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Biomedical subjects

R L Thompson

Publications and source records attributed to R L Thompson.

At least 127 records · Page 7Linked to original sources
PubMed1983

Cephalosporin antibiotics.

Cephalosporin antibiotics are bactericidal against most gram-positive cocci and gram-negative bacilli of clinical importance. They are relatively nontoxic but like the penicillins may cause hypersensitivity reactions. Agents with clinically advantageous pharmacokinetics include cefazolin, moxalactam, and cefadroxil. First-generation cephalosporins are indicated for surgical prophylaxis and for treatment of most staphylococcal and streptococcal infections in patients who are allergic to penicillins. Activity against gram-negative bacilli increases from first- to third-generation drugs, but sensitive isolates should be treated with first-generation agents to prevent resistance to newer cephalosporins and to minimize the expense for the patient. Treatment of Bacteroides fragilis and Pseudomonas aeruginosa infections is not entirely satisfactory with currently available agents. No cephalosporin is active against the enterococci, and superinfection with these organisms has occurred during treatment with moxalactam. Some experimental cephalosporins have improved activity against P. aeruginosa and gram-negative bacilli that are resistant to multiple drugs. A few of these agents have a very long half-life. It is likely that cephalosporin antibiotics will continue to proliferate.

Acinetobacter↗
PubMed1982

The antimicrobial removal device. A microbiological and clinical evaluation.

A parallel study of blood cultured conventionally and following processing in an Antimicrobial Removal Device (ARD) was conducted with patients suspected of being clinically bacteremic. Cultures yielded 205 isolates from 87 clinically bacteremic patients, of whom 28 were receiving antibiotics at the time their cultures were performed. Overall, ARD processing neither increased the isolation rate nor decreased the time interval required for detection of organisms compared with conventional processing. ARD processing was the only means of isolation of organisms from only seven of the 87 patients and three of the 28 receiving antibiotics, whereas conventional processing accounted for the only means of isolation of organisms from 17 of the 87 patients and nine of the 28 receiving antibiotics. ARD processing demonstrated no advantages over conventional processing of blood cultures.

Anti-Bacterial Agents↗
PubMed1982

In vitro activity of N-formimidoyl thienamycin and other beta-lactam antibiotics against methicillin-resistant Staphylococcus aureus.

Of 43 isolates of methicillin-resistant Staphylococcus aureus, 90% were inhibited by 8 micrograms or less of N-formimidoyl thienamycin per ml by the agar-dilution technique. Cefamandole, cefotaxime, cefoperazone, moxalactam, and cefsulodin showed relatively poor activity. Vancomycin was the most active compound by weight, inhibiting 93% of strains at 1 microgram/ml.

Anti-Bacterial Agents↗
PubMed1982

Epidemiology of nosocomial infections caused by methicillin-resistant Staphylococcus aureus.

Outbreaks of hospital-acquired infections caused by methicillin-resistant Staphylococcus aureus are being recognized with increasing frequency in the United States. Two thirds of outbreaks have been centered in critical care units. Infected and colonized inpatients appear to be the major institutional reservoir, and transient carriage on the hands of hospital personnel appears to be the most important mechanism of serial patient-to-patient transmission. In over 85% of hospitals into which they have been introduced, methicillin-resistant strains of S. aureus have become established as endemic nosocomial pathogens. A program designed to control a widespread outbreak in a university hospital used three surveillance methods to identify the major institutional reservoir of colonized and infected inpatients. Daily clinical laboratory surveillance, monthly prospective microbiology surveys of high-risk inpatients, and the recognition of previously infected 38%, 31%, and 31% of new cases, respectively. After control measures were instituted, the prevalence (p less than 0.001) and the number of acquisitions (p less than 0.002) of methicillin-resistant S. aureus declined over a 12-month period.

Burns↗
PubMed1982

Staphylococcal infective endocarditis.

Staphylococcus aureus causes an acute endocarditis, often involving previously normal valves. The criteria used for diagnosis of subacute bacterial endocarditis are frequency absent, and distinguishing acute endocarditis from bacteremia without valvular involvement is difficult. In vitro studies, including teichoic acid antibody assay and bactericidal tolerance, have been developed to aid in making the diagnosis and planning the treatment. Cases of native valve, prosthetic valve, and addict-associated endocarditis are considered separately because of differences in prognosis and approach. Use of two synergistic antibiotics has not been proved clinically superior to use one agent, and surgical intervention during treatment may be necessary in some cases. Despite prompt treatment recognition of complications, the morbidity and mortality associated with this infection remain high.

Anti-Bacterial Agents↗
PubMed1980

Rhodotorula septicemia: two cases and a review of the literature.

