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Biomedical subjects

M Levin

Publications and source records attributed to M Levin.

347 records · Page 20Linked to original sources
PubMedDate not supplied

Management of meningococcal infections.

The last 5 years has seen an increase in the number of cases of meningococcal infection. Despite the availability of highly active antibiotics, the mortality from this infection remains at 10%, rising to 40% in patients presenting in severe shock. Here we describe the spectrum and pathophysiology of meningococcal infections, and the most important aspects of treatment and management.

Bacteremia↗
PubMedDate not supplied

Diabetic foot wounds: pathogenesis and management.

The diabetic foot is prone to foot ulceration, which may lead to ischemia, infection, and the need for amputation. To try to reduce foot ulcer-related hospitalizations and decrease the amputation rate, health care providers need to understand the pathophysiology of the diabetic ulcer, treat ulcers promptly and aggressively, provide revascularization when necessary, prescribe therapeutic shoes, use a team approach, and conduct an intensive, ongoing patient-education program in foot care.

Diabetic Foot↗
PubMedDate not supplied

Erythema migrans-like rash illness at a camp in North Carolina: a new tick-borne disease?

BACKGROUND: Borrelia burgdorferi, the causative agent of Lyme disease, has never been isolated from a patient thought to have acquired Lyme disease in any southeastern state. OBJECTIVE: To investigate 14 cases of an erythema migrans (EM)-like rash illness that occurred during 2 summers at an outdoor camp in central North Carolina in an effort to determine the etiologic, epidemiological, and clinical aspects of this illness. METHODS: Using active surveillance, we identified cases of clinically diagnosed EM in residents and staff of the camp. We collected clinical and demographic information; history of exposure to ticks; acute and convalescent serum antibodies to B. burgdorferi, Rickettsia rickettsii, and Ehrlichia chaffeensis; and cultures for spirochetes from biopsy specimens of skin lesions. Serum samples from a group of residents and staff who did not develop rashes were tested for the same antibodies. We speciated ticks removed from people and collected from vegetation. RESULTS: We identified 14 cases of EM-like rash illness during the 2 summers. Of the 14 case-patients, 10 had associated mild systemic symptoms and 1 had documented fever. All 14 case-patients had removed attached ticks, and 8 remembered having removed a tick from the site where the rash developed a median of 12 days earlier (range, 2-21 days). One tick removed from the site where a rash later developed was identified as Amblyomma americanum, the Lone Star tick; 97% of ticks collected from vegetation and 95% of ticks removed from people were A. americanum. No spirochetes were isolated from skin biopsy specimens. Paired serum samples from 13 case-patients did not show diagnostic antibody responses to B. burgdorferi or other tick-borne pathogens. CONCLUSIONS: This investigation suggests the existence of a new tick-associated rash illness. We suspect that the disease agent is carried by A. americanum ticks. In the southern United States, EM-like rash illness should no longer be considered definitive evidence of early Lyme disease.

Adolescent↗