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Biomedical subjects

M Sands

Publications and source records attributed to M Sands.

At least 19 recordsLinked to original sources
PubMed1991

Interstitial deletion of the long arm of chromosome 18, del(18)(q12.2q21.1): a report of three cases of an autosomal deletion with a mild phenotype.

We describe three unrelated patients with apparently identical interstitial deletions of the segment (18) (q12.2q21.1). They were a short and markedly mentally retarded 5 year old girl, a macrocephalic and obese 2 1/2 year old boy with moderate mental retardation, and a macrocephalic, severely mentally retarded 5 year old boy. Findings common to all five liveborn patients so far identified as carrying this deletion include a pattern of minor dysmorphic features (prominent forehead, ptosis of the upper eyelids, full periorbital tissue, epicanthic folds, strabismus), muscular hypotonia, seizures, behavioural disorders, and lack of major malformations.

Abnormalities, Multiple↗
PubMed1990

Anti-mosquito antibodies reduce the susceptibility of Aedes aegypti to arbovirus infection.

Aedes aegypti (L.) mosquitoes showed a significant reduction in susceptibility to infection with Ross River virus and Murray Valley encephalitis virus when they were fed on a blood-virus mixture containing rabbit antibodies to mosquito midgut components. Presence of the antibodies did not demonstrably affect virus titres in infected mosquitoes, nor the transmission of virus from infected mosquitoes to vertebrates.

Aedes↗
PubMed1990

Alagille syndrome and deletion of 20p.

We add five cases of 20p deletion to the 10 cases already published. Four had craniofacial, vertebral, ocular, and cardiovascular features of Alagille syndrome, which adds weight to the assignment of this disorder to the short arm of chromosome 20. Included in our series is the first report of familial transmission of a 20p deletion.

Abnormalities, Multiple↗
PubMed1989

Outbreak of nosocomial Flavobacterium meningosepticum respiratory infections associated with use of aerosolized polymyxin B.

Flavobacterium meningosepticum is an uncommon cause of adult nosocomial infection. On a medical/surgical intensive care unit we recently encountered an adult outbreak of respiratory colonization and infection caused by this organism, which was associated with the prophylactic use of aerosolized polymyxin B that had been used in an attempt to abort an outbreak of infection caused by highly resistant strains of Pseudomonas aeruginosa. Twenty isolates (95% from respiratory secretions) of F. meningosepticum from nine persons were identified during a 2 1/2-month period. No environmental source has been identified to date. Pneumonia developed in five patients, and two deaths associated with this organism occurred. All isolates were sensitive to ciprofloxacin; none were sensitive to other antibiotics tested, including third-generation cephalosporins, aminoglycosides, erythromycin, trimethoprim-sulfamethoxazole, antipseudomonal penicillins, aztreonam, and imipenem/cilastatin. Two patients with nosocomial pneumonia were successfully treated with oral ciprofloxacin. F. meningosepticum may emerge as an important pathogen if prophylactic use of polymyxin B becomes more widespread. Ciprofloxacin may become the agent of choice for treatment of this organism.

Administration, Inhalation↗
PubMed1989

Outpatient intravenous antibiotic therapy.

Outpatient intravenous antibiotic therapy is a cost-effective modality to shorten hospital stays and provide continued care to patients with infections. The recent availability of tamper-proof pumps that can deliver multiple antibiotics on independently timed regimens will further expand the use of home intravenous antibiotics. Problems with reimbursement remain, and new classes of oral antibiotics may provide alternatives to parenteral medications.

Ambulatory Care↗
PubMed1988

Herpes simplex lymphangitis. Two cases and a review of the literature.

Lymphangitis and lymphedema are rarely reported complications of herpetic hand or genital infection. The natural history of these complications is gradual resolution over 14 to 21 days. Recognition of this presentation of herpes infection avoids unnecessary surgery and antibacterial therapy. Antiviral therapy may have a role in shortening the duration of symptoms and aborting recurrent lymphangitic episodes.

Acyclovir↗
PubMed1988

Prospective study of clinical bleeding in intensive care unit patients.

We investigated prospectively clinical bleeding in 1,328 consecutive patients admitted to a medical/surgical ICU over 1 yr. One hundred thirty-eight (10.4%) patients bled after ICU admission, and an additional 388 (29.2%) bled coincident with admission. The upper GI tract was the site of bleeding in 34.8% of patients whose bleeds commenced in the ICU, and accounted for 22% of total sites. Patients with clinical bleeding after ICU admission had a significantly (p less than .001) higher likelihood of death than those who did not bleed, and those with multiple bleeding sites had a higher mortality (54.9%) than those with single sites (31%) (p less than .006). Multiple logistic regression analyses revealed that risk ratios (RR) for bleeding after ICU admission were mechanical ventilation (RR = 1.82), nutritional failure (RR = 3.45), acute renal failure (RR = 3.36), antiulcer medication (RR = 3.36), and anticoagulants (RR = 4.19). No antibiotics could be specifically incriminated. This study defines the scope, characteristics, and importance of bleeding in ICU patients and establishes risk factors.

Aged↗
PubMed1988

Drinking practices among black and white alcoholics and alcoholics of different personality types.

In order to examine the effects that race and personality type have on self-reported drinking practices, samples of 49 White and 49 Black male alcoholics were matched on age and education, and classified into two personality types according to MMPI scores. The results of multivariate and univariate analyses of variance yielded significant main effects. White alcoholics reported a greater: (a) use of alcohol for symptomatic relief of psychological distress, (b) loss of motor control and tendency to engage in destructive acts, and (c) daily consumption of beverage alcohol than Black alcoholics. Alcoholics with psychiatric-appearing MMPI profiles reported greater: (a) social benefits of alcohol use, (b) alcohol use for symptomatic relief of psychological distress, and (c) perceptual distortions associated with alcohol withdrawal than alcoholics with characterlogical-appearing MMPIs. Results were discussed in terms of need to control confounding effects of biosocial variables in cross-cultural research and implications that these effects may have on the generalizability of alcoholic personality typologies.

