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Biomedical subjects

Baruch Brenner

Publications and source records attributed to Baruch Brenner.

24 records · Page 2Linked to original sources

[Smallpox--past, present and future].

Smallpox has played a notorious role in human history. It has been the cause of millions of deaths throughout the centuries, yet, it was the first infectious disease that was ever eradicated thanks to a worldwide program. Smallpox vaccine, manufactured from the vaccinia virus, was the first vaccine ever produced. Recent bioterrorism events in the USA have brought smallpox back into the limelight, both medically and politically, because of the fear of the return of this horrific disease through the unscrupulous actions of terrorists who might spread variola virus. This article presents the history of smallpox, emphasizing its clinical variants. We also review the treatment of the disease, especially the vaccine--its efficacy and its disadvantages, and the public health measures that must be taken in order to control the disease. In conclusion, we will discuss the possibility of the resurgence of smallpox and global preparedness for such an outbreak.

Bioterrorism↗

[Biological warfare: disease prevention and post exposure medical treatment].

The use of biological warfare agents has become a reality in recent years, emphasizing the need for local and national preparedness programs. In the event of a biological attack, the use of medical measures for prophylaxis and treatment can greatly reduce its impact. Antibiotics, active and passive immunizations, and antiviral agents can all be used for this purpose. Since diseases resulting from biological warfare agents have an incubation period of days, there is a short time period in which proper post exposure prophylaxis may be given. This paper provides a therapeutic approach to patients exposed to biological warfare agents, in comparison to the management of naturally occurring diseases.

Biological Warfare↗

[Tularemia as a biological weapon].

Tularemia is a zoonosis, caused by the Gram-negative bacterium, Francisella tularensis. The organism penetrates the human body through interrupted skin or mucous membranes, via animal contact or bites from ticks, deer-flies and mosquitoes. Contaminated aerosol and water are alternative modes of transmitting the germ through the respiratory and alimentary tracks. In light of its high infectivity in aerosol and its offensive occupation in the past, tularemia may appear in a biological warfare context. After an incubation period of 3-5 days, the disease begins with systemic symptoms, which abate, leaving a clinical picture, dominated by one of the listed patterns: ulceroglandular, typhoidal, glandular, occuloglandular, pharyngeal or pneumonic. Diagnosis and identification of the bacterium is difficult and even hazardous. Most diagnoses are established by serology which is positive in 50-70% of the patients after 2 weeks of illness, and in most of them by 4-8 weeks. The treatment of choice is streptomycin intra-muscular, or gentamicin intra-venous for 10-14 days. Prophylaxis may be achieved by tetracycline treatment, beginning up to 24 hours from exposure, for 2 weeks, or by a live attenuated, investigational vaccine. Nevertheless, post-exposure, or even better so, pre-exposure intervention is the most effective way of preventing the devastating results of the attack.

Animals↗

[Viral hemorrhagic fever as a biological weapon].

The viruses that cause hemorrhagic fever belong to four virus families: the Arenaviridae, Bunyaviridae, Filoviridae and Flaviviridae. These viruses are candidates for biological warfare agents because they are stable when aerosolized and cause severe debilitating disease. Research and development regarding the use of these viruses as warfare agents has been performed in the former Soviet Union and other countries. The introduction of these agents into non endemic countries poses a major public health threat to that country. Israel is not endemic for these agents, and therefore, local infection can occur from a traveller (human or animal) from an endemic country or due to intentional dissemination. Major clinical manifestations of hemorrhagic fevers are that of fever, rash, malaise and hemorrhagic signs. Due to the similarity between syndromes, any person with a history of persistent fever and any sign of hemorrhage should be considered as having viral hemorrhagic fever, and appropriate care instituted. Definitive diagnosis requires laboratory testing and is important to identify a possible biological warfare attack and to prepare for appropriate defense. This paper reviews the viruses that cause hemorrhagic fever, and their role as possible warfare agents.

Biological Warfare↗

Variable cytotoxicity of amifostine in malignant and non-malignant cell lines.

Amifostine is the best known radioprotector and chemoprotector which has already been incorporated into general oncology practice. However, the data regarding its action at the cellular level remain unclear. The present study examined the effect of amifostine with and without ionizing radiation on the growth of malignant and non-malignant cell lines. Amifostine was found to have a remarkable cytotoxic effect on malignant epithelial cell lines but a modest cytotoxic effect on malignant melanoma and non-malignant cell lines. It demonstrated an additive effect with radiation therapy on the malignant cell line and a variable effect on the non-malignant cell line. Endothelial cells were not affected by amifostine, but the myoblast cells showed a synergistic effect of amifostine and radiation. These findings demonstrate that the cytotoxic as well as the radioprotective effect of amifostine are cell-specific. Thus, caution should be exercised in the use of amifostine as a radioprotector, and it should be tested for each model of disease.

Acridine Orange↗

Older age and second skin cancer as prognostic factors in localized malignant melanomas.

Of the numerous prognostic factors for patients with localized malignant melanoma (LMM), none is superior to the simple parameter of tumor thickness. The aim of the present study was to better define prognostic factors for this disease. Between January 1992 and December 1994, 188 consecutive patients with LMM were treated at the Rabin Medical Center. Patient and tumor characteristics were retrospectively examined as potential prognostic factors. Patients (n=173) who had had at least two-year follow-up were included in the overall survival (OS) analysis, and 159 patients for whom accurate data on recurrent disease were available were included in the disease-free survival (DFS) analysis. At a median follow-up of 85 months (range 24-114), 48 patients (30%) had recurrent disease which resulted in death in 35 (20%). The five-year OS and DFS rates for the entire group were 82 and 72%, respectively. On univariate analysis, female gender, age younger than 75 years, metachronous or synchronous second skin cancer (including melanoma), light skin color, tumor thickness and TNM stage were predictive of both OS and DFS. Tumor location and ulceration, correlated with only one endpoint, OS or DFS, respectively. On multivariate analysis, three factors retained statistical significance with regard to both OS and DFS: tumor thickness (p=0.000 for both), second skin cancer (p=0.02 for both), and age (p=0.04 for both). Alongside the well-established predictive factor of tumor thickness in LMM, older age and the presence of a second skin cancer also have prognostic significance. The prognostic importance of the latter is reported here for the first time.

Adolescent↗