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Biomedical subjects

W J Ledger

Publications and source records attributed to W J Ledger.

At least 127 records · Page 7Linked to original sources
PubMed1976

Postmenopausal tuboovarian abscess.

Twelve postmenopausal women with tuboovarian abscess were manages at the Los Angeles County-University of Southern California Medical Center in the period 1970 to 1975. Post-menopausal uterine bleeding and a palpable pelvic mass were the most common findings. On admission however, presenting signs and symptoms were generally not helpful in making a correct descriptive diagnosis. Four of the patients had a ruptured tuboovarian abscess at the time of surgery, and additional pathologic findings were common. The total hospital course was prolonged, with significant postoperative complications in 7 patients. Three patients developed gastrointestinal fistulas and 5 patients required further surgery. Possible etiologies of these adnexal abscesses and suggested patient management including appropriate antibiotic therapy is discussed.

Abscess↗
PubMed1976

Obstetric observations in eleven cases of neonatal sepsis due to the group B beta hemolytic streptococcus.

Neonatal sepsis due to Group B streptococcus is reported to be increasing, but the reasons are unclear. Eleven cases from a single hospital were reviewed for common obstetric factors. Frequent observations associated with 8 surviving infants were maternal infection, early evaluation and treatment of the newborn, and 4+ or 5+ growth on maternal cultures. In contrast, mothers of the 3 infants who died had no clinical signs of infection, and cultures were not obtained. All 11 infants had direct monitoring during labor but the frequency of infection, 1/1600 live births, was lower than usually reported. Three surviving infants and 3 nonsurvivors were premature. Semiquantitative culture technics suggest that the predominance of Group B streptococcus in the vagina may be a more important etiologic factor than the frequency of its presence.

Female↗
PubMed1976

Colpotomy drainage of pelvic abscess.

Sixty-five patients who had a pelvic abscess drained by colpotomy or rectal incision were studied. The minority of the patients (28) developed the abscess after a hospital-acquired infection (Group I) while the other 37 patients developed the abscess after a community-acquired infection (Group II). Except for those patients who developed an abscess after hysterectomy, about one-third of the patients in both groups required a subsequent major operative procedure because of residual infection or symptoms. Of the 40 patients in whom there was a possibility of conceiving following the drainage procedure, 4 (10%) conceived at a later date.

Abscess↗
PubMed1975

Guidelines for antibiotic prophylaxis in gynecology.

Using a random table of numbers, 100 premenopausal women undergoing vaginal hysterectomy were assigned to a short-term or long-term antibiotic prophylaxis regimen. The short-term regimen patients received a total of 3 Gm. of cephaloridine in divided doses on the day of operation, while the long-term regimen patients also received oral cephalexin postoperatively. The preoperative profiles of the two study groups were similar, and the postoperative results were not significantly different. A quantitative evaluation of aerobic and anaerobic bacteria recovered from the surface of the vagina was done, and cephaloridine content of vaginal washings, serum, and vaginal tissue was determined. This information was utilized to suggest guidelines for antibiotic prophylaxis in gynecology.

Adult↗
PubMed1975

Bacteremia on an obstetric-gynecologic service.

In a one-year evaluation of the Obstetric-Gynecologic Services of the Los Angeles County University of Southern California Medical Center, bacteremia was confirmed on 144 occasions in 139 patients. This represented an over-all incidence of 7/1,000 admissions with gram-negative bacteremia observed in 3.1/1,000 admissions. There were four deaths in this series. The most frequently recovered aerobes were Escherichia coli, enterococci, and beta hemolytic streptococci, not Group A or D, while the most commonly isolated anaerobes were peptostreptococci, peptococci, and Bacteroides. These patterns of bacterial isolation should be acknowledged in antibiotic strategies for septic patients. There is a positive correlation between the incidence of intrapartum maternal and fetal monitoring and postpartum maternal bacteremia. The oncology patients were the most seriously ill women with bacteremia.

Adolescent↗
PubMed1975

The fever index: A technic for evaluating the clinical response to bacteremia.

The fever index, quantitative measure of the total amount of fever in degree hours, was determined in obstetric-gynecologic patients with bacteremia. Comparison of the mean fever index between those women with hospital-or community-acquired infections, those patients monitored or not monitored during labor, or by grouping of single organisms recovered by culture revealed no significant differences. Bacteremia patients over the age of 40 had significantly more fever than those under the age of 40. Patients with postpartum with postpartum bacteremia following cesarean section had a mean fever index significantly greater than women who had vaginal delivery. The implications of these findings are discussed.

Adult↗
PubMed1975

Death from pseudomembranous enterocolitis.

During the past 2 years at the Los Angeles County-University of Southern California Medical Center (LAC-USC), there have been 2 deaths from pseudomembranous enterocolitis. Each of these deaths occurred postoperatively in previously healthy women who received pronlonged antibiotic prophylasix. The implications of these poor therapeutic results are discussed. The distinctive clinical symptology of a patient with pseudomembranous enterocolitis is described, and current treatment recommendiations are presented.

Adult↗