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Biomedical subjects

S C Stein

Publications and source records attributed to S C Stein.

At least 55 records · Page 3Linked to original sources

Vancomycin and rifampin therapy for Staphylococcus epidermidis meningitis associated with CSF shunts: report of three cases.

Three patients with Staphylococcus epidermis meningitis associated with cerebrospinal fluid (CSF) shunt devices were treated with a combination of intravenous vancomycin and oral rifampin. Two of the isolates were methicillin-resistant. All patients had a favorable clinical response. Time-kill curves showed that the addition of rifampin to vancomycin resulted in enhanced bactericidal activity against all isolates when compared to either antibiotic alone. This finding suggests that the combination of oral rifampin and intravenous vancomycin may be useful in the treatment of methicillin-resistant and recalcitrant methicillin-sensitive S. epidermis meningitis associated with CSF shunts. In vitro susceptibility testing should be performed.

Aged↗

The epidemiology of congenital hydrocephalus. A study in Brooklyn, N.Y. 1968--1976.

In a hospital-based study of almost 174,000 total births during 1968--1976, the authors found the incidence of congenital hydrocephalus to be 66 cases per 100,000 births. There was a significantly higher frequency in children born to mothers who themselves had been born in Puerto Rico but no significant difference in incidence between whites and blacks. The influences of maternal age, previous pregnancies, socioeconomic status, temporal and other factors are assessed and compared to previous reports.

Ethnicity↗

Hydrocephalus in myelomeningocele.

156 children born with myelomeningocele were studied over a 3- to 10-year follow-up period. The appearance, type and rate of development of hydrocephalus were noted and correlated with the findings on neonatal and follow-up physical examination. 80% of the children developed overt hydrocephalus; 73.4% of these cases were secondary to aqueductal stenosis. Only 15.3% of the cases showed physical evidence of hydrocephalus at birth. Another 64.8% of the children developed clinical signs of hydrocephalus during the follow-up period, most during the first few weeks but some as late as the third year of life. The neonatal examination is unable to predict the subsequent appearance of hydrocephalus or its rate of development, and even serial determinations of head circumference are often of limited value. The authors conclude that the early diagnosis of hydrocephalus in children with myelomeningocele cannot reliably be made on physical examination alone and that other means of assessing ventricular size should be employed.

Age Factors↗

Toxic substances in spinal cord injury.

Several investigators have implicated norepinephrine and other toxic substances released in the region of a spinal cord injury in the genesis of the progressive pathological and clinical changes that follow spinal trauma. To test this hypothesis, we subjected cats to T-10 to T-12 laminectomy and monitored epidural spinal evoked potentials from sciatic nerve stimulation. The spinal subarachnoid space was perfused with normal saline, with norepinephrine solution, or with heparinized autologous blood or the pial surface of the spinal cord was exposed to macerated gray matter taken from the upper cervical cord. During 1- to 2-hour exposure periods, we noted no significant changes in the base line spinal evoked potentials. In another series of cats, we have shown that norepinephrine perfused over the spinal cord in this manner diffuses rapidly into the subpial white matter. Therefore, its failure to affect spinal evoked potentials does not represent a failure to penetrate the spinal cord. Putative toxins must originate either in extravasated blood or damaged neural tissue in the region of the spinal cord injury. The failure of ascending spinal tracts to react to blood or cord tissue in our experiment suggests that toxins are not involved in the spinal cord dysfunction that occurs soon after injury.

Animals↗

Tuberculin sensitivity in a high-risk canine population.

An epidemiologic study of tuberculosis in dogs exposed to humans with recently reported tuberculosis was undertaken in Philadelphia between July 1966 and June 1968. A total of 29 dogs meeting the criteria for inclusion in the high-risk population were studied by history, physical examination, intradermal tuberculin tests, and radiographic and bacteriologic examination. Ten of the 29 dogs showed positive responses to US Department of Agriculture (USDA) standard mammalian tuberculin. Positive tuberculin tests to second strength PPD were demonstrated in five of the 10 responders to USDA mammalian tuberculin. No physical, radiographic or bacteriologic evidence of tuberculosis was found in any of the high-risk animals examined. In a comparison group of 70 dogs without knwon exposure to tuberculosis, two positive responses to USDA tuberculin were demonstrated and none to PPD.

Animals↗

Selection of early treatment of myelomeningocele: a retrospective analysis of selection procedures.

In an attempt to formulate a procedure for the selection of those children with open myelomeningocele most likely to benefit from early surgery, the records of 163 children have been reviewed. No physical findings, either singly or in combination, were found to distinguish accurately between children with good and poor prognoses, and an alternative selection procedure is proposed which takes into consideration the absence or presence of lacunar skull deformity (a finding strongly associated with mental retardation). Early surgery is not recommended for children with lacunar skull deformity and at least two of Lorber's major adverse neonatal criteria, or children with associated gross congenital anomalies. This selection procedure has been applied retrospectively to the 163 children reviewed and has been shown to predict the (known) outcome of these children much more reliably than existing selection criteria.

Follow-Up Studies↗