Meats from ratite family receive inspection.
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Animals↗
Biomedical subjects
B Kaplan
Publications and source records attributed to B Kaplan.
Calcium-dependent and -independent binding of the pentraxin serum amyloid P component to glycosaminoglycans and amyloid proteins: enhanced binding at slightly acid pH.
Serum amyloid P component (SAP), a member of the pentraxin family of proteins, binds calcium-dependently to several ligands including glycosaminoglycans (GAG's). We have investigated the influence of pH on the Ca2(+)-dependent binding of SAP to solid phase GAG's and amyloid fibril proteins (AA and beta2M) by ELISA. An increase in the dose-dependent binding of SAP to heparan sulfate, AA-protein and beta2M was observed as the pH decreased from 8.0 to 5.0. Furthermore, a lower, but significant Ca2(+)-independent binding of SAP to heparan sulfate, dermatan sulfate, AA protein and the amyloid precursor protein beta2M was observed. This binding was also enhanced at slightly acid pH, most pronounced at pH 5.0. The results of this study indicate that SAP can exhibit both Ca2(+)-dependent and -independent binding to ligands involved in amyloid fibril formation and that the binding is enhanced under conditions of slightly lowered pH.
Amyloid↗
FSIS consolidates to improve services.
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Animals↗
Prevention is best against foodborne illness.
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Animals↗
The role of PCR in the diagnosis and management of CMV in solid organ recipients: what is the predictive value for the development of disease and should PCR be used to guide antiviral therapy?
Cytomegalovirus remains a significant source of morbidity and mortality in immunocompromised hosts. The increased sensitivity of molecular diagnostic techniques (PCR, antigenemia) has resulted in our ability to detect viral replication earlier in the posttransplant period, before the onset of symptoms. With the advent of effective antiviral therapy, "preemptive therapy," guided by sensitive, early and specific predictors of CMV disease, has become a realistic objective. Although multiple studies have analyzed the sensitivity and specificity of these tests, their predictive value for the development of disease has not been defined. The purpose of this study was to evaluate the predictive value of a positive CMV PCR in the setting of solid abdominal organ transplantation. A total of 476 PCR assays were performed on 134 transplant recipients (102 kidney, 19 kidney/pancreas, 11 liver, 2 other) either as protocol serial samples or as dictated by clinical events. All samples were concomitantly analyzed using standard virological assays for CMV including culture, shell vial, and serology. Patients with any CMV seropositive donor/recipient (D/R) combination received ganciclovir prophylaxis in conjunction with antilymphocyte induction for 14 days. No subsequent CMV prophylaxis was used. The positive predictive value was 55% in all seropositive donor/recipient combinations. The highest risk group (seronegative recipient of seropositive donor) showed the highest positive predictive value, whereas seropositive recipients of either seropositive or seronegative donors showed positive predictive values of 45% and 25%, respectively. Negative predictive value was 100% for all groups. Early detection of CMV infection has important implications for patient management, including preemptive therapy, which can be guided by PCR, especially in high risk (D+/R-) patients.
Acyclovir↗
Preimplantation diagnosis of single gene disorders by two-step oocyte genetic analysis using first and second polar body.
Previous work on preimplantation genetic diagnosis (PGD) of single gene disorders by the first polar body (IPB) analysis has demonstrated that the genotype of a considerable number of embryos resulting from heterozygous oocytes cannot be predicted without testing their second PB (IIPB). To overcome this limitation we introduce a two-step DNA analysis of oocytes using both IPB and IIPB to identify hemizygous mutation-free oocytes following the second meiotic division. In the application of the approach to PGD of cystic fibrosis (CF) Delta F-508 mutation, sickle cell disease, and hemophilia B, 80 oocytes were studied by both PBs, resulting in the identification and transfer of 32 homozygous normal embryos. A follow-up genotyping of 52 embryos, resulting from oocytes tested by both IPB and IIPB demonstrated the accuracy of the predicted genotypes. In addition to a nested PCR analysis of the mutant genes in PBs and resulting embryos, simultaneous amplification of different polymorphic markers was performed, demonstrating the reliability of the two-step polar body analysis of oocytes.
Alleles↗
Single-dose systemic oral fluconazole for the treatment of vaginal candidiasis.
OBJECTIVES: To evaluate the acceptance of fluconazole given in a single oral dose, for the safe, effective treatment of vaginal candidiasis. METHODS: A total of 428 patients who had a first or recurrent episode of vaginal candidiasis diagnosed clinically or by culture, were offered treatment with fluconazole by 40 primary care gynecologists who were unfamiliar with fluconazole treatment of vaginal candidiasis. The efficacy of this treatment was evaluated by both physicians and patients. RESULTS: Most of the physicians (72%) and most of the patients (69%) found the drug effective in relieving or at least alleviating the signs and symptoms of the disease. The majority of patients (83.5%) rated it better than other drugs they had received for vaginitis in the past. No recurrences were noted at the 6-week follow-up. CONCLUSIONS: Fluconazole has been found effective by physicians and patients. Both physician willingness to use it and patient compliance are satisfactory.
