PubMed Health⌕ Search

Biomedical subjects

S Friedman

Publications and source records attributed to S Friedman.

At least 37 records · Page 2Linked to original sources
PubMed2004

Early enteral feeding and nosocomial sepsis in very low birthweight infants.

BACKGROUND: The interrelations between early enteral feeding, necrotising enterocolitis (NEC), and nosocomial sepsis (NS) remain unclear. OBJECTIVE: To evaluate the effect of age at the introduction of enteral feeding on the incidence of NS and NEC in very low birthweight (VLBW< 1500 g) infants. METHODS: Data were collected on the pattern of enteral feeding and perinatal and neonatal morbidity on all VLBW infants born in one centre during 1995-2001. Enteral feeding was compared between infants with and without NS and/or NEC. RESULTS: The study sample included 385 infants. Of these, 163 (42%) developed NS and 35 (9%) developed NEC. Enteral feeding was started at a significantly earlier mean (SD) age in infants who did not develop nosocomial sepsis (2.8 (2.6) v 4.8 (3.7) days, p = 0.0001). Enteral feeding was introduced at the same age in babies who did or did not develop NEC (3.1 (2) v 3.7 (3) days, p = 0.28). Over the study period, the mean annual age at the start of enteral feeding fell consistently, and this correlated with the mean annual incidence of NS (r(2) = 0.891, p = 0.007). Multiple logistic regression analysis showed age at start of enteral feeding, respiratory distress syndrome, and birth weight to be the most significant predictors of risk of NS (p = 0.0005, p = 0.024, p = 0.011). CONCLUSIONS: Early enteral feeding was associated with a reduced risk of NS but no change in the risk of NEC in VLBW infants. These findings support the use of early enteral feeding in this high risk population, but this needs to be confirmed in a large randomised controlled trial.

Age Factors↗
PubMed2003

Antimicrobial susceptibility and genetic relatedness of Salmonella serovars isolated from animal-derived dog treats in the USA.

OBJECTIVES: The objectives of this study were to determine the potential risk of dog treats in transmitting Salmonella to humans in the USA, and to characterize genetic relatedness and antimicrobial resistance among the isolates. METHODS: A total of 158 dog treats derived from pig ears and other animal parts were randomly collected nationwide and assayed for the presence of Salmonella. The Salmonella isolates were characterized using serotyping, pulsed-field gel electrophoresis (PFGE) and antimicrobial susceptibility testing. RESULTS: Forty-one percent (65/158) of samples were positive for Salmonella. Eighty-four Salmonella isolates, comprising 24 serotypes, were recovered from the 65 positive samples. Fourteen samples were contaminated with more than one Salmonella serotype. PFGE analysis of 78 Salmonella isolates yielded 64 patterns. S. Infantis with PFGE patterns indistinguishable from those of strains identified in Canadian outbreaks in 1999 were recovered in several dog treat products. The majority of Salmonella isolates were susceptible to the antimicrobials tested; however, resistance was observed to tetracycline (26%), streptomycin (23%), sulfamethoxazole (19%), chloramphenicol (8%) and ampicillin (8%). Twenty-eight (36%) Salmonella isolates were resistant to at least one antimicrobial and 10 (13%) isolates displayed resistance to four or more antimicrobials. Two isolates were identified as S. Typhimurium DT104 with the characteristic penta-resistance phenotype (ampicillin, chloramphenicol, streptomycin, sulfamethoxazole and tetracycline). One S. Brandenburg isolate was resistant to eight antimicrobials. Seven Salmonella isolates also contained class I integrons encoding resistance genes to aminoglycosides, beta-lactam and streptothricin antimicrobials. CONCLUSIONS: The study indicates that animal-derived dog treats in the USA could be a potential source of animal and human infections with Salmonella, including multidrug-resistant Salmonella strains.

Animal Feed↗
PubMed2003

Life-threatening thrombotic thrombocytopenic purpura (TTP) in a patient with sickle cell-hemoglobin C disease.

We report a patient with hemoglobin sickle cell-hemoglobin C disease who developed the clinical syndrome of thrombotic thrombocytopenic purpura (TTP) during admission for typical acute pain crisis. The potential for multiorgan involvement secondary to vaso-occlusive crisis complicated the diagnosis and overlapped with the patient's clinical presentation of chronic bone pain and hemolytic anemia. Clinical improvement and normalization of laboratory parameters followed rapidly in response to plasma exchange therapy.

