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Biomedical subjects

J A Mohr

Publications and source records attributed to J A Mohr.

At least 19 recordsLinked to original sources
PubMed1999

Adherence of human immunodeficiency virus-infected patients to antiretroviral therapy.

The impact of demographic, psychosocial, and medical regimen-related variables on adherence of 123 human immunodeficiency virus (HIV)-infected patients to antiretroviral therapy was assessed by means of refill methodology. Satisfaction with social support (P = .029), problem-focused coping (P = .027), and active-behavioral coping (P = .011) correlated significantly with adherence, whereas loss of motivation (P = .006), hopelessness (P = .16), and avoidant coping (p = .015) correlated with nonadherence. At the 6-month follow-up, the mean CD4 cell count differed significantly among adherent versus nonadherent patients (a mean increase of 78/mm3 vs. a mean decrease of 5/mm3; P = .018). Adherence did not correlate with the number of antiretroviral medications consumed per day (mean, 3.0 vs. 2.5). Non-Caucasian patients were more likely to be nonadherent than Caucasian patients (relative risk, 2.5; 95% confidence interval, 1.2-5.3; P = .013); this difference was not explained by age, education, employment, income, history of intravenous drug use, or medical regimen. Non-Caucasian patients, however, were less satisfied with their social support (P = .04) and informational support (P = .016) and were more likely to utilize emotion-focused coping (P = .01). Thus, satisfaction with social support and coping style significantly impacted adherence and likely accounted for the observed racial difference in adherence among HIV-infected patients.

Adaptation, Psychological↗
PubMed1989

Timolol side effects and inadvertent overdosing.

The case reports demonstrate that significant and potentially dangerous side effects from timolol maleate occur as a result of inadvertent overdosing. Because many glaucoma patients are elderly and vision is frequently impaired, overdosing may be the mechanism of side effects in many patients especially the elderly. A simple dropper that would withdraw only one drop and deliver the same would resolve this problem.

Aged↗
PubMed1983

Bacteremia associated with esophageal dilatation.

The present study was undertaken because the previously reported incidence of bacteremia associated with esophageal dilatation seemed high, and did not correlate well with clinical experience. Seventeen adult patients were dilated for benign esophageal strictures with one to three dilators on 41 occasions. Five blood cultures were taken over the 30-minute period after each dilatation. Either routinely sterilized dilators or dilators resterilized just before the procedure were used in a random fashion. On 22 of the occasions that routinely sterilized dilators were used in 17 patients, temperatures, white blood counts, and blood cultures were normal in each instance. Resterilized dilators were used on 19 occasions in 15 subjects, and postdilation temperatures and white blood counts were also normal. Two blood cultures from different patients grew Staphylococcus epidermidis, which were felt to be contaminants. On the basis of this and previous studies, extra precautions do not appear to be necessary for dilatation of routine benign strictures. In patients at risk for endocarditis, or those with cancer or tight strictures, it seems advisable to sterilize dilators just before use, and take extra precautions.

Adult↗
PubMed1983

Syphilis and axial arthropathy.

Inadequately treated syphilis predisposes the patient to the long-term complications of his disease. Neuropathic arthropathy (the Charcot joint), especially when axial or spinal, is critical to diagnosis, but is sometimes overlooked. We have reported a patient with syphilis, both neurologic and joint disease, and included the first computed tomographic views of vertebral syphilitic osteitis.

Aged↗
PubMed1983

Stress urinary incontinence: a simple and practical approach to diagnosis and treatment.

A study to evaluate the efficacy of a simple and inexpensive diagnostic and therapeutic approach to stress incontinence in 46 elderly women is described. The treatment had two aspects: estrogens, both orally and topically, and a pelvic floor exercise program. The study shows that stress incontinence and stress incontinence with urgency incontinence in non-institutionalized, ambulant elderly women can be diagnosed and successfully treated in the great majority of cases without the need for expensive and potentially hazardous diagnostic and therapeutic modalities.

Adult↗
PubMed1983

Bronchoscopic diagnosis of pulmonary infections. Comparison of protected-specimen brush and cytology brush with lung aspirates.

