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Biomedical subjects

G M Caputo

Publications and source records attributed to G M Caputo.

32 records · Page 2Linked to original sources
PubMed1993

Endocarditis due to coagulase-negative staphylococci. Microbiologic, epidemiologic, and clinical considerations.

Coagulase-negative staphylococci are the most frequently isolated pathogens in prosthetic valve endocarditis and cause 5% of infections involving native valves. Distinguishing contamination from bacteremia may be challenging. The presence of heteroresistance in many strains makes rigorous susceptibility testing a requirement for selecting appropriate antibiotic selection. Infection is frequently complicated by valvular insufficiency with congestive heart failure, local tissue invasion or synthetic embolization, making surgical intervention necessary in many cases.

Coagulase↗
PubMed1992

Concomitant oculoglandular and ulceroglandular fever due to herpes simplex virus type I.

Herpes simplex virus is a commonly encountered infectious agent in clinical practice. The syndromes with which it is usually associated are well described and generally easily recognized. This report documents that two uncommon clinical syndromes, ulceroglandular fever and oculoglandular fever, may be caused by this virus. Our patient's case was even more unusual in that both conditions occurred simultaneously.

Adolescent↗
PubMed1991

Lyme anxiety.

Explore the source record for details and available documents.

Anxiety↗
PubMed1987

Native valve endocarditis due to coagulase-negative staphylococci. Clinical and microbiologic features.

Twenty-one patients with native valve endocarditis caused by coagulase-negative staphylococci were studied; 14 had pre-existing valvular or congenital heart disease. Although commonly subacute in presentation, complications of endocarditis were frequent: arterial emboli in five patients, new electrocardiographic conduction system abnormalities in nine, congestive heart failure in eight, annular or myocardial abscesses in five, and disruption of valve leaflets in three. Cures were achieved in 10 of 12 patients treated medically and seven of nine treated surgically. In microbiologic studies of 16 coagulase-negative staphylococci from patients with endocarditis, only eight were identified as Staphylococcus epidermidis. All isolates were susceptible to vancomycin. Antibiotic resistance (methicillin, four isolates; gentamicin, two isolates; rifampin, one isolate) was usually associated with nosocomial acquisition of endocarditis. Rather than representing contamination, coagulase-negative staphylococci in blood cultures may indicate life-threatening endocarditis. However, with careful attention to the selection of antibiotics for therapy and to the occurrence of heart failure due to intracardiac complications, treatment of this form of endocarditis is frequently successful. Organisms must always be tested for cryptic resistance to beta-lactam antibiotics. Valve replacement may be required frequently.

Anti-Bacterial Agents↗
PubMed1987

Reeducative treatment of female genuine stress incontinence.

Three-months re-education treatment of genuine stress incontinence was given to 26 female outpatients: 22 patients completed the treatment programme and 4 interrupted it for various reasons. The aims of the treatment were both to correct compensatory habits that patients used to conceal or reduce leakage accidents and to give specific education and strengthening of pelvic floor muscles. All patients who completed the three-months treatment definitely improved and 7 were cured. Accordingly a marked reduction or absence of weekly incontinence episodes as well as a reduction of the daily frequency of micturition was observed. On vaginal palpation a clear-cut improvement of pubococcygeous muscle contractility was detectable. Urethral closure pressure profilometry showed significant improvement of functional urethral profile length at rest and of maximal urethral closure present both at rest and during maximal voluntary contraction of the pelvic floor muscles. Micturition cystourethrography, repeated in 15 patients at the end of the treatment, showed a clear-cut improvement of bladder neck suspension defects in all but 2 patients. Follow-up assessments showed that the clinical effects were long-lasting. Possible mechanisms of this re-educative technique are discussed.

Adult↗
PubMed1986

Cefoperazone for empiric therapy in patients with impaired renal function.