Adult↗
PubMed2003

Alexithymia in insulin-dependent diabetes mellitus is related to depression and not to somatic variables or compliance.

OBJECTIVES: To assess the prevalence of alexithymia in insulin-dependent diabetic mellitus (IDDM) outpatients. To examine whether alexithymia is associated with diabetic somatic variables, depression, and compliance. METHOD: Our sample comprised 69 diabetic outpatients followed in a university hospital. We assessed the prevalence of alexithymia (26-item Toronto Alexithymia Scale, TAS-26) and the relationships among alexithymia, depression (13-item Beck Depression Inventory, BDI-13), somatic diabetic variables (glycosylated hemoglobin, number of mild or severe hypoglycemia, somatic complications), and compliance (observer-rater scale completed by diabetologist). RESULTS: The prevalence of alexithymia in IDDM patients was low (14.4%). Alexithymia and depression, as measured by TAS-26 and BDI-13 scores, respectively, correlated with each other. Alexithymia was not correlated with glycemic control, somatic complications, or compliance. CONCLUSION: In our sample, alexithymia was related to depression and not to somatic factors or compliance.

Adult↗
PubMed2003

Corynebacterium pseudotuberculosis infection in Israeli dairy cattle.

Two forms of Corynebacterium pseudotuberculosis infection in Israeli dairy cattle herds during a survey period of 13 years (1989-2001) are described. The more common form, which was diagnosed in 45 herds, was characterized by ulcerative granulomatous lesions which occurred either sporadically--in 26 herds (with a morbidity rate of up to 5%)--or in an epidemic course in 19 herds. Most (80.6%) of the affected animals were cows; the rest were first-calving cows (16.2%) and heifers (3.2%). The morbidity occurred mostly during the summer months. The ulcerative granulomatous lesions appeared in three clinical forms: cutaneous, mastitic and visceral. Mixed forms were also observed. The morbidity rate was 6.4% and the culling rate reached 16.3% of the affected animals. Most of the strains of C. pseudotuberculosis which were isolated from the abscesses in the cutaneous form of the disease and from milk samples failed to reduce nitrate. A decrease in milk production (6%) and an increase in bulk-milk somatic cell count were noted. Necrotic and ulcerative dermatitis on the heel of the foot occurred in an epidemic course in heifers in only two herds during the winter months, with morbidity rates of 7.5 and 76.2%, respectively. C. pseudotuberculosis isolates from skin lesions and from the soil did reduce nitrate. Clinical, epizootiological and microbiological aspects of the infection are described.

Animals↗
PubMed2003

Periapical health and treatment quality assessment of root-filled teeth in two Canadian populations.

AIM: The prevalence of apical periodontitis (AP) and the quality of root fillings and restorations were determined in two Canadian populations differing in avail-ability of endodontists. METHODOLOGY: Radiographs of first-time university patients aged 25-40 years in Toronto and Saskatoon were examined for missing teeth, presence and standard of root fillings, standard of restoration, and AP according to the Periapical Index. Patients with root-filled teeth were invited for clinical examination and interview to inspect the restorations, and to reveal the providers of endodontic treatment and reasons for extractions of missing teeth. Chi-square and independent t-tests interpreted at the 5% significance level were used to examine associations between the prevalence of AP in root-filled teeth and the standard of the root filling, restoration, and providers of treatment. RESULTS: Proportion of patients with root-filled teeth was significantly higher (P < 0.001) in Toronto than in Saskatoon (39 and 26%, respectively). Presence of AP about root-filled teeth (44% in Toronto, 51% in Saskatoon) was significantly associated with poor density (OR = 2.7) short (OR = 2.4) and long (OR = 2.8) root fillings, and with poor radiographic quality of the restoration (OR = 1.7) Prevalence of AP did not differ significantly between teeth treated by generalists and endodontists. CONCLUSIONS: The prevalence of AP in root-filled and untreated teeth was comparable to that reported in previous methodologically compatible studies. The quality of both the root filling and the restoration were found to impact on the periapical health of root-filled teeth, with the impact of the restoration being most critical when the quality of the root filling was adequate.

Adult↗
PubMed2003

Characterization of Salmonella enterica serotype newport isolated from humans and food animals.

