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Biomedical subjects

T W Rice

Publications and source records attributed to T W Rice.

At least 145 records · Page 8Linked to original sources
PubMed1985

Outbreak of endocarditis caused by Pseudomonas aeruginosa serotype O11 among pentazocine and tripelennamine abusers in Chicago.

At Cook County Hospital (Chicago), before 1977, the incidence of endocarditis caused by Pseudomonas aeruginosa was one or two cases per year. The frequency of P. aeruginosa as an etiologic agent of endocarditis among drug abusers increased steadily from five (23%) of 22 patients in 1977 to 15 (68%) of 22 in 1980. P. aeruginosa serotype O11 accounted for 34 (76%) of 42 of the strains serotyped. The total increase in incidence of P. aeruginosa endocarditis that we observed can be attributed to disease caused by serotype O11. We serotyped 152 strains of P. aeruginosa obtained from hospital inpatients without endocarditis. Serotype O11 was the most frequently isolated type, accounting for 27% of the total. Incidence of serotype O11 in drug addicts with endocarditis is significantly higher than the incidence in patients with nonendocarditis infections (chi 2 = 32.89; P less than .001). There was a high degree of correlation between pentazocine and tripelennamine ("T's and Blues") abuse and endocarditis caused by P. aeruginosa (chi 2 = 36.71; P less than .001).

Chicago↗
PubMed1984

Device for the secure fixation of the U tube.

A yoke constructed from a segment of chest tube provides secure U-tube fixation during the early postoperative period. The complications of U-tube dislodgement and bile leakage are thus avoided.

Biliary Tract Surgical Procedures↗
PubMed1984

Failure of medical therapy in tricuspid endocarditis due to Staphylococcus aureus.

A patient with isolated tricuspid endocarditis due to Staphylococcus aureus had persistent bacteremia despite antibiotic therapy for 47 days until surgery. Cultures of the resected valve disclosed 1.4 X 10(8) colony forming units per gram of valve. Time-kill studies done with the strain of S. aureus and the antibiotics used in the therapy of this patient disclosed decreased bactericidal activity of these antibiotics with increasing inocula concentrations. At 10(8) inoculum, only the combination of vancomycin and tobramycin was bactericidal. The inoculum dependence of bactericidal activity might explain the lack of correlation between in vitro susceptibility tests with clinical outcome of some endocarditis patients.

Adult↗
PubMed1983

A technique for gastrostomy.

A technique for gastrostomy has been described which includes circumferential, staggered interrupted sutures and an omental seal. The technique minimizes gastric necrosis and intraperitoneal leaks.

Gastrostomy↗
PubMed1983

Nutrition and the patient requiring mechanical ventilatory support.

Respiratory function in mechanically ventilated patients (VP) is adversely affected by starvation and hypermetabolic stress. These patients are more successfully managed and extubated if proper nutritional support is provided. The features of metabolism and respiratory function in VP require moderation in glucose, fat, and protein administration. In delivering energy to VP, attention must be given to nearby tracheostomy sites complicating the parenteral route and airway-cuff problems that may inhibit effective enteral feeding.

Energy Metabolism↗
PubMed1980

Identification of Anaplasmataceae (Haemobartonella) antigen and antibodies in systemic lupus erythematosus.

Free antigen related to Anaplasma marginale (AM) (Haemobartonella) was demonstrated in the glomeruli of one patient with lupus nephritis. Indirect fluorescent antibodies against this rickettsia were demonstrated in all of 22 lupus sera tested, with titers ranging from 1:20 to 1:1280. Geometric mean titer (GMT) was 116. Fifty-eight percent of 102 controls did not react to AM by indirect fluorescent antibody technique, and GMT of all controls was 10.7 Immunofluorescence was eliminated by neutralization and blocking techniques.

Adult↗
PubMedDate not supplied

Endosonography in the evaluation of patients with Barrett's esophagus and high-grade dysplasia.

Endosonography, which provides high-resolution images of the esophageal wall, could potentially detect carcinoma not visible endoscopically in patients with Barrett's esophagus and high-grade dysplasia. We studied the ability of endosonography to detect early esophageal carcinoma in 9 patients with Barrett's esophagus and high-grade dysplasia who were candidates for esophagectomy. Pre-operative endoscopy and biopsy revealed high-grade dysplasia without evidence of carcinoma in all patients. Pre-operative endosonographic evaluations were compared to the pathologic diagnoses of resected specimens. Post-operatively, 3 of the 9 patients were found to have intra-mucosal carcinoma. Endosonography identified a tumor in only 1 of these 3 patients and over-staged it as invasive carcinoma (T2, N1). In 2 of the 6 patients without intra-mucosal carcinoma, endosonography predicted invasive carcinoma (T2, N0). Endoscopy revealed mucosal nodularity in each of the 3 over-staged patients. We conclude that recommendation of the routine use of endosonography to determine the need for surgery in patients with Barrett's esophagus and high-grade dysplasia would be premature, because the current generation of echo-endoscopes does not reliably differentiate between benign and malignant wall thickening.

Adenocarcinoma↗
PubMedDate not supplied

Intraoperative transesophageal echocardiographic localization of tumor embolus during pneumonectomy.

We describe a patient undergoing pneumonectomy for large-cell carcinoma, which at the time of surgery was found to invade the pulmonary veins. Transesophageal echocardiography was used to confirm and localize suspected tumor embolization during surgery. Although tumor embolization from the pulmonary veins has been previously reported in the literature, this is the first case, to our knowledge, of transesophageal echocardiographic documentation of such an occurrence. The use of echocardiography in patients at potential risk for tumor involvement of the pulmonary veins is discussed.

Aorta↗
PubMedDate not supplied

Lung and heart-lung transplantation: the state of the art.

Lung and heart-lung transplantation is one of the most rapidly evolving transplantation fields. Survival has been improving with better patient selection, better graft preservation, and better immunosuppression. This paper outlines criteria for patient selection, reviews the surgical options involving lung transplantation, and discusses factors influencing morbidity and survival in these patients. The Cleveland Clinic Foundation experience with these procedures is presented. Lung and heart-lung transplantation has emerged from the experimental realm to the therapeutic, and can now be offered as an effective treatment option to many patients with previously fatal heart and lung disorders.

Contraindications↗