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Biomedical subjects

H D Lewis

Publications and source records attributed to H D Lewis.

35 records · Page 2Linked to original sources
PubMed1981

Hepatitis B infection in hospital personnel during an eight-year period; policies for screening and pregnancy in high risk areas.

From 1972 through 1979, acute hepatitis, type B, or asymptomatic hepatitis B surface (HBs) antigenemia developed in 34 employees at Yale-New Haven Hospital. The average yearly incidence of the infection was 1.2 cases per 1,000 employees. The incidence was highest in those administering venipunctures followed, respectively, by those in the emergency room, hemodialysis unit, housestaff, laboratory, general nursing, and support service personnel. Three cases were detected during eight years of routine screening of personnel; in 1972, one of these, a pregnant nurse working in the hemodialysis unit, was moved from that unit. Subsequently, seven personnel in the unit have been transferred during pregnancy. However, staphylococcal pneumonia was acquired by one of them on a medical floor, and another nurse, seeking work in oncology, was not hired while pregnant. Both cases resulted in administrative complaints. Currently, we screen personnel in the hemodialysis and venipuncture units quarterly for hepatitis B surface antigen (HBsAg) and antibody (anti-HBs) (participation is optional for those in the emergency room and oncology) and strongly urge seronegative pregnant women to transfer from these areas.

Connecticut↗
PubMed1980

Myxomatous degeneration and cystic medial necrosis associated with acromegaly.

Although valvular lesions are rare in acromegaly, two patients with click-murmur syndrome and one patient with aortic insufficiency secondary to myxomatous degeneration and cystic medial necrosis of the aorta have been reported. Growth hormone excess has been postulated to potentiate these connective tissue defects. Excess mucopolysaccharide deposition is stimulated by growth hormone and is characteristic of both cystic medial necrosis and myxomatous degeneration. Both lesions are found in experimental lathyrism, which is potentiated by growth hormone. We observed a patient with mitral insufficiency, acromegaly documented by growth hormone levels, myxomatous degeneration of all four cardiac valves, and cystic medial necrosis of the aorta and pulmonary artery. This case presents further evidence that excess growth hormone may potentiate the connective tissue cardiovascular lesions in acromegaly.

Acromegaly↗
PubMed1979

Response to influenza A vaccine among high-risk patients.

In recent years, it has been recommended that "high-risk" patients receive influenza immunizations annually. During the 1976 National Influenza Immunization Program, a higher priority was given to these patients than to the general population. The present study was undertaken to compare the antibody response of high-risk patients with that of a group of individuals with no underlying disease after immunization with 0.5 ml of bivalent, split-virus vaccine containing 200 CCA units each of influenza A/New Jersey/76 and A/Victoria/75. Sera were obtained before and after immunization from 41 "healthy" volunteers and from 57 cariology, 31 hematology, 13 hemodialysis, and 16 renal transplant patients. The control, cardiology, and hemodialysis groups responded equally well to A/Victoria/75 antigen, but the hematology and renal transplant groups did not respond as well (P less than .05). Only the hematology patients responded at a significantly lower level (P less than .05) than the control group to A/New Jersey/76. The control and renal transplant groups had a significantly greater response to A/New Jersey/76 antigen than to A/Victoria/75 antigen (P less than .002). Although the same pattern was demonstrated by the other patient groups, the differences were not significant. Because hematology and renal transplant patients responded relatively poorly to influenza immunization, prophylactic administration of amantadine during influenza outbreaks should be considered in patients with renal function adequate to excrete this drug.

Antibodies, Viral↗
PubMed1978

Platelet aggregation. Adult-onset diabetes mellitus and coronary artery disease.

Using a turbidimetric technique, we determined 1.7 micrometer adenosine diphosphate--induced platelet aggregation and disaggregation at 37 degrees C in the platelet-rich plasmas of two groups of men with coronary artery disease. Eleven men were nondiabetic and 11 had adult-onset diabetes mellitus without retinopathy. There were no significant differences (P greater than .05) between diabetics and nondiabetics of the following variables: age, platelet count in platelet-rich plasma, first and second phases of platelet aggregation, maximum extent of aggregation, and percent disaggregation at three minutes after maximum aggregation occurred. Although the mean adenosine diphosphate--induced platelet aggregation in the platelet-rich plasmas of adult-onset diabetic men with coronary artery disease and no retinopathy was not enhanced, and the mean rate of disaggregation was not reduced, when compared with nondiabetic men with coronary artery disease or with healthy men; a slow rate of platelet disaggregation (less than 10%) occurred more frequently in the platelet-rich plasmas of men with coronary artery disease.

Adenosine Diphosphate↗
PubMed1978

Effect of aspirin on exercise-induced angina.

Suspecting that platelet thromboemboli could play a role in the pathogenesis of myocardial ischemia, we did a random-order, double-blind, crossover study of the effect of the platelet aggregation inhibitor, aspirin, on treadmill exercise-induced angina in 13 men with coronary artery disease. Although collagen-induced platelet aggregation and the second phase of adenosine diphosphate (ADP)-induced platelet aggregation were significantly decreased and the rate of disaggregation of ADP-induced platelet aggregates was significantly increased after 650 mg aspirin in buffered solution, there was no delay in onset of exercise-induced angina, change in heart rate-blood pressure product at onset of angina, or change in S-T segment depression at onset of angina. Regardless of whether the patients had received placebo or aspirin on the preceding day, treadmill exercise until angina was followed by no changes in platelet aggregation or disaggregation, platelet count in blood or platelet-rich plasma, or of the plasma concentration of nonesterified fatty acids.

Adult↗
PubMed1977

Prosthetic valve endocarditis: reviewing the problem.

Bacterial endocarditis is a serious complication of valve replacement, with an overall mortality of 59%. Fever, although a constant feature of the condition, is a nonspecific finding; other manifestations may or may not be present and the diagnosis may be overlooked. Any patient with a prosthetic heart valve and bacteremia should be considered to have endocarditis and should be treated accordingly.

Anti-Bacterial Agents↗
PubMed1975

Acoustic impedance measurements in cleft-palate children.

Clinical acoustic impedance findings in a group of 40 children with cleft lip or palate and a group of 20 noncleft children are presented. The cleft subjects exhibited a high incidence of hearing loss and aural pathology. The data suggest that impedance measurements lend pertinent supportive information to routine puretone audiometric testing in the detection and management of middle-ear disease in the cleft-palate population.

Adolescent↗