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Biomedical subjects

J W Winter

Publications and source records attributed to J W Winter.

9 recordsLinked to original sources
PubMed1989

Cholecystectomy.

We retrospectively reviewed 360 consecutive cholecystectomies done by the four surgeons in our private group practice. No patient had dehiscence of the wound or evisceration. One patient had a seroma, which was opened in the office, but the fluid contained no white blood cells or bacteria on smear, and the culture was negative. No deaths occurred during the hospitalization or within 30 days after the operation. Routine perioperative antibiotics were used, and most wounds were drained with closed suction drainage. Routine intraoperative cholangiography was also done. On the basis of the favorable morbidity and mortality in this large group of patients and a review of the literature, we recommend the routine use of antibiotics and cholecystectomy for most patients with gallstones.

Cephalosporins↗
PubMed1985

Hepatic cirrhosis in young adults: association with adolescent onset of alcohol and parenteral heroin abuse.

Hepatic cirrhosis is infrequently diagnosed in young adults. In a hospital for addictive diseases in New York City, we found cirrhosis in 53 patients under age 35 within just 40 months. The cirrhosis was biopsy-proven in 37 patients (group I) and diagnosed clinically in 16 patients with severe liver disease (group II). Alcohol abuse was found in 51 patients (96%), and parenteral heroin abuse was seen in 52 (98%). The duration of alcohol abuse was seven or fewer years in 24 patients (45%) and 10 or fewer in 39 (74%). In 44 (83%), the substance abuse began in adolescence. Comparison of group I cirrhotic patients with 65 non-cirrhotic biopsied patients showed that cirrhosis was significantly associated with abuse of both alcohol and parenteral heroin (p less than 0.001). The distribution of 66 HLA antigens from A, B, C, and DR loci showed no differences when 42 patients were compared with 42 ethnically-matched control substance abusers. The early development of cirrhosis in these young patients may be related to multiple hepatic injuries induced by alcohol and parenteral heroin abuse and to the onset of addictive diseases during adolescence or early adult life.

Adult↗
PubMed1983

Mycotic aortic aneurysm. A complication of Campylobacter fetus septicemia.

The first surviving case, to our knowledge, of a Campylobacter fetus mycotic aortic aneurysm is reported. Bacteremia and an ileofemoral thrombophlebitis preceded the development of the infected aneurysm, reconfirming the vascular tropism of this organism. The clinical similarity with infections caused by Salmonella choleraesuis is illustrated by this case. The full recovery of our patient attests to the efficacy of extralanatomic bypass combined with long-term antibiotic therapy in the treatment of aortic mycotic aneurysm. Because of frequent changes in nomenclature and insufficient emphasis on speciation of the various campylobacters, pathogenesis and optimal antimicrobial therapy for systemic C fetus infections have not yet been adequately defined.

Aged↗