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Biomedical subjects

T W Austin

Publications and source records attributed to T W Austin.

At least 37 records · Page 2Linked to original sources
PubMed1985

A 12-month fever surveillance study in a veterans' long-stay institution.

This report describes a 12-month fever surveillance survey in a 258-bed veterans long-term care institution. There were 128 episodes of fever (one episode per 24 patient-months); 114 were studied. Lower respiratory tract infections were most frequent, 36 (32%), with 26 (23%) urinary tract infections. Streptococcus pneumoniae was the most common pathogen in the chest infections and Proteus mirabilis the most common of the urinary tract infections. In 40 (35%) there was no evidence of a lower respiratory tract, urinary tract, or other bacterial infection. Most recovered rapidly, many with no specific treatment. There was a 16% mortality associated with the febrile episodes.

Aged↗
PubMed1984

Rosoxacin in the therapy of uncomplicated gonorrhea.

In this randomized, multicentered study, 157 males and 130 females with laboratory-confirmed, uncomplicated anogenital Neisseria gonorrhoeae infections were evaluated to determine the efficacy and safety of a single 300-mg oral dose of rosoxacin versus 3.5 g of ampicillin plus 1 g of probenecid. A total of 130 males and 101 females were evaluated. Rosoxacin cured 90.3% (P = 0.053) and 94.1% (P = 0.62), respectively, whereas ampicillin was effective in 98.5 and 98% of males and females, respectively. All 39 patients with anorectal infections were cured. One penicillinase-producing N. gonorrhoeae strain was isolated and was eradicated with rosoxacin. Of 212 pretreatment isolates tested, 201 were inhibited by 0.06 micrograms or less of rosoxacin per ml. The MICs of rosoxacin for the remaining 11 isolates ranged up to 0.5 micrograms/ml. The incidence of adverse effects was relatively high (29% for the rosoxacin group versus 18% for the ampicillin group), but none of the reactions required medical intervention nor did they result in serious sequelae.

4-Quinolones↗
PubMed1983

Overwhelming pneumococcal infection in a hyposplenic adult.

In a woman with an atrophic, apparently nonfunctioning spleen pneumococcal septicemia led to death within 72 hours of admission. As in five previously described adults, the patient's presentation and subsequent clinical course were identical to those of the syndrome of overwhelming postsplenectomy infection, except that there was no history of splenectomy. Patients without spleens may be given penicillin prophylaxis for an indefinite period, vaccinated against pneumococci or both.

Atrophy↗
PubMed1982

Metronidazole in a single dose for the treatment of trichomoniasis. Failure of a 1-g single dose.

To determine the minimum effective dose of metronidazole in the treatment of vaginal trichomoniasis, a randomised clinical trial comparing single 1-g and 2-g doses was carried out on 163 patients attending sexually transmitted diseases and family planning clinics. Seventy-two of 86 (84%) patients receiving a single 2-g dose of metronidazole were cured compared with only 42 of 77 (55%) receiving a 1-g dose. The body weight of the patient was a significant variable affecting treatment outcome only in the latter group; 69% of patients weighing more than 57 kg or less when cured compared with only 43% of those weighing more. Patients who failed after either dose regimen were retreated with a single 2-g dose. Eighteen of 21 (86%) and seven of 10 (70%) failures with the initial 1-g and 2-g doses respectively were cured. A single 1-g dose of metronidazole is not recommended as routine treatment for vaginal trichomoniasis.

Adolescent↗
PubMed1981

Vancomycin blood levels during cardiac bypass surgery.

Because of the allergic reaction that some patients have to penicillin and cephalosporins, there is a need for an alternative antimicrobial agent to protect the patient who undergoes coronary artery bypass grafting from infection perioperatively. Vancomycin, a bactericidal antibiotic active against gram-positive organisms was studied in 13 men who underwent aortocoronary bypass grafting. For 60 minutes from the time the patient arrived in the operating room, vancomycin (15 mg/kg) was given intravenously. Blood levels were assayed up to 12 hours thereafter. Adequate antistaphylococcal levels of the drug were maintained throughout operation. Twelve hours later levels were subtherapeutic. There was no cardiovascular, cutaneous or renal toxicity. Two patients had minor wound infections.

Adult↗
PubMed1980

Aortocoronary bypass procedures and sternotomy infections: a study of antistaphylococcal prophylaxis.

In a prospective study of cephalothin prophylaxis for patients who underwent aortocoronary bypass an unacceptably high rate (44%) of Staphylococcus aureus sternotomy infections occurred in a placebo-treated group. In two other groups of patients, one group given cephalothin intraoperatively and the other given the antibiotic both intra- and postoperatively, such infections occurred with similar frequency (2.6% and 2.1% respectively). This study demonstrates the need for antistaphylococcal agents during aortocoronary bypass operation. No advantage is derived by extending this therapy beyond the operative period.

