Health programs should become family affairs.
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Biomedical subjects
Publications and source records attributed to S Marks.
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Emergence of gram-negative bacteria resistnant to a number of antibiotics in intensive care nurseries for neonates emphasizes the need for alternatives in antibiotic combinations. One commonly used combination, gentamicin-ampicillin, and two newer combinations, tobramycin-cephalothin and amikacinampicillin, were evaluated prospectively in 60 newborns in such a nursery. Subjects were randomly assigned to one of the above therapy groups. Dosages in mg/kg.d were 100 for ampicillin and cephalothin, 6 for gentamicin and tobramycin and 15 for amikacin. Aminoglycoside serum concentrations, clinical tolerance and toxicity were monitored. Aminoglycoside concentrations after intravenous administration of the drugs were within the expected range (gentamicin and tobramycin 4 to 6 microgram/mL and amikacin 15 to 20 microgram/mL). There was no hematologic, renal or hepatic toxicity attributable to antibiotic therapy and the combinations were tolerated equally; no bilirubin displacement was detected in vitro or in vivo.
The persistence in the structure of IgM anti-IgGs obtained from the serum of a patient (Gil) with Felty's syndrome was studied. Co-isoelectric focusing experiments showed that intact IgM from early (1970) and late (1973) sera, and their heavy and light chains had identical isoelectric points (pI). Light chains from 1970, 1973, and 1974 IgM-Gil had identical amino terminal amino acid sequences and belonged to the v Kappa II light chain subgroup. Specificity studies of IgM-Gil isolated from serum obtained in 1970, 1972 and 1974 showed identical patterns of reactivity with IgG and IgG subunits of all gamma chain subclasses. Finally, by haemagglutination-inhibition, antisera specific for idiotypic determinants of IgM-Gil-1970 were shown to be shared by IgM from 1970, 1972 and 1974 sera. The data support the notion that autoantibody-producing cell clones persist unaltered during the course of an untreated autoimmune disease, in this instance for 4 1/2 years.
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A case of hypothyroidism is described in a young woman who on thyroid scan had a discrete functioning "nodule" with homogeneous radioactive iodine uptake, and surrounded by atrophic non-functioning thyroid tissue. Antithyroglobulin antibodies were not demonstrable, but anti-microsomal antibodies were positive at a titer of 1:25,600. Histologically, the "nodule" represented Hashimoto's thyroiditis with more extensive destruction of the remaining gland. Although it is unusual, Hashimoto's disease should be considered in the differential diagnosis of functioning thyroid nodules, and both anti-thyroglobulin and anti-microsomal antibodies should be obtained in such circumstances.
Data have been accumulated to determine the prevalence of yeast colonization of the skin and digestive tract of hospitalized and nonhospitalized infants and children. There was no difference in the prevalence between hospitalized patients at the time of admission and nonhospitalized children. However, there was a positive correlation of the duration of hospitalization and the prevalence of yeast colonization. There were no correlations of hospitalization with site of colonization, age of the patient, or type of yeast isolated.
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