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Biomedical subjects

R Raz

Publications and source records attributed to R Raz.

At least 163 records · Page 9Linked to original sources
PubMed1983

Prognostic implication of detecting vegetations by M-mode echocardiography.

The prognostic significance of finding vegetations by M-mode echocardiography in patients with infective endocarditis remains controversial because many such patients are referred for early surgery. We detected vegetations in 7 of 25 consecutive subjects with active infective endocarditis (28.1%) studied by M-mode echocardiography. 11 patients died within 1 year and only 1 underwent surgery. Patients with vegetations had a higher likelihood of developing serious complications such as death, congestive heart failure or "severe congestive heart failure' when compared with patients without vegetation. This study validates previously reported series including a high percentage of patients "requiring surgery' and points to the serious prognostic implication of finding a vegetation by M-mode echocardiography.

Adolescent↗
PubMed1982

Nosocomial bacteremia due to Acinetobacter calcoaceticus.

In 1980, 13 patients with positive blood cultures for Acinetobacter calcoaceticus were detected in an 800 bed university medical center. Twelve of the 13 isolates were identified as Acinetobacter calcoaceticus var. anitratus and one as var. lwoffi. In the same period there were 361 positive specimens of A. calcoaceticus. Eight of the patients were classified as having significant bacteremia (Group A) with a serious infection in which Acinetobacter was considered a significant pathogen. Five additional patients, however, (Group B) had fever and only one set of positive blood cultures. The significance of these positive isolates was unclear to the attending clinicians. All but one Group A patient appeared to have acquired their infection during hospitalization. In this group, one patient had an underlying pneumonia as the source of bacteremia. In the remaining patients bacteremia was related to some form of invasive catheterization. Seven patients responded rapidly to appropriate antimicrobial therapy and one patient with terminal cancer died as a result of infection. This report reviews the clinical spectrum of Acinetobacter bacteremia, which can range from mild, possibly self-limiting bacteremia to serious, life-threatening septicaemia, especially in compromised hospitalized patients.

Acinetobacter↗
PubMed1980

Subacute bacterial endocarditis.

Two patients in whom various immunological phenomena obscured and delayed the diagnosis of subacute bacterial endocarditis (SBE) are described. Immunological abnormalities usually correlate well with the chronicity and severity of the disease, as is demonstrated here. The mechanisms underlying the various immunological phenomena are discussed. The importance of alertness to the possibility of SBE in cases of disease manifesting itself as an immunological disorder, thus achieving early diagnosis and early antimicrobial treatment, is stressed.

Adult↗
PubMedDate not supplied

Urinary Mycobacterium fortuitum infection.

Mycobacterium fortuitum, a common saprophyte usually found in water and soil, can also be isolated from sputum and gastric secretions of healthy carriers. Under certain conditions, significant clinical infections due to M. fortuitum do occur. Urinary tract infections are rarely caused by atypical mycobacteria. This report describes a urinary tract infection caused by M. fortuitum in a 73-year-old patient treated with corticosteroids for bronchial asthma, who was successfully treated with ofloxacin.

Adrenal Cortex Hormones↗
PubMedDate not supplied

The elimination of gentamicin-resistant gram-negative bacteria in a newborn intensive care unit.

The aminoglycosides play a central role in the treatment of infectious diseases caused by gram-negative bacteria. During the period of January to June 1984, 45 clinical specimens collected in our neonatal intensive care unit grew Enterobacter cloacae; 41 of them were gentamicin resistant. One neonate developed septicemia. The routine antibiotic protocol was then changed from gentamicin-ampicillin to amikacin-ampicillin for a period of six months. During this period the resistance to gentamicin declined to a minimum. Only eight of 122 specimens proved to harbor gram-negative organisms resistant to gentamicin. The gentamicin-resistant E. cloacae vanished. No isolate was resistant to amikacin. The gentamicin-ampicillin regimen was then reintroduced.

Amikacin↗
PubMedDate not supplied

The use of ceftriaxone in the prevention of urinary tract infection in patients undergoing transurethral resection of the prostate (TUR-P).

