Search PubMed⌕ Search

Biomedical subjects

L O Gentry

Publications and source records attributed to L O Gentry.

At least 91 records · Page 5Linked to original sources
PubMed1981

Intraabdominal abscess after penetrating abdominal trauma.

In 57 (2.4 percent) of 2,416 patients undergoing laparotomy for penetrating abdominal trauma from 1977 to 1980, an intraabdominal abscess developed in the postoperative period. Preoperative antibiotic administration, careful closure of gastrointestinal tract perforation with diversion as necessary, and copious irrigation of the peritoneal cavity at the completion of surgery were common factors in all operations. Over 80 percent of penetrating wounds leading to abscesses occurred in the upper quadrants, and common risk factors included multiple intraabdominal solid organ injuries requiring open drainage, coupled with gastrointestinal tract perforation. Physician delay in the recognition of patients with intraabdominal abscess and in reoperation was a common problem.

Abdominal Injuries↗
PubMed1981

Effects of sodium piperacillin on platelet function in normal volunteers.

Piperacillin is a new semisynthetic penicillin which is similar in structure to carbenicillin and ticarcillin. Since the latter antibiotics have been shown to cause abnormalities in hemostasis, we studied the effects of piperacillin on blood coagulation and platelet function. Fifteen healthy volunteers received the drug in doses of either 100, 200, or 300 mg/kg per day for a period of 7 days. Serial studies showed no abnormalities in blood coagulation in any subject. Decreased platelet aggregation responses to adenosine diphosphate, epinephrine, collagen, and achidonic acid were commonly noted, but prolongation of the bleeding time occurred in only 3 of 15 subjects after 7 days of piperacillin administration. These results suggest that although piperacillin also induces platelet dysfunction, these effects may be less than those caused by ticarcillin or carbenicillin at an equivalent dosage.

Blood Coagulation↗
PubMed1980

Intrarenal abscess. Report of 14 cases.

Six of 14 patients with renal abscess had prior history of urinary tract infection; initial symptoms included fever and flank pain in 12. A drip-infusion intravenous pyelogram was the most sensitive radiologic test, but selective renal arteriography was most specific. Urine cultures were positive in all 14 patients; blood cultures were positive in nine. Six patients were treated with antibiotics alone and eight required surgery. Of the eight, five had pus-filled cavities, one had multiple stones, one had a renal infarct, and one had a resolving abscess. Of six treated with antibiotics alone, one died of unrelated complications and five have demonstrated no pathological renal condition after three to six years.

Abscess↗
PubMed1980

Antimicrobial susceptibility testing of Haemophilus parainfluenzae by a kinetic killing-curve method.

A kinetic killing-curve method, designed to mimic several aspects of clinical therapy in endocarditis, was used to test 10 strains of Haemophilus parainfluenzae against 28 antibiotic regimens. In an effort to simulate changing in vivo levels of antibiotic in serum, concentrations of three penicillins, three cephalosporins, gentamicin, and chloramphenicol were sequentially adjusted over a 12-hr period. Against six beta-lactamase-negative strains, gentamicin in combination with penicillin or cephalosporin invariably resulted in an additive or synergistic effect. Chloramphenicol and a penicillin or cephalosporin usually displayed an indifferent effect, but chloramphenicol was often antagonistic when combined with gentamicin. With four beta-lactamase-positive strains, variable responses were noted to penicillin-aminoglycoside combinations; cephalosporin-aminoglycoside combinations were usually synergistic. This dynamic approach to killing-curve studies may be more appropriate than a static system for in vitro examination of the effect of antimicrobial combinations against selected organisms.

Ampicillin↗
PubMed1980

Cefamandole alone and combined with gentamicin or tobramycin in the treatment of acute pyelonephritis.

