Biomedical subjects
M Garty
Publications and source records attributed to M Garty.
[Non-Compliance with drug therapy].
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Correlation of a quinidine-induced platelet-specific antibody with development of thrombocytopenia.
The rapidity by which drug-dependent antiplatelet antibodies can develop is not known, since patients are only studied during or after the episode of thrombocytopenia. This report describes the development of quinidine-induced immune thrombocytopenia in a healthy volunteer during a drug study. The thrombocytopenia developed within two weeks of initiation of quinidine therapy. During the thrombocytopenic episode, but not before receiving the drug, the patient had an IgG antiplatelet antibody that bound to control platelets in the absence of the drug. This antibody was absent when the drug was discontinued and the platelet count rose. The patient's acute serum also induced the release of serotonin from control platelets, and the reaction was enhanced by quinidine. This indicates that drug-dependent antiplatelet antibodies can develop rapidly and supports the hypothesis that quinidine-induced thrombocytopenia is due to a quinidine-dependent platelet-specific IgG.
Reduction of serum theophylline levels by terbutaline in children with asthma.
We studied the effect of oral terbutaline on serum theophylline levels in 12 children with asthma. Sustained-release theophylline (10 mg/kg twice a day) was given with placebo or terbutaline (0.075 mg/kg three times a day) in a chronic, randomized, double-blind, crossover design. The trough serum theophylline concentration fell from 13.8 +/- 4.0 to 10.8 +/- 3.6 micrograms/ml and the peak expiratory flow rate increased from 285 +/- 30 to 310 +/- 29 L/min after terbutaline. Further investigation is needed to clarify the mechanism of action by which terbutaline decreases serum theophylline levels.
Effects of morphine on the disposition of ampicillin in mice.
Morphine raised the levels of intravenously administered ampicillin in the plasma of mice. Despite higher ampicillin levels in plasma after administration of morphine, levels of this antibiotic in bile and urine were not elevated. After ligation of the common bile duct, ampicillin levels in plasma were elevated. Morphine caused a further rise in drug levels in plasma of duct-ligated mice. Ampicillin levels in plasma were higher in mice made anephric by prolonged ligation of their external urethras. In such animals, morphine also caused ampicillin levels in plasma to be even higher. These experiments suggest that morphine impairs both renal and hepatobiliary elimination of ampicillin. These effects of morphine were completely reversed by naloxone. In contrast to effects on intravenously administered ampicillin, morphine markedly reduced drug levels in plasma when ampicillin was given by gastric intubation. This resulted from delayed absorption because of retardation of gastric emptying by morphine.
Ethical dilemmas of the doctors' strike in Israel.
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Pericarditis after minoxidil reinstitution.
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Ultrasonography in the diagnosis and follow-up of hepatic sinusoidal dilatation.
Hepatic sinusoidal dilatation is a rare complication of oral contraceptive use. A 29-year-old woman who had been taking oral contraceptive pills for eight years was found to have persistently elevated erythrocyte sedimentation rates and alkaline phosphatase levels, hepatomegaly, diffuse hepatic sinusoidal dilatation, and a large nonhomogeneous hyperechogenic lesion in the right hepatic lobe. The abdominal ultrasonogram, liver size, erythrocyte sedimentation rates, and alkaline phosphatase levels reverted to normal within 24 months after discontinuing oral contraceptives. This case should encourage the use of abdominal ultrasonography in detection and follow-up of hepatic sinusoidal dilatation.
Bioavailability of phenytoin: comparison between three preparations.
Crossover studies, following single oral doses given to 19 healthy volunteers were conducted to compare the bioavailability of three phenytoin preparations: DANTOIN and IDANTOIN (Teva, Israel) and EPANUTIN (Parke-Davis, USA). The first has recently replaced the second as the only preparation available in Israel for alleged better bioavailability. The area under the serum concentration time curve (AUCo----48), however, did not significantly differ between preparations, indicating equivalent absorption of the three preparations. These results suggest that no overall adjustments are required when switching from one preparation to another.
Sternoclavicular arthritis and osteomyelitis due to Pseudomonas aeruginosa, not related to drug abuse.
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Opioid effects on lidocaine disposition and toxicity in mice.
Morphine sulfate, 20 mg/kg, or equivalent doses of the opioids, meperidine and fentanyl, elevated plasma levels of lidocaine after i.v. administration of this antiarrhythmic drug. Plasma levels of the lidocaine metabolites, monoethylglycinexylidine and glycinexylidine, were reduced by opioids as lidocaine levels were elevated. The opioid antagonist, naloxone, 1 mg/kg, reversed the effects of morphine, 20 mg/kg, on lidocaine. After morphine, plasma levels of both lidocaine and indocyanine green were elevated, suggesting that the effect of morphine on lidocaine disposition was related to reduced hepatic blood flow. Morphine and meperidine increased lethality of i.v. lidocaine, as shown by marked reduction of LD50 by either opioid.
[Phenytoin--change in bioavailability and toxicity].
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[Captopril in congestive heart failure].
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[Antimicrobial treatment in staphylococcal aureus endocarditis].
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[Simple benign renal cyst--diagnostic procedures].
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[Rare side effects following paracetamol poisoning].
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Spontaneous bacterial pleuritis in a patient with cirrhosis.
Empyema of the left pleural cavity developed suddenly in a nonalcoholic cirrhotic patient. Cultures of the pleural fluid under anaerobic conditions grew Clostridium perfringens, an organism normally found in the enteric flora. The infection developed in an old pleural effusion. Since there was no evidence of trauma, necrotizing pneumonitis or subphrenic infection, spontaneous bacterial pleuritis is proposed.