Search PubMed⌕ Search

Biomedical subjects

A M Yinnon

Publications and source records attributed to A M Yinnon.

68 records · Page 4Linked to original sources
PubMed1993

Effect of age and duration of disease on the clinical manifestations of brucellosis. A study of 73 consecutive patients in Israel.

We describe our experience with 73 patients diagnosed with brucellosis during the years 1979-91 at two Jerusalem hospitals: Hadassah Mount Scopus (37 patients from 1979-1984) and Shaare Zedek (36 patients from 1979-1991). The patients included 32 children less than 14 years old and 41 adults; 70 of the patients were non-Jews. In all cases the pathogen was Brucella melitensis. The high proportion of children and the equal sex distribution was quite different from the age and sex distribution of brucellosis in Western countries where it is more common in adult males, and similar to that reported from other near-Eastern countries where household dairy products, and not occupational exposure, are the most common source of infection. The short duration of disease (< 2 weeks) prior to diagnosis in 70% of the patients is attributed to the ready availability of appropriate medical care, and a very high index of suspicion for brucellosis in the Jerusalem non-Jewish population. Abdominal symptoms were more common in adults, whereas enlarged lymph nodes and liver, skin rash and pharyngitis were more frequently observed in children. Some of these differences may be attributed to the very short duration of disease in most children at the time of presentation. Combination therapy with tetracycline-streptomycin or tetracycline-rifampin yielded superior results as compared with single-drug treatment in terms of early defervescence and relapse rates. The present experience underlines the importance of endemic brucellosis which still represents a significant public health problem in children and adults in Mediterranean countries.

Adolescent↗
PubMed1992

A practical intervention programme aimed at decreasing high serum cholesterol levels in primary care.

A practical, primary care based intervention programme which aimed to lower serum cholesterol in a large percentage of hypercholesterolaemic subjects in general practice is described. Intervention consisted of a 8-10 minute interview supplying oral and written diet counselling. The programme was tried in a kibbutz (agricultural settlement) with 93 adult members: 89 had their serum cholesterol determined, 35 of whom (39%) were hypercholesterolaemic--19 had borderline high cholesterol (5.2-6.2 mmol/l), 16 had definitely high cholesterol (greater than or equal to 6.2 mmol/l). Repeat blood samples were taken from 33 of the 35 hypercholesterolaemic patients 6-9 months after exposure to the intervention programme. The initial cholesterol level of the hypercholesterolaemic group was 6.31 +/- 0.2 mmol/l (mean +/- SE): at follow up it was 5.3 +/- 0.2 mmol/l (P less than 0.001), a decrease in serum cholesterol (mean 22.2 +/- 2.1%) being seen in 28 of 33 patients (84%). In 19 patients (58%) cholesterol dropped to normal values, and in six additional cases (18%) it fell to borderline values. These data suggest that high cholesterol levels in otherwise normal adults may be reduced with little effort by the primary care physician and nurse.

Adult↗
PubMed1992

Quality of sleep in the medical department.

The quality of sleep in 134 patients admitted to two medical departments and an intensive coronary care unit was studied by comparing pre- and post-admission sleeping scores. Four aspects of sleep have been evaluated: duration of sleep; number of awakenings; personal assessment of quality of sleep; and the need for using sleeping pills. Results were expressed in scores ranging from 1 (worst) to 4 (best). A significant reduction in the mean quality of sleep for the entire group was found for all scores employed (P < 0.01-P < 0.001). Of the 134 patients, 51% had a reduction in post-admission total sleep score (23 +/- 3%, mean +/- SE); 31% had no change or mixed trends in the various scores, with a change in total sleep score not exceeding 3 +/- 3%; and 18% had an improved total sleep score (16 +/- 2%). Of the individual scores, a deterioration was found in the following order of frequency: number of awakenings (37%); personal assessment of quality of sleep (32%); duration of sleep (31%); and the need for using sleeping pills (26%). Of the reasons specified for impaired quality of sleep, the most important were noise made by other patients or by the medical staff (47%), and the patient's own disease (30%). Significant differences in the quality of sleep between the two medical departments located in different hospitals have been encountered (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Fever and chills caused by nitrofurantoin taken after sexual intercourse.