Rhodotorula glutinis var. glutinis was isolated from the blood of two patients who were seriously ill and required long-term intravenous therapy. Although both isolates were sensitive to amphotericin B and 5-fluorocytosine, neither patient received antifungal therapy. One of the two patients died, but Rhodotorula was not recovered at autopsy. Review of the literature shows that Rhodotorula septicemia is often associated with contamination of intravenous infusion equipment, resulting in toxemia and hypotension. Initial therapy for fungemia should consist of removal of infected cannulas and fluid replacement. If fungemia persists, antifungal drug therapy should be considered.

Adult↗
PubMed1978

Anticoagulant therapy and central nervous system complications in patients with prosthetic valve endocarditis.

Among 52 cases of prosthetic valve endocarditis, adequate anticoagulant therapy was administered in 38 and discontinued or given in subtherapeutic dosage in 14. Our data suggest that anticoagulant therapy does not appreciably increase morbidity or mortality in patients with prosthetic valve endocarditis. On the contrary, in our patients the incidence of major clinical CNS (central nervous system) complications was increased and the mortality was higher if anticoagulant therapy was discontinued. CNS complications occurred in 10 of the 14 patients without adequate anticoagulant therapy and in three of the 38 with adequate anticoagulant therapy. Mortality was 57% among those treated without adequate anticoagulation and 47% among those with adequate anticoagulation. At autopsy, CNS complications were thought to be the primary cause of five of the eight deaths in cases without adequate anticoagulation.

Adolescent↗
PubMed1977

Intraocular wooden foreign body clinically resembling a pearl cyst.

Five years after injuring his right eye with a wooden arrow, an 11-year-old boy had an iris lesion resembling a pearl cyst. Surgery demonstrated an intraocular wooden foreign body. Wooden foreign bodies are uncommon but may be surprisingly well tolerated if uncontaminated. A differential diagnosis of iris mass lesions in the posttraumatic eye is provided.

Anterior Chamber↗
PubMed1977

Prophylaxis of infective endocarditis: a reevaluation.

Established practice dictates that physicians and dentists give antimicrobial agents at the time of procedures associated with bacteremia in an effort to prevent IE in persons with underlying cardiovascular diseases. Although prospective controlled study has not been established efficacy, very few cases of IE have been reported in patients at risk who have been treated with regimens recommended by the American Heart Association. Furthermore, studies in rabbits in recent years have shown that IE can be prevented by antimicrobials. The results in rabbits have raised some theoretical questions regarding efficacy of currently recommended regimens for man and have led some investigators to propose revisions of the American Heart Association recommendations. We feel that direct translation of results from experimental IE in rabbits into recommendations for prophylaxis of IE in man is subject to question. It is unlikely that a prospective study comparing placebo with antimicrobials will be undertaken, but it is possible and reasonable to undertake studies to document the occurrence of IE in patients at risk who are given established antibiotic regimens. With such data, modifications of established regimens could be proposed and tested. Regimens that are found to be totally effective in a large number of patients at risk might be modified toward simpler programs--for example, modifying parenteral therapy to oral therapy or changing multiple doses of antibiotic to a single dose. If regimens fail, even once in several thousand patients at risk, the factors responsible might be determined and a clear rationale for modification achieved.

Animals↗
PubMed1977

Recurrent brain abscess: manifestation of pulmonary arteriovenous fistula and hereditary hemorrhagic telangiectasia.

A unique case of recurrent brain abscess as the primary manifestation of pulmonary arteriovenous fistula is presented. In the absence of hematologic abnormalities and characteristic physical findings, the diagnosis of pulmonary arteriovenous fistula is particularly elusive. Patients with brain abscess must be carefully evaluated for the presence of pulmonary arteriovenous fistula or hereditary hemorrhagic telangiectasia.

Arteriovenous Malformations↗
PubMed1977

The cephalosporins.

Cephalosporin antibiotics are bactericidal against most gram-positive cocci and many gram-negative bacilli of clinical importance. They are relatively nontoxic but share with penicillins a tendency to elicit hypersensitivity reactions. They are indicated in certain instances for treatment of infections in patients with penicillin allergy and are frequently chosen as one of the agents in an empiric program in life-threatening infections. Cephalosporins should not be used in infections caused by group D enterococcal streptococci, Pseudomonas aeruginosa, or Bacillus fragilis, Newer cephalosporins soon to be available have a somewhat wider gram-negative spectrum; however, as with all members of this family of drugs, in vitro susceptibility must be established.

Acute Kidney Injury↗
PubMed1977

Joint Committee on Aviation Pathology: VI. Cause of death in aircraft accidents: drowning vs. traumatic injuries.

Sometimes it is difficult to differentiate between injuries and drowning as a cause of death in aircraft-accident fatalities. There are certain anatomic and chemical changes that are compatible with drowning, but there is no single change that is diagnostic of drowning. Drowning is a diagnosis that can be made only after all other causes of death have been excluded. Only after a complete review of the circumstances surrounding the accident and the performance of a thorough autopsy can a correct diagnosis be made when there is a possibility of drowning.

Accidents, Aviation↗