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Biomedical subjects

P Lowe

Publications and source records attributed to P Lowe.

At least 37 records · Page 2Linked to original sources
PubMed1990

A comparison between imipenem and metronidazole prophylaxis against sepsis following appendicectomy.

A single preoperative dose of imipenem/cilastatin was compared with metronidazole for the prevention of infectious sequelae following emergency appendicectomy. Patients with established sepsis received in addition 72 h of either intravenous imipenem or ampicillin, gentamicin and metronidazole postoperatively. Two hundred and sixty-eight patients were studied. Wound infection rate in low-risk patients was 9% for metronidazole and 8% for imipenem. When sepsis was already established intraperitoneally the wound infection rate was 24% for the triple therapy regimen and 8% for imipenem. There was no statistically significant difference between the infection rates in the two groups of treatment whatever the state of the appendix, but there was a trend in favour of imipenem in those patients with a perforated appendix.

Adolescent↗
PubMed1988

Evaluation of roxithromycin (RU-965) versus cephradine in pneumococcal pneumonia.

One hundred and sixty black South African gold miners with acute pneumococcal pneumonia were enrolled in a prospective randomized double-blind trial comparing roxithromycin (150 mg 2 X day) with cephradine (1.0 g 2 X day). Ninety patients with pneumonia caused by Streptococcus pneumoniae were treated for 5-10 days. Forty-three of 46 (93.4%) of the roxithromycin and all 44 (100%) of the cephradine treated groups had satisfactory clinical responses. In eight of the 46 (17%) roxithromycin treated patients and 10 of the 44 (23%) cephradine treated patients, Streptococcus pneumoniae was not eradicated from sputum cultures by the tenth day. Side effects in 18 patients (20%) were mild and were usually manifested by elevation of the transaminases; these were more common in the cephradine group (12) than in the roxithromycin group (5). Roxithromycin appears to be a safe and effective oral antibiotic for treatment of patients with mild to moderate pneumococcal pneumonia.

Adult↗
PubMed1988

Helminth infestations in Asian women attending an antenatal clinic in England.

Asian women attending an antenatal clinic in England were studied to determine the infestation rates with intestinal helminths. An overall rate of 9% was found, rising to 18% in those women resident for less than 7 years. Indians had a carriage rate of 3%, Pakistanis 7.3% and Bangladeshis 45%. Species detected were hookworm, whipworm (Trichuris trichiura), dwarf tapeworm (Hymenolepis nana) and roundworm (Ascaris lumbricoides).

Adult↗
PubMed1987

Relation between histological age-changes in the carotid body and atherosclerosis in the carotid arteries.

Histological changes in the human carotid body associated with increasing age are accompanied by occlusive atherosclerotic lesions in the arteries of the carotid bifurcation, and are probably ischaemic in origin. The carotid sinus, however, is unusually susceptible to the development of atheroma and its occlusion appears to have little influence in compromising blood flow through the glomic arteries.

Adult↗
PubMed1987

Mast cells in the human carotid body.

Mast cell counts were carried out on sections of human carotid bodies from 39 subjects showing one of four stages of histological change associated with aging, and in five subjects showing different forms of histopathology in the carotid body associated with disease. There was no relation between mast cell density and age or the histological changes associated with aging of glomic tissue. The normal range of mast cell density calculated in terms of the 80% confidence limits was 18.5 to 67.5/mm2. In three middle aged subjects with carotid bodies of normal histological appearance there was an abnormally high density of 83 to 96/mm2. In two elderly subjects showing age changes of fibrosis and accumulation of lymphocytes there was an abnormally low density of 12/mm2 or less. Mast cell density was not related to different types of carotid body hyperplasia. The mast cells were essentially stromal in location, usually closely applied to the walls of small glomic blood vessels, and were rarely found in intimate association with glomic chief cells. This suggests that mast cells are not directly concerned with the functions of glomic cells but does not preclude the possibility that they may have some effect on regulating glomic blood vessels and thus participate in the distribution of blood supply within the carotid body.

