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Biomedical subjects

S Berman

Publications and source records attributed to S Berman.

At least 37 records · Page 2Linked to original sources
PubMed1991

Acute respiratory infections.

During the past decade, recognition of the significance of pneumonia for childhood mortality has greatly increased. Etiologic studies have clarified the role of Streptococcus pneumoniae and H. influenzae as the pathogens most responsible for childhood pneumonia in developing countries. Case management intervention strategies using community health workers to identify cases of pneumonia by counting respiratory rate and observing chest indrawing have been shown to reduce ARI-related mortality. Although research is underway to develop more effective vaccines against Streptococcus pneumoniae and non-type b H. influenzae, effective case management will remain the most realistic method of reducing mortality in the next decade. Important gaps remain in our understanding of the pathogenesis, etiology, and epidemiology of acute respiratory infections. Our understanding is complicated by the multiplicity of viral and bacterial agents and their interrelationships, by an abundance of interacting host risk factors, and by diverse social, cultural, and environmental factors. However, sufficient knowledge is available to support the implementation of the WHO case management intervention strategies, which will save the lives of the many children now dying because of pneumonia.

Acute Disease↗
PubMed1991

Evaluation of developmental/behavioral training in primary care.

Primary care and regular track residents in one pediatric program were compared with respect to knowledge, perceived level of competence, and attitudes relative to developmental and behavioral pediatrics from beginning to end of the residency. Measures of knowledge and self-perception of competence showed a common pattern characterized by (1) no differences between primary care and regular track residents on entry into the program, (2) significant progress in both groups over the period of the residency, (3) significantly greater progress by primary care residents. Ratings regarding relevance of developmental and behavioral issues for pediatric practice showed that ratings of relevance were significantly higher at the beginning of the residency among primary care residents and remained higher throughout.

Behavior Therapy↗
PubMed1990

Effect of diuretics on captopril-induced urinary zinc excretion.

The urinary zinc/creatinine ratio has been measured in five groups of patients with essential hypertension and in a group of healthy controls. The first four groups of patients consisted of subjects being treated for at least three months with captopril alone, hydrochlorothiazide alone, captopril plus hydrochlorothiazide, or captopril and furosemide. The fifth group comprised hypertensive patients not on any medication. The first four patient groups exhibited significantly increased urinary zinc/creatinine ratios when compared to the control and untreated hypertensive groups, but in the two combination regimens there was little zincuria. It is suggested that both diuretics inactivate the zincuric effect of captopril by binding to its sulphydryl group within the tubular lumen.

Adult↗
PubMed1990

Interleukin-2 receptor is similarly expressed by activated lymphocytes from patients on chronic hemodialysis and healthy subjects.

We studied peripheral blood mononuclear cells (PBMC) from 10 patients on chronic hemodialysis vs 10 healthy controls. T cells were counted by E rosette formation. Interleukin (IL)-2 receptor (IL-2R) carrier cells were identified by Dako-IL-2R, which was chosen as a monoclonal antibody that binds to the alpha chain of IL-2R without interrupting the cell machinery of mitogen-induced IL production. Fluorescein-tagged goat anti-rabbit IgG1* was used for subsequent cell staining, and cells were counted by FACS. Net numbers of PHA-activated IL-2R carrier cells were derived by subtracting appropriate background controls. The average number of these cells relative to numbers of total T cell population in uremic PBMC was statistically not different from healthy controls. Several defects in cellular activation associated with IL-2 mechanisms could be envisaged to account for the impaired proliferative response to PHA, manifested by uremic T cells.

Adult↗
PubMed1990

A developmental study of event-related potentials during explicit and implicit memory.

Event-related potentials (ERPs) were recorded from children, adolescents and adults in response to drawings of common objects or their printed names. Explicit memory was assessed in a continuous recognition paradigm, where each item had (old) or had not (new) been presented earlier. Implicit memory was assessed in separate blocks of pictures and words where item repetition was incidental to the assigned task of identifying stimuli in a given semantic category. Accuracy measures replicated the finding that word memory decays more rapidly than picture memory. A larger anterior negativity to pictures than words in children, but not adolescents or adults, suggested the existence of separate picture/word processing mechanisms that undergo developmental change. ERP repetition effects involved at least two components: a negativity that was larger to new items in both tasks, and a subsequent centroparietal positivity, most likely P3b, that was larger in response to old items for the explicit task only. Both components did not appear to undergo developmental change.

