Stacy Childs - Academia.edu (original) (raw)

Papers by Stacy Childs

Clinical Infectious Diseases, 1996

Archives of Internal Medicine, 1995

Abdollah Iravani, MD; Alan D. Tice, MD; James McCarty, MD; David H. Sikes, MD; Thomas Nolen, MD; ... more Abdollah Iravani, MD; Alan D. Tice, MD; James McCarty, MD; David H. Sikes, MD; Thomas Nolen, MD; Harry A. Gallis, MD; Edward P. Whalen, PhD; Robert L. Tosiello, MS; Allen Heyd, PhD; Steven F. Kowalsky, PharmD; Roger M. Echols, MD; for the Urinary Tract Infection ...

Urology, 1990

17 exacerbation and 13 latent CBP cases received ciprofloxacin in a dose 500 mg twice a day orall... more 17 exacerbation and 13 latent CBP cases received ciprofloxacin in a dose 500 mg twice a day orally for 6-34 days. At pretreatment microbiological investigation of the prostatic juice 49 cultures of 7 microorganism species were isolated (12 cases of monoculture, 18 cases of 2-component associations). S. epidermidis and E. faecalis occurred more frequently (in 29.4 and 25%, respectively). Ciprofloxacin was highly active against all the isolated agents and by the number of sensitive to it strains proved superior to control antimicrobial drugs. Good and satisfactory treatment outcomes were achieved in 76.8% of patients. Side effects recorded in 8 patients (26.6%) caused the drug undue discontinuation in 1 patient only.

The Urologic clinics of North America, 1994

DMSO2 is one alternative for treating interstitial cystitis. Research with this compound is very ... more DMSO2 is one alternative for treating interstitial cystitis. Research with this compound is very limited, but side effects have been negligible. The drug may hold promise for interstitial cystitis patients, as well as those suffering from painful bladder (urethral) syndrome.

The American journal of medicine, Jan 22, 1993

Patients were entered in a double-blind, placebo-controlled, multicenter study to compare low- an... more Patients were entered in a double-blind, placebo-controlled, multicenter study to compare low- and high-dose fleroxacin with norfloxacin for the treatment of complicated urinary tract infection (UTI). A total of 296 patients were enrolled; 102, 97, and 97 patients were randomized to receive 200 mg of fleroxacin (low-dose), 400 mg of fleroxacin (high-dose), both once daily, or 400 mg of norfloxacin twice daily, respectively, for 10 days. Of these patients, 101, 94, and 95 were included in the safety analysis, and 71, 61, and 58 in the efficacy analysis. The main reason for exclusion from the efficacy analysis was failure to isolate a pathogen at baseline. The groups were comparable with respect to demographics. In the low-dose fleroxacin group, 68 (96%) of 71 patients had bacteriologic cures (eight with superinfection), compared with 56 (92%) of 61 in the high-dose fleroxacin group (two with superinfection) and 52 (90%) of 58 in the norfloxacin group (four with superinfection). Esche...

Urol Clin N Amer, 1996

Aging is associated with a decreased physiological functioning, reflecting the body's pro... more Aging is associated with a decreased physiological functioning, reflecting the body's progressive inability to maintain homeostasis as age increases. The physiologic dysfunctions experienced in response to the aging process increase the individual's susceptibility to infection. Many elderly subjects are hospitalized for the care and treatment of functional disabilities; thus, an increased exposure to possible uropathogens (many with antimicrobial resistance) often results in infection. Additionally, indwelling catheters and other attending procedures may provide a microenvironment conducive to infection. In catheterized patients, the drainage bag often is infected with polymicrobes, which enhances the transference of antimicrobial genetic information. Postmenopause reflects a decrease in circulating estrogen, and a relational decrease in lactobacilli colonization with a lower vaginal pH. Consequently, vaginal colonization with possible uropathogenic and gastrointestinal bacteria increases, which partially may account for the generally higher incidence of bacteriuria in elderly women as opposed to elderly men. Urinary infections in the elderly more commonly are asymptomatic. Treatment for asymptomatic bacteriuria is not justified and will often present opportunities for the infecting organism to acquire antimicrobial resistance. Only symptomatic bacteriuria presenting adverse conditions in the host should be treated. Antimicrobial selection for the treatment of complicating symptomatic urinary infections in elderly subjects is complicated by the many physiological and environmental conditions associated with older age patients. Unfortunately, data confirming the efficacy and safety of antimicrobial agents for the treatment of symptomatic infections in the elderly presently are insufficient.