Adult↗
PubMed1987

Infections in a pediatric intensive care unit.

All infections occurring in a busy pediatric intensive care unit (PICU) from 1982 to 1984 were characterized by site, bacteriology, acquisition status, and outcome. Standard Centers for Disease Control criteria were employed. Nine hundred sixty-five patients were admitted to the PICU. Mortality was 3.4%. Two hundred twenty-one infections occurred in 180 patients. Infection rates were 23% and 6% for total and PICU-acquired infections, respectively. Infections of the central nervous system (n = 56), lower respiratory tract (n = 53), and genitourinary tract (n = 46) made up 70% of all infections. Haemophilus influenzae (n = 39) was the most commonly isolated pathogen. Staphylococcus aureus (20%) and Klebsiella-Enterobacter-Serratia (18.3%) were most commonly noted in PICU-acquired infections. Twenty infected patients (11.1%) died in the PICU. Lower respiratory tract infections (20.5%) were associated with the highest mortality. Both PICU-acquired and community-acquired infections were associated with similar mortalities. Infected patients in a PICU have a mortality approximately 300% higher than that seen in the overall PICU population. The data presented document the importance of infection and provide information against which similar units can gauge their infection status for quality-assurance purposes.

Bacterial Infections↗
PubMed1987

Surgical wound infections documented after hospital discharge.

Shorter lengths of hospitalization may result in more surgical wound infections being documented after hospital discharge. The current investigation analyzed 1644 surgical procedures performed over a 3-month period, and documented surgical wound infections both before and for 1 month after hospital discharge. Physician and patient questionnaires were used. One hundred eight infections were noted, of which 50 (46%) were seen after hospital discharge by either the patient or the surgeon. Rates of infection were 5.2%, 7.5%, and 7.5% for clean, clean-contaminated, and contaminated-dirty categories, respectively. Had postdischarge surveillance not been used, rates would have appeared to be 2.5%, 6.5%, and 6.8% for the same surgical classes. Infections following clean and clean-contaminated procedures were more likely to be noticed after hospital discharge. Excluding those that were patient-documented, wound infection rates would have been 4.2% (clean), 6.3% (clean-contaminated) and 6.8% (contaminated-dirty). Postdischarge surveillance is imperative to meaningfully document true rates of surgical wound infection, inasmuch as increasing numbers are likely to occur only after patients leave the hospital.

Follow-Up Studies↗
PubMed1987

Concurrent community-acquired pneumonia with Legionella pneumophila and Streptococcus pneumoniae.

Both Streptococcus pneumoniae and Legionella pneumophila are well defined causes of community-acquired pneumonia, and may be associated with substantial mortality. Optimal therapy consists of penicillin for the former organism and erythromycin for the latter. We have presented a case of pneumonia caused by simultaneous infection with both of these agents. Organisms were recovered either from blood or lung tissue. This case carries important implications for treatment of community-acquired pneumonia, and conceivably could explain some of the mortality that continues to be seen with pneumococcal pneumonia.

Female↗
PubMed1987

Streptococcus pneumoniae endocarditis.

We have reported a case of Streptococcus pneumoniae endocarditis involving the aortic valve of a 61-year-old alcoholic man. Antibiotic therapy with vancomycin sterilized the blood and valve, but aortic valve replacement was required for progressive congestive heart failure resulting from a ruptured valve leaflet.

Aortic Valve↗
PubMed1986

Postoperative radiographic appearance of intracranial hemostatic gelatin sponge.

Hemostatic gelatin sponges were placed in hemispheric defects created in four dogs which were then periodically scanned by computed tomography to determine the postoperative appearance of the sponges. The hemostatic sponges appeared as low attenuation regions for 7-10 days. The attenuation value of these Gelfoam cavities was intermediate between fat and air. Subsequently, clinical cases were selected in which the location of gelatin sponges were known to demonstrate the appearance of the material in patients. In addition to enhancing the accuracy of computed tomographic interpretation, we have found that the gelatin sponge can be useful as a transient computed tomography marker for localization of surgical activity.

Adolescent↗
PubMed1986

Splenic abscess following nonoperative management of splenic rupture.

A recent case of posttraumatic splenic abscess in a young man following nonoperative management of his splenic rupture is reported. With the recent trend toward nonoperative management of hemodynamically stable splenic rupture, the potential complications of splenic abscess may become more common. In view of the high mortality associated with unrecognized splenic abscess, it is important for the clinician to be aware of this entity.

Abscess↗
PubMed1986

Community-acquired pneumonia caused by mixed aerobic bacteria.

Mixed bacterial pneumonia caused by organisms other than anaerobes has been infrequently reported. We describe six cases and review the literature. Two patients had co-infection with S pneumoniae and L pneumophila. Two were infected with S pneumoniae and K pneumoniae and the others simultaneously harbored M tuberculosis and N asteroides. The first two sets of patients had bacteria isolated from usually sterile sites (blood and lung), while the latter harbored repeatedly isolated organisms not usually felt to be part of the normal respiratory flora. Mixed infection may help explain the substantial mortality still seen from pneumonia. This is especially true if Legionella, mycobacteria, or Nocardia species are encountered where routine smears and cultures may not aid in the diagnosis. Poor clinical response to specific antibacterial therapy in pneumonia should trigger further investigation for other potential pathogens.

Adult↗