organic susceptibility is raised with reference to the case presented here.

Adult↗
PubMed1984

The mechanisms of action for beta-lactam antibiotics and inhibitors of bacterial protein synthesis.

The replication of bacteria, when unchecked, may lead to morbidity or mortality in a susceptible host. The majority of antimicrobial agents either modify or inhibit the synthesis of key substances and are reflected by morphologic, if not lethal, changes. Activity occurs during synthesis of the bacterial cell wall and synthesis of bacterial protein. These two events are described in terms of the local mechanism of action of different classes of antibiotics. The role of antibacterial agents in the replication of bacteria should be clearly understood before antibiotic therapy is administered.

Anti-Bacterial Agents↗
PubMed1983

Use of antibiotics in open tibial fractures.

Data concerning 1102 open fractures are presented with bacteriologic and antibiotic considerations analyzed in 363 open tibiae fractures treated in three prospective one-year studies during the period from 1970 to 1980. The highest infection rate was in open tibiae receiving no antibiotics (24%, 6 infections in 25 open tibial fracture wounds), and the lowest was in the group receiving a cephalosporin and an aminoglycoside (4.5%, 5 infections in 109 open tibial fracture wounds).

Anti-Bacterial Agents↗