Aged↗
PubMed1979

Predictive value for survival of lymphocytes and polymorphonuclear leukocytes in patients with sepsis.

To study their value in predicting prognosis, tests were performed on peripheral blood lymphomononuclear cells and polymorphonuclear leukocytes in 34 critically ill patients with sepsis. Intially, the number of lymphomononuclear cells was reduced by 32% compared with healthy control subjects and was 42% lower in those who died than in survivors. The values remained low in those who died. The numbers of T and B cells, determined by rosette formation using sheep and mouse erythrocytes, did not change during the period of observation. Intially, K cell activity was decreased by 48% compared with normal activity. In those younger than 65 years, K cell activity was 68% lower in patients who later died than in survivors. It returned to normal at 20 to 30 days and decreased in those who died. Polymorphonuclear leukocyte adherence was decreased by 50% compared with healthy control subjects and tended to be lower in those who died. Chemotactic migration of polymorphonuclear leukocytes and intracellular killing of Staphylococcus aureus and Pseudomonas aeruginosa were not impaired. It was concluded that the lymphomononuclear cell count, K cell activity and adherence of polymorphonuclear leukocytes were decreased in patients with sepsis and that the values were useful in predicting prognosis.

Adolescent↗
PubMed1978

Gonorrhea in homosexual men.

Extragenital gonorrhea was seen in 65% of 54 cases of gonorrhea in 43 homosexual men attending a venereal diseases clinic between 1974 and 1977; in 21 cases the infection was extragenital only. This type of gonorrhea was often asymptomatic and was associated with a high rate of failure of initial treatment in 6 of the 50 cases in which the patient returned for follow-up assessment, and in 5 of the 6 the persistent infection was extragenital. Syphillis was seen concomitantly or had previously occurred in 6 of the 54 cases. Fifteen of 28 cases of primary, secondary or early latent syphilis seen in men during the same study period had occurred in homosexuals. Appropriate testing for extragenital gonorrhea and for syphilis is important in homosexual men who present for examination, and homosexuality with the possibility of extragenital gonorrhea should be considered in a man with syphilis of recent onset.

Gonorrhea↗
PubMed1978

Hyperthermia, antipyretics and function of polymorphonuclear leukocytes.

Whether hyperthermia (temperature, 40 degrees C), salicylates, acetaminophen or phenacetin has an adverse effect on polymorphonuclear leukocyte (PMNL) function was examined. Migration experiemnts were carried out in Boyden chambers with bacterial chemotactic factor as the attract, and bactericidal assays were done with Staphylococcus aureus and serum from an AB blood group donor as a source of opsonins. PMNL viability was determined by the trypan blue exclusion method. Neither hyperthermia nor any of the drugs tested affected PMNL viability adversely, but sodium salicylate and phenacetin suppressed PMNL migration. Early staphylococcal killing was greater at 40 degrees C; however, after 2 hours the converse was true. Bactericidal activity was suppressed by acetylsalicylic acid, sodium salicylate and phenacetin. Hence it appears PMNL function is similar at 37 degrees and 40 degrees C but that some commonly used antipyretics have an adverse effect on PMNL activity.

Acetaminophen↗
PubMed1977

Cephalothin Prophylaxis and valve replacement.

In a study of antibiotic prophylaxis in adults undergoing heart valve replacement, we found that a 2 gm dose of cephalothin given intraoperatively produced adequate antimicrobial activity in the bloodstream throughout the period of cardiopulmonary bypass. A dosage of 1 gm every four hours postoperatively did not lead to significant accumulation of the antibiotic. With prophylaxis restricted to the intraoperative and early postoperative period, adverse drug reactions and superinfections were not a problem. Further, no cases of prosthetic valvulitis were encountered.

Aortic Valve↗
PubMed1976

Prophylactic antibiotic therapy and heart valve replacement.

Patients undergoing cardiac bypass for heart valve replacement maintained adequate blood concentrations of cloxacillin throughout the duration of bypass, provided their initial blood concentration was in the therapeutic range. Blood levels related to the time between the last preoperative dose of antibiotic and operation. Maximal values were achieved if an intraoperative bolus of drug was given.

Adolescent↗
PubMed1975

The use of trimethoprim-sulfamethoxazole in gonococcal infections.

In a multicentre trial of trimethoprim-sulfamethoxazole (TMP-SMX) for the treatment of uncomplicated gonococcal urethritis, optimal results were achieved with a regimen of six tablets once daily for 3 days. Treatment failure was found to be related significantly to the relative resistance to SMX of the pretreatment isolate. Further, the difference between therapeutic results from various geographic areas could be correlated with the relative sensitivity of pretreatment isolates to both SMX and TMP for that area. In view of these observations the role of TMP-SMX in the treatment of gonococcal disease is discussed.

Administration, Oral↗