PubMed Health⌕ Search

Biomedical subjects

M Rudy

Publications and source records attributed to M Rudy.

14 recordsLinked to original sources
PubMed1998

[Bacterial flora in pharyngitis and tonsillitis].

The aim of the study was a microbiological analysis of pharyngeal swabs obtained from 158 patients with the diagnosis of pharyngitis and purulent exudates from the tonsillar crypts of 10 patients treated for chronic purulent tonsillitis. Beta haemolytic streptococci groups A, B, C and G were isolated from 30% of the patients. The most frequently isolated were Streptococcus pyogenes--12% of patients and Streptococcus group C--10.7%. Other streptococci were isolated less frequently: Streptococcus group B--44%, group G--2.5%. The majority of isolated bacteria belonged to potential pathogenic flora (70% patients). Staphylococcus aureus (37%) and Haemophilus spp. (36%) were isolated most frequently. Other bacteria were isolated in the following sequence: Moraxella catarrhalis--22%, Streptococcus pneumoniae--17% and Gram-negative rods from the Enterobacteriaceae family--6%. One case of Plaut-Vincent tonsillitis was diagnosed. Aerobic and anaerobic bacteria were isolated from purulent exudates from the tonsillar crypts of 10 patients treated for chronic purulent tonsillitis. The isolated anaerobic bacteria belonged to genus of Prevotella, Fusobacterium, Peptostreptococcus and Gemella.

Bacteria↗
PubMed1997

[Bacterial flora in chronic inner ear infections in adults].

The aim of the study was to analyse microbiologically middle ear exudate obtained from 56 patients, aged 17 to 83 years, treated for chronic otitis media. Aerobic bacteria only were found 49 patients (87,5%). Mixed aerobic and anaerobic isolates were recovered from 7 patients (12,5%). The most common bacteria isolated from the middle ear exudate, in descending order frequency, were Staphylococcus aureus (45%), Pseudomonas aeruginosa (34%), Proteus mirabilis (16%) and Prevotella melaninogenica (9%). Other organisms were isolated less frequently. In 34 patients only one isolate was recovered, in 22 patients the isolated bacteria coexisted with other microorganisms.

Adolescent↗
PubMed1995

Neonatal circumcision: associated factors and length of hospital stay.

BACKGROUND: Controversy exists regarding the efficacy of routine neonatal circumcision of male infants. Little is known about parental or provider characteristics or the use of medical resources associated with this procedure. METHODS: Records of 3703 male infants born during 1990 and 1991 at four US sites were analyzed to discern associations between circumcision and the above factors. Analyses were limited to healthy infants. RESULTS: Eighty-five percent of the infants in the study population were circumcised. White and African-American male infants were much more likely to be circumcised than those of other races (odds ratios [ORs], 7.3 and 7.1, respectively, P < .001). Compared with self-pay patients, those covered by private insurance were 2.5 times more likely to be circumcised (P < .001). Logistic regression showed that rates for obstetricians and family physicians were not significantly different. Increased odds of circumcision were found if the mother received an episiotomy (OR = 1.9, P < .001) or cesarean section (OR = 2.1, P < .001). Circumcised infants stayed in the hospital an average of one fourth of a day longer than did those who were not circumcised (mean difference, 0.26 days; 95% confidence interval, 0.16 to 0.36). CONCLUSIONS: Mother's insurance status and race as well as surgical interventions during delivery are related to circumcision. Associations with episiotomy and cesarean section suggest physician and/or parental preference for interventional approaches to health care. Generalizing the difference in hospital length of stay to the United States suggests an annual cost between $234 million and $527 million beyond charges for the procedure itself.

Circumcision, Male↗
PubMed1995

Differences in labor and delivery experience in family physician- and obstetrician-supervised teaching services.

