Dental prophylaxis for endocarditis.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to A P Ball.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
We treated 193 patients either intravenously (94) or subcutaneously (99) for at least 5 days with porcine intestinal mucosal heparin and followed them up prospectively with frequent platelet counts to determine the incidence of heparin-related thrombocytopenia and arterial thrombosis. None of the patients in the study developed severe thrombocytopenia (platelet count, less than 100 x 10(9)/L) or arterial thrombosis. Eight patients had a platelet count of 100 to 140 X 10(9)/L on one occasion, with a count of greater than 140 x 10(9)/L on the subsequent measurement. The mean (+/- SD) values of the initial and lowest platelet counts during therapy in all patients were 288 +/- 100 x 10(9)/L and 253 +/- 88 x 10(9)/L, respectively, with the lowest counts occurring on day 4.1 +/- 4.2. A least-squares line was computed for each patient to fit the day and counts; the slopes were significantly different from zero and negative in 7.8% of patients and positive in 14.5%. This multicenter study confirms the reports that the incidence of heparin-related severe thrombocytopenia and arterial thrombosis is distinctly low in patients treated with porcine-mucosal heparin.
Explore the source record for details and available documents.
Ciprofloxacin is a new 4-quinolone antibacterial agent with an extended antibacterial spectrum, enhanced potency and the ability to produce therapeutic serum, tissue and urine concentrations after oral administration. Unlike earlier 4-quinolones, it is active against gram-positive cocci and opportunistic organisms such as Pseudomonas aeruginosa. This overview demonstrates that the oral formulation has been shown to be clinically effective in a broad range of urinary and respiratory infections, gonorrhoea, gastro-intestinal infections including typhoid fever, surgical infections, skin and soft tissue sepsis and in a variety of infections caused by Pseudomonas aeruginosa, notably cystic fibrosis. Adverse reactions are infrequent and in almost every case have proved mild and transient. Ciprofloxacin has great potential for the oral therapy of infections which have traditionally required parenteral chemotherapy.
The pharmacokinetics of ciprofloxacin following a single 100 mg oral dose were evaluated in elderly patients (mean age 74 years), laboratory staff (30-40 years) and students (less than 20 years). There were no significant differences in serum Tmax (1.2-1.3 h) or in overall serum elimination half-life (3.7-4.0 h) but Cmax in elderly patients was more than double that in young volunteers (P less than 0.005). The serum AUC value was greater both in fasting students (1.4 mg/h/l) compared with the same subjects after food (1.09: P less than 0.01) and, after food, in elderly patients (1.95) compared with students (0.81: P less than 0.005). Urinary recoveries were greater in fasting subjects and in all categories of volunteers compared with elderly patients. However, in the elderly, urinary ciprofloxacin concentrations (0-6 h mean 66 mg/l: range 17.4-200 mg/l) were more than adequate for the eradication of urinary pathogens.
An intravenous formulation of Augmentin was used as sole chemotherapy in the treatment of patients with severe infections. Fourteen of 17 assessable patients (82%) responded satisfactorily including six with bacteraemia. Adverse reactions occurred in 38% of patients but in all but one, withdrawn due to diarrhoea, were trivial. There was no significant intolerance.
Cefuroxime axetil, an orally absorbed pro-drug of cefuroxime was used to treat a mainly elderly group of patients with symptomatic urinary tract infections. The drug was clinically effective and the bacteriological short term and long term cure rates (55% and 48% respectively) comparable to those of other antibiotics. The study had to be terminated however after the development of three cases of antibiotic associated colitis. Studies of the pharmacokinetics of the drug in volunteers gave inconsistent results suggesting that there may be variable bioavailability of the compound.
Explore the source record for details and available documents.
28 patients suffering from a variety of bacterial infections have been treated with cefuroxime. 18 were cured and 6 improved during treatment. Side effects were minimal and intramuscular injection was well tolerated. Serum and urine levels well in excess of the MICs of sensitive organisms were obtained using dosages of 750 mg 8 hourly. Biliary excretion was impaired in the presence of obstruction, but adequate bile levels of cefuroxime were observed following relief of the obstruction. Cefuroxime was widely active against gram-negative bacilli and against Streptococcus faecalis, but less active against Bacteroides spp.
Explore the source record for details and available documents.
In this paper infections associated with immunological and white blood cell deficiencies are discussed, together with certain aspects of infection in patients suffering from chronic renal failure and other non-malignant disease states. Reference is made to experience of opportunistic infections at East Birmingham Hospital, and certain aspects of the prevention and management of these conditions are outlined.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
In the summer of 1975 an extensive epidemic of disease due to echovirus type 19 occurred in the West Midlands. The features of this outbreak, and their relationship to the syndrome referred to as 'epidemic neuromyasthenia', are discussed. The two diseases are considered to be separate entities.
We have studied cefuroxime, a new beta-lactamase resistant cephalosporin, and cefoxitin, the first cephamycin antibiotic, which is also resistant to many beta-lactamases. Both of these antibiotics have been shown to be microbiologically superior to the "first generation" cephalosporins, cefuroxime having notable activity against Haemophilus influenzae, and cefoxitin against Bacteroides fragilis. Neither antibiotic is absorbed from the gut but, following parenteral administration, serum, urine and bile concentrations are high. Clinical trials have been conducted on both cefoxitin and cefuroxime. The results of these have been satisfactory and untoward side-effects minimal. We suggest that cefoxitin will be particularly valuable in the management of abdominal sepsis and cefuroxime in infections caused by H. influenzae.