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Biomedical subjects

M Dan

Publications and source records attributed to M Dan.

178 records · Page 10Linked to original sources
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Isolation of Chlamydia trachomatis from prostatic tissue of patients undergoing transurethral prostatectomy.

Chlamydia trachomatis was isolated from three of 100 prostatic tissue specimens obtained from patients undergoing transurethral resection of the prostate. All examined patients were free from symptoms of urethral or prostatic inflammation. Our findings are in accordance with the high incidence of asymptomatic chlamydial infection of the lower genital tract and the increasing evidence that C. trachomatis can cause infection of the prostate.

Aged↗
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Incidence of erysipelas following venectomy for coronary artery bypass surgery.

The incidence of erysipelas in extremities used for saphenous vein donation was evaluated by interviewing 302 patients who had undergone coronary artery bypass surgery. Erysipelas occurred in 6.2% of patients, and was twice as common as in patients with a history of varicose vein stripping. The difference, however, was not statistically significant.

Adult↗
PubMedDate not supplied

Carriage of methicillin-resistant Staphylococcus aureus by non-hospitalized subjects in Israel.

The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in the anterior nares and axilla was studied in 920 non-hospitalized subjects: 350 drug addicts, 350 individuals presenting at a hospital emergency room for various reasons, and 220 hospital health care workers. S. aureus was isolated from 105 (11.4%) subjects, in six (6.3%) of whom the isolates were methicillin-resistant. The isolation rate of the organism and the prevalence of resistant strains in the different subgroups were, respectively: drug-addicts, n = 32 (9.1%), n = 2 (6.9%); emergency room patients, n = 36 (10.2%), n = 1 (3.2%); and hospital health care workers, n = 37 (16.8%), n = 3 (8.5%). Our findings suggest that MRSA remains uncommon in the community, while the prevalence of S. aureus carriage (including methicillin-resistant strains) in hospital personnel is quite similar in divergent geographical areas.

Adult↗
PubMedDate not supplied

Cutaneous manifestations of infection with Corynebacterium group JK.

Multiple necrotic soft tissue lesions were observed in the groin of a granulocytopenic patient with Corynebacterium group JK septicemia. Complete healing followed vancomycin therapy. Review of the English-language literature disclosed that skin and soft tissue manifestations were seen in one-quarter of the patients with Corynebacterium group JK septicemia, all of whom were granulocytopenic; in no case of endocarditis were similar findings reported. The majority of lesions consisted of local infections at sites of previous bone marrow biopsy, intravascular catheter insertion, or perianal fissure; they preceded septicemia and were designated primary lesions. Less often, skin and soft tissue manifestations--including papular skin rash, soft tissue abscesses, and necrotic soft tissue lesions--developed in patients with established septicemia and were considered secondary.

Adult↗
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Varied presentations of sporadic group A streptococcal bacteremia: clinical experience and attempt at classification.

The epidemiologic, clinical, and laboratory aspects of group A streptococcal bacteremia were studied in 33 patients seen at two urban hospitals in the Tel Aviv (Israel) area, over an 8-year period. Most patients (two-thirds) were female. Clinically significant bacteremia was observed in 26 patients, two of whom acquired their infection (puerperal sepsis) during hospitalization. A portal of entry, mainly cutaneous, was recognized in 61% of the patients, and a chronic underlying condition was observed in 69%. The case-fatality rate was 27%, with death occurring predominantly in patients admitted with shock or cryptogenic bacteremia. Our clinical experience and literature review show that the presentation of group A streptococcal bacteremia is diverse, with transient bacteremia of uncertain clinical significance on one end of the spectrum and overwhelming sepsis on the other. A practical classification of the various clinical forms of group A streptococcal bacteremia is proposed.

Adult↗
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Septic arthritis in young infants: clinical and microbiologic correlations and therapeutic implications.

