Biomedical subjects
Publications and source records attributed to P Gates.
Listeria rhomboencephalitis is a rare form of listeriosis which is frequently not diagnosed before death. We here describe an instance in an apparently healthy immunocompetent lady which responded to appropriate therapy. Treatment with intravenous ampicillin with or without an aminoglycoside antibiotic should be instituted early if the patient is to survive.
In a prospective study of 87 patients with TIA or minor stroke (48 men and 39 women, average age 65 years) a history of ischaemic heart disease (IHD) was present in 30 (angina in 25 and myocardial infarction (MI) in 19, 14 having both). The London School of Hygiene Questionnaire did not confirm the diagnosis of IHD in 7 patients, but did detect a further 5 patients with angina and/or MI. The Minnesota coding of the ECG revealed 5 patients with asymptomatic suspect IHD and 15 with probable IHD (a total of 23%). Cardiomegaly (cardiothoracic ratio greater than 0.5) was present in 28 patients, 9 with a history of MI and 8 with a history of angina. These findings indicate that IHD is common in patients with cerebral vascular disease. As both probable IHD on Minnesota coding of the ECG and the presence of cardiomegaly are highly predictive of a poorer outcome, the findings add further weight to the argument that, amongst patients with minor cerebral ischaemia, a sub-group at high risk of death due to IHD can be detected by using simple methods rather than by performing routine coronary angiography on all patients as has been suggested in recent times.
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The authors prospectively evaluated the clinical event rate over a 72 hour period following femorocerebral angiography in 1002 procedures. The neurologic event rate was 1.3 per cent in the first 24 hours (0.1% permanent) and 1.8 per cent between 24 and 72 hours (0.3% permanent). The non-neurologic event rate (mostly hematomas) was 7.2 per cent. There were no deaths. One hundred and nine pieces of data per procedure were analysed statistically. Delayed cerebral ischemia does occur and could be secondary to the procedure. The low risk of judiciously performed cerebral angiography was confirmed. Carefully cataloguing all events for up to 72 hours neither verifies nor excludes angiography as the cause of deterioration.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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Three posterior fusion reconstruction procedures for a canine experimental model of the C4-C5 bilateral facet dislocation are herein mechanically tested. The two procedures utilizing polymethylmethacrylate have increased angular stiffness as compared with the normal posterior soft tissue structures and the reconstruction procedure utilizing wire alone. Their ultimate moments are not significantly greater. These findings lead us to predict an increased incidence of fixation failure when polymethylmethacrylate acrylic cement preparations are used for instantaneous posterior "fusions" as compared with the more traditional wire and bone graft procedure.