Thirty-five patients with serious infections and impaired renal function were treated empirically with 2 to 8 g of cefoperazone per day. Infections included sepsis in 14, nonbacteremic urinary infections in nine, pneumonia in five, intra-abdominal infection in five, fasciitis in one, and malignant otitis externa in one. The average age of this group was 64.3 years, 25 had ultimately fatal underlying diseases, and their average serum creatinine level was 5.2 mg/dl. Infections were caused by Enterobacteriaceae in 23 patients, Streptococcus faecalis in five, Pseudomonas aeruginosa in four, Staphylococcus aureus in four, Hemophilus influenzae in three, and Staphylococcus epidermidis, Streptococcus pneumoniae, and Clostridium sordelli in one each. Overall, 32 patients had clinical and microbiologic cures, two had improvement, and one had failure. Hypoprothrombinemia occurred in 18 of 28 patients not given vitamin K for prophylaxis and occurred more often in those with serum albumin concentrations below 3.5 g/dl. Prothrombin times returned to normal within 36 hours of treatment with vitamin K, although two patients experienced mild hematemesis. In anicteric patients with liver function abnormalities, 2 g every 12 hours produced peak and trough serum concentrations that averaged 254 and 125 micrograms/ml, respectively, compared with 179.5 and 19.5 micrograms/ml, respectively, in five with normal liver function test results. In jaundiced patients treated with 1 g every 12 hours, trough concentrations were comparably elevated. Serum concentrations did not correlate with hypoprothrombinemia, but high levels throughout the dosing interval may have contributed to the excellent cure rate in this study.

Acute Kidney Injury↗
PubMed1986

In vitro activity of CI-934, a new quinolone antimicrobial, against gram-positive bacteria.

The in vitro activity of CI-934, a new quinolone antimicrobial, was compared with that of ciprofloxacin against selected gram-positive bacteria. Concentrations of CI-934 required to inhibit 90% of strains (MIC90) were twofold to eightfold lower than those of ciprofloxacin. With the exception of Streptococcus faecium, all isolates were inhibited by CI-934 at concentrations less than or equal to 1.0 microgram/ml.

Anti-Bacterial Agents↗
PubMed1985

The effects of latamoxef, cefotaxime, and cefoperazone on platelet function and coagulation in normal volunteers.

A bleeding diathesis characterized by in-vitro platelet dysfunction and prolongation of the template bleeding time (TBT) has been reported in patients receiving latamoxef ('moxalactam'), but not cefotaxime or cefoperazone. Hypoprothrombinaemia has been associated with the use of both latamoxef and cefoperazone in seriously ill and malnourished patients. We administered either latamoxef, cefotaxime or cefoperazone intravenously, at dosages within the range recommended by each manufacturer, to 14 normal volunteers. Latamoxef caused a dose and time dependent defect in platelet function characterized in vitro by abnormalities in aggregation to adenosine diphosphate and in vivo by prolongation of the template bleeding time. In two out of two subjects, a single 4 g dose of latamoxef caused neither prolongation of template bleeding times nor aggregation abnormalities. Two out of two subjects receiving latamoxef 6 g/day for six days had progressive prolongation of bleeding times to 12 and 15 min. Two additional subjects receiving latamoxef 12 g/day for four days had prolongation of template bleeding times to greater than 20 min. Of four subjects receiving cefotaxime 12 g/day for seven days, none had prolongation of template bleeding times or abnormalities in platelet aggregations. Of four subjects receiving cefoperazone 6 g/day, none had significant prolongation of template bleeding times and one had abnormalities in aggregation attributed to inadvertent salicylate ingestion. Prolongation of the prothrombin time or activated partial thromboplastin time did not occur in any of the 14 volunteers. Latamoxef is more likely to interfere with platelet function than either cefotaxime or cefoperazone.

Blood Coagulation↗
PubMedDate not supplied

New developments in the biomechanics of the diabetic foot.

Biomechanical issues are now widely recognized as being important in the treatment of diabetic foot disease. The purpose of the present review is to identify advances that have occurred since the previous International Conference on the Diabetic Foot in 1995 in the understanding of foot biomechanics in relation to diabetes. Attention continues to be focused on the identification of a threshold plantar pressure that leads to tissue damage. Recent studies have suggested that peak barefoot pressure may be only 65% specific for the development of ulceration. The association between foot deformity and plantar pressure has been the subject of several quantitative studies, but new questions have been raised about the etiology of claw toes. The measurement of shear stress continues to be an elusive goal although several small studies have presented possibly feasible technical approaches. The importance of callus as a precursor to ulceration has been confirmed experimentally and quantitative measures of motor neuropathy have been presented. Although a number of new devices have been introduced as alternatives to the Total Contact Cast, few clinical studies of their efficacy are available yet. New information on the properties of insole materials has been published including data on changes with repeated cycling. Complications of prophylactic surgery have been shown to include a high rate of Charcot fractures. Two new series describing the fixation of such fractures have also been reported. Biomechanical issues have also been addressed in two sets of guidelines for treatment that have recently been published. These many studies confirm the central role of mechanical stress and its relief in the treatment of neuropathic foot problems in diabetes.

Biomechanical Phenomena↗