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Biomedical subjects

A J Weinstein

Publications and source records attributed to A J Weinstein.

At least 19 recordsLinked to original sources
PubMed1992

Resection of intraocular squamous cell carcinoma.

A patient with recurrent squamous cell carcinoma of the conjunctiva was referred with 20/20 vision in an eye with obvious intraocular extension. A modified iridocyclochoroidectomy was performed and the tumour was removed. Three and a half years later the patient's vision is 20/30 and there is no recurrence. This is the first case in which an eye has been successfully salvaged with documented intraocular squamous cell carcinoma of the conjunctiva.

Carcinoma, Squamous Cell↗
PubMed1988

The surgical management of megaureters in duplex systems: the efficacy of ureteral tapering and common sheath reimplantation.

We describe 6 children with renal duplication associated with megaureter(s) who underwent ureteral tapering and common sheath reimplantation. Of the patients 4 had complete duplication with reflux into 1 or both ureters and 2 had incomplete duplication with a short distal segment that was obstructed at the ureterovesical junction. All obstructed or refluxing ureteral segments were dilated to a degree that tapering was required at the time of common sheath reimplantation. Megaureter repair in the presence of a duplicate collecting system proved to be safe and reliable.

Adolescent↗
PubMed1987

[Respiratory tract infections caused by Haemophilus influenzae in adults].

Pneumonia counts as one of the most frequent severe Haemophilus influenzae infections to afflict adults. 60% of patients with pneumonia caused by type b H. influenzae are more than 50 years old, 30% to 40% are alcoholics, and 30% to 40% have chronic pulmonary disease or other concurrent illness. In the majority of cases there is multilobular, maculate, diffuse and usually bilateral involvement of the pulmonary tissue. The mortality rate due to type b H. influenzae pneumonia ranges between 30% and 40%. In patients with non-bacteriaemic pneumonia caused by non-encapsulated strains of H. influenzae it is rare for several lobes to be involved, there is little exudation and the mortality rate is low. H. influenzae is a significant pathogen in acute epiglottitis in adults and it also appears to play an important role in acute exacerbations of chronic obstructive lung disease (COLD) and acute sinusitis. beta-lactamase production mediated by R-factors or plasmids of gram-negative bacteria is responsible for ampicillin resistance. In 1978 the overall rate of resistance of H. influenzae to ampicillin in American hospitals amounted to 18%. H. influenzae are found in the nasopharynx of people exposed to others infected with H. influenzae. The risk of secondary infection in children who come into contact with patients infected with type b H. influenzae amounts to approximately 2.1%. Adults in close contact with children suffering from severe H. influenzae infections must be warned of the possible risks of secondary infection.

Adult↗
PubMed1985

Bilateral emphysematous pyelonephritis.

Emphysematous pyelonephritis is a severe infection found almost exclusively in diabetics, characterized by the presence of gas within the renal parenchyma. The diagnosis is established radiographically. An additional case is added to the 52 cases reported in the literature; we believe this is the fifth reported case with bilateral emphysematous pyelonephritis. If appropriate diagnostic studies demonstrate no evidence of either perinephric abscess or urinary obstruction, intensive medical management should be the initial therapy for this condition. Surgical intervention is necessary in patients without prompt response to medical therapy.

Aged↗
PubMed1979

Treatment of bacterial infections in pregnancy.

Treatment of bacterial infections in pregnancy requires an understanding of the unique problems related to the administration of antibacterial agents to pregnant women. The clinician must be aware not only of the antibiotic-associated untoward effects which may develop in the mother, but also of the possibility that adverse reactions may occur in the fetus. Precise knowledge of the microbial aetiology of those infections which occur during pregnancy and an understanding of the intricacies of antibiotic administration to pregnant women will assure the greatest likelihood that bacterial infections in pregnancy will be effectively, and safely, treated.

Abortion, Septic↗
PubMed1979

Bacterial endocarditis in a patient with mitral valve prolapse.

Bacterial endocarditis developed following dental manipulation in a child with mitral valve prolapse. Antibiotic prophylaxis is recommended for patients with this cardiac abnormality who undergo procedures that may be associated with bacteremia.

Adolescent↗
PubMed1977

Principles of concomitant antibiotic therapy.

There are five major disadvantages of the combined use of antibiotics: (i) antibiotic antagonism; (ii) a "false sense of security"; (iii) increased toxicity; (iv) suprainfection; and (v) increased cost. Four situations clearly require the use of antibiotic combinations: (i) to produce antibiotic synergism; (ii) to prevent the emergence of resistant organisms; (iii) to treat mixed infections, such as brain abscess, peritonitis, and pelvic infections; and (iv) to institute therapy for severe infections.