Nitrofurantoin is one of many antibiotics used in the treatment of urinary tract infections (UTI). The drug is also used for the prevention of recurrent UTI in women. We report a case of nitrofurantoin drug fever associated with its use, following sexual intercourse, for chemoprophylaxis of UTI. The intermittent appearance of the side effects due to the occasional use of antibiotics, such as in this case, may easily lead to misdiagnosis.

Adult↗
PubMed1990

Chronic use of hypnotics in a family practice--patients' reluctance to stop treatment.

Insomnia is a common symptom in family practice, and hypnotics are frequently prescribed for its treatment. A survey was performed in an urban clinic serving 1900 persons in order to detect the prevalence of this disorder and to reassess the need for hypnotics. Sixty-one patients were identified who were taking prescribed hypnotic drugs, mainly benzodiazepines. All were over the age of 40, and they comprised 8.1% of this age group. Forty-five were chronic users, taking hypnotics for more than 4 months during a 6-month study period. Eighty-nine percent of these chronic users were above 60 years of age. Seventy-seven percent had difficulty initiating sleep and 23% had problems maintaining sleep. Information was given to these patients on the side effects and possible addictive nature of chronic hypnotic use. Different kinds of psychological support were offered as alternatives to drug treatment, but these were refused by all. We conclude that in view of the addiction associated with chronic use and the difficulty of weaning patients off the sleeping pill, there is a place for more careful evaluation and management before hypnotics are prescribed.

Adult↗
PubMed1990

Postpartum renal failure in systemic lupus erythematosus.

The present report describes an unusual association between postpartum renal failure and systemic lupus erythematosus. Two healty young women developed progressive renal failure several weeks after delivery accompanied by the presence in their serum of strongly reactive anti-nuclear antibodies and positive anti-DNA antibodies. In both cases kidney biopsy disclosed light and electron microscopy pictures typical of idiopathic postpartum renal failure, with multiple intravascular thrombi and no evidence of active lupus nephritis. Intrarenal microthrombi formation may represent a form of exacerbation of systemic lupus erythematosus after delivery. The early recognition of this syndrome may have therapeutic implications.

Acute Kidney Injury↗
PubMed1989

Antimalarial effect of HBED and other phenolic and catecholic iron chelators.

Previous studies showed that deferoxamine inhibits malaria by interacting with a labile iron pool within parasitized erythrocytes. Consequently, we studied the antimalarial properties of other iron-chelating drugs such as 2,3-dihydroxybenzoic acid (2,3-DHB) and its methyl ester as well as two polyanionic amines, N.N'-bis (o-hydroxybenzyl) ethylenediamine-N,N'-diacetic acid (HBED) and N,N'-ethylenebis(o-hydroxyphenylglycine) (EHPG) in rats infected with Plasmodium berghei. All drugs were delivered by subcutaneous injection at 8-hour intervals, 40 mg per animal per day. All animals receiving N,N'-ethylenebis(o-hydroxyphenylglycine) died of drug toxicity between days 6 and 11. Peak parasitemia on day 11 of infection was 32.8% in control animals; 25.3% with methyl 2,3-DHB, 15.5% with 2,3-DHB, 8.0% with deferoxamine, and 0.9% with HBED. Subsequent studies of HBED and deferoxamine in P falciparum cultures in human erythrocytes showed a marked suppression of parasite counts by both drugs at concentrations of greater than 5 mumol/L. At all concentrations tested, HBED was four to five times more effective than deferoxamine in suppressing parasite counts. The superior antimalarial activity of HBED is attributed to its increased lipophilicity and higher affinity to ferric iron. These findings indicate that selective iron deprivation by interaction with an intracellular chelator may represent a novel approach to antimalarial drug development, and that systematic screening of available iron-chelating drugs may result in identification of potentially useful antimalarial compounds.

Animals↗
PubMed1988

Koilonychia of the toenails in children.

Two hundred twenty-four children were examined for koilonychia of the toenails. Koilonychia was encountered in 55 out of 171 (32%) kibbutz children compared with 9 out of 53 (17%) of urban children (p less than 0.046). The most likely explanation for the increased prevalence of koilonychia in kibbutz children is habitual minor trauma associated with barefoot walking and frequent water immersion.

Age Factors↗
PubMed1988

Factitious injury of an extremity: a Munchausen variant.