Ninety-four cases of pyelonephritis including 20 who had concurrent bacteremia were treated with cefamandole alone or in combination with either gentamicin or tobramycin. Doses of cefamandole ranged from 1--2 g by intermittent intravenous (VI) infusion every 4 to 8 h; gentamicin and tobramycin doses ranged from 1--1.7 mg/kg every 8 h also by intermittent IV infusion. Duration of therapy ranged from 5 to 23 days (mean 7.3 days). Both single and combination therapy successfully treated acute pyelonephritis and bacteremia in all patients. Seven strains of E. coli and one of Klebsiella pneumoniae responsible for initial infection were resistant to cephalothin but sensitive to cefamandole. Relapse with cefamandole sensitive bacteria occurred in 27% of patients receiving only cefamandole and 8% of those patients receiving combination therapy. Reinfection with cefamandole resistant organisms, predominantly Pseudomonas aeruginosa occurred in five patients. One patient had an intrarenal abscess due to E. coli which was successfully treated with 23 days of cefamandole. One patient died. However, death was due to acute pulmonary embolism, not infection. None of the patients receiving cefamandole plus gentamicin or tobramycin experienced a significant decrease in creatinine clearance during or after therapy. Skin rash, mild thrombophlebitis at the IV site and transient elevation of alkaline phosphatase and SGOT were the only side effects noted.

Acute Disease↗
PubMed1979

Assay of serum tobramycin levels with the Bactec 460.

Serum tobramycin levels of synthetic and patient specimens were determined by the Bactec 460. The results were compared with those obtained from the same specimens by radioimmunoassay. These studies suggest that assays performed by either method should be run in duplicate or triplicate to achieve maximum accuracy. The studies also suggest that results obtained by the Bactec method are at least as reliable as those obtained by the radioimmunoassay method.

Anti-Bacterial Agents↗
PubMed1979

Surgery in active infective endocarditis.

Controversy persists concerning the role of early surgical intervention in severe infective endocarditis (IE). We therefore reviewed 163 episodes of well-documented IE in which 32 cardiac operations were performed during the active phase of IE. Congestive heart failure (CHF) was the principal indication for surgery in 88% (28/32); systemic emboli, 1/32; and persisting sepsis, 3/32. Staphylococcus and enterococcus were the most common infecting organisms in the operative group (44% and 16% respectively). Surgical mortality (11/32,37%) did not differ (p greater than 0.05) from medical mortality (26/131,20%). All 11 operative deaths occurred in patients moribund prior to surgery, including three with preoperative cardiac arrest. Surgical patients undergoing preoperative cardiac catheterization demonstrated marked CHF: a mean left ventricular end-diastolic pressure of 25.3 mm Hg. The mean cardiac index in 8/11 surgical deaths was lower (p less than 0.05) vs surgical survivors: 2.21/min/m2 vs. 3.21/min/m2. Postoperative complications were rare in the 21 surgical survivors. There were no episodes of continued infection, prosthetic dehiscence, or advanced heart block; only one paravalvular leak; and one systemic embolus. These findings emphasize the high medical and surgical mortality in patients with IE, suggest that delayed operative intervention may be a major causative factor resulting in a high surgical mortality, and justify an aggressive surgical approach in patients with valve dysfunction and heart failure. These data indicate that survivors of surgical intervention during active IE have eradication of infection and few postoperative complications.

Adult↗
PubMed1979

Malignant group B streptococcal endocarditis associated with saline-induced abortion.

A 20-year-old woman developed acute group B streptococcal endocarditis following saline-induced abortion. In the pre-antibiotic era, most cases of group B streptococcal endocarditis occurred in parturient or postabortal women. Currently, this disease is rarely described in obstetrical patients, and no previous cases following saline-induced abortion have been reported. Purulent pericarditis and a perivalvular abscess were present in our patient and represent only the second instance in which these findings have been documented in this disease.

Abortion, Induced↗
PubMed1979

Treatment of acute bacterial bronchitis and pneumonia with cefaclor.

Sixty patients with pneumonia and/or bronchitis were treated with cefaclor, a new orally administered cephalosporin. Of those 60, 27 adults were treated with 500 mg every 8 hours, 26 adults with 250 mg every 6 hours, and 7 children with 50 mg/kg/day. In the adults, pneumonia was caused most frequently by Streptococcus pneumoniae and Haemophilus influenzae. The 7 children had pneumococcal pneumonia. All but 2 adults, both elderly patients with chronic obstructive pulmonary disease, were successfully treated. One instance of drug hypersensitivity occurred. All 7 children responded rapidly, with no side effects, to cefaclor therapy.

Acute Disease↗
PubMed1978

Efficacy and safety of cefamandole plus either gentamicin or tobramycin in therapy of severe gram-negative bacterial infections.

