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Biomedical subjects

R E Harris

Publications and source records attributed to R E Harris.

At least 163 records · Page 9Linked to original sources
PubMed1977

Incidence and spontaneous resolution of postpartum bacteriuria.

On the first postpartum day, 53 patients (17.2 per cent) had asymptomatic bacteriuria. Spontaneous resolution of bacteriuria occurred in 40 (75.5 per cent) of the 53 patients by the third postpartum day--the most appropriate time to identify patients with true asymptomatic bacteriuria.

Bacteriuria↗
PubMed1977

Management of hereditary site-specific colon cancer.

A family with site-specific colon cancer and discrete adenomatous colon polyps in certain members has provided a prototype for the study and clinical management of hereditary cancer. Analysis of this kindred showed an autosomal dominant mode of inheritance, early onset of cancer with predilection for the right colon, and frequent extraprimary cancers of the colon. Knowledge of these phenomena are critical to the management of this hereditary cancer syndrome. On our recommendation, two brothers of the family who were treated for colon cancer by hemicolectomy underwent prophylactic total colectomy. The resected colon from one of these patients had an occult adenocarcinoma in a villoglandular polyp.

Adult↗
PubMed1977

Familial cancer syndromes: a survey.

Several pre-malignant diseases are known to have a genetic etiology. This study focuses attention upon precancerous disorders wherein the mode of inheritance is either well established or wherein it remains unclear even though familial aggregation of the particular diseases have been amply documented. These conditions will be discussed as useful models for systematic investigations of the host etiologic component in carcinogenesis. Our survey of hereditary precancerous syndromes includes multiple polyposis of the coli, the multiple mucosal neuroma syndrome, the Cancer Family Syndrome, Sipple's syndrome, Von Recklinghausen's neurofibromatosus, the multiple nevoid basal cell carcinoma syndrome, tuberous sclerosis, familial cutaneous malignant melanoma, and carcinoma of the breast. We have emphasized the heterogeneous character of many forms of familial cancer. Familial breast cancer associations clearly show such heterogeneity, as do colon cancer syndromes. Certain of these precancerous states are characterized by phenotypes which are clinically apparent, polyposis coli being the classic example. Others, such as Sipple's syndrome are amenable to routine screening for biochemical markers. The bulk of putative genetic cancer-predisposing problems require further basic investigation of modes of inheritance. Cancer control may be enhanced through communication of useful genetic and diagnostic information to primary care physicians. Referral of cancer clusters of possible genetic etiology from clinicians to human geneticists facilitates the necessary basic research.

Adolescent↗
PubMed1977

Role of heredity in multiple primary cancer.

The occurrence of multiple primary malignant neoplasms characterizes virtually all varieties of hereditary cancer. This report focuses on this phenomenon in 11 families with the Cancer Family Syndrome (heritable adenocarcinomas of the colon and endometrium) and a single extended kindred with site-specific colon cancer. Of the 316 relatives with cancer in the 12 families, 68 (21.5%) had two or more primary malignancies and 59 (86.8%) of these multiple primaries involved the colon and/or endometrium. A pooled analysis of this resource revealed a consistent 3% risk for a second primary cancer in each year of survival following first onset. If a second primary occurs, the risk for a third is extremely high (6.9% per year), but shows a nonlinear trend with increasing survival following second onset. The high risk for development of extraprimary malignancies in patients from these kindreds indicates that careful consideration should be given to total removal of their principal target organs following the initial manifestation of cancer.

Adenocarcinoma↗
PubMed1977

The surgeon, genetics, and cancer control: the Cancer Family Syndrome.

A family manifesting the Cancer Family Syndrome has been evaluated extensively from the medical and genetic standpoint. Findings of excess occurrence of carcinoma of the colon and endometrium, multiple primary cancer, early age of onset, and autosomal dominant mode of genetic transmission mandate a program of increased surveillance and cancer education. Prophylactic surgical implications are provided for certain of these enormously high cancer risk patients.