We evaluated 101 patients undergoing transurethral resection of the prostate in this open randomized study in which 51 received antibiotic prophylaxis and 50 did not (control group). In those patients receiving antibiotics, ceftriaxone 1 g was administered intravenously within 1 h before transurethral prostatectomy and a second dose was given 3-4 days postoperatively, within 1 h before the suprapubic catheter was removed. The groups had similar clinical and demographic characteristics. During the 28-day study period, bacteriuria appeared in six ceftriaxone-treated patients and in 20 control patients (p < 0.005). On days 3-4 after the resection, only two patients who had received ceftriaxone had bacteriuria compared with 14 in the control group (p < 0.005). In addition, the incidence and duration of fever and length of hospitalization were shorter in the patients treated with ceftriaxone. In conclusion, these results support the use of prophylactic antibiotics in transurethral prostatectomy, even in patients at low risk of developing bacteriuria.

Aged↗
PubMedDate not supplied

Group B streptococcal vertebral osteomyelitis in an adult.

Group B beta-hemolytic streptococcus (Streptococcus agalactiae) vertebral osteomyelitis was diagnosed in a 65-year-old man. The patient received a 3-week course of in-hospital intravenous ampicillin followed by ceftriaxone and continued to receive ceftriaxone therapy on an ambulatory basis for 3 more weeks. Hospitalization and follow-up were uncomplicated with no neurological sequelae. Review of the medical literature documented only 15 cases of group B streptococcal osteomyelitis in adults and only three cases of vertebral osteomyelitis due to this pathogen. As in most adult patients with group B streptococcal infections, the patient had coexisting chronic conditions (chronic obstructive lung disease, diabetes mellitus) but bacteremia was not present. Although uncommon, group B streptococcus should be considered as an opportunistic pathogen in patients with debilitating conditions, but vertebral osteomyelitis is even rarer.

Aged↗
PubMedDate not supplied

A randomised, multinational study with sequential therapy comparing ciprofloxacin twice daily and ofloxacin once daily.

In a multinational, open, randomised, controlled clinical study, 474 hospitalised patients with moderate or severe infections were treated with sequential regimens of ofloxacin or ciprofloxacin. Ofloxacin 400 mg once daily or ciprofloxacin 200 mg twice daily were given intravenously for at least 3 days followed by oral treatment with ofloxacin 400 mg once daily or ciprofloxacin 500 mg twice daily. Overall cure rates of 86.8% (85.7%) in the ofloxacin group and 89.6 (89.5%) in the ciprofloxacin group were achieved in the intention-to-treat analysis (per protocol analysis). The overall bacteriological response rate (ofloxacin 89.5%, ciprofloxacin 89.0%) was comparable to the clinical cure rate. Both drugs were well tolerated and adverse events were rarely observed. It is concluded that ofloxacin and ciprofloxacin can be used successfully in the treatment of hospitalised patients with aerobic gram-positive and gram-negative infections. Ofloxacin has the advantage of a once-daily regimen, compared to the twice-daily regimen with ciprofloxacin.

Adolescent↗
PubMedDate not supplied

Malignant external otitis: treatment with fluoroquinolones.

Malignant external otitis (MEO) is still a potentially lethal disease. Early treatment based on a correct diagnosis is the most important single factor in achieving a cure for the disease. The preferred treatment is long-term systemic antibiotics followed by surgical intervention. Hyperbaric oxygen therapy may be supplemented in refractory cases. A new fluoroquinolone, Ciprofloxacin, has been successfully used in four cases of MEO which did not respond to the accepted treatment. Ciprofloxacin is active against a broad spectrum of bacteria, including Pseudomonas aeruginosa, and several clinical studies have demonstrated its efficacy in the treatment of urinary tract and soft tissue infections, osteomyelitis, pneumonia, and gastroenteritis. This report is the first of which we are aware to document the use of Ciprofloxacin in the treatment of MEO.

Aged↗