Adolescent↗
PubMed1986

Cefadroxil compared with cefaclor in the treatment of streptococcal pneumonia in adults.

103 young male Black African gold-miners with pneumococcal pneumonia confirmed by culture or serology were randomly assigned to receive the long acting oral cephalosporin cefadroxil 1 g every 12 hours or cefaclor 500 mg every 8 hours for 10 days. Clinical cures were obtained in 94% of the group who received cefadroxil and in 94% of the cefaclor group. Similarly, the causative organism S. pneumoniae was eradicated in 98% and 96% of patients who received cefadroxil and cefaclor, respectively. Minimal side effects occurred in both groups, although 1 patient withdrew from therapy with cefaclor because of severe diarrhoea. Thus, cefadroxil and cefaclor both displayed effective antimicrobial activity with low toxicity in the treatment of pneumococcal pneumonia.

Adult↗
PubMed1985

Metronidazole and Augmentin in the prevention of sepsis after appendicectomy.

Two hundred and fifty patients were admitted to a prospective randomized trial to compare the efficacy of Augmentin with metronidazole in the prevention of sepsis after appendicectomy. Pre-operatively they received either 500 mg metronidazole or 1.2g Augmentin intravenously. Those patients with gangrenous or perforated appendices received eight additional doses of the trial drug at 8 hourly intervals. Overall there were 13 wound infections in the Augmentin group (11 per cent) and 21 in the metronidazole group (18 per cent). The 90 per cent confidence limits for the overall 7 per cent difference in infection rates were +/- 8.5 per cent. There were high rates of wound infection in the gangrenous group (Augmentin 8 per cent versus metronidazole 19 per cent) and especially in the perforated group (Augmentin 33 per cent versus metronidazole 63 per cent). There was no statistically significant difference between the infection rates with the two antibiotics but our study suggests that Augmentin, which is active against both aerobes and anaerobes, may be more effective than metronidazole in reducing wound sepsis after appendicectomy.

Adult↗
PubMed1985

Testicular torsion after orchiopexy.

We report 2 cases of testicular torsion after orchiopexy, which is rare but potentially catastrophic. A review of the literature revealed that absorbable suture was used in 15 of 16 cases of recurrent torsion. We conclude that the tunica albuginea should be secured to the scrotal wall with several nonabsorbable sutures to pex the testes permanently.

Adolescent↗
PubMed1985

Load bearing and suspension characteristics of airsplint as a temporary prosthesis.

Maximum weight bearing observed, using a static weighing scale, in above-knee amputees wearing an airsplint, with a foot, was 10 kg and in below-knee amputees 11 kg with inflation pressures of 40 mmHg. While airsplints with a foot permitted greater weight bearing before deformation occurred, the increase is judged to be of little clinical advantage. Use of an airsplint without a foot would be more efficient for immediate post-operative dressing and for early ambulation in the parallel bars as it is less cumbersome and not subject to toe drag in the swing phase of gait. With the type of airsplints studied inflation pressures above 45 mmHg offered no advantage in terms of weight bearing in the below-knee amputee. In the above-knee amputee similarly, inflation pressures over 40 mmHg offered no advantage and had the effect of reducing the suspension of the prosthesis on the stump.

Air Pressure↗
PubMed1983

Metronidazole and ticarcillin in the prevention of sepsis after appendicectomy.

Ticarcillin was compared with metronidazole in the prevention of wound infection after appendicectomy. Two hundred nine patients with a diagnosis of acute appendicitis were admitted to a prospective, randomized study and received 500 mg of metronidazole or 5 g of ticarcillin intravenously before operation. Those patients with gangrenous or perforated appendices received two additional doses of the trial drug at 8 hourly intervals. The overall incidence of wound infections in both the metronidazole and the ticarcillin groups was 9 percent. There were no intraabdominal abscesses. Metronidazole abolished anaerobic wound infections. All the early wound infections (between 2 and 4 days after operation) occurred in patients with gangrenous or perforated appendices. We conclude that ticarcillin is as effective as metronidazole in the prevention of wound infection after appendicectomy, but in high-risk patients, (those with gangrenous or perforated appendices) longer courses of antibiotics should be employed.

