Search PubMed⌕ Search

Biomedical subjects

R A Wright

Publications and source records attributed to R A Wright.

At least 163 records · Page 9Linked to original sources

Penile veneral edema.

A one-year epidemiologic study of penile venereal edema in a clinic for sexually transmitted diseases identified 25 cases, a rate of 1.7 per 1,000 male visits. Twenty-four patients had coexisting urethritis (36%), infected penile lesions (36%), or both (24%). Men with penile edema were significantly more likely to have gonococcal urethritis (40%), genital scabies (12%), genital herpes (12%), and inguinal adenopathy (52%) than men without penile edema. Penile edema is self-limited and seems to resolve along with the underlying penile disease. Lymphatic involvement may be the final common factor.

Circumcision, Male↗

Relationship of hiatal hernia to endoscopically proved reflux esophagitis.

The relationship between reflux esophagitis and hiatal hernia was studied using fiberoptic endoscopy. Of 293 patients having upper-gastrointestinal endoscopy during an 18-month period, 64 (22%) had a hiatal hernia and 38 (13%) had esophagitis. Half the patients with a hiatal hernia had esophagitis, whereas the vast majority (84%) of patients with esophagitis had a concomitant hiatal hernia. The association between esophagitis and hiatal hernia was highly significant (P less than 0.0001). There was no statistically significant association between the size of the hiatal hernia and the degree of esophagitis on endoscopy. A permissive role of hiatal hernia in the genesis of reflux esophagitis is suggested.

Endoscopy↗

Effect of metoclopramide on gastric stasis after reversed jejunal loop for postvagotomy diarrhea.

The effect of metoclopramide on gastric emptying in a patient with an antiperistaltic jejunal loop interposed between the stomach and duodenum because of postvagotomy dumping symdrome is studied. Solid particle emptying by 99mTc-labeled chicken liver revealed profound gastric stasis with resultant bezoar formation. Orally administered metoclopramide resulted in correction of the gastric emptying rate and dramatic symptomatic relief. The possible use of metoclopramide in patients with stasis following surgical intervention to correct postvagotomy dumping is suggested.

Adult↗

Relative and seasonal incidences of the sexually transmitted diseases. A two-year statistical review.

In the United States statistics on sexually transmitted diseases (STDs), other than gonorrhoea and syphilis, are meagre. In this study the relative and seasonal incidences of most STDs in an American clinic where 34,938 patient visits were recorded over a two-year period (1975-76) are assessed. Gonorrhoea was the most common STD in male and female patients combined (18%), while nongonococcal urethritis (NGU) was most common in men (23%), and vaginitis (trichomonal 7.5%, yeast 7.1%, and non-specific 7.1%) was the most common in women. A significantly higher incidence of NGU occurred in Caucasian (63%) than in black (42%) men (P less than 0.005). No other STD was diagnosed in more than 5% of patients, and 31% had normal findings on clinical examination and investigation, and could be described as the 'worried well'. Two or more STDs co-existed in 4.2% of patients. In 1976 the incidence of genital herpes and scabies decreased in contrast to other STDs and total patient visits, which increased. A seasonal peak in late summer and early autumn was observed for most STDs. These observations indicate the importance of a comprehensive approach when attempting to compile accurate statistics on selected epidemiological aspects of sexually transmitted diseases.

Black or African American↗

Tuberculous infection in a vascular prosthesis: a case of aortic graft infection resulting from disseminated tuberculosis.

Insertion of an aortic prosthetic bypass graft in a patient with untreated disseminated tuberculosis resulted in graft infection with formation of a pseudoaneurysm. Microbiologic cultures implicated Mycobacterium tuberculosis as the causative agent, and a subsequent review of the literature indicated this report to be the first clinical demonstration of the susceptibility of vascular prosthesis to M tuberculosis infection to our knowledge.

Aorta↗

Giardiasis in Colorado: an epidemiologic study.

A one-year retrospective laboratory survey in Colorado revealed that 691 (3%) of 22,743 stool examinations for ova and parasites were positive for Giardia lamblia, a higher percentage than that reported from surveys outside of Colorado. The majority of infected residents who were surveyed had experienced an episode of chronic watery diarrhea (median duration 3.8 weeks) with bloating, flatulence, and weight loss (averaging 5.1 kg), and had responded to a course of metronidazole or quinacrine. A statewide telephone survey of 256 cases and matched controls identified: 1) and increased incidence of giardiasis in persons between the ages of 16 and 45, p less than .001, with males and females equally affected; and 2) a higher proportion of cases than controls who visited Colorado mountains (69% vs. 47%), camped out overnight (38% vs. 18%), and drank untreated mountain water (50% vs. 17%), p less than .001. Also identified was a correlation between the seasonal distribution of cases and degree of fecal contamination of mountain streams. These results indicated that G. lamblia is endemic in Colorado and that drinking untreated mountain water is an important cause of endemic ifection.

Adolescent↗

Recent micturition does not affect the detection of urethral gonorrhoea.

In 202 men with urethral gonorrhoea (176 symptomatic and 26 asymptomatic) who had modified Thayer-Martin cultures taken before and within five minutes after micturition there was complete agreement between results of the two cultures. Micturition did, however, temporarily eliminate the discharge in 100 (56.8%) and make interpretation of Gram-stained smears more laborious.

Gonorrhea↗

Hepatitis A and B in the family unit. Nonparenteral transmission by asymptomatic children.

Investigation of an outbreak of hepatitis A among members of an adoption organization implicated recently arrived Vietnamese orphans as the source of infection. A serologic study disclosed a 27% prevalence of hepatitis B surface antigen among Vietnamese orphans and a 23.1% (6 of 26) prevalence of hepatitis B antibody among American children of adopting families. Five of the six antibody-positive American children were in families with HBsAg-positive orphans. Thus,healthy orphans from high hepatitis incidence areas may transmit hepatitis B, as well as hepatitis A, in the family unit.

Adolescent↗

Hepatitis B and the HB-SAg carrier. An outbreak related to sexual contact.

Within six months, acute viral hepatitis, type B, developed in three individuals associated with a nursing home in Denver. This attack rate, 1.4 cases per 100 patients and employees, was apparently higher than the reported incidence of hepatitis B in Denver during the same period. Parenteral inoculations could not be implicated as the means of acquiring hepatitis B. However, two of the hepatitis patients had had sexual contact within six months before their illness with an employee who was an insulin-dependent diabetic and a symptomatic carrier of HB-Sg. In addition, anti-HB-S antibodies were detected in his homosexual roommate. Although the chronic carrier was a food-handler, a seroepidemiologic survey of the employee population showed no spread of HB-Sag by means of food or casual contact. Only 1 (4.6%) of 22 employees tested had anti-HB-S antibodies. These results suggest that household and, in particular, sexual contact with a symptomatic HB-SAg carrier may be an effective nonparenteral or inapparent parenteral mode of transmitting HB-SAg.

Acute Disease↗