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Biomedical subjects

D Merzbach

Publications and source records attributed to D Merzbach.

At least 19 recordsLinked to original sources
PubMed1992

Traveller's coccidioidomycosis: case report of pulmonary infection diagnosed in Israel.

A 60-year-old temporary Israeli resident travelled to Arizona, developed an influenzalike infection, and returned with a space-occupying lesion in the lung. Since the patient was a heavy smoker, lung cancer was suspected and he was operated on. A granuloma was reported on frozen sections, and Coccidioides immitis was revealed on stained preparations and by microbiological investigation. Coccidioidomycosis is unusual in Israel; therefore, it is important to be aware of this mycosis in patients who have a history of recent visits to areas of endemicity in North America, Central America, and South America.

Coccidioidomycosis↗
PubMed1991

Effect of Tamm-Horsfall protein on chemoluminescence response of polymorphonuclear leukocytes to uropathogenic Escherichia coli.

Mannose residues on the outer membranes of polymorphonuclear leukocytes (PMNL) are capable of binding mannose-sensitive Escherichia coli. Tamm-Horsfall protein, a major urinary glycoprotein, has also been shown to bind mannose-sensitive E. coli via mannose-containing side chains. The effect of Tamm-Horsfall protein on the interaction between PMNL and mannose-sensitive E. coli was studied by measuring luminol-dependent chemoluminescence after bacterial stimulation. In the presence of 0.475, 4.75, 47.5, and 475 mg/l Tamm-Horsfall protein, chemoluminescence responses were reduced in a dose-dependent fashion by 8.7%, 38.1%, 60.3%, and 96.1%, respectively. Addition of 0.003 units/ml alpha-mannosidase reversed the effect of increasing concentrations significantly. Thus, urinary Tamm-Horsfall protein seems to compete with PMNL for mannose-sensitive E. coli in a mannose-sensitive fashion, thereby significantly reducing the role of PMNL as a defense mechanism in the urine of patients with urinary tract infection.

Escherichia coli↗
PubMed1991

Effect of urine and urine components on the chemiluminescent response of bacteria-stimulated polymorphonuclear leukocytes.

The role of polymorphonuclear leukocytes (PMN) found in urine during infectious episodes is still unknown. Opsonophagocytosis of Escherichia coli by normal blood PMN in the presence of urine was measured using a chemiluminescence (CL) assay. PMN were challenged by a type I fimbriated E. coli strain shown to elicit a CL response through attachment to the mannose-containing receptors on the leukocytes. In the presence of urine the CL response decreased significantly. Urine osmolality due to inorganic salts partially caused this decrease. A higher inhibitory effect was elicited by urea. Under otherwise similar conditions, the presence of an additional CL-inhibiting factor, most probably a protein, was detected in urine; however, its identity has not yet been defined. In vitro and in vivo urine dilution improved PMN function. No difference in effect on CL response was found between urine obtained from 25 children with recurrent urinary tract infections and urine from 15 age-matched controls.

Adolescent↗
PubMed1990

Intraamniotic infection in the very early phase of the second trimester.

A total of 157 consecutive patients were studied in an effort to examine prospectively the incidence of asymptomatic intraamniotic infection in the early phase of the second trimester. All patients were referred for amniotic fluid karyotyping. In addition, the amniotic fluids were examined for Gram stain and were directly cultured on blood agar and MacConkey agar as well as in thioglycollate broth. We found positive amniotic fluid cultures in eight cases (5.09%); however, results of Gram stain examinations were negative in all amniotic fluid samples. The data indicate that there is no correlation between white blood cells in the amniotic fluid and positive amniotic fluid culture results. Only one pregnancy with positive amniotic fluid culture resulted in a septic abortion. Therefore we can suggest that intraamniotic infection can exist early in pregnancy, even with intact membranes, and in most cases without any clinical symptoms.

