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Biomedical subjects

L E Curtis

Publications and source records attributed to L E Curtis.

At least 19 recordsLinked to original sources
PubMed1984

Antibiotic prophylaxis in high-risk biliary operations: multicenter trial of single preoperative ceftriaxone versus multidose cefazolin.

A prospective, double-blind trial of a single preoperative dose of ceftriaxone, a new long-acting cephalosporin, versus one preoperative and three postoperative doses of cefazolin was carried out in 81 patients at high risk of infection after biliary surgery. Indications for antibiotic prophylaxis included recent or ongoing cholecystitis (52 patients), common duct stones (14 patients), common duct obstruction (3 patients), and age greater than 70 years (22 patients). Intraoperative bile cultures were positive in 7 of 41 patients (17.1 percent) given ceftriaxone and 12 of 40 patients (30 percent) given cefazolin, but there were no wound infections in either group. Neither regimen was associated with significant antibiotic resistance. Side effects, such as proteinuria and elevated liver transaminases and alkaline phosphatase levels, were transient and not definitely related to the antibiotics. We conclude that a single preoperative dose of ceftriaxone is as effective as multiple perioperative doses of cefazolin in the prophylaxis of infection associated with biliary tract surgery.

Adolescent↗
PubMed1981

Infant perception of numerosity.

A multiple habituation paradigm was used to determine whether 10--12-month-old infants were able to discriminate between visual arrays which differed only in their numerosity (2 vs. 3, 3, vs. 4, or 4 vs. 5 items). 96 infants were tested in one of two conditions. In the heterogeneous condition, infants were habituated to a series of slides in which only the number of items remained invariant, while the item type (e.g., dogs, houses, etc.), size, and position varied on each slide. In the homogeneous condition, both the item type (chicks) and number remained invariant, while the size and position of the stimuli varied. Infants in both conditions were then tested with slides which contained either N + 1 or N - 1 items. The results demonstrated that, regardless of condition (homogeneous/heterogeneous), infants were able to discriminate between 2 and 3 items and unable to discriminate between 4 and 5 items. For the 3 versus 4 discrimination, a condition x sex interaction indicated that females discriminated between the items in the homogeneous condition while males were able to make the discrimination in the heterogeneous condition. Since the subjects in this study were preverbal infants, the results suggest that early counting skills are preceded by a more perceptual awareness of numerosity.

Concept Formation↗
PubMed1978

Effect of acid and pepsin on blood coagulation and platelet aggregation. A possible contributor prolonged gastroduodenal mucosal hemorrhage.

In a series of in vitro studies, both the soluble (plasmatic) coagulation system and the cellular (platelet-mediated) aspect of coagulation were shown to be extremely sensitive to relatively minor increases in hydrogen ion concentration. All studies became abnormal at pH 6.8. At pH 6.4, assays of the intrinsic and extrinsic coaglution systems, the polymerization of fibrinogen, and assay of the availability of platelet phospholipid (platelet factor 3) were twice prolonged over control values. Platelet aggregation was reduced by more than 50%. At pH 5.4 in vitro, platelet aggregation and plasma coagulation were both virtually abolished. Furthermore, previously formed platelet aggregates disaggregated at a slightly acid pH. Pepsin further enhanced platelet disaggregation. Because gastric acidity is normally two to four orders of magnitude greater than that which abolishes platelet aggregation and plasma clotting in vitro, and pepsin is present in abundance, we call attention to the probable antihemostatic effect of hydrocloric acid and pepsin in the upper gastrointestinal tract. This in vitro study may provide a rationale for meticulous regulation of intragastric pH in an effort to control upper gastrointestinal hemorrhage.

Blood Coagulation↗
PubMed1976

Gastrinoma of duodenal G-cell origin.

A 65-year-old man with hypergastrinemia associated with the Zollinger-Ellison syndrome was found to have a duodenal "carcinoid-islet cell tumor." Gastrin levels have remained normal for more than 1 year following total gastrectomy and removal of the duodenal tumor. Immunohistochemical studies for gastrin localization revealed positive staining of the tumor and of a population of nonneoplastic G-cells in the adjacent duodenal mucosa and Brunner's glands. These results support the hypothesis that gastrinomas may arise as primary tumors from duodenal G-cells rather than from ectopic pancreatic tissue. "Carcinoidislet cell tumors," like other tumors of APUD-cell origin, may express dual biochemical functions in the form of polypeptide hormone and/or amine secretion. Their content of specific hormonal products may be predicted on the basis of sensitive histochemical and immunohistochemical techniques.

Adenoma, Islet Cell↗
PubMed1976

Abdominal incision and closure. A systems approach.

The application of systems analysis and flow charting technics to abdominal incision and closure allow a complete display of objectives and alternatives. A route of alternatives has been chosen and supported by the best available principles in the surgical literature. The choices include an unconventional large bite monofilament continuous one-layer closure of the abdominal aponeurosis as well as several less commonly used principles to minimize the risk of wound infection. The process of graphic display of objectives and alternatives in a surgical procedure or disorder allows one to more sharply focus on alternatives at different steps and more rigidly support them by careful analysis of past experience or review of the literature.

Abdomen↗
PubMed1976

Treatment of hemorrhagic gastritis by antacid.

A simple and safe method of nonsurgical treatment for the control of massive acute gastric mucosal hemorrhage is described. The procedure was developed from experimental and clinical observations that the presence of gastric hydrocloric acid played an important part in the development and perpetuation of the entity. The treatment consists of complete neutralization of gastric acid with antacid to a pH of 7. The antacid is intermittently added and aspirate at 7. In a retrospective analysis, the hemorrhage was controlled in 44 of 49 patients (89%). Five patients who continued to bleed underwent surgery (10%). Three patients had vagotomy and pyloroplasty and their bleeding ceased without recurrence. Two patients underwent partial gastrectomy, but they developed recurrent bleeding and died. One patient whose bleeding has been controlled by vagotomy and pyloroplasty died without hemorrhage 10 days after operation. Of the 44 patients whose bleeding had been controlled by antacid, 11 patients died without hemorrhage one or more weeks later. These results of 89% control of hemorrhage compare favorably with those in the literature.

Adult↗
PubMed1975

Efficacy of intravenous clindamycin and methicillin in gram-positive soft tissue infections.

In a comparative study on a general surgical service, intravenous clindamycin phosphate or methicillin was used to treat a variety of soft tissue infections due to gram-positive organisms, chiefly staphylococci. The infections were rated according to severity, responsible organisms, and site of the infection. Excellent or good clinical and bacteriologic responses were obtained with both clindamycin and methicillin as adjuncts to basic surgical therapy in these soft tissue infections. The adverse effects of each drug were detailed, and were comparable. Clindamycin phosphate is a satisfactory substitute for methicillin in soft tissue infections secondary to gram-positive organisms.

Adult↗