Adolescent↗
PubMed1990

Cell wall structures which may be important for successful immunization with Salmonella-Shigella hybrid vaccines.

Three separate lots of S. typhi/S. sonnei hybrid (Ty/Shig) live oral vaccine strain 5076-1C were tested for efficacy in human volunteers challenged with virulent S. sonnei. Two lots (2 and 5) protected volunteers, a third lot (8) did not. The three lots were evaluated by immunological tests and electron microscopy. Lots 2 and 5, which protected, contained bacteria that reacted with anti-flagellar serum and had observable attached flagella and pili. Lot 8, which failed to protect, did not react with anti-flagellar serum, and had no observable pili. There was no correlation between vaccine efficacy and the reaction of IgG in patient's sera in western blot analysis. Surface structures on the Ty-Shig hybrid may be important for generating a protective immune response.

Animals↗
PubMed1990

Management of chronic middle ear effusion with prednisone combined with trimethoprim-sulfamethoxazole.

Fifty-three patients were enrolled and evaluable in a randomized, double-blinded controlled clinical trial comparing prednisone for 7 days plus trimethoprim-sulfamethoxazole (TMP/SMZ) for 30 days vs. TMP/SMZ alone in treating chronic middle ear effusion (MEE). Clearing of the effusion in both ears or in one when only one was involved was called complete resolution; clearing in one of two affected ears was called partial resolution. The outcomes 2 weeks after initiation of therapy of 26 patients initially treated with prednisone plus TMP/SMZ were complete resolution in 20, partial resolution in three, and unchanged in three. The outcomes in 27 patients initially treated with TMP/SMZ alone were complete resolution in eight, partial resolution in three, unchanged in 13 and development of acute otitis media in three (P less than 0.01 for complete resolution). Two weeks after initiation of therapy, patients with a MEE that failed to clear were crossed over to the alternative regimen. Overall 29 of 41 patients (71%) who received oral prednisone plus TMP/SMZ initially or after the crossover had complete resolution of their middle ear effusion at 2 weeks after starting prednisone and TMP/SMZ. Five of 35 (14%) patients treated with prednisone plus TMP/SMZ and one of six (17%) patients treated with TMP/SMZ alone who had complete resolution at 4 weeks required subsequent referrals for tympanostomy tubes. A course of prednisone for 7 days plus TMP/SMZ for 30 days with monthly follow-up should be considered in children with MEE persisting beyond 6-8 weeks before referral for tympanostomy tube placement.

Chronic Disease↗
PubMed1990

Acute respiratory infections during the first three months of life: clinical, radiologic and physiologic predictors of etiology.

The usefulness of clinical, radiologic, and physiologic characteristics to identify pathogens was assessed in 90 infants aged two through 12 weeks, presenting to an outpatient clinic with an acute respiratory infection. Eighty-four cases had cultures or rapid diagnostic tests for RSV, of which 25 were positive. Eighty-two infants had cultures or rapid diagnostic tests for Chlamydia, of which 16 were positive. Additional respiratory pathogens identified included parainfluenza (6 cases), rhinovirus (3 cases), pertussis (2 cases), and CMV (1 case). Multiple pathogens were identified in four cases: Chlamydia and RSV (2 cases), Chlamydia and parainfluenza (1 case), and Chlamydia and CMV (1 case). Clinical characteristics other than the need for hospitalization were not useful predictors of specific pathogens. X-rays were obtained in 20 (80%) of the RSV infections, 13 (81%) of the Chlamydia infections, six of the parainfluenza infections, two pertussis infections, and 25 cases without identification of the pathogen. X-ray findings could not distinguish between patients with or without a pathogen or between the pathogens. Severe findings were present in 28% (11/40) of cases with a pathogen identified, compared to 12% (3/26) of cases without a pathogen identified (NS). Moderate findings were present in 58% (23/40) of cases with a pathogen identified compared to 62% (16/26) of cases without a pathogen identified. Slight/negative findings were present in 15% (6/40) of cases with a pathogen identified, compared to 27% (7/26) of cases without a pathogen identified. Pulse oximetry was done in 30 cases, 22 of which had a pathogen identified (RSV 14, Chlamydia 7, pertussis 1).(ABSTRACT TRUNCATED AT 250 WORDS)