Pharmacotherapy

Aztreonam is a new, totally synthetic beta-lactamase agent--the first monobactam. It is highly re... more Aztreonam is a new, totally synthetic beta-lactamase agent--the first monobactam. It is highly resistant to hydrolytic inactivation caused by plasmid-mediated (except PSE-2 enzyme found in some Pseudomonas species) or chromosomally mediated beta-lactamases (except for K1 produced by rare strains of Klebsiella oxytoca). Accordingly, aztreonam remains active against many pathogens that are resistant to other beta-lactam antibiotics. The drug exhibits directed antibacterial activity against gram-negative organisms and is effective as monotherapy against most Enterobacteriaceae and Hemophilus and Neisseria species, including beta-lactamase-producing strains; it is not active against anaerobes or gram-positive organisms. Before culture results are known, it may be necessary to administer the agent empirically in combination with other antibiotics. Aztreonam is rapidly distributed to most body tissues and fluids when administered parenterally. Its serum half-life is 1.7 hours, suggesting ...

Transurethral resection of the prostate (TURP) has been combined with Nd:YAG application for the ... more Transurethral resection of the prostate (TURP) has been combined with Nd:YAG application for the treatment of prostatic carcinoma for a decade. The inability to deliver the energy at right angles has made the procedure technically difficult, but results have been encouraging. A pilot study was begun in 1991 on ten patients who refused or were not candidates for radical prostatectomy. The protocol consisted of transrectal ultrasound imaging (TRUS) during extended TURP (EXTURP) followed immediately by Nd:YAG energy applied to the prostate bed and capsule. A second laser application under real time TRUS followed in eight weeks and a third (or fourth in one patient) was undertaken eight weeks later. Energy of 30,000- 85,000 Joules was applied during each procedure with the right angle urolase fiber (Bard) at 60 watts. Lesions were created for 30-60 seconds in each area of remaining tissue documented on TRUS. A thermocoupler was used to monitor rectal temperature. Complications include u...

Urologic Clinics of North America, 1996

Archives of Internal Medicine, 1983

... moxalactam disodium." It should come as no surprise that moxalactam has been associa... more ... moxalactam disodium." It should come as no surprise that moxalactam has been associated with bleeding epi-sodes as has cefamandole nafate and cefoperazone sodium. This has been well documented in the literature,1-10 and may well be attributable to the chemical ...

Postgraduate Medicine, 2000

Urinary tract infection (UTI) is a common problem that is distressing for patients and costly for... more Urinary tract infection (UTI) is a common problem that is distressing for patients and costly for the healthcare system. UTIs commonly affect young, sexually active women; the elderly; and patients who have predisposing factors, such as catheterization. Recurrent infections are likely to occur in all these patients groups. Patients who are pregnant or have predisposing factors are at increased risk for complications related to untreated UTIs, such as long-term renal damage. Given these risks and the public health burden associated with the condition, it is important that clinicians have up-to-date information regarding the classification, symptoms, pathogenesis, and empiric treatment of UTIs.

Urology, 1998

Objectives. The ability of percent free prostate-specific antigen (PSA) to distinguish benign fro... more Objectives. The ability of percent free prostate-specific antigen (PSA) to distinguish benign from malignant prostate disease has been established within the 4.0 to 20.0 ng/mL total PSA range, but its utility within the less than 4.0 ng/mL total PSA range has not been clearly defined. We undertook this study to determine the lower limit for the percent free PSA reflex range. Methods. Four hundred seventy-nine men (mean age [ϮSD] 63.2 Ϯ 9.68 years) met the following criteria:

Urology, 1986

Despite the high rate of urinary tract infections seen in hospitals, until recently many surgeons... more Despite the high rate of urinary tract infections seen in hospitals, until recently many surgeons did not advise antibiotic prophylaxis for transurethral genitourinary surgery. This situation has changed with the realization that older trials with questionable results were poorly designed. Several recent well-controlled clinical studies show that appropriate antibiotic prophylaxis greatly reduces the high incidence of infections following transurethral genitourinary surgery. Effective antibiotic prophylaxis for transurethral operations may be a major route to substantial reduction in nosocomial urinary tract infections and bacteremia. To achieve effective prophylaxis, the surgeon must choose a correct antibiotic and use it according to proved principles.