BACKGROUND: Other studies have shown that family physicians' pregnancy management styles are different from obstetricians' styles. This study examines whether these differences also exist in teaching services supervised by family physicians and obstetricians. METHODS: A retrospective study was done of deliveries performed by residents at five teaching hospitals in five states. A total of 4,558 women were admitted to teaching services supervised by either family physicians (n = 1,754) or obstetricians (n = 2,804). Medical records for women whose labor and delivery were supervised by family physicians and obstetricians were reviewed and compared for demographics, pregnancy history, delivery management, and outcome variables. RESULTS: Women admitted to teaching services supervised by family physicians were more likely to be younger and have no insurance, compared with those on services supervised by obstetricians. Even after adjustment for pregnancy risk, obstetrician-supervised teaching services had an increased incidence of preterm labor, more frequent use of epidural anesthesia, and higher episiotomy and cesarean section rates than family practice teaching services. CONCLUSIONS: The demographic and clinical characteristics of family practice and obstetric teaching services differ. Patients on the services supervised by family physicians were more representative of the maternity practice of practicing family physicians.

Delivery, Obstetric↗
PubMed1994

Religious affiliation and obstetric outcome.

The purpose of this study was to explore the relationship between religious affiliation and obstetric outcome. We reviewed 1,919 records of patients whose infants were born at a university medical center. Data obtained from maternal and newborn records included demographic information, prenatal history, labor and delivery records, and religious affiliation. Maternal complications and neonatal intensive care unit (NICU) admissions were lowest for mainline Christians (11%, 11%), intermediate for evangelical Christians (17%, 12%), and highest for patients with no religious preferences (21%, 18%). After controlling for possible confounders, the association of religious affiliation and lower NICU admission rates remained. Mainline Christians had a lower frequency of maternal complications. Patients with a religious affiliation had better obstetric outcome than those without. Most of the association seems to be due to a lower risk social profile, but a small positive influence of religion persisted.

Adult↗
PubMed1994

Factors associated with the use of intrapartum epidural analgesia.

OBJECTIVE: To evaluate the influence of socioeconomic factors and provider characteristics on the use of intrapartum epidural anesthesia. METHODS: A total of 8229 deliveries at five hospitals were reviewed retrospectively. Bivariate analysis was performed to identify potential biases in epidural use. Logistic regression was performed to control for confounding variables. RESULTS: Epidural use was predominantly related to parity, with nulliparous women more likely to use an epidural during labor. In hospitals where epidurals were used in a higher percentage of women, we found an association between the woman's insurance status and the specialty of the physician managing labor. Race also appeared to be associated with epidural use in the participating hospital that had a large non-white population. CONCLUSION: Use of intrapartum epidural analgesia varies considerably among sites and is associated with nulliparity, higher maternal age, and several nonclinical factors.

Analgesia, Epidural↗
PubMed1994

Factors predicting elective repeat cesarean delivery.

OBJECTIVE: To determine which factors influence a trial of labor after previous cesarean delivery. METHODS: Among 8829 deliveries at five participating hospitals, the charts of 1001 women who had a previous cesarean delivery were reviewed to determine whether a trial of labor or elective cesarean had been performed. Bivariate analysis compared demographic factors, and logistic regression adjusted for other possible influential variables. RESULTS: Fifty-eight percent of the women underwent a trial of labor. Although obstetric variables did not differ between the groups, those undergoing a trial of labor were significantly more likely to be younger, non-white, unmarried, to have no one in the household employed, and to lack private insurance. When logistic regression was performed, only the site of care (odds ratio 0.36-0.52 depending on the site; P < .05) and private insurance (odds ratio 0.52, P < .0001) were independent predictors of a trial of labor. CONCLUSIONS: Local factors and insurance status are important in determining whether a woman receives a trial of labor or elective cesarean delivery. These issues must be addressed if reduction of the national cesarean rate is to be realized.

Adult↗
PubMed1993

A comparison of labor and delivery management between nurse midwives and family physicians.

BACKGROUND: Practice associations between family physicians and nurse midwives have been suggested as a means to increase the availability of obstetric care in rural areas. No evidence exists, however, that family physicians and midwives have comparable practice styles or achieve similar outcomes in obstetric patients. METHODS: The study examines patients cared for by a co-practice of nurse midwives and family physicians at a rural hospital. Data were collected through a retrospective chart audit for all patients whose prenatal care, labor, or delivery was managed by members of the practice in 1990 and 1991. RESULTS: Few differences were noted between nurse midwives and family physicians in the management of labor or delivery. The only consistent finding was that family physicians were more likely than midwives to use an episiotomy for delivery (40% vs 30% in primiparous women, P = .02; and 20% vs 10% in multiparous women, P = .007). Despite seemingly similar management styles, primiparous women managed by family physicians were more likely to undergo cesarean section (14% vs 8%, P = .05) resulting from the diagnosis of dystocia. When practice specialty was included in a logistic regression model with parity and the number of preexisting risk factors, the effect of specialty on cesarean sections remained significant with a relative risk of 2.79 for cesarean section if patients had their labor managed by a family physician (P < .001). CONCLUSIONS: Family physicians and nurse midwives managed patients in labor similarly, but nurse midwives were more likely to achieve a vaginal delivery in primiparous women and do so without an episiotomy. Although the differences found would not interfere with a collaborative practice, subtle differences in patient management do exist. Further exploration of these differences may be helpful in understanding the impact of these differences on mixed-specialty practices.