Salmonella enterica serotype Newport isolates resistant to at least nine antimicrobials (including extended-spectrum cephalosporins), known as serotype Newport MDR-AmpC isolates, have been rapidly emerging as pathogens in both animals and humans throughout the United States. Resistance to extended-spectrum cephalosporins is associated with clinical failures, including death, in patients with systemic infections. In this study, 87 Salmonella serotype Newport strains were characterized by pulsed-field gel electrophoresis (PFGE) and antimicrobial susceptibility testing and examined for the presence of class 1 integrons and bla(CMY) genes. Thirty-five PFGE patterns were observed with XbaI, and three of these patterns were indistinguishable among isolates from humans and animals. Fifty-three (60%) Salmonella serotype Newport isolates were identified as serotype Newport MDR-AmpC, including 16 (53%) of 30 human isolates, 27 (93%) of 29 cattle isolates, 7 (70%) of 10 swine isolates, and 3 (30%) of 10 chicken isolates. However, 28 (32%) Salmonella serotype Newport isolates were susceptible to all 16 antimicrobials tested. The bla(CMY) gene was present in all serotype Newport MDR-AmpC isolates. Furthermore, the plasmid-mediated bla(CMY) gene was transferable via conjugation to an Escherichia coli strain. The transconjugant showed the MDR-AmpC resistance profile. Thirty-five (40%) of the isolates possessed class 1 integrons. Sequence analyses of the integrons showed that they contained aadA, which confers resistance to streptomycin, or aadA and dhfr, which confer resistance to trimethoprim-sulfamethoxazole. One integron from a swine isolate contained the sat-1 gene, which encodes resistance to streptothricin, an antimicrobial agent that has never been approved for use in the United States. In conclusion, Salmonella serotype Newport MDR-AmpC was commonly identified among Salmonella serotype Newport isolates recovered from humans and food animals. These findings support the possibility of transmission of this organism to humans through the food chain.

Animals↗
PubMed2003

Reduction in multiresistant nosocomial infections in neonates following substitution of ceftazidime with piperacillin/tazobactam in empiric antibiotic therapy.

AIM: To evaluate the effect of a change in antibiotic protocol on pathogens that cause neonatal sepsis. METHODS: Suspected sepsis was treated with amikacin together with ceftazidime in 1995-1998 and piperacillin/tazobactam in 1999-2002. RESULTS: The annual rate for Klebsiella sepsis fell from 2.5 to 0.45 cases per 1000 admission days (p = 0.0001) between the two periods studied. CONCLUSION: The change from ceftazidime to piperacillin/tazobactam is associated with a decrease in the incidence of Klebsiella sepsis.

Anti-Bacterial Agents↗
PubMed2002

Polyethylene glycol, determined by near-infrared reflectance spectroscopy, as a marker of fecal output in goats.

We report the application of NIR spectroscopy to determine the fecal concentration of poly(ethylene glycol) (PEG, MW 6000) used as an external marker of fecal output in goats. Calibration was carried out, using the modified partial least-squares method (MPLS), combining all wavelengths in the 1100-2500 nm range, with high linearity (R2 = 0.99). In goats fed at maintenance level, the recovery of PEG in feces was complete, and the estimation of fecal output was accurate, when a moderate dose of PEG was given (20 g/d). A higher dose of PEG (40 g/d) was associated with underestimation of fecal output, probably because PEG interacted with water metabolism. Using PEG and its NIRS-aided analysis to determine fecal output is accurate, simple, and cheap. However, the feasibility of this new method must be verified in goats feeding on tannin-containing diets, and in goats at high feeding level.

Animal Nutritional Physiological Phenomena↗
PubMed2002

Characterization of antimicrobial resistance among Escherichia coli O111 isolates of animal and human origin.