Abortion, Septic↗
PubMed1990

Interleukin-2 and neopterin-induced neopterin release from peripheral blood mononuclear cells.

Stimulation of peripheral blood mononuclear cells (PBMC) by the mitogenic lectins, phytohaemagglutinin (PHA) and concanavalin A (conA), the lymphokine gamma-interferon (gamma-IFN) and interleukin-2 (IL-2) and the pterin neopterin, caused an increased release of neopterin from those cells, with peak levels after 7 days of stimulation. In contrast to gamma-IFN, IL-2 and neopterin failed to induce neopterin release from purified macrophages. IL-2- and neopterin-induced release of neopterin from PBMC is not dependent on proliferation and is partially inhibited by the addition of anti gamma-IFN or anti IL-2 receptor. Neopterin autoinductive production can explain the amplificated neopterin release during activation of the cellular-mediated immune response (CMI), in spite of the decrease in the T helper cell subsets, which are the main gamma-IFN producers.

Biopterins↗
PubMed1990

Effect of an intravenous gammaglobulin preparation on the opsonophagocytic activity of preterm serum against coagulase-negative staphylococci.

Recent reports have described cases of septicaemia caused by coagulase-negative staphylococci in preterm neonates, mainly due to the use of artificial intravenous devices. It was of interest to examine if intravenous immunoglobulin therapy, known to be effective in group B streptococcal infections of neonates, had a similar beneficial effect in coagulase-negative staphylococcal infections. Opsonophagocytosis of coagulase-negative staphylococci by normal polymorphonuclear leukocytes in the presence of cord blood serum supplemented with the commercial IgG preparation 'Sandoglobulin' was investigated, using luminol-dependent chemiluminescence. It was found that with two different coagulase-negative staphylococcal strains, Sandoglobulin had a concentration-dependent enhancing effect on the chemiluminescent response. This effect was demonstrated in the presence of native as well as inactivated cord blood serum and in the presence of sera from preterm infants (28-33 weeks). It is concluded that intravenous Sandoglobulin therapy may be effective in the treatment of preterm infants with severe coagulase-negative staphylococcal infections.

Drug Evaluation↗
PubMed1990

Clinical and epidemiological significance of species identification of coagulase-negative staphylococci in a microbiological laboratory.

Although coagulase-negative staphylococci have been implicated in certain human infections, they are generally regarded as contaminants and their clinical significance has been questioned. To assess their role as pathogens, we studied 203 isolates of coagulase-negative staphylococci cultured from blood, wounds, body fluids (pleural, peritoneal and cerebrospinal), urine, and catheter tips. Patients' charts were reviewed and the clinical significance of these isolates was determined. Staphylococcus epidermidis accounted for 48% of isolates, S. hemolyticus for 33%, and other species (including S. capitis, S. hominis, S. warneri, S. cohnii, S. simulans, S. xylosus and S. saprophyticus) for the remaining 19%. There was no correlation between the pathogenicity and the species isolated, the source it was isolated from, or the pattern of antibiotic susceptibility. These observations suggest that identification of coagulase-negative staphylococcal species may be of limited value in predicting clinical significance.

Coagulase↗
PubMed1989

The effect of immunomodulators on PHA or gamma-IFN induced release of neopterin from purified macrophages and peripheral blood mononuclear cells.

Immunomodulators cause changes in neopterin-release from purified macrophages or peripheral blood mononuclear cells by affecting the macrophage and T cell subsets activity, the intracellular cGMP/cAMP balance, or the intracellular pteridines-related biochemical pathways. Increased neopterin release was achieved by gamma-IFN or its inducers (PHA, IL-2), by interfering with the biopterin production by increased levels of cGMP or by decreasing the activity of the T suppressor cells. The released neopterin levels decreased due to decreased macrophage and T-helper cell activity or due to increased levels of cAMP. The in vitro effect of the immunomodulators has to be taken into account when assessing the neopterin levels in immunomodulators-treated patients.