Appendectomy↗
PubMed1983

Primary vesical pheochromocytoma.

Pheochromocytoma of the urinary bladder is a rare neoplasm that often occurs with the unique symptom complex of micturitional attacks due to increased catecholamine secretion during detrusor activity. Analysis of 3 of our patients is added to a discussion of 97 cases reported in the world literature. Therapeutic decision is complicated by the absence of unequivocal histologic criteria of malignancy for these tumors. Future perspectives in determining the malignant potential of pheochromocytoma are presented and our treatment plan elaborated.

Adolescent↗
PubMed1983

Urinary tract calculi in children.

One hundred and nine children with urinary tract calculi were reviewed and in some cases reinvestigated. Eighteen children had lower urinary tract calculi, which in all cases were associated with an underlying urodynamic abnormality. Sixty percent of 91 children with upper urinary tract calculi could be classified into 4 similarly sized etiological groups: an underlying urodynamic abnormality; urinary tract infection without a urodynamic abnormality; metabolic disorders; idiopathic hypercalciuria. An underlying abnormality was not found in 32% of cases. A painless presentation occurred in 39% of those with upper tract calculi. A family history of urinary calculi occurred in approximately one-half of children with either an idiopathic calculus or a calculus associated with cystinuria or idiopathic hypercalciuria. We conclude that urinary tract calculi, though rare in children, require extensive investigation to rule out urodynamic, infective and metabolic abnormalities. If such abnormalities are not found, the recurrence rate in the remainder is small and conservative treatment can usually be recommended.

Adolescent↗
PubMed1982

Pleomorphic, enveloped, virus-like particles associated with gastrointestinal illness in neonates.

Pleomorphic, enveloped, virus-like particles were detected by electron microscopy in the stools of symptomatic infants during an outbreak of gastrointestinal illness in a neonatal intensive-care unit. To determine the incidence of virus-like particles in the stool and their relation to gastrointestinal symptoms, eight surveys of stools for the particles were conducted over 40 weeks. The incidence of virus-like particles in the stool decreased from 69% to less than 10% over the study period. Most infants surveyed were premature; overall, 32 (36%) of 88 neonates were positive for virus-like particles. Statistically significant associations were found between virus-like particles in the stool and gastrointestinal symptoms within one week of each survey. These symptoms included water-loss stools, blood in the stool, gastric retention, bilious gastric aspirates, and abdominal distention. Several infants with virus-like particles whose mothers had gastrointestinal or "flu-like" symptoms before delivery were identified in the community (not part of the survey study).

Coronaviridae↗
PubMed1980

Malignant pheochromocytoma of the bladder.

A review of malignant pheochromocytoma of the bladder is presented with an illustrative case, emphasizing the importance of preoperative localization and an extirpative surgical approach for such patients. Since histologic criteria of malignancy in phoechromocytomas have not yet been established all of these patiets warrant a thorough intraoperative search and long-term postoperative followup for possible metastases.

Adult↗
PubMed1978

Comparison of endoscopic retrograde and intravenous cholangiography in diagnosis of biliary calculi.

The results of endoscopic retrograde cholangiography (E.R.C.) and intravenous cholangiography (I.V.C.) were compared in patients undergoing surgery for biliary calculi. E.R.C. gave a significantly higher rate of correct diagnosis of gallbladder calculi (p = 0.026) and common bileduct calculi (p = 0.002) than I.V.C. Biliary stones may thus frequently be present in patients with a normal I.V.C. and E.R.C. may reduce the rate of diagnostic errors in patients with symptoms of biliary disease.

Cholangiography↗