Thirty-one patients with severe gram-negative bacterial infections were treated successfully with a combination of cefamandole nafate plus gentamicin or tobramycin. The patients were divided into two treatment groups: group 1 received low-dose therapy (80--100 mg of cefamandole nafate/kg per 24 hr plus 3 mg of either gentamicin or tobramycin/kg per 24 hr), and group 2 patients, who had suspected bacteremia, received high-dose therapy (170 mg of cefamandole nafate/kg per 24 hr plus 5 mg of either gentamicin or tobramycin/kg per 24 hr). All of the patients were clinically and bacteriologically cured of their primary infections. All four episodes of bacteremia were cleared within 24 hr after therapy was initiated. There was a uniform decrease in the rate of creatinine clearance which was slightly greater in group 2 patients; however, all creatinine clearance values were within the normal range and actually improved during therapy. There was no difference between the clearance values of the tobramycin-treated patients and gentamicin-treated patients. A few transient abnormalities in results of liver function tests occurred during the study. In one patient whose serum was positive for hepatitis-associated antigen, the alkaline phosphatase, aspartate aminotransferase, and bilirubin values were elevated on admisssion of the patient to the hospital, increased fivefold during therapy, and decreased to the base-line admission values six days after therapy; however, it is difficult to establish that this reaction was antibiotic-induced hepatic toxicity.

Adolescent↗
PubMed1976

A family outbreak of serious streptococcal infection.

A localized outbreak of scarlet fever was caused by an M-nontypable T-1 (NT/1) group A beta-hemolytic Streptococcus. The result was a fatal outcome in a 5-year-old child and a near fatality in his 10-year-old sibling. The outbreak was confined to family units that had members with whom the children were close playmates. Extensive epidemiologic studies in neighborhood schools and local hospital emergency rooms did not demonstrate a disemination of the causative serotype in the community.

Acute Disease↗
PubMed1976

Therapy for disseminated coccidioidomycosis with transfer factor from a related donor.

A 17 year old caucasian woman in whom disseminated coccidioidomycosis developed with culture positive meningitis during her third trimester of pregnancy was treated with amphotericin B and subsequently with transfer factor prepared from her father's peripheral lymphocytes. Clinical response and in vivo and in vitro immunologic data indicated that this transfer factor afforded a significant contribution to her survival whereas previous therapy with transfer factor from an unrelated donor provided only transient immunologic reactivity. This experience suggests that transfer factor prepared from a related donor with positive responses to C. immitis may be more efficacious than that prepared from an unrelated donor.

Adolescent↗
PubMed1976

A randomized, comparative study of tobramycin and gentamicin in treatment of acute urinary tract infections.

Eighty patients with urinary tract infections were randomly divided into two equal groups; one group received tobramycin, and the other received gentamicin. The daily dose of antibiotic for each group was 3 mg/kg. Mean levels in serum were 4.5 and 4.7 mug/ml, respectively, 1 hr after an intramuscular injection, and the mean duration of therapy was 6.5 days. Mean ages and sex ratios were similar in the two groups. Essentially equal numbers of patients with pyelonephritis and cystitis were assigned randomly to each group. Eradication of infection was similar in patients in the two treatment groups, and there was not a significant number of relapses or reinfections in either group. Renal function was abnormal in seven patients treated with gentamicin and in two patients treated with tobramycin. One patient in the gentamicin group developed a skin eruption. Our data suggest that tobramycin is as effective as gentamicin in the treatment of acute urinary tract infection and may be less nephrotoxic at similar doses.

Acute Disease↗
PubMed1976

Skin test and blastogenic responses to Sporotrichun schenckii.

In vivo skin testing and in vitro lymphocyte blastogenesis were evaluated in a young adult population as methods for detecting cellular immunity to Sporotrichum schenckii. Similar procedures for Candida albicans and Coccidioides immitis were also investigated. 5 of 143 subjects had positive skin tests and 14 had positive blastogenic responses to S. schenckii. These 14 subjects also exhibited unusually high responses to C. albicans in vitro and 11 of the 14 were female. Data demonstrated a correlation coefficient of 0.89 when comparing the blastogenic assays for S. schenckii and C. albicans, suggesting cross antigenicity. Intact cellular immune mechanisms in combination with exposure to C. albicans may protect the host from systemic infection with S. schenckii. Although a limited number of subjects were studied, as a group, females had more vigorous cellular immune responses to C. albicans than males. The rare occurence of sporothrix infection in females as compared to males may be the result of antigenic stimulation from commonly observed vaginal colonization with C. albicans. The present data indirectly support this hypothesis.

Adolescent↗