Adjuvants, Immunologic↗
PubMed1989

The emergence of methicillin-resistant Staphylococcus aureus infections in an Israeli hospital.

Between July 1984 and August 1985, 200 cases of methicillin-resistant Staphylococcus aureus (MRSA) occurred in a large, tertiary care, medical school-affiliated hospital. During this period, a limited outbreak, causing serious infections, was identified in the Intensive Care Unit and was contained by appropriate infection control measures. Bacteriophage typing and surveillance cultures failed to identify a common or single source of dissemination of these strains. It appears that MRSA strains have emerged in Israel as endemic pathogens in hospitals, capable of causing serious nosocomial outbreaks.

Cross Infection↗
PubMed1989

[Epistaxis caused by leeches].

Among the conditions which can cause epistaxis are intranasal or nasopharyngeal foreign bodies. A living foreign body, or parasite, in the nose or nasopharynx is rare in western countries, but in other parts of the world is a fairly common cause of epistaxis. In the past 5 years 17 cases of epistaxis due to infestation with leeches were treated in our 2 departments. In 14 patients, 9-27 years old, the complaint was of recurrent episodes of mild epistaxis and blood-spitting several days before admission. 3 patients were admitted hemorrhaging profusely from the nose and mouth. Examination showed a green-brown mass protruding from the nasopharynx behind the soft palate, which is every case was a blood-engorged leech. Treatment consisted of removing the leech by applying a forceps to the middle of the leech's body and giving a quick pull. Bleeding ceased immediately after removal of the leech. All the patients had drunk water from brooks, streams or fresh water lakes. Therefore, in areas in which leeches are present only boiled or filtered water should be drunk.

Adolescent↗
PubMed1989

Bone and joint infections due to Pseudomonas aeruginosa: clinical aspects and treatment.

The occurrence of nine cases of Pseudomonas septic arthritis and osteomyelitis within a 12-month period may be considered an uncommon experience even in a large, tertiary referral center. These cases are reported here and the various clinical patterns and therapeutic implications associated with Pseudomonas bone infections are discussed. Epidemiologic serotyping of the isolated strains indicated that they do not represent a single nosocomial outbreak.

Arthritis, Infectious↗
PubMed1989

Occurrence of Demodex in nose follicles of outpatients attending an otorhinolaryngology clinic.

The occurrence of Demodex in sebum from nasolabial folds was studied in fifty outpatients attending an otorhinolaryngology clinic. Thirty-one male and nineteen female patients aged fifteen to eighty years were examined. Twenty percent (eight men and two women) showed positive findings, demonstrating one to six parasites per specimen. A higher detection rate was found in older patients, and more mite particles were seen in subjects with otitis media. It is suggested that examination of nasolabial folds may serve as a screening test for the possible presence of Demodex in the ears.

Adolescent↗
PubMed1989

Neopterin measured in serum and tissue culture supernates by a competitive enzyme-linked immunosorbant assay.

In this solid-phase competitive enzyme-linked immunosorbant assay for neopterin (a product of activated macrophages) in serum or supernates of cell cultures, we incubate antiserum to neopterin with standards or samples in the presence of solid-phase-bound conjugate of carrier-neopterin. Incubation with second antibody labeled with peroxidase then follows, before reaction with substrate. Analytical recovery, precision, and sensitivity of this method are similar to those of other immunoassays. The assay range is between 0.4 and 100 micrograms of neopterin per liter. Results obtained by this method compared with those from a conventional radioimmunoassay gave a correlation coefficient of 0.974.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Waterborne typhoid fever in Haifa, Israel: clinical, microbiologic, and therapeutic aspects of a major outbreak.

