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T Stopler

Publications and source records attributed to T Stopler.

7 recordsLinked to original sources

Outbreak of pertussis in a closed population with a high vaccination rate.

An outbreak of pertussis encompassing 78 cases in a population of 964 persons living on kibbutz is described. The attack rate was 36.1% among children aged 4 to 11 years, although all had been fully vaccinated. Female predominance and seasonal incidence conformed with what has been reported in the literature. The age distribution, however, was markedly different from that usually observed, indicating that local factors may influence the epidemiology of whooping cough. Despite the seeming paradox of the disease breaking out in a population with a high immunization rate, our results suggest that the vaccine had a protective effect in all age-groups. The incidence of pertussis in Israel in 1987 was considerably higher than that in the United States for the same year, and raises the question of changing the recommendations for vaccination here.

Adolescent

Low holotranscobalamin II is the earliest serum marker for subnormal vitamin B12 (cobalamin) absorption in patients with AIDS.

In AIDS, as previously found in pernicious anemia (PA), the earliest serum marker of subnormal vitamin B12 (cobalamin) absorption, and therefore of negative B12 balance, is low serum holotranscobalamin II (holo-TC II; B12-TC II) despite normal total serum B12 level, normal serum homocysteine, and normal classic (oral free radio-B12) Schilling test. This may be accompanied by subtle and insidious damage to hematopoietic, immunologic, neuropsychiatric, nutritional and alimentary systems, confirmed by correction on therapeutic trial with B12 therapy. Our studies suggest such selective B12 deficiency occurs in about half of the HIV-1 infected, in part due to frequent depression of B12 absorption by HIV-1 attack on the gastric mucosa and/or opportunistic infection attack on the small bowel, and in part due to a telescoping of the continuum of the stages of negative B12 balance in relation to damage to B12 delivery by the infective and/or systemic disease process. In AIDS, when total serum B12 is normal despite tissue depletion of B12, if the classic Schilling test does not reveal subnormal food B12 absorption, the food Schilling test does. We hypothesize that DNA-synthesizing cells of the hematopoietic, immunologic, neurologic and other systems which have surface receptors solely for holo-TC II, and which have low B12 stores, rapidly become dysfunctional due to B12 deficiency when holo-TC II is low, while cells (such as liver cells) which also have surface receptors for holohaptocorrin (B12-haptocorrin) remain B12-replete. We believe this to be another example of the concept of selective nutrient deficiency in one cell line but not another.

Absorption

Resistance of Mycoplasma pneumoniae to macrolides, lincomycin and streptogramin B.

Of four strains of Mycoplasma pneumoniae, highly resistant to erythromycin and related antibiotics, three were homogeneously resistant, but the fourth showed heterogeneous resistance, with only 1% of the cells manifesting this property. Stable, homogeneous resistance was generated in this strain in the presence of erythromycin, whereas the heterogeneous resistance was lost spontaneously on passage in the absence of antibiotics, or on treatment with acridine orange. The mechanism of induction of stable resistance appears to be different from that seen in Staphylococcus aureus.

Acridine Orange

Use of a combined DTP-polio vaccine in a reduced schedule.

A five-year serologic follow-up and a four-year monitoring of the polio and pertussis morbidity in an area immunized with a 2 + 1 dose schedule of a combined DTP-Po vaccine have shown that: the individual protection against polio measured by the presence of neutralizing antibody persists at a very adequate level five years after the first booster; after three years of a steady high proportion of children with pertussis antibody, a considerable drop is observed and in about 28% of individuals agglutinin levels of less than 1:20 were found five years after booster; the community protection against paralytic poliomyelitis and pertussis is satisfactory up to four years after the introduction of the program. Continuation of immunization with a 2 + 1 dose schedule at a maximal coverage and close seroepidemiologic surveillance are necessary in order to draw definite conclusions, because of the potentially strong impact of very dynamic ecological factors present in our geopolitical area upon the agent-host interrelationship.

Agglutination Tests

A modified schedule for routine pertussis immunization.

As part of a study with a quadruple inactivated vaccine (diphtheria-pertussis-tetanus-polio), the serologic response to the pertussis antigen was investigated in infants at the age of routine immunization, inoculated with one of the following two regimens: either 0.5 ml vaccine at 2 and 3 1/2 months and a booster six months later, or an identical dose of vaccine given at 2, 4 and 6 months and a booster at the age of 12 months. A pertussis agglutination titer of greater than or equal to 1:10 was considered an immune response to the administration of the antigen. Two basic doses of pertussis antigen induced an immune response in about 92% of children, which was very close to that following three basic doses. A 100% seroconversion was observed in both groups one month after the booster dose, and geometric mean values were high in both regimens. At one and two years after the booster, the pertussis agglutinins were present in 100% of children of both groups, with higher geometric mean values in the group given the three basic doses regimen.

Age Factors