Fifty isolates of Escherichia coli serogroup O111 recovered from humans and various animal species over a 24-year period (1976-1999) were examined for typical virulence-associated factors and susceptibilities to antimicrobials of human and veterinary significance. Nine H (flagellar) types were identified including nonmotile (n = 24), 32 (n = 12), negative (n = 5), and 56 (n = 3). Thirty-five (70%) isolates possessed at least one Shiga-toxin-producing E. coli (STEC)-associated virulence determinants (eae, stxl, stx2, hlyA) via PCR analysis. Of these 35 isolates, 20 possessed eae, stxl, and hlyA genes, whereas three isolates possessed eae, stxl, stx2, and hylA genes. Multiple antibiotic resistance was observed in 70% of the 50 E. coli O111 isolates. The majority of isolates displayed resistance to streptomycin, sulfamethoxazole, tetracycline, and kanamycin. Bacterial resistance to ampicillin, gentamicin, chloramphenicol, trimethoprim and apramycin was also observed. Integrons were identified in 23 (46%) of the E. coli isolates assayed, with a 1-kb amplicon being most frequently observed. DNA sequencing of these integrons revealed the presence of the aadA gene, encoding resistance to streptomycin. Two integrons of 1.5 and 2 kb contained the aadA2 and either dfrI or dfrXII genes, encoding resistance to streptomycin and trimethoprim, respectively. Integrons were also identified from isolates dating back to 1982. Isolates were further genetically characterized via ribotyping, which identified 15 distinct ribogroups, with 62% of isolates clustering into four major ribogroups. Certain riboprint patterns from different animal species, including humans, were observed in isolates spanning the 24-year collection period, suggesting the dissemination of specialized pathogenic O111 clones.

Animals↗
PubMed2002

A PCR-based method for the detection of Streptococcus agalactiae in milk.

Bovine mastitis caused by Streptococcus agalactiae is mainly subclinical and therefore can be diagnosed only in the laboratory. We developed a polymerase chain reaction (PCR)-based method for specific and sensitive detection of S. agalactiae in raw milk. The specificity of the PCR reaction is based on unique S. agalactiae DNA sequences within the 16S subunit of the rRNA genes. Two pairs of sequences were used as positive controls; general streptococci primers, which anneal to conserved areas within the 16S rRNA subunit gene, and primers, which anneal to sequences within bovine mitochondrial DNA. The method of detection includes selective enrichment of S. agalactiae in the milk sample, followed by DNA extraction using a rapid and simple procedure developed for this purpose, and specific PCR reaction with appropriate controls. The method enables the detection of one bacterium in 1 ml of raw milk. The method developed can be easily incorporated as part of routine screening of bulk milk collection tanks for early detection of infected cows in a herd.

Animals↗
PubMed2001

Three-dimensional structure of the Hospital Anxiety and Depression Scale in a large French primary care population suffering from major depression.

Few studies have been specifically carried out to characterize the dimensional structure of the Hospital Anxiety and Depression Scale (HADS) and those that have, have yielded contradictory results. We have examined the factor structure and sensitivity to change of the HADS in a large French outpatient primary care population treated with sertraline for major depression (DSM-IV criteria). Factor analysis of the HADS was performed in 2669 outpatients and in subsamples using a principal component procedure with Varimax rotation. Concurrent change sensitivity of the HADS was compared with that for the Hamilton Depression Rating Scale (HDRS) after at least 45 days of sertraline treatment. Three distinct factors emerged from the HADS factor analysis: a "depression" factor and two separate anxiety subscales: "psychic anxiety" and "psychomotor agitation" whose mean reductions in scores from baseline were significantly correlated (0.36-0.45) with the reduction of the HDRS baseline score. These new data provide support for the use of the HADS's three-dimensional structure to measure improvement of selected symptoms of anxiety during antidepressant therapy.

Adult↗
PubMed2001

The isolation of antibiotic-resistant salmonella from retail ground meats.

BACKGROUND: Salmonella is a leading cause of foodborne illness. The emergence of antimicrobial-resistant salmonella is associated with the use of antibiotics in animals raised for food; resistant bacteria can be transmitted to humans through foods, particularly those of animal origin. We identified and characterized strains of salmonella isolated from ground meats purchased in the Washington, D.C., area. METHODS: Salmonella was isolated from samples of ground chicken, beef, turkey, and pork purchased at three supermarkets. The isolates were characterized by serotyping, antimicrobial-susceptibility testing, phage typing, and pulsed-field gel electrophoresis. The polymerase chain reaction and DNA sequencing were used to identify resistance integrons and extended spectrum beta-lactamase genes. RESULTS: Of 200 meat samples, 41 (20 percent) contained salmonella, with a total of 13 serotypes. Eighty-four percent of the isolates were resistant to at least one antibiotic, and 53 percent were resistant to at least three antibiotics. Sixteen percent of the isolates were resistant to ceftriaxone, the drug of choice for treating salmonellosis in children. Bacteriophage typing identified four isolates of Salmonella enterica serotype typhimurium definitive type 104 (DT104), one of DT104b, and two of DT208. Five isolates of S. enterica serotype agona had resistance to 9 antibiotics, and the two isolates of serotype typhimurium DT208 were resistant to 12 antibiotics. Electrophoretic patterns of DNA that were indistinguishable from one another were repeatedly found in isolates from different meat samples and different stores. Eighteen isolates, representing four serotypes, had integrons with genes conferring resistance to aminoglycosides, sulfonamides, trimethoprim, and beta-lactams. CONCLUSIONS: Resistant strains of salmonella are common in retail ground meats. These findings provide support for the adoption of guidelines for the prudent use of antibiotics in food animals and for a reduction in the number of pathogens present on farms and in slaughterhouses. National surveillance for antimicrobial-resistant salmonella should be extended to include retail meats.