Self-induced injury of one or more of the extremities may represent a distinct variety of Munchausen syndrome. The nature of the injury may be infectious, dermatologic or orthopedic. The mechanism may be secondary gain or another unconscious motivation that causes a craving for attention. In many cases, the underlying psychopathology is personality disorder.

Abscess↗
PubMed1986

Medical problems in Ethiopian refugees airlifted to Israel: experience in 131 patients admitted to a general hospital.

Within a 2 month period 131 Ethiopian immigrants were admitted for treatment at a general hospital in Jerusalem. There were 52 patients with malaria, 13 with typhoid fever, 24 with pneumonia, seven with tuberculosis, nine with shigella and 11 with campylobacter. Over three-quarters of these patients were anaemic. In the majority of cases anaemia was normocytic and was most probably secondary to malaria and other intercurrent infections. The prevalence of diffuse non-toxic goitre was 7% in children and 19% in adults with a male to female ratio of 4:13. A positive rapid plasma reagin (RPR) test was found in 4% of sera tested and a positive HBsAg in 13%. IgG antibodies to HBc antigen were found in 75% of subjects. All patients with infectious diseases responded to therapy and, despite their poor condition at arrival, there were no fatalities and no late sequelae. The high HBsAg carrier state calls attention to the risk of vertical transmission by infected mothers and underlines the need for active immunization of infants at risk. The high prevalence of untreated tuberculosis and malaria poses a potential public health hazard, but with the current systematic screening of this population leading to identification and effective treatment of affected subjects, chances for the practical eradication of malaria and tuberculosis are excellent. Finally, the large scale transfer of a population from rural Africa to a modern and largely urban society presents a unique opportunity for a prospective study of the impact of environment on the emergence of diseases which plague modern society such as diabetes, atherosclerotic cardiovascular disease, hypertension and cancer.

Adolescent↗
PubMedDate not supplied

Comparison of peritoneal fluid culture results from adults and children undergoing CAPD.

BACKGROUND: Peritonitis is a common complication in patients with end-stage renal disease treated by continuous ambulatory peritoneal dialysis (CAPD). Empirical treatment is based on the organisms that are most frequently isolated and their susceptibilities. OBJECTIVE: To analyze and then compare peritoneal fluid culture results from adult and pediatric patients on CAPD, with respect to micro-organisms and antimicrobial susceptibilities. DESIGN: Three-year retrospective review of peritoneal fluid cultures from adults and children on CAPD. RESULTS: We isolated 481 organisms from 378 peritoneal fluid specimens, collected from 135 patients (45 children, 90 adults). There were 191 episodes of peritonitis in children (mean 4.2+/-3.5, range 1 - 15) compared to 187 in adults (2.1+/-1.9, range 1 - 10) (p< 0.001). Two or more episodes occurred in 30 of 45 children (67%) compared to 33 of 90 adults (37%) (p < 0.001).The number of different organisms/patient as well as the total number of isolates/patient were significantly greater in children (respectively, 2.8+/-2.3, range 1 - 12; and 5.3+/-5.2, range 1 - 27) than in adults (2.0+/-1.3, range 1 - 6; and 2.7+/-2.4, range 1 - 10) (p< 0.005). After Staphylococcus epidermidis, S. aureus was the most frequently isolated organism, occurring in 18% of episodes in adults and 12% of episodes in children (p< 0.01). Twenty-two of 33 fungal isolates (67%) in children were Candida parapsilosis compared to 3 of 24 (12%) in adults (p < 0.001). Subanalysis of multiple episodes revealed that Pseudomonas and Candida occurred significantly more often in children (p< 0.01), whereas S. aureus occurred more often in adults (p< 0.001). In polymicrobial episodes S. epidermidis occurred more often in adults (p < 0.05). Significant differences in susceptibilities to ampicillin, ceftriaxone, chloramphenicol, and gentamicin were found between children and adults (p< 0.05 - 0.001). CONCLUSIONS: CAPD-associated peritonitis occurs significantly more often in children than adults. Significant differences in microbial etiology and susceptibilities were found between pediatric and adult patients. Each dialysis unit should periodically analyze peritoneal fluid culture results from its CAPD patients. These data can then be used for optimization of empirical antimicrobial therapy of peritonitis.

Adult↗