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Biomedical subjects

S Maayan

Publications and source records attributed to S Maayan.

At least 55 records · Page 3Linked to original sources
PubMed1988

AIDS in Israel, 1987.

Between mid-1982 and 1 January 1988, 35 cases of AIDS among permanent residents of Israel were reported to the Israel Ministry of Health. In contrast to the experience in the United States and Europe, the semiannual incidence rates of AIDS are low and have increased slowly over the past 6 years (0.6 to 1.1 cases/million). Risk factors for AIDS were identified in 34 patients: homosexuality in 18, hemophilia in 14 and blood transfusions in 2. Seventeen of the 18 homosexuals were most likely infected abroad, and all hemophilia patients had received imported commercial clotting factors. The two patients associated with blood transfusion received blood donated in Israel. The spectrum of clinical presentations and opportunistic pathogens is similar to that reported in the Western world, except for one case of disseminated Mycobacterium simiae infection. Sexual relations abroad of local homosexuals and receipt of imported clotting factors by Israeli hemophiliacs are currently the most important risk factors for AIDS in Israel. However, the prevalence of HIV infection among Israeli homosexuals is still low and is probably indicative of the more conservative life-style, the later introduction of the virus, and the earlier application of safe sex, in comparison with other Western countries. Furthermore, since spread of the virus seems to be increasing among Israeli i.v. drug abusers, attention should be focused on this group as well, so as to prevent a major outbreak of AIDS in Israel.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Prevention of herpes simplex virus (HSV) infection in recipients of HLA-matched T-lymphocyte-depleted bone marrow allografts.

The occurrence of HSV infection and the effect of prophylaxis with oral acyclovir were evaluated prospectively in 34 consecutive patients undergoing bone marrow transplantation (BMT). All allogeneic BMT procedures involved T-lymphocyte depletion for prevention of graft-vs.-host disease (GVHD). Five HSV-seronegative patients did not receive acyclovir, and they did not develop HSV infection. Oral acyclovir was administered to 15 HSV-seropositive BMT recipients; 14 untreated HSV-seropositive BMT recipients served as a control group. The adult dose of acyclovir was 400 mg three times a day on Days -6 to +14 and 200 mg three times a day on Days +15 to +90. Children received 500 mg/m2 per day divided into three equal doses on Days -6 to +14 and 250 mg/m2 per day again divided into three on Days +15 to +90. In the group on prophylaxis, only one developed HSV infection during the time prior to engraftment. In the reference group, 12 of 14 (85.7%) developed oral HSV infection within 0 to 16 days (median 11 days) after the transplantation. Time for engraftment (duration of neutropenia) was shorter in patients receiving acyclovir. After engraftment, HSV infection was not observed during administration or following discontinuation of acyclovir on Day 90, but occurred in three patients in whom acyclovir was discontinued on Days 25, 35 and 40 after BMT. In the untreated group, two patients had recurrence of HSV infection on Days 40 to 60, and one had two infectious episodes. GVHD occurred in only two recipients, neither of whom had HSV infection. We conclude that the incidence of HSV infection during the period until engraftment in recipients of T-lymphocyte-depleted BMT is high, similar to that reported by others in recipients of whole BMT. Relatively low-dose oral acyclovir administered for 90 days can effectively prevent HSV infections in previously HSV-seropositive BMT recipients and may also shorten the period until engraftment.

Acyclovir↗
PubMed1987

Strongyloides stercoralis hyperinfection in a patient with the acquired immune deficiency syndrome.

Severe infections with Strongyloides stercoralis occur in immunocompromised patients. Strongyloides hyperinfection syndrome complicated by gram-negative bacteremia and meningitis in a bisexual man with the acquired immune deficiency syndrome (AIDS) is described. Increased awareness of this infection, which may also be sexually transmitted, is recommended when caring for patients with AIDS who are homosexual, or have resided in areas endemic for strongyloidiasis. Multiple stool examinations should be performed routinely for such patients. Examination of sputum for the parasite is recommended if pneumonia is present. Prompt diagnosis and therapy are essential for prevention of fatal dissemination.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Mycobacterium tuberculosis infection in the acquired immunodeficiency syndrome. A review of 14 patients.

The clinical findings in 13 drug abusers and one homosexual man with tuberculosis and the acquired immunodeficiency syndrome (AIDS) from New York City are described. Tuberculosis preceded the diagnosis of AIDS in nine of the 14 patients by a mean of 7 months and occurred within the same month in the remaining five. The presence of thrush, generalised lymphadenopathy, lymphopenia, cutaneous anergy and chest radiographs showing hilar adenopathy and/or lower lobe infiltrates was common among the patients in whom tuberculosis preceded AIDS. Eight of our patients had extra-pulmonary tuberculosis, six had disseminated tuberculosis and five had tuberculous lymphadenitis. Cultures of tissue biopsies may be positive for Mycobacterium tuberculosis despite the absence of acid fast bacilli or granulomas on microscopic examination. Tuberculosis generally responded to chemotherapy, but the majority of patients died from opportunist infections.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Diagnostic value of the determination of an interferon-induced enzyme activity: decreased 2',5'-oligoadenylate dependent binding protein activity in AIDS patient lymphocytes.

The 2, 5'-oligoadenylate dependent binding protein activity was measured in peripheral blood lymphocyte extracts of AIDS and pre-AIDS and compared to healthy heterosexual controls. The binding activity in lymphocytes from AIDS (mean, 0.71 fmole/10(6) cells) and pre-AIDS (mean, 0.66 fmole/10(6) cells) was approximately 65% lower than that found in controls (mean, 2.41 fmole/10(6) cells) suggesting that this enzymatic activity may be a useful biochemical marker for the diagnosis of AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Transmission of acquired immune deficiency syndrome (AIDS) by a blood transfusion given in 1979 in Israel.