Journal of Endourology, 1995

Initial studies utilizing the original visual laser ablation prostatectomy (VLAP) technique of co... more Initial studies utilizing the original visual laser ablation prostatectomy (VLAP) technique of coagulation and a pilot study applying laser energy to prostate cancer led to the realization that these procedures could be monitored effectively in real time by ultrasound. Physical and chemical changes occur in prostate tissue with heating by laser energy, and these changes can be detected, not only as cavitation when the prostate tissue is vaporized, but also as a hyperechoic alteration that presumably is cell death leading to necrosis. Utilizing real-time monitoring helps assure the efficacy of the procedure and predict greater cavitation from slough of dead tissue. Monitoring by ultrasound scanning also allows following of the change of directions of the laser beam in tissue, which could be dangerous to the patient. With ultrasonography, one can make sure that the neurovascular bundle is not compromised and that the energy is not allowed to proceed past the posterior capsule of the prostate into the rectal wall. This is particularly helpful in patients with a high bladder neck but with minimal prostatic tissue posteriorly at the base. Also, the amount of tissue and the length from the verumontanum to the external sphincter can be accurately assessed and correlated with the lesion created at that level to avoid damage to the external sphincter.

Journal of Diagnostic Medical Sonography, 2000

Clinical Pharmacokinetics, 1989

The fluoroquinolones in general, and particularly enoxacin, show great promise in the treatment o... more The fluoroquinolones in general, and particularly enoxacin, show great promise in the treatment of urinary tract infection. Orally administered enoxacin achieves high concentrations in the serum and urine as well as in prostate tissue, kidney and perirenal fat and muscle. These concentrations are generally in excess of the minimum inhibitory concentrations (MIC) for 95% of the common uropathogens, including Escherichia coli, Pseudomonas aeruginosa, Klebsiella spp., Proteus spp., Enterobacter spp., Serratia marcescens and Staphylococcus saprophyticus. In comparative clinical trials, treatment with oral enoxacin has achieved satisfactory clinical results (symptoms improved or absent) in 67 to 96% of patients and satisfactory bacteriological results (less than 10(4) colony count of the original bacteria) in 77 to 98% of patients. Clinical cure or improvement occurred in 94 to 100% of patients in uncontrolled trials, with corresponding satisfactory bacteriological results of 82 to 100%. In a number of studies of patients with difficult-to-treat infections, satisfactory clinical results were achieved in 92 to 100% of patients and satisfactory bacteriological results in 89 to 100% of patients.

The American Journal of Medicine, 1985

The possible advantages of the monobactam antibiotic aztreonam iri the treatment of hospital-acqu... more The possible advantages of the monobactam antibiotic aztreonam iri the treatment of hospital-acquired urinary tract infection were assessed in a study comparing aztreonam (0.5 to 1 g twice daily or three times daily) to cefamandole (1 g three times dkily) in 159 patients. Initial pathogens were eradicated in 91.7 percent of the patievts of the aztreonam group who were treated three times daily, in 82.7 percent of the group treated twice daily, and in 78.3 percent of the patients receiving cefamandole. Reinfection and superinfection were most commonly caused by enterococci in t,he aztreonam groups and by Pseudomonas aeruginosa in the cefamandole group. In a second study, 35 patients infected with organisms resistant to other antibiotics were treated with aztreonam 1 to 6 g per day for eight days. The overall cure rates were 93 percent for Pseudomonas infections, 87.5 percent for Escherichia coli infections, and 100 percent for other pathogens.