Animals↗
PubMed1977

Systemic absorption of neomycin irrigating solution.

Systemic absorption of neomycin sulfate occurred in ten patients in whom neomycin wound irrigating solutions were used during total hip replacement. The use of neomycin in this manner may be associated with the risk of ototoxicity and nephrotoxicity.

Adult↗
PubMed1977

Listeria monocytogenes endophthalmitis.

Listeria monocytogenes and a staphylococcus organism caused a catastrophic endophthalmitis in a patient despite appropriate local and systemic antimicrobial chemotherapy. Although L monocytogenes is widespread in nature and has produced a variety of clinical illnesses, it has only one previously been reported to cause endophthalmitis. If appropriate microbiologic techniques are not employed, the organism may go unrecognized as an ocular pathogen.

Ampicillin↗
PubMed1977

Penicillinase-resistant penicillins plus gentamicin in experimental enterococcal endocarditis.

Previous in vitro studies demonstrating that the penicillinase-resistant penicillins act synergistically in combination with gentamicin against some enterococci have suggested that these combinations might be effective therapy for enterococcal infections in vivo. To determine the in vivo effectiveness of such combinations, we treated rabbits with enterococcal endocarditis with gentamicin and either nafcillin, oxacillin, or methicillin. Despite doses of the penicillins equivalent to 12 or 24 g/day in a 70-kg patient, the percentage of animals in each treatment group with sterile valves at autopsy after spontaneous death or sacrifice after 21 days of therapy was low. High-dose therapy with the penicillins did not significantly increase survival over the low-dose treatment groups. Thus, it seems prudent to include penicillin with a penicillinase-resistant penicillin and gentamicin as the initial therapy of patients with endocarditis possibly caused by enterococci.

Animals↗
PubMed1977

CT detection and aspiration of abdominal abscesses.

Computed tomography (CT) is effective in detecting intraabdominal abscesses. Loculations of fluid and extraluminal gas are clearly localized in relation to other organs. Of 22 abscess in this series, CT successfully detected 20; comparative information with gallium, techneticum, and ultrasound scans is presented. In addition to localizing these collections, CT can be used to guide needle aspiration and drainage procedures. Three sizes of needles were used to aspirate specimens and/or provide drainage. This was accomplished successfully in 12 of 14 CT-guided procedures.

Abdomen↗
PubMed1977

Therapeutic use of gentamicin in horses: concentrations in serum, urine, and synovial fluid and evaluation of renal function.

Serum, synovial fluid, and urine concentrations of gentamicin were measured in normal mature horses which had been given a single dose of the drug. Mean peak serum concentration (16.8 microgram/ml) occurred in horses 30 minutes after they were given a single intramuscular dose of 4.4 mg of gentamicin/kg of body weight. In horses given a smaller dose of gentamicin (1.7 mg/kg), mean peak serum concentrations of gentamicin (10.2 microgram/ml) appeared at 1 hour. Synovial fluid concentration was maximum at 2 hours for both doses; in horses given the larger dose, mean peak concentration was 6.4 microgram/ml, and in those given the smaller dose (1.7 mg/kg), 3.4 microgram/ml. Measurable concentrations of gentamicin in serum and synovial fluid persisted 8 hours. During the first 8 hours, percentages of gentamicin excreted in the urine were between 3.9 and 32.8% of the larger dose and between 3.3 and 13.4% of the smaller dose. Serum creatinine concentrations were serially measured in 10 hospitalized horses intramuscularly given 1.7 to 4.4 mg of gentamicin/kg 4 times a day' significant increase in creatinine concentration was not found.

Animals↗
PubMed1976

Routine blood cultures from febrile outpatients. Use in detecting bacteremia.

Of 565 febrile patients examined in the emergency room of a metropolitan hospital, 210 had blood samples cultured (37.1%). Bacteremia was present in 9 of 86 patients who were admitted to the hospital but in only one of 124 patients who were not admitted (P less than .005). Thus, approximately 5% of febrile adult outpatients had bacteremia, and these patients were usually admitted before the results of the culture were known. Since positive cultures were found so infrequently in patients not admitted and were, therefore, of little value in guiding the treatment of these patients, we conclude that use of routine blood cultures to screen for bacteremia in unnecessary for febrile adult outpatients who are not admitted to the hospital.

Adult↗