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Biomedical subjects

R D Meyer

Publications and source records attributed to R D Meyer.

At least 73 records · Page 4Linked to original sources
PubMed1987

Legionella infections.

Legionnaires' disease is a distinct clinical entity caused by Legionella pneumophila. Following an epidemic of pneumonia in Philadelphia in 1976, it was found that the bacterium had in fact been first isolated in 1947. Other species of Legionella have been identified, many of which are indistinguishable from L. pneumophila infection. Legionella species also cause extrapulmonary infections and a mild nonpneumonic form of disease known in its epidemic form as Pontiac Fever.

Diagnosis, Differential↗
PubMed1986

Risk factors and comparisons of clinical nephrotoxicity of aminoglycosides.

Controversy continues regarding risk factors for nephrotoxicity and the possible differences in nephrotoxicity rates associated with the aminoglycosides commonly used in clinical practice. Review of published data, including 27 comparative clinical studies, indicates the following: sensitive markers of tubular toxicity do not correlate directly with clinically significant diminution in glomerular filtration rate; of all the proposed risk factors, few are consistently found; despite numerous studies, some with potential drawbacks, no current aminoglycoside has been shown to be consistently and conclusively less nephrotoxic than another; and, as per a previous recommendation, the choice of an aminoglycoside should not be made on the basis of nephrologic criteria.

Amikacin↗
PubMed1986

[Breast saving cancer surgery. Results of a long-term study (Berlin study, 1963-1982)].

Between 1963 and 1982, 1,139 patients underwent surgery for unilateral mammary malignoma at the Charlottenburg Gynaecological Clinic of the Free University Berlin. Primary therapy consisted of simple mastectomy in 948 cases and tumourectomy/quadrantectomy with subsequent radiotherapy (40 Gy) in 191 cases. We performed a retrospective analysis of "matched samples" of tumourectomy/quadrantectomy and mastectomy. The observation period of both groups spans a minimum of one year to a maximum of 20 years after primary operation. In pT1- and pT2-tumours the overall survival after tumourectomy/quadrantectomy at 5, 10 and 15 years was no worse than after total breast removal. The results of our long-term follow-up study lead us to conclude that tumourectomy/quadrantectomy and breast irradiation are suitable for primary treatment of mammary cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Total hip arthroplasty: comparison of infection rates in a VA and a university hospital.

We reviewed charts of total hip arthroplasties from a ten-year period (January 1973 through December 1982) to determine the rate of infection at the Birmingham Veterans Administration Medical Center. Of 321 procedures, 296 were reviewed (92%). Overall, there were 24 infections (8.1%), 13 of which (4.4%) were deep infections. Seven of the deep infections were due to Serratia marcescens, resulting in six implant removals. These figures are compared to the 1.1% deep infection rate after total hip arthroplasty at the adjoining University Hospital, University of Alabama at Birmingham. The main determinants for risk of infection at the VA Hospital were length of procedure and previous procedures on the affected joint.

Adult↗
PubMed1986

In vitro activity of aryl fluoroquinolones, Abbott 56619 and Abbott 56620, compared to ciprofloxacin, norfloxacin and beta-lactams versus multidrug-resistant Enterobacteriaceae and Pseudomonas aeruginosa.

The new aryl fluoroquinolones, Abbott 56619 and Abbott 56620, were compared to ciprofloxacin, norfloxacin and newer beta-lactam agents in standardized microtiter testing versus multidrug-resistant gram-negative bacilli. Ciprofloxacin, followed by Abbott 56620, was generally the most active quinolone and imipenem the most active beta-lactam agent.

Anti-Bacterial Agents↗
PubMed1986

Treatment of adult and obstetrical brachial plexus injuries.

Twenty-five percent of patients with injuries to the plexus require surgical intervention for optimal results. Patients with loss of serratus and rhomboids, Horner's syndrome, positive myelogram, or negative evoked potentials have a high incidence of lower root avulsions and a probability of upper root ruptures. These should be explored early. Results depend on the amount of remaining axonal input available for grafting. Using intraoperative electrical studies, elements which will recover spontaneously may be saved and improved function obtained by grafting only damaged elements. Obstetrical palsy patients should be immobilized for several weeks; passive stretching should then be done. Recovery within 2 months yields a normal arm; if recovery of the biceps or arm occurs within 3 months, the arm will be good. If biceps recovery has not begun by the third month, surgical intervention with appropriate repair will yield at least one grade higher function than in conservatively treated patients.

Adult↗
PubMed1986

Cutaneous and mucosal manifestations of the deep mycotic infections.

The deep mycoses are increasing in importance both as opportunistic infections and from exposure in geographically defined areas. Diagnosis may be difficult in both groups. Mucosal involvement may be non-specific (e.g., in disseminated candidiasis) or highly predictive of disseminated disease (e.g., histoplasmosis, blastomycosis and paracoccidioidomycosis). Skin involvement is generally uncommon in disseminated aspergillosis, mucormycosis and cryptococcosis but is more common in candidemia and coccidioidomycosis. Manifestations of mucosal and cutaneous lesions of the deep mycoses are reviewed and the need for an aggressive diagnostic approach stressed. Culture is more specific than histopathologic examination alone but the latter may have to suffice in some cases. Control of underlying disease and administration of amphotericin B remain the mainstays of therapy. Ketoconazole is being evaluated as an alternative in therapy of some deep mycoses.

Amphotericin B↗
PubMed1985

Potable water as a source of Legionnaires' disease.

