Biomedical subjects
R Kimbrough
Publications and source records attributed to R Kimbrough.
Intraoral radiographs.
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UTIs and two new antibiotics in the elderly.
Of the new antimicrobials available for the treatment of urinary tract infections (UTIs), aztreonam and imipenem/cilastatin represent two structurally unique, but distinct, classes of beta-lactam antibiotics. Aztreonam has a directed spectrum of activity covering gram-negative bacilli usually associated with UTIs. In comparative clinical trials of patients with complicated UTIs, aztreonam is well-tolerated and is as effective as conventional control regimens, including aminoglycosides. On the other hand, the antimicrobial spectrum of imipenem/cilastatin includes not only gram-negative bacilli but also gram-positive cocci and anaerobes. As such, this broad-spectrum antibiotic should be reserved for the treatment of mixed infections.
Effects of beta-aminopropionitrile after glaucoma filtration surgery: pilot human trial.
Beta-aminopropionitrile fumarate, an inhibitor of collagen cross-linking, was used topically in patients after filtration surgery for difficult cases of glaucoma (aphakic, repeat surgery, neovascular). Twenty-three patients received the drug for a total treatment period of three months following surgery. The mean preoperative intraocular pressure was 40.0 +/- 14.1 mm Hg (mean +/- standard deviation). The mean postoperative pressure was 19.0 +/- 8.9 mm Hg, with the mean follow-up at 26.4 +/- 11 weeks. The overall success rate was 74%, with success being defined as an intraocular pressure of 22 mm Hg or less at the last visit. Side effects consisted primarily of stinging immediately after the medication was applied. Inhibition of collagen cross-linking may represent an alternative method to the use of injectable 5-fluorouracil to maintain patency of filtration blebs.
Commentary on 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD).
There is deep concern about the long term health effects of exposure to phenoxy herbicides and the contaminant TCDD; however, there is considerable scientific and medical uncertainty regarding the health effects from exposure to these chemicals. There are at least ten ongoing studies on reproduction, morbidity and mortality as well as studies of tissue concentrations of TCDD that are attempting to determine the health effects of these chemicals (see Table 2). Appropriate efforts should be made to prevent human and environmental exposure and to decontaminate the environment while awaiting the results of these investigations. Animal toxicity studies show such wide variations that extrapolations from a different species to humans are tenuous. Human studies on exposed workers and nonoccupational exposures are difficult to interpret because the exposure has not been quantified and because workers were exposed to mixtures of chemicals. Chloracne appears to be an important specific clinical marker of TCDD exposure, however, it can be caused by structurally similar compounds. Many of the past studies on human health effects of 2,4,5-T and TCDD are controversial. Since the scientific data are not firm, no specific statements can be made regarding the long term health effects at this time. Any individual who has had a significant exposure to TCDD should see his/her physician and have appropriate consultation. Long term follow up will be required. Physicians should be instructed regarding the possible manifestations of TCDD exposure to look for chloracne, soft tissue masses, muscle pain, fatigue, peripheral neuropathy, tender hepatic enlargement, enlargement, elevated liver enzymes, elevated lipids, prolonged prothrombin time, hemorrhagic cystitis and hirsutism.(ABSTRACT TRUNCATED AT 250 WORDS)
Chlorinated hydrocarbon insecticides in plasma and milk of pregnant and lactating women.
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Toxicology of Abate in laboratory animals.
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Toxicity of hexamethylphosphoramide in rats.
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Spontaneous malignant gastric tumor in a Rhesus monkey (Macaca mulatta).
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Acute arsine posioning in two workers cleaning a clogged drain.
On February 6, 1978, two maintenance workers employed by a chemical company in Atlanta, Georgia, became ill after cleaning a clogged drain. Both were hospitalized with acute fulminant hemolytic anemia and renal failure. While the clinical picture suggested arsine or stibine poisoning, preliminary investigation of the plant revealed no obvious source of arsenic, antimony, or hydrogen gas. During the cleaning operation, the men drained a mixing tank that 5 yr before had been used to store arsenical herbicides. To unclog the drain, they added a standard drain cleaner containing sodium hydroxide and aluminum chips, a combination that reacted to release hydrogen gas. This gas combined with the arsenic residue to form toxic quantities of arsine gas (arsenic trihydride). Arsenic was found in the liquid and gas from the drain and in blood and urine of both patients, and of two other workers who worked in the vicinity of the drain. This investigation suggests that drain cleaners which react to release hydrogen should not be used in situations where arsenic or antimony may be present. Furthermore, maintenance men, who may be exposed to the chemicals used in a plant, should be educated, supervised, and screened so that their risk for occupational hazards may be reduced.