Adolescent↗
PubMed1993

[Action in vitro of disodium ethylenediaminetetraacetic acid (Na2EDTA) and antibiotics on resistant strains of staphylococcus aureus].

The investigation of action of Na2EDTA and doxycycline on strains of staphylococci resistant to doxycycline was performed by two methods: serial dilutions of tested substances in the fluid and solid medium. MIC values for Na2EDTA, doxycycline and both substances together were determined. Both methods resulted in an observation that for majority of tested doxycycline-resistant strains, application of various concentrations of doxycycline together with Na2EDTA resulted in a change of sensitivity of bacteria to the antibiotic by lowering concentration needed for bacterial growth inhibition. It seems that in further studies laborious and time-consuming method of serial dilutions in the fluid medium, should be replaced by more convenient and easier to perform method of serial dilutions of drugs in solid agar medium.

Doxycycline↗
PubMed1993

[Treatment with neomycin and Na2EDTA for skin infections in rabbits caused by Staphylococcus aureus].

The rabbits were infected intradermally with a strain of S. aureus resistant to neomycin. They were treated with neomycin, Na2EDTA and by combination of these substances, which were applied as a cream with differing concentrations of these factors. Simultaneous application of neomycin and Na2EDTA for treatment of experimental staphylococcal infections caused in rabbits with a strain resistant to neomycin, resulted in acceleration of healing of pustular changes, when compared with results obtained in animals treated with these substances alone.

Administration, Topical↗
PubMed1991

[Effects of disodium salt of ethylenediaminetetraacetic acid (Na2EDTA) and tetracyclines on drug resistant bacteria. Studies in vitro].

An effect of Na2EDTA and tetracycline (oxytetracycline and doxycycline) resistant strains of Staphylococcus aureus and Pseudomonas aeruginosa was tested. The strains were isolated from clinical specimens. The tests were performed in vitro by serial dilutions of the drugs in liquid medium. MIC for Na2EDTA, tetracyclines and a combination of Na2EDTA and tetracyclines was determined. It was shown that the combination of oxytetracycline or doxycycline with Na2EDTA caused changes in sensitivity of Staphylococcus aureus and Pseudomonas aeruginosa resistant to these antibiotics. After an application of the mixture of various concentrations of tetracycline and Na2EDTA it was observed that, with the reduction of the effective Na2EDTA dose by about half, the lowest concentrations of tetracyclines inhibiting the growth of resistant bacteria were 2-64 times lower than MIC values of antibiotics without Na2EDTA.

Doxycycline↗
PubMedDate not supplied

[Effect of ethylenediaminetetraacetic acid disodium salt and doxycycline on drug resistant bacteria].

Effect of Na2EDTA and doxycycline applied alone and in combination in the treatment of experimentally induced dermatitis in rabbits with Staphylococcus aureus resistant to tetracyclines was studied. The rabbits were divided into three groups. The animals of group I were treated locally with the ointment containing 1% doxycycline or 1% Na2EDTA. In group II topical treatment was applied by means of injections of Na2EDTA solution in doses of 12.5 and 6.25 mg Na2EDTA per 1 kg/body weight. Group III was also treated locally with Na2EDTA solution like in group II, but additionally doxycycline in a dose of 50 micrograms per 1 kg/body weight was given i.v. Favourable therapeutic results were observed in the case of local, simultaneous application of Na2EDTA and doxycycline, or local application of Na2EDTA, and intravenous administration of doxycycline. However, the best therapeutic effect was seen in the case of local, simultaneous application of the ointment containing Na2EDTA and doxycycline.

Animals↗