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Biomedical subjects

S L Berk

Publications and source records attributed to S L Berk.

At least 91 records · Page 5Linked to original sources
PubMed1984

Pseudophakic bullous keratopathy. Relationship to preoperative corneal endothelial status.

Pseudophakic bullous keratopathy is one of the complications of intraocular lens implantation. A knowledge of the preoperative status of corneal endothelium may help to minimize the incidence of this complication. The preoperative corneal endothelial status of 118 eyes of 102 patients who received Worst-Medallion intraocular lenses more than five years ago was analyzed retrospectively. This data was then correlated with the postoperative clinical status of the cornea. Twelve eyes (10%) underwent penetrating keratoplasty for irreversible corneal edema, and 28 of the remaining eyes (22%) had clinical evidence of peripheral corneal edema. No correlation was found between the preoperative endothelial cell density or the degree of postoperative cell loss and the development of corneal edema. Significant correlation was found between variation in cell size (pleomorphism) and the development of postoperative corneal edema. Greater density of precipitates on endothelium and abnormality in cell shape postoperatively were also frequently seen in corneas that developed edema subsequently.

Aged↗
PubMed1983

Enterococcal pneumonia. Occurrence in patients receiving broad-spectrum antibiotic regimens and enteral feeding.

Enterococcal pneumonia occurred as a superinfection in two patients who received broad-spectrum antibiotic therapy. Both patients were receiving enteral hyperalimentation by Dobb-Hoff tube. The organism was isolated from transtracheal aspirate in pure culture and gram-positive cocci were visible on gram-stained smear. Enterococcal pneumonia may occur in patients receiving cephalosporin-aminoglycoside therapy, and may be anticipated as a consequence of third-generation cephalosporin therapy.

Aged↗
PubMed1983

Bacterial pneumonia in the elderly.

Bacterial pneumonia in the elderly is common, and causes more morbidity and mortality than in the younger adult. As patients live longer with more underlying disease and more iatrogenic disease, the incidence of nosocomial pneumonia will probably rise. Adequate sterilization of inhalation therapy equipment can reduce the risk of gram-negative nosocomial pneumonia. Methods to prevent colonization and microaspiration need to be investigated. The development of a gram-negative vaccine using Salmonella RE or E. coli J5 mutant would augur well for the future. Most important, the elderly patient with pneumonia should be managed promptly and aggressively in an attempt to determine the specific etiology of the pneumonia. The practice of antibiotic "shotgunning" of the elderly patient is to be avoided. Transtracheal aspiration or sheathed bronchoscopy can be performed if the patient is not able to produce sputum, or Gram stain is difficult to interpret. Morbidity and mortality can be reduced by early appropriate antibiotic therapy directed by Gram stain.

Acinetobacter↗
PubMed1983

Spontaneous Escherichia coli K1 meningitis in an adult.

We have described a 47-year-old white woman who had spontaneous E coli K1 meningitis after acquiring an E coli K1 urinary tract infection with associated sepsis. The patient's symptoms consisted only of severe headache, fever, and malaise. She had no meningeal or focal neurologic signs, and the CSF did not contain white blood cells. Evidence of meningitis included elevated opening pressure on lumbar puncture, positive CSF culture, and small ventricles on CT scan.

Antigens↗
PubMed1983

Enterococcal liver abscess associated with moxalactam therapy. Review of literature on enterococcal superinfections in association with moxalactam therapy.

Moxalactam, a third-generation cephalosporin, has been demonstrated to have an ultrawide spectrum of antibacterial activity. One important gap in this impressive spectrum is the enterococcus. Superinfections and colonization with enterococci have been reported following moxalactam therapy. Sites involved have included the urinary tract, wounds, middle ear, and blood stream. To our knowledge, we report the first case of enterococcal liver abscess following moxalactam therapy. The abscess was localized by ultrasound examination and microbiologic diagnosis made by aspiration using a skinny needle. Without surgical drainage or therapeutic aspiration, institution of appropriate antibiotic therapy in optimum dosage resulted in complete resolution. The literature on enterococcal superinfections in association with moxalactam therapy and nonsurgical management of liver abscesses is reviewed.

Cephalosporins↗
PubMed1982

Escherichia coli pneumonia in the elderly with reference to the role of E. coli K1 capsular polysaccharide antigen.

Escherichia coli pneumonia occurred in 17 elderly patients over a two-year period. All cases were documented by transtracheal aspiration. Six of the 17 E. coli organisms causing pneumonia contained K1 capsular polysaccharide. E. coli K1 organisms did not appear to be more virulent than non-K1 strains as measured by incidence of bacteremia, shock and death. E. coli K1 pneumonia was usually community- acquired (five of six cases) and occurred in patients with a prior history of urinary infection. Non-K1 E. coli pneumonia occurred in the hospital setting in eight of 11 patients, and a gastrointestinal source of infection was likely in five patients. All patients were treated with appropriate initial antibiotic therapy, and 71 percent of patients survived.

Aged↗
PubMed1982

Bacteremic group G streptococcal pneumonia.

Bacteremic group G streptococcal pneumonia occurred in a patient with premyelogenous leukemia and porphyria cutanea tarda. Group G streptococci have been recognized as a cause of endocarditis, septic arthritis, puerperal sepsis, and cellulitis. The organism has not previously been implicated as a pneumonic pathogen in adults. Group G streptococcal infection may be more common than previously reported, and is likely to cause infection in patients with underlying malignancy.

Amikacin↗
PubMed1982

Nontypeable Haemophilus influenzae in the elderly.

Nontypeable Haemophilus influenzae pneumonia occurred in 12 patients older than 60 years in a 15-month period. These patients represented approximately 11% of the 104 elderly patients with bacterial pneumonia in whom transtracheal aspiration was performed. Eighty-five percent of H influenzae isolates (12/14) recovered from elderly patients with pneumonia were nontypeable. Nontypeable H influenzae pneumonia occurred in the community, in nursing homes, and in the hospital. Patterns of both bilateral patchy bronchopneumonia and dense lobar consolidation were seen on chest roentgenograms.

Age Factors↗
PubMed1982

Group b Streptococcal pneumonia in the elderly.

Group B streptococcal infections, although well studied in neonates, have only recently been appreciated as important infectious agents in adults. Seven cases of Group B streptococcal pneumonia were verified by transtracheal aspiration, blood and sputum cultures, or multiple stab cultures at autopsy. The infections were largely nosocomial and, ultimately, fatal in all seven patients. Our patients were older (average age, 73 years) and much more debilitated than the 13 cases reported in the literature. Diabetes was less common than previously reported. Previous antibiotic therapy was common. Concomitant isolation of another organism (especially Staphylococcus aureus) occurred in five patients. The morphologic findings at autopsy, in one patient, were characterized by a severely necrotizing destructive process. In our experience, Group B streptococcal pneumonia is more common, more devastating, and occurs in an older population than previously reported.

Adult↗