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Biomedical subjects

R Andersen

Publications and source records attributed to R Andersen.

At least 55 records · Page 3Linked to original sources

Infections as a problem in the intensive care unit.

Problems of infections in the intensive care unit (ICU) center on patients admitted because of sepsis, patients with compromised host defenses and patients subject to invasive procedures. The mortality rate in septic shock is high, 47% in our own study. Escherichia coli was found in half the cases. Multiple organ failure is often the common denominator in patients with sepsis. Hypovolaemia and low serum proteins make the patients more susceptible to infections. Typical ICU procedure, i.e. central venous catheters, arterial lines, Swan-Ganz catheters, endotracheal tubes and urinary catheters violate natural bacterial defence barriers and may be a source of infection. Use of corticosteroids and cimetidine may impair defence mechanisms. The use and abuse of antibiotics is vital to the successful control and treatment of infections in the ICU. Infection has been quoted as the most important single factor which determines the outcome of the intensive care patient.

Anti-Bacterial Agents

Reduction of post-cesarean section infectious morbidity by means of antibiotic irrigation.

The effectiveness of antibiotic irrigation in reducing post-cesarean section infectious morbidity was studied in a prospective, randomized, double-blind trial. One hundred twenty-eight patients were divided into three groups and irrigated with either cefoxitin solution, cephapirin solution, or saline. Following delivery of the placenta, the uterine cavity and incision, bladder flap, pelvic gutters, and subcutaneous tissue of the patients were irrigated. There was a significant reduction in total infectious morbidity (p less than 0.02) and wound infection (p less than 0.04) when antibiotic use was compared to the saline control. No statistical difference in the effectiveness of the two antibiotics could be demonstrated. No adverse effects were noted. Antibiotic irrigation is a safe and effective method in reducing infectious morbidity of the parturient patient.

Bacterial Infections

Acyclovir.

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Acyclovir

Vectorcardiography in the diagnosis of postoperative myocardial infarction.

Fifty-three consecutive patients, mean age 63 years, undergoing either peripheral vascular reconstructive surgery (n = 40) or lobectomy for bronchial carcinoma (n = 13) were examined pre- and postoperatively with conventional electrocardiogram (ECG), vectorcardiogram (VCG) and estimation of serum levels of aspartate aminotransferase, alanine aminotransferase, total lactic dehydrogenase and the heat-stable fraction of lactic dehydrogenase for the diagnosis of per/postoperative myocardial infarction (MI). Six patients (11%) developed signs of acute MI. In 2 patients whose ECG showed only unspecific changes, the VCG was decisive for the diagnosis. The serum enzyme values alone were of limited value in the diagnosis of per/postoperative MI.

Aged

Legionnaires' disease combined with erythema multiforme in a 3-year-old boy.

A case of Legionnaires' disease (LD) is described in a 3-year-old boy. He had fulminant disease with typical signs like bilateral pneumonia, gastrointestinal symptoms, and somnolence indicating involvement of the central nervous system. There was no premorbidity. An outstanding development was erythema multiforme, which has never previously been described in LD. The basic disease was caused by Legionella pneumophila. This is evidenced by specific serum IgM at admission and a subsequent significant rise in titers against L. pneumophila. At an early stage respiratory syncytial virus (RSV) was isolated from the patient's throat, although there was no antiviral serological response at the outset of erythema multiforme or 3 weeks after onset of disease; anti-RSV appeared later. The prolonged course of the disease can be explained by the successive occurrence of two infections. The possibility that the virus could have contributed to the development of erythema multiforme cannot be ruled out. The role of concomitant medication cannot be separated out, but on the basis of general knowledge of their immunogenicity and the fact that immunosuppressive cortisone was given at the time it is less likely that the antibiotics contributed significantly.

Child, Preschool

Methodological issues in health care surveys of the Spanish heritage population.

This paper examines national survey data on access to medical care to explore methodological issues associated with conducting health care surveys of Spanish-heritage persons. These include problems of identifying and sampling such groups, achieving respondent cooperation, designing valid interview protocols, and controlling biases that may result from the cultural specificity of the concepts being studied. The findings suggest that more attention should be given to the following in designing health care surveys of Spanish-heritage individuals: cultural and economic heterogeneity of "Spanish-heritage" grouping, validity studies of health care utilization, and yea-saying tendencies related to health care attitude items. Given that there is a paucity of information available on methodological problems associated with health care surveys of Spanish-heritage persons, these analyses should serve to inform researchers of issues to be taken into account in designing such studies and to suggest useful hypotheses to explore in evaluating the validity of social survey data on minority (especially non-English speaking) populations' health care practices.

Adolescent