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Biomedical subjects

R Gleckman

Publications and source records attributed to R Gleckman.

At least 37 records · Page 2Linked to original sources
PubMed1982

Hemophilus influenzae bronchitis and pneumonia.

Hemophilus influenzae is increasingly recognized as an important pathogen in a wide spectrum of diseases in adults. It is often implicated in the infectious exacerbation of chronic bronchitis, and it is a frequent cause of pneumonia in adults. The recent recognition of ampicillin-resistant strains should be a reminder to obtain beta-lactamase or antibiotic susceptibility testing when H. influenzae is isolated in specimens from patients with lower respiratory infections.

Aged↗
PubMed1981

Gram-negative bacteremic shock: pathophysiology, clinical features, and treatment.

Life-threatening, gram-negative-rod bacteremia often complicates modern surgical procedures. The development of shock in association with gram-negative bacteremia represents a grave complication. The pathophysiology and clinical features of gram-negative bacteremic shock are reviewed, and contemporary forms of therapy are evaluated.

Anti-Bacterial Agents↗
PubMed1979

Epididymitis as cause of antibody-coated bacteria in urine.

The antibody-coated bacteria (ACB) immunofluorescence test has emerged as the preferred noninvasive technique to distinguish reliably between pyelonephritis and cystitis. Investigators have recently correlated a positive test with chronic bacterial prostatitis and cystitis complicating a bladder tumor or stone. We present data that appear to prove that acute bacterial epididymitis associated with bacteriuria can also evoke a positive ACB determination.

Antibody-Coated Bacteria Test, Urinary↗
PubMed1979

A critical review of the antibody-coated bacteria test.

Reports extolling the virtues of the antibody-coated bacteria immunofluorescent test continue to appear and therapeutic decisions are being made on the results of this test. In this review 2 unresolved issues are examined: 1) what constitutes a positive test and 2) how accurately does the antibody-coated bacteria test define the tissue source of infection. These issues should be resolved before all clinicians and researchers jump on the antibody-coated bacteria test bandwagon.

Antibody-Coated Bacteria Test, Urinary↗
PubMed1979

Reliability of a single urine culture in establishing diagnosis of asymptomatic bacteriuria in adult males.

Fifty-nine asymptomatic men without catheters of ileal-loop bladders, who were attending a urology clinic and were incidentally discovered to have 100,000 or more Enterobacteriaceae per ml ("significant bacteriuria") in a clean voided urine sample, were prospectively evaluated. To identify these 59 patients, 5,876 urine samples, collected exclusively from men, had been subjected to quantitation and identification. A repeat urine culture performed on these patients invariably confirmed the results of the initial culture. The reproducibility of a single urine culture containing significant bacteriuria occurred independently of the tissue source of infection, as determined by the antibody-coated-bacteria immunofluorescence test. We conclude that a single urine culture obtained from a cooperative man can establish the diagnosis of asymptomatic bacteriuria.

Adult↗
PubMed1979

Drug therapy reviews: nitrofurantoin.

Mechanism of action, antimicrobial spectrum, pharmacology, adverse reactions and therapeutic uses of nitrofurantoin, a broad-spectrum antimicrobial agent, are discussed. The frequency and potential severity of reactions attributed to nitrofurantoin, plus its inability to achieve therapeutic blood concentrations, relegate this drug to a position of secondary importance. Nitrofurantoin compares favorably with other standard agents for the therapy of acute and recurrent urinary tract infections in women which may be caused by susceptible organisms, and it is an effective chemoprophylactic agent for patients with recurrent urinary tract infections. The compound has no apparent adverse effects on the developing fetus and can be used in pregnant women. This is not sanctioned by the package insert, however. Nitrofurantoin should not be administered when the possibility of bacteremia exists, as the drug does not achieve therapeutic serum levels when administered orally. Nitrofurantoin is contraindicated for patients with renal insufficiency. The value of this compound for men with acute urinary tract infection, recurrent urinary tract infection, acute bacterial prostatitis or chronic bacterial prostatitis has not been established. There are no indications for prescribing parenteral nitrofurantoin.

Adult↗
PubMed1979

Drug therapy reviews: trimethoprim-sulfamethoxazole.

The mechanism of action, antimicrobial spectrum, pharmacokinetic properties, drug interactions, adverse reactions and therapeutic uses of trimethoprim-sulfamethoxazole, a combination enzyme-specific inhibitor of bacterial folate synthesis, are reviewed. Trimethoprim-sulfamethoxazole currently is approved by the FDA for the therapy of established recurrent bacterial urinary tract infections, pneumocystosis, otitis media in children and shigellosis. Claimed advantages of the drug are synergistic activity, bactericidal activity and ability to decrease the rate of emergence of resistance to the individual components. Trimethoprim-sulfamethoxazole is the drug of choice for treatment of pneumocystosis and an acceptable oral therapy for recurrent urinary tract infections caused by susceptible bacteria. In children with otitis media, it is used as an alternative to ampicillin and amoxicillin and is preferred when these patients are penicillin-sensitive or when the infection is caused by beta-lactamase-producing Haemophilus influenzae. Hematologic reactions (anemia, thrombocytopenia, granulocytopenia, agranulocytosis) to trimethoprim-sulfamethoxazole occur rarely. Gastrointestinal intolerance and skin eruptions are the most prevalent adverse reactions. Most untoward reactions to trimethoprim-sulfamethoxazole develop within two weeks of onset of therapy, and their incidence compares favorably with that of standard agents administered for the same indications.

Acute Disease↗
PubMed1979

Drug therapy reviews: methenamine mandelate and methenamine hippurate.

The mechanism of action, spectrum of antimicrobial activity, pharmacokinetics, adverse effects, therapeutic use, and dosage of methenamine hippurate and methenamine mandelate are reviewed. The antimicrobial activity of methenamine depends on its conversion in the urine to formaldehyde. Formaldehyde's spectrum of antibacterial activity encompasses all urinary tract pathogens. Urinary concentrations of formaldehyde vary with pH and urine volume; however, there is no documentation that acdification of the urine enhances methenamine's therapeutic activity. Adverse reactions to methenamine, including gastrointestinal intolerance and skin reactions, are mild and reversible and occur infrequently. Methenamine mandelate and hippurate are effective in the prevention of recurrent urinary tract infections except in patients with Foley catheters or who require intermittent catheterization.

Bacteria↗
PubMed1978

Symptomatic bacterial urinary tract infections in men: limitations of quantitative urine cultures.

Occasionally, physicians have discarded the diagnosis of acute symptomatic bacterial urinary tract infection when the urine coutn failed to approach or exceed 100,000 organisms per ml. Previous studies done in women have established the fact that sole reliance cannot be placed on this value to exclude the diagnosis of symptomatic bacterial urinary tract infection. A retrospective analysis of the charts of male patients, with an unequivocal diagnosis of symptomatic bacterial urinary tract infection, demonstrates the limitations of the urine colony count as a diagnostic test in men.

Aged↗
PubMed1978

Septic shock with Micrococcus luteus.

Micrococcus luteus is considered a non-pathogenic saprophyte of human skin and eye. Disease in man caused by this organism is not recorded in medical literature. We present a case of septic shock cause by M luteus. The value of this report is to document the pathogenicity of coagulase-negative staphylococci in patients without valvular heart disease, surgically implanted artifificial prosthetic devices, or polyethylene intravenous catheters.

Aged↗