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Biomedical subjects

S Yosselson-Superstine

Publications and source records attributed to S Yosselson-Superstine.

At least 19 recordsLinked to original sources
PubMed1990

Breast cancer screening in Tel Aviv.

Optimal breast cancer screening includes both physical examination and mammography. In anticipation of the addition of routine mammographic screening to Israel's 25-year-old early breast cancer detection program, we examined the demographic characteristics of almost one thousand women attending a breast cancer screening examination in Tel Aviv for the first time. The specific objective of the survey was to see whether women attending screening were those who stood a good chance of benefiting from it. Only half the women were aged 40 or older, and there was a preponderance of women of Western origin. Almost half had a breast-related complaint at the time of the visit. Targeted public education and appropriate administrative measures are necessary to ensure that women who can benefit from screening attend screening clinics and that clinics are not filled to capacity by women needing diagnostic evaluation and followup rather than routine screening. Tel Aviv general practitioners appeared to be aware of the advantages of breast cancer screening.

Adult↗
PubMed1986

The propriety of narcotic usage in hospitalized patients.

The propriety of narcotic usage at the Hadassah Hospital has been studied in 35 cancer patients and 70 post-operative patients. Eighty-three per cent of the cancer patients and 66% of the surgical patients remained in moderate to severe distress in spite of the analgesic therapy. Insomnia and anxiety, plus depression in the cancer patients, were the major results of uncontrolled pain. The inadequacy of the treatment was attributed to the incorrect selection of medication, usage "as needed' policy and smaller daily doses than advocated. This resulted mainly because of exaggeration of the risk of tolerance and addiction by both patients and personnel.

Drug Utilization↗
PubMed1986

Drug interference with urine protein determination.

The purpose of this study was to detect the possibility of drug interference in the estimation of urine protein in patients receiving therapeutic doses of penicillin G, ampicillin, methicillin, cefoxitin, cefazolin, gentamicin, co-trimoxazole, phenothiazines, glibenclamide and acetazolamide. Five different methods for urine protein determination were compared in these patients, when different amounts of albumin were added to urine in vitro, and in a control group of patients not treated with drugs known to interfere with these methods. The techniques included two semi-quantitative tests--a strip test (Albustix) and heat and acetic acid turbidity test; and three quantitative tests--sulphosalicylic acid test, trichloroacetic acid test and a test based on a formation of Ponceau S dye-protein complex (Urin-Pak). The only significant interference found was that of gentamicin with the Ponceau S dye test.

Albumins↗
PubMed1985

Theophylline versus aminophylline in rectal administration.

This study was undertaken to compare the bioavailability and the in vitro release rates of theophylline from suppositories containing either theophylline or aminophylline. The absorption of theophylline from solution and from freshly prepared suppositories formulated with Suppocire and containing anhydrous theophylline 250 mg or aminophylline 300 mg was investigated in six healthy volunteers in a blind crossover design experiment. Venous blood samples were collected before drug administration and at 1, 2, 4, 6 and 8 h afterwards. Theophylline serum levels were measured spectrophotometrically. The pharmacokinetic parameters obtained: Cmax 6.7 and 5.4 micrograms ml-1, tmax 2 h, and F8h 0.79 and 0.83 for theophylline and aminophylline, respectively, show that the two formulations are almost bioequivalent, with a slightly higher Cmax for theophylline. The in vitro release rate of theophylline from freshly prepared formulations was, however, higher (4.8 mg min-1) from aminophylline suppositories relative to those containing theophylline (2.9 mg min-1). This lack of correlation between the in vitro and in vivo results is explained by the different drug thermodynamic activities in the processes of release and membrane penetration. Thus, a better water-solubility does not automatically point to a better rectal bioavailability. The release rate of aminophylline suppositories tested after 1-year storage at room temperature dropped from 4.8 to 0.5 mg min-1. The bioequivalence of theophylline and aminophylline freshly prepared suppositories and the stability problems associated with fatty-base aminophylline suppositories indicate that the choice of ethylenediamine derivative of theophylline is an empirical development, theoretically unjustified, and must be replaced by theophylline reformulations.

