PubMed Health⌕ Search

Biomedical subjects

M Shapiro

Publications and source records attributed to M Shapiro.

At least 37 records · Page 2Linked to original sources
PubMed1990

Failure of prolonged treatment with ciprofloxacin in acute infections due to Brucella melitensis.

A randomized prospective, pilot study was performed to compare the efficacy of oral ciprofloxacin (750 mg or 1000 mg bd) with standard oral antimicrobial therapy (rifampicin plus doxycycline) in the treatment of acute infection with Brucella melitensis. All antimicrobial drugs were administered for 42 days. Although all patients responded rapidly, five of the six patients receiving ciprofloxacin relapsed following cessation of therapy. There were no relapses among the patients who received doxycycline/rifampicin. Despite its in-vitro activity against B. melitensis (MIC 0.5 mg/l), ciprofloxacin, administered twice daily, does not appear to constitute adequate therapy for acute brucellosis.

Acute Disease↗
PubMed1990

Selective arterial stimulation of secretin in localization of gastrinomas.

In two patients with malignant gastrinoma and the Zollinger-Ellison syndrome, we were able to use selective arterial stimulation with secretin as a technique to localize the lesions accurately, allowing resection. The technique of selected arterial secretin stimulation is one of measuring variations in gastrin levels in both the hepatic vein and a peripheral artery at specified times after injection of secretin into a specific artery. When the criteria for localization have been met, one can plot the presence of the gastrinoma within the blood supply of the injected artery and, using angiograms, thus accurately localize the lesion. This method promises to be a valuable additional tumor-localizing procedure, particularly when gastrinomas are extrapancreatic.

Adenoma, Islet Cell↗
PubMed1990

Cutaneous responses to histamine, compound 48/80 and codeine in patients with hyperthyroidism.

The regulatory effects of various endocrine factors on allergic processes have been widely studied. The clinical importance of hyperthyroidism in asthma and in chronic urticaria has been demonstrated in several cases. These observations may be attributed to modulatory effects of thyroid hormones on mast cell releasability and/or on other target organs as blood vessels. To evaluate the effects of thyroid hormones on mast cell releasability and on the cutaneous vasculature, we analyzed the wheal and flare response to compound 48/80, to codeine, and to histamine in patients with hyperthyroidism and in a control group. No significant difference was found between the two groups. We could not demonstrate any in vivo effect of the thyrotoxic state on the cutaneous response to these substances.

Adolescent↗
PubMed1979

Use of antimicrobial drugs in general hospitals: patterns of prophylaxis.

The patterns of prophylactic use of antimicrobial drugs were reviewed in 5288 charts drawn by a random method from 20 randomly selected short-stay general hospitals in Pennsylvania. About 10 per cent of hospitalized patients received antimicrobial drugs for prophylaxis in operations or nonsurgical procedures, and prophylaxis accounted for about 30 per cent of all antimicrobial drugs administered in hospitals. The drugs used most often for prophylaxis were cephalosporins, followed by benzyl penicillins, ampicillin and tetracyclines, in that order. Despite indications that prophylaxis, when useful at all, is effective only when given concurrently with and for 24 to 48 hours after operation, it was usually continued throughout hospitalization. Almost 80 per cent of prophylactic antimicrobial drugs were administered at least 48 hours after an operation or procedure -- suggesting that limiting prophylaxis to the first 24 to 48 hours, as currently recommended, would substantially reduce expenditures for antimicrobial drugs in hospitals.

Ampicillin↗
PubMed1979

Use of antimicrobial drugs in general hospitals. I. Description of population and definition of methods.

The patterns of use of antimicrobial drugs in a random sample of general hosptials in Pennsylvania were studied. The sample was tested for validity, and all deaths and discharges were analyzed for 10 random days drawn across the year spanning July 1973 to June 1974. Methods were developed for abstracting the hospital records and for determining the reproducibility of the findings of the physician and nonphysician chart reviewers. More than 99% of the requested charts were available. In the 5,288 charts reviewed, most of the required data were readily available. The study population was 84% white and 58% female; most patients were in hospitals that had more than 300 beds and that were located in towns with populations of greater than 10,000. In 41% of the 2,070 antimicrobial courses administered to almost 30% of the patients, an explicit clinical statement of why the drug was being given could be found in the chart. The information for review was found in clinical charts, but in half of the charts, the information required was not on face sheets and discharge summaries.

Anti-Bacterial Agents↗
PubMed1979

Use of antimicrobial drugs in general hospitals. II. Analysis of patterns of use.

The hospital charts were surveyed of 5,288 patients in 20 hospitals that were randomly selected from the 194 general hospitals in Pennsylvania. Antimicrobial drugs were administered to 28% of the patients, with little variation in pattern according to hospital size. Surgical services accounted for 61% of the patients who received antimicrobial drugs, and the proportion of patients receiving such drugs varied from 84% on thoracic and cardiovascular surgical services to 13% on obstetrical services. General medicine accounted for 29% of the patients who received antimicrobial drugs and pediatrics for 9%. Eight percent of the hospital population accounted for 50% of all antimicrobial drugs used. Ampicillin was the most frequently used drug, being given in 22% of all courses, with cephalosporins (18%), benzylpenicillins (14%), and tetracycline (13%) next in order. Approximately 30% of the antimicrobial courses were used for prophylaxis.

Anti-Bacterial Agents↗
PubMed1979

Quantitative analysis of flow microfluorometric data for screening gynecologic cytology specimens.