AIDS developed in a blood donor-recipient pair in Israel. Transmission of HTLV III/LAV probably occurred via a blood transfusion in November 1979. The donor was asymptomatic at the time of blood donation, but initial symptoms of AIDS-related complex developed in the donor 3 months later and in the recipient 6 months following the blood transfusion.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Central nervous system involvement in patients with acquired immune deficiency syndrome (AIDS).

Central nervous system involvement occurred in 28 of 121 patients with acquired immune deficiency syndrome (AIDS). The major risk factor in this AIDS population was intravenous drug abuse (64%). A neurologic symptom or disability was the principal reason for hospitalization in 16 cases (57%). Three patients had primary lymphoma of the brain and the remainder had opportunistic infections. Patients with focal neurological features usually had toxoplasmosis. Progressive headache and meningeal signs occurred with cryptococcosis. A progressive subacute dementia was probably due to cytomegalovirus. Other infections included atypical mycobacteria, candida, herpes zoster and possible progressive multifocal leukoencephalopathy.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Acquired immunodeficiency syndrome (AIDS) in an economically disadvantaged population.

Forty patients with acquired immunodeficiency syndrome (AIDS), 70% of whom were intravenous drug abusers (IVDAs), were seen over a 20-month period (July 1, 1981, through Feb 28, 1983). Most of the patients came from two inner-city sections of New York City and from nearby correctional facilities. Eighty-five percent of the patients were black or Hispanic; only 15% were white. Unique features of AIDS in this mostly heterosexual population were the high incidence of opportunistic infections (90% of the patients), the low incidence of Kaposi's sarcoma (10%), and the high mortality rate (34% died during initial hospitalization, 74% after one year of follow-up). Tuberculosis occurred in 10% of cases, preceding other opportunistic infections by four to 24 months. We found that AIDS was a common disease among inpatient IVDAs, and in one of the participating hospitals, its incidence was similar to that of infective endocarditis. Acquired immunodeficiency syndrome should be considered as the underlying illness in all IVDAs with oral thrush, shortness of breath, pneumonia, or extra-pulmonary tuberculosis.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Diagnosis of giardiasis by two methods. Immunofluorescence and enzyme-linked immunosorbent assay.

Antibody response in giardiasis was measured by indirect fluorescent antibody (IFA) and enzyme-linked immunosorbent assays (ELISA) on serum samples of 125 patients. Twenty-nine of these patients had symptomatic giardiasis; 30 were asymptomatic (carriers); 40 had other parasitic infections; 16 had inflammatory bowel diseases; ten were normal subjects. It was found that those patients with symptomatic giardiasis had higher IFA titers compared with all patients who did not have giardiasis and patients who had asymptomatic giardiasis. Serum samples with titers of 1:64 or greater in Giardia IFA were absorbed with Giardia and other parasite antigens. Only absorption with Giardia caused the titers to fall significantly. The ELISA technique was less specific than the IFA technique. Giardiasis elicits a specific host antibody response that may be used as an adjunct in its diagnosis.

Antibodies↗
PubMed1982

Opportunistic infection in previously healthy women. Initial manifestations of a community-acquired cellular immunodeficiency.

Opportunistic infections and unusual tumors have been reported in an unprecedented outbreak of community-acquired cellular immune deficiency among homosexual and drug-abusing men. We report five women with the same syndrome. The women were residents of metropolitan New York City closely associated with drug abuse either by personal use (our patients) or close sexual contact with an abuser (one patient). One patient was bisexual. All five patients developed Pneumocystis carinii pneumonia as well as combinations of other opportunistic infections including oral candida, disseminated mycobacteria, and ulcerative herpes simplex infections. All patients had marked depression of cellular immune function. Three patients died. The appearance of this syndrome in women has important implications with regard to the epidemiology and etiology of this emerging syndrome.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Meningococcal meningitis among Rwandan refugees: diagnosis, management, and outcome in a field hospital.

OBJECTIVE: To study the diagnostic process, clinical course, and outcome of Rwandan refugees with meningococcal meningitis, treated in an Israeli field hospital in Goma, Zaire, in the summer of 1994. METHODS: Patient hospital charts and laboratory records were reviewed with critical evaluation of clinical presentation and diagnostic tests. Patients were treated as part of a disaster relief effort in a refugee camp experiencing several coexisting lethal epidemics. RESULTS: A total of 65 patients were identified as having group A meningococcal meningitis. Latex agglutination test for Neisseria meningitidis soluble antigen in the cerebrospinal fluid was found to be a superior diagnostic tool, as compared to Gram stain, and at least as effective as culture. The mortality rate was 14%; mortality was markedly affected by co-morbidity (e.g., dysentery, pneumonia, and malnutrition). CONCLUSIONS: The outcome of patients with meningococcal meningitis, treated in referral centers within a disaster area may be favorable, despite overwhelming coexisting epidemics, and may be comparable to that achieved in advanced medical facilities. Encephalopathy may be a diagnostic pitfall in the perspective of coexisting epidemics, requiring a high index of suspicion and routine lumbar puncture. The latex agglutination test is highly useful in achieving prompt diagnosis of meningococcal meningitis, in particular when sample handling for culture and microscopy is suboptimal.

Adolescent↗