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Biomedical subjects

M Dan

Publications and source records attributed to M Dan.

At least 109 records · Page 6Linked to original sources
PubMed1990

Mitral valve disruption following percutaneous balloon valvuloplasty.

Two cases of massive mitral regurgitation due to mitral valve disruption following percutaneous balloon valvuloplasty are reported. This severe complication occurred in two elderly women with recurrent mitral stenosis after previous surgical commissurotomy. Due to their unstable hemodynamic and clinical condition, both patients underwent emergency valve replacement. At surgery, the commissures appeared fused and heavily calcified; the chordae tendineae thickened, shortened, and fused; and the leaflets presented a large tear with sheared edges. Because the technical aspects of both procedures were unremarkable, the anatomic features of the mitral valve seemed to affect the occurrence of severe mitral regurgitation. Percutaneous balloon valvuloplasty should be therefore applied carefully to patients with prior surgical valvotomy, in whom the structural alterations of the mitral apparatus may predispose to severe valvular damage.

Acute Disease↗
PubMed1990

Value of transesophageal echocardiography during repair of congenital heart defects.

Two-dimensional transesophageal color Doppler echocardiography was employed intraoperatively in 30 children undergoing repair of a variety of simple and complex cardiac malformations. There were 16 female and 14 male patients, with a mean age of 9 +/- 3 years (range, 4 to 13 years) and a mean weight of 31 +/- 9 kg (range, 16 to 50 kg), 16 children weighing less than 30 kg. A standard, commercially available transesophageal echocardiography probe (5 MHz, 64 elements) was used in all patients without complications. Transesophageal echocardiography proved helpful in selecting the surgical approach, in assessing the adequacy of surgical repair, in detecting residual intracardiac shunts, and in allowing uninterrupted monitoring of ventricular performance throughout the procedure. Our initial experience suggests that transesophageal echocardiography is a valuable tool to be used in children with congenital cardiac malformations, particularly in those requiring complex intracardiac procedures. The amount of information obtained by the surgeon should favor the routine use of transesophageal echocardiography during open heart procedures and stimulate the development of probes to be safely used even in infants and newborns.

Child↗
PubMed1990

Prevalence of cryptosporidiosis in Israeli children with diarrhoea.

In a prospective study, Cryptosporidium oocysts were detected in seven (3.25%) immunocompetent children with diarrhoea. The predominant clinical features were watery diarrhoea and vomiting. The patients' mean age was 19 years and infection was more common in late summer-autumn than in the rest of the year. This first survey on cryptosporidiosis in Israeli children has shown a prevalence similar to that observed in other developed countries.

Animals↗
PubMed1990

Left atrial myxoma: excision guided by transesophageal cross-sectional echocardiography.

We present a patient with a left atrial myxoma in whom the intraoperative use of transesophageal cross-sectional echocardiography proved helpful in selecting the most appropriate surgical approach, thus allowing expeditious and complete excision of the tumor. This technique, which permits continuous monitoring of cardiac function throughout open heart procedures, appears particularly valuable in patients with intracardiac masses.

Echocardiography↗
PubMed1990

Cross resistance to ciprofloxacin and other antimicrobial agents among clinical isolates of Acinetobacter calcoaceticus biovar anitratus.

Using an agar dilution assay, for 66 of 104 (63.5%) clinical isolates of Acinetobacter calcoaceticus biovar anitratus, the MIC of ciprofloxacin was greater than or equal to 1.0 micrograms/ml. Cross resistance was demonstrable to ciprofloxacin and gentamicin (P less than 0.001), amikacin (P less than 0.01), cefotaxime (P less than 0.001), azlocillin (P less than 0.001), ceftazidime (P less than 0.001), trimethoprim-sulfamethoxazole (P less than 0.001), and minocycline (P less than 0.05). The mean MIC of ciprofloxacin for drug-susceptible isolates was consistently lower than that for resistant isolates; however, these differences were significant only for amikacin (P = 0.036).

Acinetobacter↗
PubMed1990

Oral ciprofloxacin treatment of Pseudomonas aeruginosa osteomyelitis.