Adult↗
PubMed1977

Myotonic muscular dystrophy in pregnancy.

Myotonic muscular dystrophy is an autosomal dominant disease inherited with variable penetrance. With pregnancy, the myotonia and muscle weakness may increase. There is also an increased incidence of abortion, prematurity, fetal death, labor dysfunction, and postpartum hemorrhage. A description of two pregnant patients and a review of the literature illustrate the interaction of the disease and pregnancy.

Adolescent↗
PubMed1977

Postpartum surveillance for urinary tract infection: patients at risk of developing pyelonephritis after catheterization.

Asymptomatic postpartum bacteriuria occurred in ten of 354 patients not catheterized (2.8%) and in 19 of 313 patients who were catheterized (6.1%). Obstetric lacterations were commonly associated with bacteriuric patients who were not catheterized. Primigravidas as a total group were more likely to have significant bacteriuria. Nine of 23 patients with urinary retention (39.1%), requiring catheterization for longer than 24 hours, developed asymptomatic bacteriuria; urinary tract infection tended to be progressive in these patients, ascending from lower to upper urinary tract involvement. Using the fluorescent antibody (FA) test, antibody-coated bacteria were demonstrated in specimens from five of these nine patients (56%), indicating silent renal infection.

Antibodies, Bacterial↗
PubMed1977

Reliability of the Bacturcult system in the clinical evaluation of postpartum bacteriuria.

The reliability of the Bacturcult system versus the standard calibrated loop-direct streak technic for screening bacteriuria was determined for 182 postpartum patients. Both false negative and false positive results were obtained by the Bacturcult system, therefore precluding its usefulness as a screening method. Based on these findings, therapy should not be instituted prior to performance of the standard culture technic.

Bacteriological Techniques↗
PubMed1977

Utilization of antibiotics for prevention of symptomatic postpartum infections.

This analysis determined the incidence, indications, and efficiency of postpartum antibiotic therapy. At Wilford Hall USAF Medical Center, 384 of 2000 consecutive delivered patients (19.2%) were treated with antibiotics during the postpartum period. The greatest utilization of antibiotics was prophylactic or for subclinical infection (290 patients; 75.5%) as compared to treatment for symptomatic infection. The most frequent indications for therapy were for patients at high risk to develop pelvic infection or to prevent urinary tract infection. The failure of antibiotic therapy and the development of infections other than those for which therapy was given were evaluated. Of the 290 patients treated prophylactically or for subclinical infection, only 11 patients (3.8%) did have subsequent infection necessitating a change in antibiotic therapy. Careful selection of antibiotic therapy in the obstetric patient is essential for effective control of puerperal infections.

Anti-Bacterial Agents↗
PubMed1977

Successful management of pregnancy-induced pancytopenia.

The 46th case of known pregnancy-induced pancytopenia is reported. Pregnancy may play an etiologic role in this rare condition, but the specific mechanism is unknown. Maternal mortality is 63%, and fetal and neonatal wastage is 46%. The patient reported is a 24-year-old Oriental woman who delivered a healthy female infant. Her survival is attributed to conservative management with carefully timed packed cell and platelet transfusions.

Adult↗
PubMed1976

The management of the pregnant patient with idiopathic thrombocytopenic purpura.

The approach to management of idiopathic thrombocytopenic purpura (ITP) during pregnancy remains controversial--particularly regarding the method of delivery. Regardless of the maternal platelet count, we believe that these patients should be delivered by elective cesarean section at term because of the continued presence of maternal antiplatelet IgG antibodies, which cross the placenta. Despite the method of treatment used to increase maternal platelets, immunologic factors are significnat for neonatal involvement and should be considered in the management of these patients. The single largest factor responsible for reported neonatal losses has been intracranial hemorrhage secondary to thrombocytopenia and birth injury. Two patients with ITP are presented with data to substantiate our position on the method of delivery. The infants were transiently thrombocytopenic following delivery (despite adequate maternal levels of platelets).

Adult↗