Animals↗
PubMed2001

Deficiency of molecular hydrogen in the disk of beta Pictoris.

Molecular hydrogen (H2) is by far the most abundant material from which stars, protoplanetary disks and giant planets form, but it is difficult to detect directly. Infrared emission lines from H2 have recently been reported towards beta Pictoris, a star harbouring a young planetary system. This star is surrounded by a dusty 'debris disk' that is continuously replenished either by collisions between asteroidal objects or by evaporation of ices on Chiron-like objects. A gaseous disk has also been inferred from absorption lines in the stellar spectrum. Here we present the far-ultraviolet spectrum of beta Pictoris, in which H2 absorption lines are not seen. This allows us to set a very low upper limit on the column density of H2: N(H2) </= 1018 cm-2. This non-detection is puzzling when compared to the quantity of H2 inferred from the infrared observations, but it does show that H2 is not in the disk on the direct line of sight. Carbon monoxide (CO) has been seen in absorption against the star, yielding a ratio of CO/H2 > 6 x 10-4. As CO would be destroyed under ambient conditions in about 200 years (refs 9, 11), our result demonstrates that the CO in the disk arises from evaporation of planetesimals.

Astronomical Phenomena↗
PubMed2001

Embryonic expression of Krüppel-like factor 6 in neural and non-neural tissues.

Mammalian Krüppel-like transcription factors include 12 zinc finger proteins (KLF1-12) that are involved in regulation of cell proliferation and differentiation during morphogenesis and development (Trends Biochem. Sci., 24 (1999) 236). Structural considerations have segregated KLF6 and KLF7 into a separate sub-group, whereas in situ hybridizations have revealed predominant expression of the mouse klf7 gene in the developing nervous system. We examined the embryonic pattern of mouse klf6 in order to assess whether close kinship between KLF6 and KLF7 reflects similar expression patterns of the genes. The results of the in situ hybridizations demonstrate that klf6 expression in the developing nervous system is more restricted than klf7. In contrast to klf7, we also identified several non-neural sites of strong klf6 expression; they include the developing hindgut, heart, lung, kidney, and autopod.

Animals↗
PubMed2001

Screening and surveillance colonoscopy in chronic Crohn's colitis.

BACKGROUND & AIMS: Unlike ulcerative colitis, there are few reports on the efficacy of surveillance colonoscopy in patients with chronic Crohn's colitis and therefore little agreement as to whether routine surveillance is indicated. We report on 259 patients with chronic Crohn's colitis who underwent screening and subsequent surveillance colonoscopy and biopsy since 1980. METHODS: Biopsies were performed at 10-cm intervals and from strictures and polypoid masses. Pathology was classified as normal, dysplasia (indefinite, low-grade, high-grade), or carcinoma. RESULTS: A total of 663 examinations were performed on 259 patients. The median interval between examinations was 24 months; examinations were performed more frequently (1-6 months) in patients with dysplasia on biopsy. A thinner-caliber colonoscope was required to complete 12% of screening examinations and 23% of surveillance examinations. The pediatric colonoscope helped increase our yield of neoplasia by 19%. The screening and surveillance program detected dysplasia or cancer in 16% (10 indefinite, 23 low-grade, and 4 high-grade dysplasias and 5 cancers). A finding of definite dysplasia or cancer was associated with age >45 years and increased symptoms. By life table analysis, the probability of detecting dysplasia or cancer after a negative screening colonoscopy was 22% by the fourth surveillance examination. CONCLUSIONS: Colonoscopic surveillance should be strongly considered in chronic extensive Crohn's colitis.

Adolescent↗