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Biomedical subjects

S Krajden

Publications and source records attributed to S Krajden.

41 records · Page 3Linked to original sources
PubMedDate not supplied

Modern management of cervical scrofula.

From 1970 to 1984, 32 patients were treated for tuberculous (TB) masses, which measured 1.2-5.5 cm. The posterior triangle was involved in 19 patients, anterior triangle in 7, and more than one triangle in 6 (3 bilateral). A superficial node was excised for diagnosis. Acid-fast bacilli were identified on the smear of 18 patients. Caseation necrosis was present in 27 specimens, sarcoidosis in four, nonspecific lymphadenitis in one; all cultures grew Mycobacterium tuberculosis. A chest x-ray showed no active TB. Chemotherapy was given for 9-18 months (9 months when only one node was diseased and 18 months with extensive nodal involvement). Follow-up examinations in all patients (greater than 3 years, mean 8.6 years) has revealed no recurrence. The need to excise all cervical TB nodes, chronically inflamed and often fused to important structures, was eliminated by adequate chemotherapy.

Adolescent↗
PubMedDate not supplied

Infections caused by Trichophyton raubitschekii: clinical and epidemiological features.

Thirty-eight cases of human infection with the recently described dermatophyte species Trichophyton raubitschekii were studied and a description is presented of the clinical and epidemiological features of infection with this organism. Results revealed the usual preponderance of males (2:1) but a high proportion of individuals of Asian origin (60.5%) in the infected population. Tinea corporis, tinea cruris and tinea pedis were the most common infections. T. raubitschekii differed significantly from the more common Trichophyton rubrum and T. mentagrophytes in being more strongly associated with tinea corporis. Some T. raubitschekii infections produced inflammatory lesions while others clinically resembled those caused by the related species T. rubrum and T. mentagrophytes. T. raubitschekii could be distinguished from related species by means of special mycological procedures in the laboratory.

Adolescent↗
PubMedDate not supplied

An outbreak of Staphylococcus epidermidis septicemia.

During 45 wk from August 1980 to June 1981, the catheter sepsis rate increased from a prior 2 to 34% (23 of 68 patients on intravenous hyperalimentation). The causative organism was Staphylococcus epidermidis, grown on blood cultures in 21 of the 23 patients and on the catheter-tips of all 23. Routine cultures of the catheter-tips of the 45 patients who received intravenous hyperalimentation during this period with no evidence of catheter sepsis grew S. epidermidis on three catheter-tips (6.7%), possibly contamination during catheter removal. Sepsis resolved within 24 hr after catheter removal, with no antibiotics given for the sepsis. The organism had identical antibiograms on the blood and catheter-tip cultures in each patient, but antibiograms varied between patients. In these complex patients undergoing multiple medical events, the intravenous hyperalimentation nurse recorded that iv tubing in septic patients had leaked solution at the attachment to the catheter hub, and a review of nursing notes on charts of patients who had been on intravenous hyperalimentation revealed that a leak had been noted in the patients who subsequently had catheter sepsis. The leak was due to a manufacturing defect resulting in a decrease in diameter of the plastic connection of the iv tubing, which produced a loose attachment to the hub. The problem was remedied by switching to a Luer-lok attachment. However, in July 1982, two patients had separation of the Luer due to a manufacturing defect in the threads, followed by a catheter sepsis. Sepsis from the local contamination was not manifest until 5.4 +/- 2.7 days later. Quality control by manufacturers is emphasized.

Catheters, Indwelling↗
PubMedDate not supplied

Selection of antibiotic coverage in vascular patients undergoing cystoscopy.

Bacteremic seeding of prosthetic vascular grafts represents a cause for graft infection; transurethral procedures account for one source of bacteremia. Therefore, a prospective study of 200 patients undergoing cystoscopy was conducted to identify the incidence of bacteruria and factors associated with it, organisms involved and their antibiotic sensitivities. Positive cultures were found in 21%. The incidence was 64% in in-patients and 8% in out-patients. Positive cultures were found in 12% of patients who received antibiotics and 29% who did not. Four percent showed signs of bacteremia. The cultures identified both Gram positive and negative organisms; multiple organisms grew in 22%. Gram negative organisms were more common in in-patients. Candida grew in 8%. The Gram positive organisms were sensitive to ampicillin (92%), sulfatrimethoprim (75%) and cefazolin (60%); Gram negative to aminoglycosides (100%) and cefazolin (92%). In view of the unpredictable and multiple organisms, it is recommended that pre-cystoscopy cultures be performed and specific antibiotic coverage be based on the sensitivities.

Anti-Bacterial Agents↗