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Biomedical subjects

S R Jones

Publications and source records attributed to S R Jones.

At least 127 records · Page 7Linked to original sources
PubMed1988

UTIs and two new antibiotics in the elderly.

Of the new antimicrobials available for the treatment of urinary tract infections (UTIs), aztreonam and imipenem/cilastatin represent two structurally unique, but distinct, classes of beta-lactam antibiotics. Aztreonam has a directed spectrum of activity covering gram-negative bacilli usually associated with UTIs. In comparative clinical trials of patients with complicated UTIs, aztreonam is well-tolerated and is as effective as conventional control regimens, including aminoglycosides. On the other hand, the antimicrobial spectrum of imipenem/cilastatin includes not only gram-negative bacilli but also gram-positive cocci and anaerobes. As such, this broad-spectrum antibiotic should be reserved for the treatment of mixed infections.

Aged↗
PubMed1987

Appropriateness of antibiotic therapy in long-term care facilities.

The objective of this study was to examine the appropriateness of antibiotic therapy in nursing homes. Information was abstracted from infection control reports and patients' charts for a three-month period at two nursing homes in Portland, Oregon. A panel of two board-certified infectious disease specialists and one hospital pharmacist reviewed the information and rated the appropriateness of each prescription using a previously developed scale. Among the 120 infections, treatment was rated as appropriate in 49 percent, as inappropriate in 42 percent, and as unjustified in 9 percent. Cephalosporins received the lowest percent of appropriate ratings (27 percent). The primary reason for an inappropriate rating was that a more effective drug was recommended for empiric therapy of gram-negative bacillary infections. These bacteria are often resistant to oral antibiotics. There were no significant differences in appropriateness by type of organism, infection site, or clinical outcome. Physician education and the development of systems and guidelines for optimal management in this population are appropriate actions for the future.

Aged↗
PubMed1987

Superoxide removal and radiation protection in bacteria.

Previous work with procaryotic cells has identified one kind of lethal damage from ionizing radiation which occurs only within a specific range of low O2 concentrations, about 10(-6) to 10(-4) M. Within this range, protection can occur in three ways: through the enzymatic decomposition of hydrogen peroxide (H2O2) by added catalase, through the enzymatic degradation of superoxide anion radicals (.O2-) by added superoxide dismutase (SOD), and through scavenging hydroxyl radicals (.OH) by various additives. These results indicate that three radiolytic products, H2O2, .OH, and .O2- (and/or the conjugate acid, the perhydroxyl radical, .HO2) are involved in this single kind of radiation-induced damage. Although the radiolytic productions of H2O2 and .O2- are strongly enhanced in higher O2 concentrations, neither enzyme protects when these air-equilibrated bacteria are irradiated. These experiments address this apparent contradiction and focus on the specific issue of why the addition of SOD protects at low but not at high O2 concentrations. We propose that, at a given O2 concentration, .O2- (and/or .HO2) may either react (with some cellular component?) to cause damage or react (with itself) to form hydrogen peroxide (H2O2). The specific O2 concentration during irradiation would determine the relative rates of these competing reactions and therefore the O2 concentration itself would establish whether or not we will observe damage from .O2-.

Escherichia coli↗
PubMed1986

Immediate tricuspid valve replacement for endocarditis. Indications and results.

Tricuspid valve excision for tricuspid endocarditis in addicts is recommended to avoid early reinfection, continued sepsis, and late reinfection because of the resumption of intravenous drug abuse. Valvectomy is allegedly well tolerated hemodynamically by some, but it leads to heart failure in at least a third of patients. In our experience in 10 addicts with staphylococcal endocarditis who had failed to respond to antibiotic therapy, tricuspid valve replacement allowed all 10 to leave the hospital free of infection and free of heart failure. Resumption of drug addiction in three led to septic death, but not necessarily to tricuspid reinfection. Two returned to jobs requiring a high level of physical labor and tolerated this without difficulty. We find no need to follow the practice of tricuspid valve excision for tricuspid endocarditis in addicts. Those who refrain from drug abuse are well served by valve replacement. Those who do not are doomed with or without a tricuspid valve.

Acute Disease↗
PubMed1984

Group B streptococcal meningitis appearing as acute deafness in an adult.

A case of group B streptococcal meningitis developed in a previously healthy adult. The group B streptococcus may be underrecognized as a pathogen in human disease. Survival is good after appropriate therapy, with only six fatalities in 33 cases reported in the literature. However, our patient showed the unusual neurologic complication of bilateral deafness in group B meningitis in adults.

Acute Disease↗
PubMed1984

The use of cefotaxime in a community hospital.

The use of cefotaxime was monitored to evaluate the appropriateness and cost of its use. This was done by chart review and physician questionnaire. Of 57 patients reviewed, 19 were treated empirically for specific established infections; 19 for sepsis without an identified source; 3 for infections with a known pathogen; and 16 for surgical prophylaxis. In the majority of patients treated empirically for specific infection or sepsis, the use of cefotaxime was judged appropriate by infectious disease consultants, while for surgical prophylaxis, it usually was judged inappropriate. The average charge for cefotaxime was +396 per course vs. +318 for antibiotics commonly used before cefotaxime became available. When used alone, cefotaxime was less expensive to the patient than a combination of antibiotics in 22 of 29 cases. We concluded that cefotaxime was used appropriately for empiric therapy without increasing costs greatly.

Bacterial Infections↗
PubMed1984

Acetaldehyde-hemoglobin adducts: an unreliable marker of alcohol abuse.

Acetaldehyde reacts with hemoglobin in vitro to produce acetaldehyde-hemoglobin adducts, but we could not detect these in the blood of 20 alcoholics, either by cation-exchange chromatography or agar gel electrophoresis. Thus, contrary to previous reports, this test is not a reliable marker of alcohol abuse. Nuclear magnetic resonance and gas chromatographic-mass spectroscopic analysis of acetaldehyde revealed the presence of aldehydic impurities. Formation of adducts in vitro may thus result from the reaction of hemoglobin with these impurities or with acetaldehyde condensation products (aldol) or from acetaldehyde condensation/dehydration products (crotonaldehyde).

Acetaldehyde↗