Diagnosis, Differential↗
PubMed1990

Cytomegalovirus-induced osteomyelitis in a patient with the acquired immunodeficiency syndrome.

A 43-year-old man with AIDS had a periodontal abscess, no fever, and normal findings on funduscopic examination. Three months later, the abscess area was debrided, and histologic examination of the tissue revealed osteomyelitis of the mandible. Within the area of osteomyelitis were numerous cells with inclusions typical of cytomegalovirus (CMV) infected cells. Funduscopic examination at that time revealed extensive CMV retinitis. Osteomyelitis should be added to the list of infections caused by CMV in patients with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Induction of suppressor cell activity by cyclosporin A and/or uremic serum in normal versus uremic peripheral blood mononuclear cells.

We investigated induction of suppressor cell activity in peripheral blood mononuclear cells (PBMC) from normal or uremic subjects. The cells were primed with cyclosporin A (CS-A), uremic serum, or both and subsequently cocultured with fresh phytohemagglutinin-stimulated normal allogeneic responders. CS-A-primed normal as well as uremic PBMC significantly suppressed responder cell thymidine incorporation. Uremic serum primed normal, but not the uremic, PBMC exerted a significant suppression on responder cell proliferation. No significant additive suppressive effect was detected following coculture of responders with PBMC primed by CS-A and uremic serum together. Exclusion of a distinct suppressor cell subset by panning, using anti-Leu-2b monoclonal antibody, did not result in blunting suppressive activity of the CS-A or uremic serum pretreated cells. On the other hand, adherent cell depletion of primed PBMC completely abolished their subsequent suppressive effect on responder cell proliferation.

Adult↗
PubMed1990

Induction of suppressor cell activity in normal peripheral blood mononuclear cells by sera from predialytic uremic patients.

Normal peripheral blood mononuclear cells (PBMC) were primed with sera from 22 predialytic uremic patients, normal sera, concanavalin A, or both. Their suppressive activity was subsequently tested on fresh phytohemagglutinin-stimulated allogeneic responders (i.e., genetically unrelated to either primed cell or sera donors). Uremic serum induced suppressor cell activity in the normal PBMC. No correlation was found between serum urea/creatinine levels and their effects on suppressor cell activity. The induced activity, expressed as percent suppression, was similar to that induced by concanavalin A. In PBMC primed with both concanavalin A and uremic serum, an additive suppressive effect was evident. The suppressor subset(s) induced by uremic serum proved to belong to adherent cell population. Addition of indomethacin or catalase to responder systems did not abolish the suppressive effects, thus suggesting a mechanism of action other than prostaglandin or hydrogen peroxide release.

Adult↗
PubMed1990

Norfloxacin use in urinary tract infection by urologists and infectious disease specialists.

One hundred thirty-one patients of urologists and infectious disease specialists were entered into an open trial of norfloxacin in the therapy of urinary tract infections (UTIs). All patients were evaluable for tolerability and 98 were evaluable for efficacy. The patient population in this study was older (mean age 53 years) and had more underlying urogenital disorders (30%) or recent invasive urologic procedures (20%) than the typical patient population with UTIs. Over 50% of the patients had infections due to organisms other than Escherichia coli, including Pseudomonas aeruginosa (14), Klebsiella pneumoniae (5), Enterobacter spp (3) and Group D streptococcus (6). Clinical and bacteriologic cure rates were 90 and 91%, respectively. Side effects occurred in 5 patients and were generally mild.

Administration, Oral↗