In order to assess and correlate the bacteriology of neonatal septic arthritis with its clinical presentation, the records of nine infants with this disease that were diagnosed at Edmonton hospitals between 1964 and 1981 were reviewed and 92 other cases reported in the English-language literature since 1960 were evaluated. All Edmonton cases developed outside of the hospital in previously healthy infants. A Streptococcus species was isolated in four of six patients from whom joint fluid was obtained before antibiotic therapy. Analysis of cases from the literature revealed a more variable bacteriology that seemed dependent on whether the case was hospital or community acquired. In 52 hospital-acquired cases, staphylococci were the predominant isolates (62%); next in frequency were Candida species (17%) and gram-negative enteric bacilli (15%). Community-acquired neonatal septic arthritis was most often caused by streptococci (52% of cases), staphylococci (26%), and gonococci (17%). Since 1970 the relative imbalance between staphylococcal (5%) and streptococcal (75%) isolates in community-acquired neonatal septic arthritis is even more pronounced. This pattern emphasizes the importance of ensuring optimal coverage against penicillin-sensitive organisms in community-acquired neonatal septic arthritis; this is in contrast to the situation with hospital-acquired arthritis, where wider-spectrum coverage against staphylococci and gram-negative enteric bacilli remains mandatory.

Anti-Bacterial Agents↗
PubMedDate not supplied

Etiology of acute pelvic inflammatory disease proven by laparoscopy.

BACKGROUND: Only a few studies have investigated the etiology of acute pelvic inflammatory disease (PID) in laparoscopy-proven cases using pelvic samples for culture. Most of these studies were conducted in North America and Scandinavia. GOAL OF THE STUDY: To study the microbial etiology of laparoscopy-proven acute pelvic inflammatory disease in Israeli women. STUDY DESIGN: A prospective survey of women admitted to a hospital for treatment of acute pelvic inflammatory disease. All diagnoses were laparoscopy confirmed. Specimens for culture were obtained from the pelvic cavity via the laparoscope, and two serum samples were sent for serologic studies. RESULTS: Forty patients were studied. Their mean age was 34.4 years of age, and 27.5% had a history of PID. Chlamydia trachomatis infection was diagnosed in 14 (35%) patients (group A). Facultative and/or anaerobic bacteria were isolated from pelvic specimens of 7 (17.5%) patients (group B), one of these patients also had positive chlamydial serology. Mycoplasma hominis was cultured from a pelvic specimen of one woman, and herpes simplex virus grew from a pelvic sample of another patient in whom C. trachomatis was also found. In 19 (47.5%) women, the microbial etiology could not be determined (group C). In no case was Neisseria gonorrhoeae isolated. Stage I (mild) PID was diagnosed most often in group A (75% vs. 14% in group B [P < 0.02]), whereas the opposite was true for stage III (severe) PID (71.4% in group B vs 25% in group A [P = 0.07]). Tubal abscess was mainly diagnosed in group B patients (57% vs 16.6% in group A [P = 0.09]). CONCLUSION: In Israel, C. trachomatis is the most common cause of PID, while gonococci are rarely involved in this infection.

Acute Disease↗
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Comparative serum bactericidal activity against Pseudomonas aeruginosa of six antipseudomonal agents.

Serum levels and serum bactericidal activities of six antipseudomonal agents were studied comparatively in 60 patients. Single intravenous doses of gentamicin (1.5 mg/kg), piperacillin (4 g), ceftazidime (1 g), imipenem (0.5 g), aztreonam (1 g), and ciprofloxacin (200 mg) were given over 30 min to 10 patients each, and serum samples were obtained 30 min, 1, 2, 3, 4, 6, 8 and 12 h after beginning the infusion. Serum bactericidal activity was determined by the broth microdilution method against 10 recent isolates of Pseudomonas aeruginosa. Mean peak serum levels were as follows: gentamicin 10.4 micrograms/ml, piperacillin 227.5 micrograms/ml, ceftazidime 43.5 micrograms/ml, imipenem 17.3 micrograms/ml, aztreonam 42.3 micrograms/ml, and ciprofloxacin 3.9 micrograms/ml. All agents demonstrated effective serum bactericidal activity (geometric mean titer > 1:2) at peak serum levels. Ceftazidime was by far the most potent compound with a mean titer of 1:46.5, followed by ciprofloxacin (1:17), imipenem (1:13.7), and aztreonam (1:13.4). Ceftazidime also showed the longest duration of activity with a mean titer of 1:5.1 at 4 h. Based on our results, ceftazidime appeared to be the most potent antipseudomonal agent, while gentamicin and piperacillin were the least effective.

