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Biomedical subjects

D Greer

Publications and source records attributed to D Greer.

28 records · Page 2Linked to original sources
PubMed1987

Comparative trial of a two-dosage schedule of ketoconazole 2% cream for the treatment of tinea pedis.

Sixty-two patients with mycologically confirmed tinea pedis received two different treatment regimens of ketoconazole 2% cream on a randomized double-blind basis for 1 month with weekly evaluations. A 4-week posttreatment follow-up permitted an assessment of recurrence or improvement. After 1 month of treatment, 90% of the patients treated once daily responded clinically, in comparison with 83% of those treated twice daily. The cure rate was 63% for the once-daily and 60% for the twice-daily group. This rate substantially improved at follow-up (77% and 73%, respectively). One patient from each group discontinued therapy for an adverse reaction. On the basis of both clinical and mycologic assessments, topical treatment with ketoconazole 2% cream was effective as a once-daily therapy.

Clinical Trials as Topic↗
PubMed1986

Anaesthesia for Treacher Collins and Pierre Robin syndromes: a report of three cases.

We present three patients with Treacher Collins or Pierre Robin syndromes who had historical and physical evidence of airway obstruction, difficulty feeding, and sleep disturbances. These preoperative findings correlated with difficult airway management intraoperatively. Based on this experience, we recommend that children with obstructive symptoms have laryngoscopy prior to anaesthetic induction. If the glottic opening is visualized, inhalational induction can proceed. If the glottic structures cannot be visualized, then the anaesthetist must choose between awake oral or nasal intubation, elective tracheostomy, or fiberoptic intubation. In all cases, a tracheostomy tray should be ready and a surgeon experienced in paediatric tracheostomy should be in attendance. After intubation, anaesthesia is best maintained with oxygen and a potent inhalational agent. Extubation should only be done with the patient fully awake and with emergency airway equipment immediately available. Postoperatively, these patients should be transferred to an intermediate care area or intensive care unit where they can be observed closely since delayed complications of airway obstruction are common in this group of patients.

Anesthesia↗
PubMed1986

Last days: a study of the quality of life of terminally ill cancer patients.

Behavior of a number of Quality of Life measures gathered from two samples of terminal cancer patients over the last weeks of their lives are reported. Samples represent patients in the 26 hospices participating in a nationwide U.S. demonstration project and patients in the palliative care units of two Montreal hospitals. The U.S. data reported are quality of life measures made by a lay principal care person (PCP) or trained interviewer; the Montreal measures were made by both an attending doctor and an attending nurse. The general finding, as expected, is one of increasing deterioration in quality of life, with accelerated deterioration between 3 and 1 week of death. Pain follows a somewhat different pattern than other measures. More patients are in either of the extreme categories at an earlier point in time than found for other measures, and there are fewer changes as death is approached. Finally, about 20% of the patients do not fall into extremely low quality of life categories, even in the week prior to death.

Activities of Daily Living↗
PubMed1984

Processed bovine cartilage: an improved biosynthetic implant for contour defects.

Irradiated human cartilage has been found to be a superior implant material for correction of contour defects; however, availability problems have prevented this material from gaining wide acceptance. Implantation of processed irradiated bovine cartilage in primates and rabbits, as described here, provides strong evidence that this material performs like irradiated allograft cartilage antigenically and has certain cosmetic advantages over allograft cartilage. Our studies in primates have shown that there is no systemically measurable antibody-antigen reaction, either cellular or noncellular, to irradiated processed bovine cartilage. Neither primary nor second-set provocative implantations produced any measurable rejection. In rabbits, composite grafts of two pieces of irradiated bovine cartilage adjacent to each other were also well tolerated, with no measurable absorption and with capsule formation typical of a foreign body reaction to an inert object.

Animals↗
PubMedDate not supplied

Spectrum of Cryptococcus neoformans infection in 68 patients infected with human immunodeficiency virus.

Sixty-eight patients infected with human immunodeficiency virus (HIV) and Cryptococcus neoformans who presented to three major medical centers in New Orleans, Louisiana, were studied retrospectively. In patients with meningitis the most common presenting symptoms were fever and headache. Those without central nervous system involvement generally had an isolated pulmonary infection due to C. neoformans and presented with cough and dyspnea. CSF parameters were abnormal in 41% of patients, and the India ink preparation was positive in 88% of patients with cultures of CSF positive for C. neoformans. The overall median survival time for the 47 patients who died was 5 months, with a range of 0-22 months. Of the 27 patients who received maintenance therapy with amphotericin B, two (7%) relapsed. The only factors found to be associated with a poor prognosis were abnormal computed tomography of the head and altered mental status on presentation. C. neoformans infections in HIV-infected patients remain difficult to treat and have a poor prognosis.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Hematogenous dissemination of Mycobacterium tuberculosis in patients with AIDS.

Proof of hematogenous dissemination of Mycobacterium tuberculosis was initially reported in the early 1900s and was noted to be most frequent in patients with miliary tuberculosis. More recently, M. tuberculosis bacteremia has been reported in human immunodeficiency virus (HIV)-infected patients. We describe 13 adult HIV-infected patients in whom hematogenous M. tuberculosis dissemination was evident. Although for most patients whose bone marrow aspirate cultures yielded M. tuberculosis a chest roentgenogram revealed a miliary pattern, roentgenograms for those with M. tuberculosis bacteremia usually revealed evidence of lobar or diffuse infiltrates. Most patients with M. tuberculosis bacteremia had other risk factors for M. tuberculosis, and many had a rapid death, suggesting acute fulminant infection. Our own experience suggests that there are various syndromes associated with hematogenous dissemination in patients infected with M. tuberculosis.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Evaluation of the effect of an AIDS prevention program on high school students' sexual risk-taking behavior.

The study evaluated the effects of an AIDS prevention program on 179 high school students' sexual risk-taking behavior. Young actors role modeled behaviors to reduce the risk of AIDS. Sexual risk-taking behavior was assessed prior to and 3 months after attending the program. The pre-test mean sexual risk-taking score was 1.8 (SD = 3.5) with 0 to 30 as the potential range. There were significant differences between pre- and post-test sexual risk-taking behavior for the low-risk group (< or = 1.8), Wilcoxon (127) = -4.5, p = .000, and high-risk group (> 1.8), Wilcoxon (52) = -2.2, p = .03. Findings suggest support for role modeling strategies in decreasing sexual risk-taking behavior among high school students.

Acquired Immunodeficiency Syndrome↗