In a recent study the use of a new plugged double-lumen protected-specimen brush with the flexible fiberoptic bronchoscope was advocated to isolate pathogens in lower respiratory tract infections while avoiding upper respiratory tract contamination. To compare the efficacy of this brush and a standard single-lumen cytology brush in identifying the etiologic agent in lower respiratory tract infections, we studied 18 patients with lung infections. Transthoracic lung aspiration was done in all but two patients in an attempt to identify the specific etiologic agent. In these two cases, cultures of specimens of blood or postmortem lung tissue yielded the causative organism. In 12 patients anaerobic or aerobic bacteria (or both) were identified, whereas one patient had a mixed bacterial and fungal infection. Using the cytology brush and the protected-specimen brush we identified at least one pathogen in 10 of 12 and 10 of 13 cases, whereas both brushes missed one or more causative organisms in 8 of 12 and 8 of 13 cases, respectively. Nonetiologic organisms were found in 8 of 12 cases by the cytology brush and 8 of 13 cases by the protected-specimen brush. Quantitative culture techniques improved the specificity of the brush results in infections where aerobes predominated. Our data show that bronchoscopic cultures of lower respiratory tract infections do not consistently recover the causative agent and are frequently subject to contamination by nonetiologic organisms. There was no difference between the brushes in avoiding contamination.

Adolescent↗
PubMed1982

Mucormycosis of the trachea: an unusual cause of acute upper airway obstruction.

Mucormycosis (phycomycosis) has been reported to involve most organ systems in man. We report a young insulin-dependent diabetic who presented with acute upper airway obstruction because of isolated mucormycosis of the trachea. A combination of amphotericin B and surgical resection of the lower two thirds of the larynx and five tracheal rings with primary reanastomosis has resulted in a cure with no evidence of recurrence after nine months of follow-up. To our knowledge, this represents the first report of isolated tracheal mucormycosis and/or acute upper airway obstruction due to mucormycosis.

Adult↗
PubMed1979

Fusarium oxysporum endophthalmitis.

A 27-year-old man sustained a thorn injury to his left eye and a culture-proven Fusarium oxysporum endophthalmitis developed. This was successfully treated with a vitrectomy, intravitreal and intravenous amphotericin B, and oral flucytosine. The patient maintains 20/20 vision at this time in his left eye. We recommend combined therapy for this filamentous fungal infection.

Adult↗
PubMed1979

Pulmonary sporotrichosis in Oklahoma in susceptibilities in vitro.

Six cases of pulmonary sporotichosis were observed in 2 institutions in Oklahoma City, Okla. Three of the patients were treated with iodides with or without surgery. Although one patient required a second course of iodides, the patients have remained well after at least 34 months of follow-up. Three patients treated with amphotericin B, single course as well as multiple courses, and other antifungal agents (hydroxystilbamidine and miconazole) have all relapsed. These cases and a reviewed of more than 40 cases of pulmonary sporotrichosis susceptibilities of Sporothrix schenckii that we observed in vitro suggest that amphotericin B is not an effective agent for the treatment of pulmonary sporotrichosis. It is our opinion that the treatment of choice for pulmonary sporotrichosis is a supersaturated solution of potassium iodide. If the patient is allergic to the medication or fails to respond, then a combination of amphotericin B plus flucytosine may be tried.

Adult↗
PubMed1979

Relapsing fever.

Explore the source record for details and available documents.

Adult↗
PubMed1979

Septic shock.

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Anti-Bacterial Agents↗
PubMed1978

Clostridial myonecrosis ('gas gangrene') during cephalosporin prophylaxis.

Four cases of clostridial myonecrosis that developed in open fractures were treated with surgical debridement and with intravenous cephalosporins as antibiotic prophylaxis. All patients recovered following amputation of the involved extremity, and treatment with high-dose penicillin in three cases, and erythromycin plus high-dose cephalothin in the fourth. This complication was not seen in patients with similar injuries that were managed surgically but used other antibiotics, usually penicillin, as prophylaxis. In vitro susceptibility tests of clostridia to cephalothin were performed; the results demonstrated that nearly 50% of clostridia tested were resistant to cephalothin.

Adult↗