Anti-Bacterial Agents↗
PubMedDate not supplied

Serum concentrations and ex vivo inhibitory/bactericidal activity of clindamycin after administration of two oral dosages.

Two dosages of clindamycin, 300 and 600 mg, were given orally to 10 patients each. The patients were admitted for minor elective surgery. Their mean age was 39.3 years; mean weight was 67.5 kg. None of them had taken antibiotics for at least 1 month. After administration of a single dose, blood samples were obtained at 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10 and 12 h after dosing. Drug levels were determined by the bioassay method using Micrococcus luteus as test organism. Serum inhibitory and bactericidal activities against five isolates each of Staphylococcus aureus and Streptococcus pyogenes were determined by the microdilution method according to the National Committee for Clinical Laboratory Standards guidelines. The mean peak serum level was 3.4 mg/l for the 300-mg dose and 4.8 mg/l for the 600-mg dose. The mean reciprocal peak inhibitory titers for the 300-/600-mg doses were 13.7/23.8 and 15.2/34.7 against S. aureus and S. pyogenes, respectively. Most serum samples did not show bactericidal activity against S. aureus.

Administration, Oral↗
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Accelerated streptokinase--a new thrombolytic regimen in acute myocardial infarction.

Efficiency and safety of an accelerated regimen of streptokinase (1.5 M.U. over 20 min., 109 patients) has been compared with the standard regimen (1.5 M.U. over 60 min, 119 patients) in 218 patients admitted within the first 6 hours after the onset of the symptoms of acute myocardial infarction. Using the noninvasive criteria we found a coronary reperfusion rate of 77.04% in patients belonging to the accelerated regimen group and this value was significantly higher than the one of 57.14% registered in the standard group. No major hemorrhagic events were registered in both groups. Although the hypotension appeared to be more frequent in patients in whom the accelerated regimen was used, however this side effect proved to be transient and well controlled using the rapid infusion of natrium chloride solution. In conclusion, the accelerated regimen of streptokinase is safe and followed by a higher rate of coronary reperfusion as compared to the standard one.

Aged↗
PubMedDate not supplied

Immunotherapy for recurrent colorectal cancers with human monoclonal antibody SK-1.

BACKGROUND: The human monoclonal antibody SK-1 recognizes a glycoprotein expressed on the majority of colon cancer tissues. In the current study, we evaluated the safety, toxicity and preliminary efficacy of escalating dosages of SK-1 in patients with advanced colon cancer. PATIENTS AND METHODS: SK-1 was administered intravenously at 2, 4 or 10 mg three times to three groups of patients with recurrent colon cancer. The clinical outcome and the induction of serum anti-idiotypic antibody (Ab2) were assessed periodically. RESULTS: The mean rate of serum CEA level increase declined significantly during the eight weeks following the treatment. In four patients, serum titer of anti-idiotypic IgG antibodies to SK-1 (Ab2) continued to increase following the treatment. CONCLUSION: HuMAb SK-1 was well-tolerated and can be safely administered. It was suggested that SK-1 natural antibody not only possessed direct cytostatic activity against colon carcinoma, but may also have induced carcinoma-related, anti-idiotypic antibody responses.

Adenocarcinoma↗
PubMedDate not supplied

Implantation of an external biventricular assist device: role of transesophageal two-dimensional echocardiography.

A patient with end-stage dilated cardiomyopathy underwent implantation of a pulsatile external biventricular assist device as a bridge to heart transplantation. The device insertion was guided by transesophageal two-dimensional echocardiography that proved extremely helpful in allowing expeditious and precise positioning of both right and left atrial withdrawal cannulas.

Cardiomyopathy, Dilated↗