Gynecologic cytology specimens that included the entire spectrum of cervical cytology classification were stained with a combination of propidium iodide and fluorescein isothiocyanate, then analyzed using a flow microfluorometer to measure nucleic acid and protein content, respectively. Numerous descriptors of the resulting two parameter distribution (nucleic acid versus protein) were defined. These descriptors included assessment of the presence or absence of abnormal cells. They also included measures of the staining intensity and dispersion of the normal squamous cell population and the intensity of inflammatory response in the cell population. Relative percentages of inflammatory and epithelial cells were demonstrated to effect the screening performance of this system only in borderline lesions. Decision tree algorithms allowed optimization of the selected parameters for screening logic of normal-abnormal decisions on a specimen-by-specimen basis. In addition, quantitative definitions of specimen adequacy were determined. Appropriate controls for batch staining of specimens were evaluated. These results of applying pattern recognition techniques to flow microfluorometer multiparameter data demonstrate that considerably more information about cell populations and subpopulations can be extracted than heretofore possible.

Adolescent↗
PubMed1979

Perinatal changes of 2,3-diphosphoglycerate and oxygen affinity in mammals not having fetal type hemoglobins.

The interrelationship of 2,3-diphosphoglycerate (2,3-DPG) and P50 levels during the fetal and postnatal life were determined in two mammalian species which do not have a switchover of hemoglobin type at the end of their fetal development. In the guinea pig and rabbit, the 2,3-DPG levels remain low during fetal life and increase only after birth remaining elevated throughout adult life. The adult levels were reached at 2 days of age in the guinea pig and the 20th day in rabbit. Fetal P50 values increased only after birth, paralleling the rise in the 2,3-DPG. The rapidity of the postnatal rise in 2,3-DPG and decrease in P50 appears related to the maturity of the newborn animal at birth in these species.

Animals↗
PubMed1979

Use of antimicrobial drugs in general hospitals: IV. Infants and children.

The use of antimicrobial drugs was studied among 933 randomly selected infants and children who were hospitalized in 20 short-stay general hospitals in Pennsylvania. Twenty-two percent of pediatric patients received antimicrobial drugs: 5% of neonates and 57% of patients aged 12 to 18 months. Sixty-eight percent of the 265 antimicrobial courses administered to these children consisted of a penicillin or a penicillin analogue. Ampicillin was the single drug most frequently administered and was given in 32% of all courses. In contrast to the findings in older children, penicillin or penicillin analogues and aminoglycosides were the only antimicrobial drug groups administered to neonataes. Seventy-nine percent of courses were initiated for proved or suspected infections and 17% were initiated to prevent infections associated with surgical or nonsurgical invasive procedures. Cultures were associated with the initiation of 84% of courses among neonates and 39% of courses among children 6 to 9 years of age. This study provides the initial information, from data derived from randomly selected general hospitals, to permit a statement of norms of practice with respect to use of antimicrobial drugs in pediatric populations.

Adolescent↗
PubMed1979

Fractionation of outdated freeze-dried plasma: a comparative study of cold- and heat-ethanol fractionation procedures.

In a comparative study a total volume of 1435 kg outdated freeze-dried plasma, equivalent to approx. 200,000 kg liquid plasma, was fractionated into albumin (20%): about 30% of the total plasma volume was fractionated following the cold-ethanol procedure and about 70% following the heat-ethanol method. Average albumin recovery following cold-ethanol preparation was 47% of the albumin originally present in the freeze-dried plasma (= 50% of total protein); following heat-ethanol fractionation, 71%. Gelfiltration of heat-ethanol albumin showed a main peak (= 93%) representing albumin monomers and one slightly faster component (= 7%) representing albumin dimers. Gelfiltration of cold-ethanol isolated albumin on the other hand showed four peaks: albumin monomers (= 60%), albumin dimers (= 15%), and two other peaks representing higher molecular weight molecules (= 25%). Hemoglobin present in the reconstituted plasma was reduced about five-fold in the cold-ethanol product and about ten-fold in the heat-ethanol albumin. Stability tests of both products did not differ from equivalent products isolated from normal human plasma. Besides albumin, immunoglobulins may be isolated as Cohn fraction II-III prior to the heating procedure without significant albumin loss.

Blood Banks↗
PubMed1978

Problems in the control of hypertension in the community.

A hypertension survey was conducted in Montreal to determine the extent, nature and distribution of the control of hypertension. Of the 12 055 persons screened in shopping centres, workplaces and a random sample of homes in four census tracts the hypertension was not controlled in 69.0% to 80.3% of those with the condition in each setting. Nearly two thirds of those with hypertension were aware of their condition, 13% were aware but had never been treated, 13% were receiving treatment inadequate to control their hypertension, and 11% had discontinued treatment, most reporting that they had done so on the advice of their physician. Among those screened in their home, discontinuance of therapy was most often reported by those with a low income, but lack of awareness of their condition was no more prevalent in this group than in the other income groups. Efforts to control hypertension should be directed to the variety of causes of lack of control, which may occur with various frequencies in different communities, and for which screening alone may be inadequate.

Adult↗
PubMed1976

Cross-matching assays of cell-mediated immunity for transplant patients.

Assays of cell-mediated immunity before transplantation were performed on 34 patients who were defined as being at high risk by the presence of preformed lymphocytotoxic antibodies and/or HL-A incompatibilities at FOUR locus. Assays for cell-mediated lympholysis type I (cml I) were performed in donor serum, and for CML II in recipient serum, to assess the possible effect of blocking factors in the patients' sera. A positive (greater than 5% specific Cr release) and in particular a greater than 10% Cr release correlated strongly with graft rejection. The correlation between CML II and graft survival was unimpressive. No clinically beneficial blocking factor was demonstrable in the patients's sera in that 5 of 6 patients with a positive CML I but a negative CML II rejected their grafts. Conversely, 6 of 8 patients with a positive CML II and a negative CML I had excellent long-term courses. The use of CML I assay in the selection of grafts for patients at high risk is recommended.

Cadaver↗