Adult↗
PubMed1985

Adjunctive antianxiety agents in the management of chronic pain.

We examined the relative clinical efficacy of three commonly used antianxiety medications and a placebo as adjuncts to analgesic treatment of chronic cancer and arthritic pain. Nine patients with chronic pain, including six with malignancy and three with rheumatic diseases, were each exposed to three treatment phases with antianxiety drugs (hydroxyzine, prochlorperazine, and chlordiazepoxide) and one placebo phase in a double-blind, counter-balanced design. Each phase lasted 2 weeks, with analgesic medication given throughout. Pre- and post-phase measures of anxiety, depression, and hostility were taken, together with daily reports by the patients on pain, mood, and medication intake. None of the antianxiety drugs were significantly more effective than the placebo in reducing pain levels, daily medication usage or hostility. Chlordiazepoxide significantly reduced anxiety and depression compared with the placebo, but also produced the most side effects (e.g., drowsiness). The preliminary findings failed to support the efficacy of the three antianxiety medications as analgesic adjuncts.

Adult↗
PubMed1982

Drug-related hospitalization in paediatric patients.

A survey, to estimate drug-related hospitalization, was conducted by a clinical pharmacist who participated in medical rounds on a paediatric ward. Data were collected from patients' medical charts and verified by the attending physicians and the patients and/or their guardians. Adverse drug reactions and inappropriate therapy were defined with criteria supported by medical publications. Approximately 18% of the 906 studied admissions were found to be drug-related; 11.0% as a result of inappropriate drug therapy, 3.4% as a result of patient non-compliance and 3.2% because of adverse reactions. Antineoplastic agents were responsible for most adverse reactions that led to hospital admission. They were followed by corticosteroids, antimicrobials and by anticonvulsants. The last two groups of drugs were also responsible for hospitalization because of inappropriate drug therapy and patient non-compliance. Adverse drug reactions were more prevalent in females, in 6-10-year-old children, in patients of Ashkenazic origin and in patients who have experienced similar reactions in the past. Non-compliance was more prevalent in patients of Sephardic origin.

Adolescent↗
PubMed1982

Relationship between quinidine concentrations measured in saliva and erythrocytes, and in serum.

The feasibility of indirect monitoring of serum quinidine concentration by determining saliva or erythrocyte levels was investigated in 16 hospitalized patients on quinidine therapy. No significant correlation was found between quinidine levels in saliva and its total or free levels in serum. The saliva to serum free drug concentration ratios were not dependent on saliva pH (r = 0.169), and they ranged from 1.238 to 6.782 among the different individuals. Quinidine serum protein binding was concentration dependent. It correlated poorly with serum levels of albumin, cholesterol, urea, creatinine, and patient's age. There was a significant positive correlation between quinidine concentration in erythrocytes (RBC) and its total or free concentration in serum (r = 0.481, p less than 0.05 and r = 0.770, p less than 0.001); however, the RBC to free serum concentration ratio varied appreciably among patients (range of ratio value 0.117 to 0.477) and did not significantly correlate with variables such as hematocrit or age. Thus, the estimation of serum protein binding of quinidine by determining its level in RBC is, as in the case of saliva, of limited usefulness. The means of the concentration of quinidine in blood, serum (total), RBC, and saliva in five patients after an overnight fast did not differ significantly from the means of the concentration determined after the consumption of lunch. Unbound quinidine levels in serum, on the other hand, were higher in the morning (1.31 micrograms/mg vs 1.01 micrograms/mg p less than 0.01). The administration of systemic heparin to one patient did not affect quinidine concentration in the various media in a consistent manner.

Adult↗
PubMed1981

Assignment of conformation and configuration to potassium permanganate oxidation products of quinidine.

Two epimeric aldehydes [(R)- and (S)-quinidinals] and the corresponding acids[(R)- and (S)-norhydroquinidinoic acids] were prepared by the oxidation of quinidine. The alpha-alpha interactions of the carbonyl group and the aromatic moiety, as reflected in the NMR spectra, were compared with those of quinidine. NMR spectroscopic analyses made it possible to assign both the stable conformation and their configuration at C-3 to these molecules. The free hydroxyl group at C-9 must be present for the chemical shift values to be concentration dependent. These findings provide more information on association in the parent molecules.

