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G D Wendel

Publications and source records attributed to G D Wendel.

59 records · Page 4Linked to original sources

Myocardial infarction during pregnancy: a review.

In the present review the world literature on pregnancy complicated by myocardial infarction is summarized, and two additional cases are presented. It is apparent that the majority of pregnant women who have died after myocardial infarction did so at the time of initial infarction, and maternal mortality was greatest if the infarction was late in pregnancy. Moreover, delivery within two weeks of infarction was associated with increased mortality as was reinfarction during labor. These results suggest that the increasing cardiovascular stresses of late pregnancy, especially when intensified by parturition, seriously compromise women with ischemic heart disease. Efforts should therefore be made to limit myocardial oxygen demand/consumption throughout pregnancy, and particularly during parturition. Although principles of management can be generalized, these high risk patients require individualization of care by a multidisciplinary team of cardiologists, anesthesiologists, and obstetricians.

Adult↗

Longitudinal evaluation of hemodynamic changes in eclampsia.

Eight primigravid women with eclampsia underwent invasive hemodynamic monitoring shortly after admission and showed initial low right and left ventricular filling pressures, hyperdynamic left ventricular function, and elevated systemic vascular resistance. These findings persisted throughout 12 postpartum hours, with management that consisted of restriction of fluid, magnesium sulfate, and intermittent hydralazine for severe hypertension. Thereafter, those women without spontaneous diuresis had elevated pulmonary capillary wedge pressures despite hyperdynamic ventricular function. We hypothesize that this phenomenon was due to mobilization of extracellular extravascular fluid prior to diuresis. Comparison of these women with those with severe preeclampsia previously reported by others suggests that their hemodynamic status is significantly influenced by differences in fluid management.

Adolescent↗

Multicenter, comparative study of cefotaxime and ceftriaxone for treatment of uncomplicated gonorrhea.

BACKGROUND AND OBJECTIVES: Cefotaxime is a third-generation cephalosporin that has in vitro activity against Neisseria gonorrhoeae, including beta-lactamase-producing strains. A single 1-g intramuscular dose is effective and is recommended by the Centers for Disease Control and Prevention as an alternative treatment for uncomplicated gonorrhea. GOAL OF THIS STUDY: This study was conducted to evaluate the efficacy and safety of a lower 500-mg dose of cefotaxime in the treatment of uncomplicated gonococcal infections. STUDY DESIGN: In a randomized multicenter study, patients who had uncomplicated gonorrhea were treated with 500 mg of cefotaxime or 250 mg of ceftriaxone. Both antibiotics were given intramuscularly. Efficacy and safety were assessed four to seven days following treatment. RESULTS: Six hundred thirteen patients were enrolled. Bacteriologic eradication rates for anogenital infection were 97.7% of the patients (213/218) in the cefotaxime group and 99.1% of the patients (221/223) in the ceftriaxone group (P = 0.243). Adverse events occurred in 4.2% and 7.5% of patients in the two groups, respectively. CONCLUSION: Cefotaxime 500 mg appears to be a safe and cost-effective alternative to ceftriaxone 250 mg for the treatment of uncomplicated gonorrhea.

Adolescent↗

Randomized comparison of cefotaxime and ceftriaxone in patients with uncomplicated gonorrhea.

Cefotaxime is a third-generation cephalosporin with excellent in vitro antimicrobial activity against Neisseria gonorrhoeae, including beta-lactamase-producing strains. A single, 1-gm, intramuscular dose has previously been shown to be effective in the treatment of uncomplicated gonorrhea. A randomized, multicenter study was conducted to evaluate the efficacy and safety of a lower, 500-mg dose of cefotaxime in comparison with ceftriaxone 250 mg, the standard treatment for uncomplicated gonorrhea. One hundred forty-two patients were enrolled and 115 were evaluable. Bacteriologic eradication rates were 95% in the cefotaxime group and 100% in the ceftriaxone group (P = 0.119). Adverse events that were possibly related to the study drug occurred in 3% and 8% of patients in the cefotaxime and ceftriaxone groups, respectively. Cefotaxime 500 mg appears to be a safe and cost-effective alternative to ceftriaxone 250 mg for the treatment of uncomplicated gonorrhea.

Adult↗