PubMed Health⌕ Search

Biomedical subjects

R Varghese

Publications and source records attributed to R Varghese.

6 recordsLinked to original sources
PubMed1995

Carcinomatous meningitis: clinical manifestations and management.

Carcinomatous meningitis (CM) is a cause of significant morbidity and mortality in patients with cancer. During the past 15 years, diffuse leptomeningeal metastases of extracranial malignant tumors have been increasingly reported [Wasserstrom et al. 1982, Theodore and Gendelman 1981, Little et al. 1974, Olson et al. 1974, Yaphey et al. 1978, Sorensen et al. 1984], CM is increasing in frequency because of improved survival of patients with systemic anti neoplastic therapies and increased awareness of this problem among physicians. In this review, we will be discussing the epidemiology, etiology, pathology, pathophysiology, clinical manifestations, diagnosis and management of carcinomatous meningitis, as well as the status of recent basic and clinical investigations.

Carcinoma↗
PubMed1981

Psychological growth and the impact of stress in middle age.

Cycles of stress and anxiety in middle age may have a developmental etiology, and may be a necessary part of the developmental process in this phase of life. Middle age often is punctuated by recurrent episodes of stress which do not appear to have a basis in any specific event. These cycles of stress instead are a function of psychological development in mid-life, with stress resulting from the need to integrate newly differentiated aspects of experience which cannot be integrated with an existing cognitive system of beliefs and values. Reintegration of the cognitive structure to accommodate these new elements reduces the stress, leaving the adult changed with respect to certain beliefs about self or world. These reintegrations are facilitated by an internal locus of control and an articulate self-other differentiation, both of which are important for a positive response to stress in middle age.

Adaptation, Psychological↗
PubMed1980

Splenic abscess.

Fourteen cases of splenic abscess are reported and 159 cases previously cited in the literature are reviewed. The incidence, predisposing factors, pathogenesis, clinical features, bacteriology and radiologic findings are discussed. Infective endocarditis was the most common single antecedent infection. Hemoglobinopathies, non-penetrating abdominal trauma, and gastrointestinal malignancy appear to predispose the spleen to abscess formation. Emphasis is placed on clinical features and radiologic findings to aid practitioners in diagnosing this uncommon but often fatal infection. Also emphasized is the necessity for prompt surgical intervention when splenic abscess is suspected. An approach to the antimicrobial therapy in different clinical settings is outlined.

Abscess↗
PubMedDate not supplied

Metronidazole treatment of Bacteroides fragilis infections.

Seven patients with Bacteroides fragilis infections were treated with intravenous and/or oral metronidazole. Infections treated included endocarditis, osteomyelitis, lung abscess, empyema, peritonitis, septicemia, and pelvic infection. Some patients had failed to respond to therapy with chloramphenicol or clindamycin or both. Metronidazole was used alone or in combination with aminoglycosides. Serum levels of metronidazole several times in excess of the minimal inhibitory concentrations for the organisms were easily achieved and in one patient the CSF metronidazole level was equal to that of the serum. Response to therapy with metronidazole was considered to be excellent. The only serious side effect noted was hypotension, which occurred in the last patient. Therapy was discontinued, and therefore therapeutic results could not be evaluated. Metronidazole appears to be a safe and effective agent in the treatment of B fragilis infections.

Adult↗