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Biomedical subjects

N C Klein

Publications and source records attributed to N C Klein.

At least 37 records · Page 2Linked to original sources
PubMed1991

Fluoroquinolones in respiratory infections.

The fluoroquinolones have excellent activity against a number of respiratory pathogens, especially gram-negative bacteria, including beta-lactamase-producing Hemophilus influenzae and Moraxella catarrhalis. Several studies have shown ciprofloxacin to be effective in the treatment of acute exacerbations of chronic bronchitis, some community-acquired and nosocomial pneumonia, and acute exacerbations of bronchopulmonary infections in cystic fibrosis. The fluoroquinolones have less activity against Streptococcus pneumoniae and limited anaerobic activity, which should limit the use of these drugs in empiric therapy of community-acquired pneumonia where the pneumococcus or anaerobes play a predominant role.

4-Quinolones↗
PubMed1990

The psychologist as admitting clinician. A single case example.

An experiential view of significant issues associated with independent hospital practice for psychologists is offered through a case presentation. The example is a model of practice in effect at a 90-bed, free-standing, inpatient facility opened in 1985, that gives psychologists full professional staff privileges.

Hospitalization↗
PubMed1990

Listeria monocytogenes meningitis in a human immunodeficiency virus-positive patient undergoing hemodialysis.

Listeria monocytogenes bacteremia without meningitis has been reported in patients who have undergone long-term hemodialysis and have transfusional iron overload. On the other hand, cases of Listeria bacteremia without meningitis have occurred sporadically among the acquired immunodeficiency syndrome population, mostly homosexuals. There have been no reports of Listeria meningitis occurring among persons who are antibody positive to human immunodeficiency virus or are intravenous drug abusers having chronic renal failure and undergoing hemodialysis. This patient represents the first case of Listeria bacteremia and meningitis to occur in an intravenous drug abuser who is human immunodeficient antibody positive, is receiving hemodialysis, and has transfusional iron overload.

Acute Kidney Injury↗
PubMed1990

Poststernotomy mediastinitis.

The clinician should suspect mediastinitis in patients after sternotomy who have unexplained fever or leukocytosis, sternal wound tenderness, or atypical chest or neck discomfort 2 to 3 weeks following surgery. Mediastinitis should be considered if any of these features are present. The diagnosis should be aggressively pursued by mediastinal aspiration via the suprasternal notch. Early empiric treatment with an antibiotic(s) with antistaphylococcal and gram-negative coverage is critical to survival.

Coronary Artery Bypass↗
PubMed1989

Cytomegalovirus and legionella species as the cause of liver enzyme elevations in haemodialysis patients.

We conclude that reinfection or recurrent infection with CMV or legionella may be responsible for serum glutamic-pyruvic transaminase (SGPT) elevations in up to one fourth of haemodialysis patients. Since NANB infection or asymptomatic coinfection with these agents cannot be discounted with certainty, it seems prudent to maintain haemodialysis patients with abnormal liver-function tests on Body Fluid Precautions, even if they remain asymptomatic.

Alanine Transaminase↗
PubMed1989

Use of mycobacterial smears in the diagnosis of pulmonary tuberculosis in AIDS/ARC patients.

Pulmonary tuberculosis in AIDS/ARC patients is an increasing problem. To assess the utility of acid-fast smears of pulmonary secretions in this patient population, we evaluated 38 AIDS/ARC patients with culture-positive pulmonary infection. A control group consisted of 57 non-AIDS/ARC patients, who also did not belong to an AIDS risk group, diagnosed during the same period. The number of culture-positive sputum samples evaluated per patient was similar in both groups (3.82 +/- 3.11 AIDS/ARC vs 4.47 +/- 2.83 control group). Significantly fewer AIDS/ARC patients, 45 percent, however, had a positive acid-fast smear compared with the control group, 81 percent (p less than 0.001). The initial sputum smear submitted was positive in only 29 percent of the AIDS/ARC group compared with 61 percent of control subjects (p less than 0.01). Further, greater than or equal to 5 negative smears were found in 60 percent of the evaluable AIDS/ARC patients compared with just 13 percent of control subjects (p less than 0.01). More extensive findings on chest roentgenograms were not associated with a significantly higher yield of smear positivity in the AIDS/ARC group. We conclude that acid-fast smears on sputum specimens are a relatively insensitive test for pulmonary tuberculosis in AIDS/ARC patients.

AIDS-Related Complex↗
PubMed1989

Brain abscess mimicking brain tumor.

