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Biomedical subjects

A A Goldberg

Publications and source records attributed to A A Goldberg.

14 recordsLinked to original sources
PubMed1992

Nosocomial acquisition of beta-lactamase--negative, ampicillin-resistant enterococcus.

BACKGROUND: A recent prospective study at the Department of Veterans Affairs Medical Center, Martinez, Calif, revealed that 9% of enterococcal clinical isolates were ampicillin resistant. We prospectively studied 100 patients hospitalized in one general medicine ward and in the medical intensive care unit to study determinants of acquisition of ampicillin-resistant enterococcus. METHODS: Rectal swabs and urine cultures were obtained from patients within 72 hours of admission to the study ward and twice weekly until discharge from the ward or the intensive care unit. Cultures were obtained from the hands of personnel and from environmental surfaces in the general medical ward and the intensive care unit. Ampicillin-resistant enterococcal isolates were examined for molecular relatedness by plasmid DNA analysis. RESULTS: The cultures from 23 patients yielded ampicillin-resistant enterococci. The rectal swabs yielded ampicillin-resistant enterococci before the urine cultures did except in one patient whose urine and rectal cultures were both positive on the same day. Acquisition of ampicillin-resistant enterococci was significantly associated with previous antimicrobial agents, Foley catheterization, and being bedridden. Resistant enterococci were not isolated from hospital personnel or environmental surfaces. Plasmid analysis by gel electrophoresis demonstrated nine strains, two of which predominated. Rectal and urine isolates from the same patient had identical plasmid electrophoresis patterns. CONCLUSIONS: We conclude that ampicillin-resistant enterococci are common in the rectal flora, can spread to the urinary system, are associated with patient characteristics that predipose to nosocomial infection, and may become an emerging clinical problem.

Aged↗
PubMed1991

Endovascular infections caused by enterococci highly resistant to ampicillin.

Enterococci frequently cause endocarditis and are the most common gram-positive isolates in polymicrobial bacteremia. We report three cases of polymicrobial endovascular infections at a single institution during a 12-month period; the enterococcal isolates were highly resistant to penicillins. These cases comprised 18% of all enterococcal endovascular isolates during the same 12-month period. Previous use of antibiotics, presence of endovascular catheters, and nosocomial acquisition of the organism occurred in all three cases. Clinicians should be aware of enterococcal resistance to penicillins and should exercise care in designing appropriate regimens for serious enterococcal infections.

Aged↗
PubMed1991

Ampicillin-resistant Enterococcus raffinosus in an acute-care hospital: case-control study and antimicrobial susceptibilities.

A prospective study identified 9 (32%) of 28 ampicillin-resistant (MIC greater than or equal to 16 micrograms/ml) enterococcus isolates as Enterococcus raffinosus. A case-control study found no significant differences with respect to underlying diseases, catheterization, or surgery between patients with ampicillin-resistant E. raffinosus and those with ampicillin-susceptible Enterococcus spp. Prior treatment with antibiotics and prolonged hospitalization were more frequent among patients with ampicillin-resistant E. raffinosus. Patients with the same strain (determined by plasmid analysis) were frequently hospitalized concurrently.

Aged↗
PubMed1990

Ampicillin-resistant enterococcal species in an acute-care hospital.

A prospective review of all enterococcal isolates for 13 months showed that 9.0% were resistant to ampicillin (MIC, greater than or equal to 16 micrograms/ml; zone diameter, less than 15 mm), as determined by the Vitek system, disk diffusion, microdilution MIC testing, and macrodilution MIC testing. All were beta-lactamase negative. A total of 19 and 3 resistant isolates were from urine and intravascular sites, respectively. Ampicillin-resistant enterococci appear to be a growing clinical problem.

Adult↗
PubMed1986

Buccal nitroglycerin in congestive cardiac failure: a multicentre study.

One-hundred-and-ninety-two elderly patients with symptoms of congestive cardiac failure, despite therapy with diuretics and inotropic agents, received buccal nitroglycerin as additional medication. They were assessed for up to 6 months. Improvements in symptoms and functional classification were apparent within 14 days, and were maintained for the duration of the study.

Administration, Oral↗
PubMed1981

A new goniometer.

A simple new goniometer has been developed for measurement of the mobility of the cervical spine. It consists of a headgear with three rigid scales calibrated in degrees, mounted on a skull cap with straps around the chin, and it measures flexion/extension, lateral flexion and horizontal rotation. Its construction and use are described. Three observers each tested the same 10 subjects to determine inter-observer error. Two observers then each tested 10 different subjects on two occasions at intervals of 10 to 30 minutes to test intra-observer error. Statistical analysis of the inter-observer error data by analysis of variance, and the intra-observer error data by calculation of means and standard errors of the differences between the means, showed that acceptably reproducible results could be obtained with this new goniometer, and it is also shown that an experienced observer can obtain more consistently reproducible results. Reference is made to the successful use of this technique in a comparative study (published elsewhere) of two drugs in degenerative joint disease of the cervical spine.

Cervical Vertebrae↗
PubMed1976

A trial of a phase-release aspirin preparation in rheumatoid arthritis.

Thirty-six patients with active rheumatoid arthritis were treated in a double-blind cross-over study of phase-release aspirin tablets and aspirin B. P. tablest. Twenty-nine patients completed the study. The phase-release preparation given twice daily proved as effective as aspirin B.P. given four times daily. Better results were produced by the phase-release aspirin in respect of the degree and duration of morning stiffness, grip strength and joint size, although the differences did not reach the level of statistical significance. The E.S.R. was significantly reduced by the B. P. preparation but this result was thought to be due to an order effect in the weeks of therapy.

Adolescent↗
PubMed1969

Post-tetanic and drug-induced repetitive firing in the soleus muscle of the cat.

1. The effects of a high frequency indirect tetanus on the responses to subsequent infrequently applied nerve shocks have been compared in the tibialis anterior and soleus muscles of cats and rabbits.2. Post-tetanic augmentation of twitches in the cat soleus muscle was shown to be partly due to repetitive firing and partly due to increased synchronization of the muscle fibre response. Post-tetanic repetitive firing was not evident in the responses of the other three muscles studied.3. Post-tetanic repetitive responses in the cat soleus muscle and nerve did not originate in the nerve trunk and were not produced by direct muscle stimulation; they were abolished by doses of tubocurarine smaller than those necessary to reduce the twitch tension below the pre-tetanic level. These findings support the conclusion of others that the repetitive firing originates at the neuromuscular junction.4. The repetitive firing could not be explained by an increase in the sensitivity of the motor endplates to acetylcholine, suggesting that an increase in and/or a prolongation of the output of transmitter from the motor nerve contributes to it.5. The cat soleus muscle was shown to be more sensitive to neostigmine than were the other three muscles studied, and acetylcholinesterase determinations showed that this muscle possesses less enzyme activity.6. It is concluded that an increase in transmitter output, coupled with a weaker cholinesterase activity, probably accounts for the post-tetanic repetitive activity in the cat soleus muscle.7. Post-tetanic repetitive firing was absent in cat soleus muscles which had been cross-innervated with the nerve formerly innervating a fast-contracting muscle.

Acetylcholine↗