A three-year epidemic of legionnaires' disease in a hospital was dramatically curtailed following hyperchlorination of the potable water supply. The hypothesis that potable water was the source for the outbreak was further supported by isolation of Legionella pneumophila (the agent of legionnaires' disease) from the hospital water supply, observation that a sudden upsurge had occurred in the number of cases following a peculiar manipulation of the hospital water system, and documentation of a 30-fold increase in concentration of organisms in the water when this manipulation was artificially recreated. Thus, potable water may be an important source of epidemic legionnaires' disease and continuous hyperchlorination a method of control.

Adult↗
PubMed1985

The biomechanics of helmets and helmet removal.

To better understand motion in the cervical spine related to helmet wearing and removal, normal volunteers underwent videotaped fluoroscopy during helmet removal and lateral spine X-rays in various positions. There was a tendency towards increased flexion in the supine position in the helmeted volunteers which disappeared with minimal traction. In forced hyperextension, the posterior lip of the helmet did not guillotine the cervical spine. There was no significant difference in cervical spine motion between a one-person and two-person technique of helmet removal, and in both techniques, a minimum amount of flexion occurred in clearing the occiput.

Biomechanical Phenomena↗
PubMed1985

Familial recurrence of terminal transverse defects of the arm.

Three families in which relatives were concordant for upper limb terminal transverse defects are described. These families and previously reported ones with similar recurrence of terminal transverse defects are reviewed and analyzed. It is suggested that, at least in part, the patterns of relatedness for these recurrences more likely are the result of a genetic contribution to the development of this birth defect, rather than such recurrences being solely due to chance.

Adult↗
PubMed1985

The acquired immunodeficiency syndrome.

AIDS is an apparently new condition that first occurred in about 1979 and is manifested primarily by profound disturbances of T-cell immunity and unusual susceptibility to either opportunistic infections (mycobacterial, fungal, parasitic, or viral) or tumors such as Kaposi's sarcoma and lymphoma. A prodrome of lymphadenopathy and wasting is also part of the spectrum of disease. The etiology is unknown, but the likely candidates are viral agents. Epidemiologic studies show that the promiscuous gay male is at particular risk, but transmission by the parenteral route and/or vertical transmission has extended the risk of acquisition to other groups. A common clinical presentation of full-blown AIDS is opportunistic infection of the lungs (especially with P. carinii), the central nervous system, or the gastrointestinal tract. Therapy against specific pathogens may be temporarily successful, but the course is frequently downhill, with relentless progressive or sequential infections or development of a tumor during continued immunodepression. Therapy for the immunologic abnormalities remains experimental. Control measures to prevent transmission are similar to those for hepatitis B.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Closed Zickel nailing.

A closed technique for Zickel nail insertion decreases morbidity, blood loss, and operative time. The Zickel intramedullary nail was originally developed as an open fixation device for fractures of the proximal third of the femur and subtrochanteric area. The open technique requires a lengthy incision, moderate blood loss, and time for insertion. For pathologic or impending pathologic fractures in sick patients, such a major operation is undesirable. The closed technique has been used successfully in five impending pathologic, three pathologic, and two traumatic subtrochanteric fractures. For these ten patients, the average operating time was one hour and 28 minutes with an average blood loss of 400 ml, a reduction of 40 minutes and 460 ml, respectively, over other available data. Time to ambulation and length of hospital stay are comparable to fractures treated openly. The closed technique is ideal for impending pathologic fractures, but may also be applicable to any pathologic or traumatic fractures that do not require an open procedure for alignment or supplementary fixation.

Bone Nails↗
PubMed1984

Synergistic enzyme induction by glucocorticoids and cyclic AMP observed in glioma x hepatoma cell hybrids but not in their parents.

Enzyme induction by hydrocortisone (HC) and dibutyryl cyclic AMP (dbcAMP) was studied in C6 rat glioma cells, FU5AH rat hepatoma cells, and five C6 x FU5AH hybrids. Hormone responsive enzymes from both parental lines were studied, including: tyrosine aminotransferase (TAT), alanine aminotransferase (AAT), glycerol phosphate dehydrogenase (GPDH), lactate dehydrogenase (LDH), and 2',3'-cyclic nucleotide 3'-phosphohydrolase (CNP). There was no overall dominance of one parental phenotype over the other in expression of uninduced or induced enzyme activity after fusion, and the hybrids possessed some enzymatic properties characteristic of both parents. GPDH was induced by dbcAMP in all five hybrids, and TAT was induced by dbcAMP in four of the hybrids, although neither of these enzymes were induced by dbcAMP in the parents. Furthermore, synergistic induction of these enzymes by HC and dbcAMP was observed in the hybrids but not in the parents. These hybrids provide a model system to study hormone interaction in enzyme induction.

2',3'-Cyclic-Nucleotide Phosphodiesterases↗
PubMed1984

Symposium on infectious complications of neoplastic disease (Part II). Legionnaires' disease. Aspects of nosocomial infection.

Tremendous progress has been made recently in characterization of Legionella pneumophila and infections caused by it. Certain areas that are particularly germane to immunosuppressed patients, who are affected more frequently than other patients, and areas that are controversial and merit particular consideration are considered herein. These include pathogenesis and correlation of experimental and clinical evidence, nosocomial outbreaks and almost ubiquitous distribution of L. pneumophila in water despite only a limited number of studies linking the two by aerosols, prevalence and possible reasons for the apparent spotty distribution, protean clinical manifestations, difficulties in diagnosis, certain aspects of therapy, and control by environmental changes.

Animals↗