We review our experience with brain abscesses presenting as primary brain tumor over a 5-year period (1983 to 1988). Four of 66 (6%) patients admitted with the diagnosis of primary brain tumor by computed tomographic scans were found at craniotomy to have brain abscesses. Periapical abscesses found after surgery were determined to be the cause of brain abscess in two of four patients. Our experience suggests that periapical abscess may be a more frequent cause of brain abscess than previously thought, and should be considered before surgery in patients with a suspected brain tumor.

Adolescent↗
PubMed1989

Early seizures in patients with acquired immunodeficiency syndrome without mass lesions.

Generalized tonic-clonic seizures in persons infected with the human immunodeficiency virus have usually occurred in the setting of space-occupying lesions in the brain. Seizures have also been known to occur in patients with acquired immunodeficiency syndrome-related dementia. Two patients, each with prior history of human immunodeficiency virus infection, had seizures early in the course of their illness. Neither patient had evidence of space-occupying lesions or dementia at the time of admission for the seizures. Patients with human immunodeficiency virus infection may present with seizures and may not have a clinically detectable focus for their seizures.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Mycobacterial meningitis. Retrospective analysis from 1970 to 1983.

The clinical presentation and course of tuberculous meningitis in 21 patients treated between 1970 and 1983 are analyzed. Tuberculous meningitis may present as acute, subacute, or chronic meningitis. Although characteristic cerebrospinal fluid findings of lymphocytic pleocytosis, low glucose level, and elevated protein level occur in the majority of cases, there are many atypical presentations. The protein level, glucose level, and white blood cell count may be normal, and there may be a predominance of polymorphonuclear cells rather than lymphocytes in the cerebrospinal fluid. Poor prognostic factors in this series were age greater than 65, underlying diseases, and stage 3 presentation. Incorrect or inadequate therapy had a disastrous outcome. Nontuberculous mycobacteria rarely are involved in central nervous system disease. Tuberculous meningitis must be considered in the differential diagnosis of any patient with fever and change in sensorium. A deteriorating mental status and falling cerebrospinal fluid glucose level in the presence of negative findings on bacterial culture and india ink preparation should lead to strong consideration for empiric initiation of anti-tuberculous therapy.

Adult↗
PubMed1976

Isolation and characterization of a glycerol auxotroph of Rhodopseudomonas capsulata: effect of lipid synthesis on the synthesis of photosynthetic pigments.

A glycerol auxotroph was isolated from Rhodopseudomonas capsulata for use as a system for studying membrane synthesis and function. When the mutant was deprived of glycerol, net phospholipid synthesis ceased immediately and a small amount of free fatty acids accumulated. A turnover of lipid occurred in both deprived and supplemented cultures. Deoxyribonucleic acid and protein synthesis continued for one doubling of cell massand then slowed down in deprived cells. Net ribonucleic acid synthesis slowed down more dramatically. Oxidative phosphorylation activity of membrane preparations from aerobically and semi-anaerobically grown cells appeared unaffected by glycerol deprivation, indicating that simultaneous lipid synthesis is not a requirement for new oxidative phosphorylating activity. In the absence of net phospholipid synthesis, bacteriochlorophyll and carotenoid syntheses were reduced to 30% of the activity of supplemented cultures. Delta-Aminolevulinic acid synthase, the first enzyme on the bacteriochlorophyll pathway that is subject to regulatory control, increased in activity in deprived cultures. Lascelles and Szilagyi (1965) showed an association between phospholipid synthesis and pigment production. They found an increased lipid content associated with pigmented cells. The present results indicate that not only is there an association between lipid and pigment synthesis, but also there is actually a dependence of bacteriochlorophyll synthesis on phospholipid synthesis.

5-Aminolevulinate Synthetase↗
PubMed1976

Purine excretion by cultured skin fibroblasts from patients with abnormal purine metabolism.

Cultured fibroblasts from patients with partial or complete deficiencies of enzymes involved in purine metabolism provide a model for investigating the biosynthesis, interconversion, and excretion of purine metabolites at the cellular level. Skin fibroblast cultures were derived from five patients with hypoxanthineguanine phosphoribosyltransferase deficiency, from five subjects with idiopathic overproduction gout, from one patient with adenosine deaminase deficiency, and from four control subjects. Purine excretion was measured by recovering labeled purines from the incubation medium of cells grown in the presence of 14C-formate. In general the patterns of purine excretion by these cultured cells resembled the urinary excretion patterns of the patients from whom they were derived.

Adenosine Deaminase↗