Biomedical subjects
Publications and source records attributed to J Blumenthal.
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Recommendations concerning nutrition and physical activity are an important part of health care in the elderly. There is increasing evidence that diet and exercise influence the development and progression of cardiovascular disease in the elderly as well as the young. Decreases in coronary risk factors can be achieved in the elderly by attention to proper diet and exercise.
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Mycotic aneurysms of the extracranial internal carotid artery are rare; they usually appear as an enlarging pulsatile neck mass with associated pain, tenderness, and fever. This case report illustrates the need for prompt diagnosis and urgent surgical intervention. The most common organisms found with these aneurysms have been Staphylococcus aureus and Streptococcus pyogenes. We report a case of a mycotic internal carotid artery aneurysm resulting from Salmonella enteritidis. A 20-year review of both the foreign and English language literature revealed only one other case of a mycotic carotid aneurysm resulting from Salmonella infection. The cornerstone of therapy in the past had been proximal ligation. More recently, primary reconstructive procedures with either an end-to-end anastomosis or an interposition vein graft have been described. The present case was managed with an end-to-end technique with the use of a Pruitt-Inahara shunt.
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Infective endocarditis is a dynamic disease for which various infective organisms may be responsible in different patient populations. Antimicrobial therapy should be directed against the specific organism after it has been identified by blood culture. An agent with a spectrum that includes the enterococci should be given in the meantime. Prophylactic use of a bactericidal agent is necessary for patients with valvular or congenital heart disease. Recent advances in microbiologic and cardiac diagnostic procedures offer the clinician various methods of following the activity of the disease, and immunobiology has provided new insights into its pathogenesis.