A major outbreak of waterborne typhoid fever involving 77 verified cases occurred in 1985 in a large suburban area of Haifa, Israel. The authors summarize the clinical, microbiologic, and therapeutic aspects of these patients. Fever, usually higher than 39 degrees C, was the hallmark of the disease. Other manifestations of typhoid, although relatively frequent, are presented as part of a mild nonspecific symptom complex, often found only in the prodromal period. An elevated level of serum glutamic-oxaloacetic transaminase (mean, 81 IU/ml) was the most characteristic laboratory abnormality, occurring in 94% of the patients. Blood cultures were positive in 46 of the 50 patients (92%), and were not affected by prior outpatient antibiotic therapy. The first blood culture was diagnostic in 93% of the cases. Although fever tended to disappear more rapidly among patients receiving ampicillin than among those treated with chloramphenicol, results of therapy were similar in both groups. Nevertheless, the relapse rate of 36% among 25 chloramphenicol-treated patients was significantly higher than the 9% noted among 22 patients treated with ampicillin. Except for one case of hemolytic anemia, serious complications were conspicuously absent, and outcomes were uniformly favorable.

Adolescent↗
PubMed1988

Chemiluminescence response of polymorphonuclear leucocytes to serum-opsonized zymosan--a predictive parameter for infections and prognosis in multiple myeloma patients.

Serum opsonization capability and phagocytosis by polymorphonuclear leucocytes (PMNL) were investigated in 37 patients with multiple myeloma (MM), 32 patients with chronic lymphocytic leukaemia (CLL), and 30 healthy controls. Opsonophagocytosis was assessed by measuring the chemiluminescence (CL) response of controls' and patients' PMNL to control- and patient-serum-opsonized zymosan particles. Control PMNL CL responses were significantly reduced both by MM and CLL sera. Normal sera restored the CL responses in MM patients, but only partially corrected the CL responses in CLL patients. Significant correlations were found between the CL responses in MM patients and four clinical parameters: clinical stage, presence of disease-related symptoms, incidence of bacterial infections, and outcome. The findings suggest a defect in MM and CLL sera opsonization ability which, at least in part, could account for the increased susceptibility to infections observed in these patients. Furthermore, the assessment of the CL response in MM patients is recommended as a simple and useful clinical tool for prediction of susceptibility to infection, and prognosis.

Acridines↗
PubMed1987

Single-dose antimicrobial therapy in the treatment of asymptomatic bacteriuria in pregnancy.

Fifty obstetric patients with asymptomatic bacteriuria were treated by single-dose antimicrobial therapy. The immediate cure rate was 84% and the recurrence rate was 12%. Seven of the eight patients in whom single-dose treatment failed responded to subsequent 7-day therapy with the same drug, indicating renal involvement. A 50% recurrence rate in the group of patients in whom single-dose treatment failed was compared with a 5% recurrence rate in the group cured by single-dose therapy, which indicates that failure with single-dose antimicrobial therapy can serve as a therapeutic test to identify patients at high risk for recurrent bacteriuria and its sequelae during pregnancy. It is concluded that single-dose antimicrobial therapy is a safe and effective way to treat asymptomatic bacteriuria in pregnant patients without urologic problems in their history.

Amoxicillin↗
PubMed1987

Five-year survey of changing patterns of susceptibility of bacterial uropathogens to trimethoprim-sulfamethoxazole and other antimicrobial agents.

We analyzed the antibiotic susceptibility of 5,348 urinary isolates of Escherichia coli, "Klebsiella aerogenes," and Proteus mirabilis grown in three laboratories from 1980 to 1985. A continuous rise in resistance to trimethoprim-sulfamethoxazole was observed; 63% of the strains from inpatients in 1984 and 51% of those from outpatients in 1985 were resistant to this drug. Isolates from outpatients in 1985 were mostly susceptible to nitrofurantoin (mean susceptibility, 92%) and to oral cephalosporins (mean susceptibility, 84%). As for isolates from inpatients, none of the antimicrobial agents now used was satisfactory for initial chemotherapy, indicating a need for new antibacterial strategies.

Ampicillin↗