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Biomedical subjects

C Stratton

Publications and source records attributed to C Stratton.

15 recordsLinked to original sources
PubMed2000

Experimental study of mortality and morbidity of contrast media and standardized fecal dose in the peritoneal cavity.

BACKGROUND: The use of radiographic contrast media in the setting of possible bowel ischemia and potential perforation is known to be associated with increased clinical risk. However, there is a lack of controlled studies using a standard native fecal load to define and compare the intrinsic mortality and morbidity among options of contrast media currently available to the radiologist. We have compared the mortality and gross and histopathologic morbidity of a standard intraperitoneal native fecal dose in the guinea pig, using barium, two iodinated media, saline and air. MATERIALS AND METHODS: The study was performed on adult Hartley guinea pigs. A standard native fecal solution with a colony count of 10(8) aerobes and 2 x 10(7) anaerobes was prepared, and the LD50 of intraperitoneal injection of the solution was determined. The standard solution at the LD50 dose was then used to compare the mortality and morbidity when commercial barium sulfate (18% w/v), Conray 30 (iothalamate meglumine 30%), 1:1 dilution of Conray 30 with sterile water, termed Conray "15" (iothalamate meglumine 15%), saline and air, were added to the intraperitoneal injection of the fecal solution in five groups of 20 animals each. Mortality and acute (96 h) and chronic (30 days) gross and histopathology were assessed and graded according to a standard system and analyzed statistically. RESULTS: Barium was significantly more deleterious than the dilute water-soluble iodinated media, saline and air. Mortality occurred within 24 h in the barium group and within the initial 48 h in all groups as follows: barium 19/20 (95%); Conray 30 16/20 (80%); Conray "15" 7/20 (35%); saline 0; air 0. Acute gross and histopathology showed extensive grade 4 lesions in 19/19 barium animals; less severe lesions were present in a lesser percentage of the animals in the other four groups. Entirely chronic lesions were present only in the single surviving barium animal and were non-significant (< 400 microns) or absent in the other four groups. CONCLUSIONS: In our study, barium incurred the most significant deleterious short and long-term effects in the setting of fecal peritonitis. Dilute water-soluble media offer a much greater margin of safety. Saline under sonographic guidance is less deleterious than any of the positive radiographic contrast media. However, in our study, air was the safest contrast medium in the setting of peritoneal soiling.

Animals↗
PubMed1996

Sternoclavicular joint septic arthritis with small-colony variant Staphylococcus aureus.

Small-colony variants of Staphylococcus aureus may cause invasive disease in adults that is prolonged and refractory to standard therapies. We present a case of sternoclavicular arthritis with small-colony variant S. aureus that occurred in an 11-year-old child and discuss the importance of identification of these variants in the clinical microbiology laboratory.

Anti-Bacterial Agents↗
PubMed1995

Increased bactericidal activity as documented by serum bactericidal titers for a triple combination of cell wall active agents against gentamicin-resistant enterococci.

Infections caused by entercocci have become increasingly difficult to treat because these bacteria are becoming increasingly resistant to commonly used antibiotics such as ampicillin, gentamicin and vancomycin. A consensus for an optimal therapy of enterococcal infections caused by resistant isolates has not yet been determined. We present a patient with prolonged enterococcal sepsis in whom a combination of ampicillin, vancomycin and imipenem was ultimately successful in suppressing enterococcal bacteremia. The enhanced activity of this triple combination was documented by the results of serial serum bactericidal titers.

Adult↗
PubMed1986

Beta-blockers, plasma total creatine kinase and creatine kinase myocardial isoenzyme, and the prognosis of subarachnoid hemorrhage.

Under double-blind randomized conditions the effects of early intervention with oral propranolol or a placebo were studied in 51 cases of subarachnoid hemorrhage. Eleven out of 23 patients randomly assigned to placebo had a poor outcome at 6 months, while 2 of the 28 patients randomly assigned to propranolol had a poor outcome (p less than 0.001). Patients with a poor outcome on the placebo had significantly higher mean plasma total creatine kinase levels (742 IU, standard error of the mean +/- 233 IU) on the fifth day after subarachnoid hemorrhage than patients with a good outcome on the placebo (108 +/- 20 IU; p less than 0.05). A raised plasma creatine kinase myocardial isoenzyme was associated with a particularly poor outlook in patients receiving the placebo, in contrast to those taking a beta-blocker. Clinical outcome and plasma creatine kinase levels in patients taking atenolol (hydrophilic) were similar to those observed in patients receiving propranolol.

Adrenergic beta-Antagonists↗
PubMed1986

In vitro fertilization and embryo transfer: two-year experience.

Between February 1983 and January 1985, 206 laparoscopies were performed on 172 women following controlled ovarian hyperstimulation with human menopausal gonadotropin (hMG) and human chorionic gonadotropin (hCG). Sixty-four clinical pregnancies advanced beyond the sixth week of gestation and were confirmed by ultrasound; and 37.2% of the patients conceived after in vitro fertilization and embryo transfer. The clinical pregnancy rate was 31.1% when based on the number of laparoscopies performed and 33.9% when based on the number of embryo transfers. There were 12 multiple pregnancies (18.8%), 11 miscarriages (17.2%), and one ectopic (tubal) pregnancy (1.6%). The most important factors contributing toward the success of this program were the establishment of specific criteria for patient selection, rigid adherence to clinical and laboratory protocols, and the maintenance of strict quality control.

Abortion, Spontaneous↗
PubMed1983

Blood testing compared with urine testing in the long term control of diabetes.

A comparison of visually read glucose oxidase strips and urine testing is reported in an unselected group of 19 diabetic children in relation to the degree of control achieved and to its acceptability. The degree of control was at least as good after five months' blood glucose monitoring at home (mean blood glucose 9.3 +/- SEM 2.9 mmol/l, mean 24 hour glucose excretion 113 +/- SEM 168 mmol/l) as after five months' urine testing (mean blood glucose 11.1 +/- SEM 4.1 mmol/l, mean 24 hour glucose excretion 141 +/- SEM 98 mmol/l). Home blood glucose monitoring was preferred either alone or in conjunction with urine testing in most cases.

Adolescent↗
PubMedDate not supplied

Fluoroquinolone antibiotics: properties of the class and individual agents.

The broad spectrum of activity and bactericidal nature of the fluoroquinolones, together with their excellent absorption, rapid distribution, and high tissue concentration, make them excellent therapeutic agents for the management of a number of complicated community-acquired and nosocomial infections of the urinary tract, bone and soft tissue, gastrointestinal tract, and prostate, as well as some respiratory tract infections and sexually transmitted diseases. Data are presented and reviewed concerning the in vitro activity, pharmacology, and clinical use of ciprofloxacin, norfloxacin, and ofloxacin, which have been available for some time, and lomefloxacin and temafloxacin, which are recently approved agents. The comparable qualities and differences in activity and clinical applications of these agents are considered. For many infections in selected patients, quinolones are excellent substitutes for parenteral agents. In general, adverse effects have been infrequent and rarely require drug discontinuation. Significant interactions, such as with theophylline and caffeine, have occurred but are quinolone dependent. Antacids can markedly impair the absorption of all quinolones. Because emerging resistance to Pseudomonas and Staphylococcus species have been observed, the improper use of the quinolones must be avoided, and the clinician must be aware that an unfavorable response may signal resistance. The development of future agents with better gram-positive activity, improved gram-negative coverage, and activity against unusual pathogens such as Chlamydia species and Mycobacterium species, will make these oral agents invaluable. Assessing the usefulness and safety of these antibiotics in children is an ongoing challenge.

4-Quinolones↗