Case 25-1979--medical treatment of echinococcosis.
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Benzimidazoles↗
Biomedical subjects
W S Kammerer
Publications and source records attributed to W S Kammerer.
Intraocular cysticercosis.
Two intravitreal Taenia cysts were removed intact by pars plana vitrectomy from a 59-year-old woman who had never left the continental United States. The intraocular course of the cysts progressed from an initial chorioretinal location, accompanied by an intense focal inflammatory reaction, to free floating in the vitreous cavity within two months; thereafter, there was only a low-grade vitritis for an additional five months until removal. Light and electron microscopic studies suggested Cysticercus cellulosae as the infecting agent, although mature hooklets were absent. Local pork products were considered to be the source of the infection. Preretinal fibrosis and posterior subcapsular vacuoles were the final residua and did not progress after removal of the cysts. Although uncommon in the United States, cysticercosis should be considered in cases of focal necrotizing chorioretinitis.
Cysticercosis↗
Nonobstetric surgery during pregnancy.
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Adrenal Gland Neoplasms↗
Risk factor assessment in 101 total hip arthroplasties: a medical perspective.
Our experience with 101 consecutive T.H.A.'s in 91 patients was examined in an attempt to identify preoperative risk factors for postoperative medical complications, especially pulmonary embolism and thrombophlebitis. Six per cent of patients developed postoperative clinical thrombophlebitis, and 8% a pulmonary embolism. Advancing age and previous venous thrombosis served as predictors for pulmonary embolism and thrombophlebitis, respectively (p less than 0.01), but obesity, venous varicosities, diabetes mellitus, cigarette smoking, previous pulmonary embolism, and length of surgery did not, for either. Fifty per cent of the patients with preoperative abnormal kidney function developed some form of medical complication postoperatively, a significant increase in risk (p less than 0.05) over patients with normal kidney function. We were unable to identify an increase in postoperative atelectasis or pneumonia associated with smoking or obesity in these patients. No consistent decrease in post-operative medical morbidity could be assigned to preoperative medical consultations, suggesting that we have not yet identified all significant risk factors. A thorough preoperative preparation and improvement in intra- and postoperative techniques and management may account for differences found in this study from traditionally held risk factors.
Adolescent↗
Consultations in internal medicine: a training program resource.
At the Milton S. Hershey Medical Center of the Pennsylvania State University an internal medicine consulting resident sees all medical consultation requests not directed to a specific subspecialty division. An audit of a nine-month experience on the consult service was compared with that of a general medicine ward service. The audit revealed that consulting residents were exposed to a quantitatively and qualitatively different spectrum of medical problems than were found on the ward service. The interdisciplinary aspects of the experience expand the consulting internist's fund of knowledge and complement outpatient exposure to other specialties, such as surgery and obstetrics-gynecology. Chief medical residents at 36 university medical centers were surveyed regarding the nature of the internal medicine consultation programs in their institutions. The survey indicated that half the programs were service oriented rather than educational and were not felt to be of profit to the medicine residents.
Adolescent↗
Clonorchiasis in New York City Chinese.
Among 150 Chinese-born residents of New York City a single stool examination showed 26% were infected with C, sinensis. Most of those infected were immigrants from the Kwangtung Province of China. The possibility of clonorchiasis in Oriental-born residents is emphasized.
China↗
Chemotherapy of hydatid disease (Echinococcus granulosus) in mice with mebendazole and bithionol.
We treated female Swiss Webster mice with heavy, long standing infections of Echinococcus granulosus with mebendazole, 50 mg/kg body weight daily for 10 days and bithionol, 70 mg/kg every other day for four doses. Necropsy performed 6 weeks after completion of therapy showed no gross or histologic differences between untreated controls and bithionol-treated mice or their cysts. Mebendazole-treated mice had a significant decrease in the total number of cysts (15 vs. 100), with many of those present being ruptured. Electron microscopy of intact, mebendazole-treated cysts revealed a marked increase in vacuolization and disarray of the distal cytoplasm, dilated and degenerating microtubules, increase in the size and number of lysosomes, a decrease in the number of normal appearing golgi, and increased density of mitochondria. Several mice died shortly after the termination of mebendazole therapy, all with ruptured cysts. Due to the large volume of the cysts, the presumed cause of death was acute volume overload, but toxic or anaphylactic reactions could not be excluded. We suggest that any proposed chemotherapy of humans with hydatid disease be done cautiously, with careful monitoring.
Animals↗
Chemotherapy of experimental Echinococcus granulosus infection. Trials in CF1 mice and jirds (Meriones unguiculatus).
Mice and jirds with experimental secondary hydatidosis (Echinococus granulous) were treated at various post-infection periods with eight different drugs; iodinized oil of thymol, ethyl-N-dimethyl ether of thymol fumarate, chloroguanide, rifampin, pentamidine isethionate, amphotericin B, suramin, and methotrexate. In initial experiments with methotrexate, mice treated after 99 days of infection had significantly fewer infections at necropsy than did controls (33% and 100%, respecitively). However, in subsequent studies at three dose levels of methotrexate in mice 10 days after infection and in mice and jirds 240 days post infection, no significant differences were found in the percentage of animals infected, cyst size, or number between treated and control animals. The other drugs tested were similarly without effect under the experimental conditions used.
Administration, Oral↗