Biomedical subjects
Publications and source records attributed to K Crossley.
A 2-year review of 316 routine intravenous catheter cultures revealed 57 positive cultures (18%), with 57% of the 74 organisms recovered interpreted as pathogens. There were five episodes of catheter-associated septicemia.
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We have added insulin to peritoneal dialysis fluid in three uraemic diabetic patients. The hyperglycaemia and pronounced fluctuations in blood glucose which complicate peritoneal dialysis in diabetic subjects have not occurred with this technique. Studies with (131)I-labelled insulin showed that less than 5% of the intraperitoneally administered insulin was absorbed during a one-hour exchange. While the physiology of the procedure needs further evaluation, this procedure has reduced the morbidity of peritoneal dialysis in diabetic patients and made its management easier.
Dexamethasone (6 mg/kg) given intravenously to anesthetized cats exerted no significant hemodynamic effect on control open-chest cats or in cats subjected to acute myocardial ischemia by coronary artery ligature. However, dexamethasone normalized elevated S-T segments toward preischemic values, and prevented much of the increase in plasma CPK activity following coronary artery ligation. Moreover, dexamethasone prevented loss of CK activity within ischemic myocardial tissue five hours after the onset of ischemia. Dexamethasone also reduced the extent of ischemic damage as assessed by a nitro-blue tetrazolium staining technique, providing anatomic verification of the reduced ischemic damage. Moreover, dexamethasone prvented the swelling and vacuolization of myocardial lysosomes in the ischemic region, indicating a stabilization of lysosomal membranes within the heart. These data indicate that lysosomal disruption is an important consequence of myocardial ischemia and that early treatment with dexamethasone prevents the loss of myocardial lysosomal and cellular enzymes as reflected in normalization of the ECG and plasma CK activity of ischemic cats. In this way, dexamethasone may act to retard the spread of the developing infarct within the ischemic myocardium.
Review of necropsy reports for evidence of undiagnosed antemortem infection is included by the Joint Commission on Accreditation of Hospitals as an element of an effective hospital infection control program. We reviewed records of 155 patients autopsied at St. Paul-Ramsey Medical Center between January 1, 1980 and March 31, 1981. In 13 patients (8%), there was a discrepancy between documentation of infection during the patient's hospitalization and at autopsy. However, in none of these cases was this information useful in our infection control program. We doubt the effectiveness of necropsy review as a tool for nosocomial infection control.
Nasal septal abscess is a potentially serious infection about which there has been little information in the infectious disease literature. A patient with acquired immunodeficiency syndrome who developed a nasal septal abscess was studied, and the literature about this infection was reviewed.
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