Diffuse thrombosis complicating therapeutic plasma exchange.
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Adult↗
Biomedical subjects
R Cushing
Publications and source records attributed to R Cushing.
Vidarabine encephalopathy.
Vidarabine (adenine arabinoside, ara-a) has been found to be useful in the treatment of various viral infections. Its adverse neurological effects include tremor and encephalopathy. Two cases of vidarabine encephalopathy are reported and the five other cases in the literature are reviewed. The clinical features of the tremor and encephalopathy are discussed.
Adult↗
Assessment of pancreatic ductal penetration of antibiotics.
Pancreatic ductal penetration of antibiotics is not uniform. Antibiotic therapy for pancreatic and pancreatic related infections, theoretically, is enhanced by drugs that reach the ductal system. The pancreatic ductal penetrance of Cefamandol (1 gm), Amikacin (7.5 mg/kg), and Chloramphenicol (1 gm) given as a single intravenous dose prior to endoscopic retrograde cholangiopancreatography was studied in ten patients. Serum and pancreatic juice were collected simultaneously, frozen, and later assayed for antibiotic concentration. Each antibiotic achieved its expected therapeutic serum level. In contrast, pancreatic ductal levels of Cefamandol and Amikacin were subtherapeutic, whereas Chloramphenicol levels were therapeutic. Further studies are needed to identify other antibiotics with good pancreatic ductal penetrance.
Amikacin↗
Herpes zoster myelitis treated with vidarabine.
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Herpes Zoster↗
The value of prophylactic antibiotic therapy during endoscopic retrograde cholangiopancreatography.
Prophylactic antibiotics have been recommended during endoscopic retrograde cholangiopancreatography in the hope of preventing septic complications. However, their effectiveness has not been proved clinically. In this study, the ability of the pancreas to secrete ampicillin, gentamicin and clindamycin after a single intravenous dosage, given prior to endoscopic retrograde cholangiopancreatography in 12 patients, was examined. Simultaneously obtained serum antibiotic levels were within the expected therapeutic range. In contrast, pancreatic ductal levels of ampicillin and gentamicin were too low to be measured in most patients. Most patients had measurable clindamycin levels which ranged from 12.0 to 3.1 micrograms per milliliter in seven patients and was 8.0 micrograms per milliliter in one patient. Parenteral prophylactic antibiotic coverage for endoscopic retrograde cholangiopancreatography is ineffective with gentamicin or ampicillin. Clindamycin may be of value, but it needs further study at higher dosages.
Adult↗
Management of subluxation and dislocation in early infancy.
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Female↗
Pulmonary infections.
It is likely that nosocomial pneumonias will continue to be a problem in critical-care areas. If there are to be breakthroughs, they will probably come in the area of prevention, not treatment. Scrupulously sterile techniques when using inhalation therapy equipment, suctioning patients, and changing tracheal tubes remains the mainstay of prevention. Early recognition and aggressive therapy of nosocomial pneumonias have had limited success in decreasing morbidity and mortality rates.
Cross Infection↗