Chemical Phenomena↗
PubMed1981

Impact of stable conformation of cinchona alkaloids on protonation site.

NMR analyses of quinidine and other cinchona alkaloids and their monoprotonated salts in deuterium oxide and in deuterochloroform revealed that the molecules assume new conformations in polar and nonpolar media, affecting the protonation site and hydrophilic-lipophilic characteristics. The ion-pair feature of the salts is lost and the molecules assume a neutral feature when they are transferred from an aqueous to a lipoid phase. Hydrophobic bonds between the molecules and their environment and within the molecule itself may affect the binding of cinchona alkaloids to membranes in biological fluids.

Chemical Phenomena↗
PubMed1980

Theophylline interference with the phosphotungstate uric acid test.

The effect of theophylline on serum uric acid measurements was studied. Serum uric acid levels were measured by the phosphotungstate method in eight healthy adults, three of whom received a single u.3-mg/kg oral theophylline dose (as aminophylline elixir) while fasting, and in 15 fasting nonuremic patients (age 14 to 51 years) on chronic oral aminophylline therapy. Uric acid levels also were measured in vitro for serum with known amounts of theophylline (0-49 microgram/ml). Serum theophylline levels were measured by high-pressure liquid chromatography for the patients receiving chronic theophylline therapy and spectrophotometrically for the subjects receiving a single oral dose. In the 15 chronic theophylline patients, actual total serum uric acid levels were not significantly different (p greater than 0.05) from those expected had they been a normal population (i.e., healthy, not receiving theophylline). Likewise, in vitro studies showed no difference in uric acid levels of serum exposed to various concentrations of theophylline. A positive correlation (r greater than or equal to 0.816) between serum theophylline and uric acid levels was found in two of the three single-dose studies, suggesting a pharmacological interaction. Therapeutic serum theophylline levels do not interfere with the measurement of serum uric acid levels by the phosphotungstate method.

Adolescent↗
PubMed1980

Drug interferences with tests performed by a 12-channel autoanalyzer.

The information reported in a variety of sources on drug interferences with routine laboratory tests (serum concentrations of sodim, potassium, carbon dioxide, chloride, glucose, BUN, cholesterol, total protein, albumin, total bilirubin, alkaline phosphatase, and SGOT) performed by a 12-channal autoanalyzer was reviewed. A determination was made whether or not the information was based on an evaluation of original articles, if the study was done in vitro or in vivo, what medium was used, if the drug level causing the interference would be encountered in a patient's serum, and if the reported conclusions were clinically significant. The review narrowed considerably the list of drug interactions with laboratory tests performed by 12-channel autoanalyzer methods. Clinically significant interactions were found for (1) aminosalicylic acid and the test for serum glucose; (2) gamma globulins and cholesterol measurement; (3) sulfonamides and paramethadione and the test for albumin; (4) albumin from placental sources and alkaline phosphatas measurement; (5) erythromycin estolate and aminosalicylic acid and the determination of SGOT; and, possibly (5) medications releasing bromide ions and the measurement of serum chloride. The study showed the need to determine the relevancy of drug interactions to the specific methods used in the laboratory of each medical institution.

Autoanalysis↗
PubMed1979

Prescribing patterns in psychiatric hospitals in Israel.

A survey conducted by pharmacists working in four psychiatric hospitals in Israel to assess the prescribing of psychotropic drugs revealed that polypharmacy was common: patients were receiving up to 11 different drugs and up to six different psychotropic drugs. The average number of psychotropic drugs per patient was two. The most popular combinations of drugs used were; one containing an antipsychotic drug(s) and an antiparkinson drug(s) and the other was a combination of more than one antipsychotic agent. Up to 30 doses per day were taken orally by one patient. Drugs that could have easily been administered on a once-a-day time schedule were often administered several times a day. Differences in prescribing patterns in the various hospitals and often times on different wards of the same institution could more easily be attributed to different educational backgrounds, habits and personal beliefs and perhaps the physician's experience as well, rather than to the types of patients treated.

Adolescent↗