Twenty-two adult patients with osteomyelitis due to Pseudomonas aeruginosa were enrolled in an open, prospective cooperative study to determine the efficacy of oral ciprofloxacin therapy in a dosage of 750 mg twice a day. Twenty patients received a complete course of treatment and could be assessed for efficacy. There were 12 men and 8 women, with a mean age of 55 years. Six patients had undergone previous, unsuccessful attempts at therapy. Eight patients had clinically important underlying conditions. The most common sites of infection were the sternum (six patients), hip (four patients), vertebrae (four patients), and tibia (two patients). Initial surgical debridement was performed in 18 of the 20 assessable patients. The mean duration of treatment was 2.85 months (range, 1 to 4 months), and that of the follow-up was 27 months (range, 6 to 52 months). Cure was achieved in 19 of the 20 (95%) patients. The only significant adverse effect (which prompted discontinuation of therapy) was severe nausea in one case. Oral ciprofloxacin coupled with adequate debridement is an effective, convenient, and safe therapy in patients with acute and subacute P. aeruginosa osteomyelitis.

Adolescent↗
PubMed1990

Penetration of aminoglycosides into human peritoneal tissue.

Each of 30 patients underwent elective laparotomy following administration of a single intravenous dose of amikacin, netilmicin or tobramycin. Therapeutic concentrations of amikacin were achieved in peritoneal tissue in 10/10 patients. Only 13/20 samples from patients receiving the other two antibiotics showed antibacterial activity. Our data suggest that the penetrability of tobramycin (53%) and amikacin (39%) into the uninflamed peritoneal tissue is superior to that of netilmicin (16%).

Amikacin↗
PubMed1989

Prevalence of antibodies to human immunodeficiency virus among intravenous drug users in Israel--association with travel abroad.

A serological survey of 400 Israeli intravenous drug users showed a 2% prevalence of antibodies to human immunodeficiency virus (HIV). No difference was found between seropositive and seronegative subjects regarding mean age, duration of intravenous drug use, and needle sharing. Seropositivity was, however, significantly associated with travel abroad since 1980 (P less than 0.001), and with intravenous drug injection abroad (P = 0.04). These data indicate that Israel is a pre-endemic area for HIV infection, and transmission of the virus among Israeli intravenous drug users seems to be infrequent at the current level of exposure.

Adult↗
PubMed1989

Comparison of preservation media and freezing conditions for storage of specimens of faeces.

To evaluate the long-term recoverability of bacterial enteropathogens, two freezing conditions (deep-freezing at -70 degrees C and liquid nitrogen) and three preservation media (Cary-Blair, Amies, and buffered glycerol-saline) were tested. These were compared with storage in containers with no preservation medium and refrigeration at 4 degrees C. At 4 degrees C, viability of organisms could not be consistently maintained beyond one month; Cary-Blair medium generally gave the best results and storage without preservation medium was the least efficient. Storage in liquid nitrogen and deep-freezing effectively preserved all organisms except Campylobacter jejuni for the entire period of study (12 months). There was no difference between the various preservation media, or between storage with or without medium. Storage in preservation medium was superior to storage without such supplement for C. jejuni. We conclude that most enteropathogens survive in faecal specimens for as long as 12 months when stored at very low temperatures (-70 degrees C) whether or not preservation media are used.

Cold Temperature↗
PubMed1989

Penetration of third-generation cephalosporins into human peritoneal tissue.

Each of 40 patients underwent elective laparotomy following administration of a single 1.0-gram intravenous dose of ceftizoxime, ceftriaxone, cefoperazone or cefotaxime. Therapeutic concentrations of cefoperazone and ceftriaxone were achieved in peritoneal tissue in 20/20 patients. Only 9/20 samples from patients receiving the other two antibiotics had detectable antibiotic activity. The antibiotic concentration in peritoneal fluid (7 samples) was 2.36-11.15 times higher than that of concurrently obtained peritoneal tissue. When adjusted for the in vitro susceptibility (MIC) of potential peritoneal pathogens, our data suggest that ceftriaxone and cefoperazone may be preferable to other third-generation cephalosporins for the prophylaxis and therapy of intraabdominal infection.

Ascitic Fluid↗
PubMed1989

Shigellosis in adults: epidemiologic, clinical, and laboratory features.

One hundred and sixteen cases of adult patients hospitalized for shigellosis have been reviewed. The most common presentation included diarrhea (most frequently watery), fever, and abdominal pain, while dysentery has been less frequent. S. flexneri infection, as compared to S. sonnei, was more common in elderly patients and in males, and was characterized by a more prolonged clinical course. Abnormalities of serum electrolytes and hepatic enzymes were the most common laboratory complications, most often seen in elderly patients. Most isolates exhibited susceptibility to the common antimicrobial agents used in shigellosis therapy.

Anti-Bacterial Agents↗