Administration, Oral↗
Transvaginal ultrasound in patients with low beta-human chorionic gonadotropin values: how often is the study diagnostic?
STUDY OBJECTIVE: To determine how often pelvic ultrasonography diagnoses or excludes ectopic pregnancy (EP) in patients who present with abdominal pain or vaginal bleeding and a beta-human chorionic gonadotropin (beta-hCG) level lower than 1,000 mIU/mL. METHODS: This was a retrospective chart review of all patients who presented to the ED of an urban teaching hospital from August 1991 through July 1995 with lower abdominal pain or bleeding, a positive beta-hCG assay, and a quantitative beta-hCG value lower than 1,000 mIU/mL in whom pelvic transvaginal ultrasound was performed within 24 hours of the ED visit. Ultrasound procedures were performed in the radiology department by ultrasound technicians under the direct supervision of an attending radiologist or resident in radiology. Patients were excluded if they had recently delivered or undergone dilatation and curettage, had had a previous ultrasound examination during this pregnancy, had decreasing beta-hCG values, or were lost to follow-up before a definitive diagnosis was made. RESULTS: : A total of 111 patients met the inclusion criteria; 19 patients (17%; 95% confidence interval [CI], 10% to 24%) had diagnostic ultrasound findings. Of these, 10 findings were diagnostic of intrauterine pregnancy and 9 for EP. The beta-hCG values for the patients with diagnostic examinations ranged from 47 to 995 mIU/mL. Twenty-three study patients ultimately received a diagnosis of EP; of these, 9 (39%; CI, 19% to 59%) had a diagnostic initial ultrasound study. Five of the nine had beta-hCG values lower than 500 mIU/mL. CONCLUSION: Approximately one third of women with EP who present with beta-hCG values lower than 1,000 mIU/mL were identified with an urgent transvaginal ultrasound examination performed by trained ultrasound technicians. Clinicians should consider the use of pelvic ultrasound in patients with suspected EP, regardless of their beta-hCG values, particularly at institutions where ultrasound is readily available.
Chorionic Gonadotropin, beta Subunit, Human↗
Amino-terminal identity of co-existent amyloid and non-amyloid immunoglobulin kappa light chain deposits. A human disease to study alterations of protein conformation.
Tissue deposition of monoclonal immunoglobulin light chains is a serious complication in some patients with B cell proliferative disorders. The deposits are typically fibrillar and Congophilic in amyloid (AL) and non-fibrillar and Congophobic in light chain deposition disease (LCDD), and rarely coexist in the same patient. From post-mortem tissue of an individual with fibrillar and non-fibrillar kappa light chain deposits in different sites, we separately extracted and analysed biochemically and immunochemically the non-amyloid deposits from isolated glomeruli, the amyloid from isolated renal arteries and the amyloid from myocardium in which the only deposits were amyloid restricted to mural arteries. Western blotting analysis of both the extracted amyloid and the non-amyloid deposits demonstrated 25-kD bands immunoreactive with anti-kappa antibody, and the identity of the N-terminal amino acid sequences that belong to the variable region kappaIV light chain subgroup. This is the first human disease in which antigenically similar but morphologically different deposits have been separately biochemically analysed. We propose that combined LCDD and AL is an ideal human disease to study the relationships and the factors that influence the conversion of non-amyloidogenic to amyloidogenic conformations.
Aged↗
Increased number of IGF-I receptors on erythrocytes of women with polycystic ovarian syndrome.
OBJECTIVE: To test the hypothesis that insulin acts though ovarian IGF-I receptors to produce excessive amounts of androgens in polycystic ovarian syndrome (PCOS), by measuring the binding capacity of IGF-I receptors on erythrocytes and relating the findings to the degree of hyperandrogenism and hyperinsulinaemia. DESIGN: A case-control study of IGF-I receptors on erythrocytes of women with PCOS and age- and weight-matched controls. PATIENTS AND METHODS: IGF-I receptors on erythrocytes, serum levels of androgens, IGF-I, GH, basal insulin and insulin response during oral glucose tolerance test (oGTT) were measured after induced or spontaneous withdrawal bleeding in 10 women with PCOS and eight normo-ovulatory women. RESULTS: An increased number of IGF-I receptors was found on erythrocytes of patients with PCOS compared with the controls (P < 0.01), irrespective of their body mass index. Serum IGF-I levels were similar in both groups. The degree of hyperinsulinaemia, provoked by oGTT, correlated positively with basal insulin (r = 0.69; P = 0.003), but not with the number of IGF-I receptors. However, the number of IGF-I receptors correlated positively with androstenedione (r = 0.54, P = 0.0018). CONCLUSIONS: The findings in the present study that the number of IGF-I receptors and not the insulin levels correlate with serum androstenedione support the theory that the hyperandrogenism in PCOS is not a direct effect of the hyperinsulinaemia, but IGF-I mediated.
Adolescent↗
Effect on fetal circulation of low-dose aspirin for prevention and treatment of pre-eclampsia and intrauterine growth restriction: Doppler flow study.
The use of low-dose aspirin for the prevention and treatment of pre-eclampsia and intrauterine growth restriction has been studied extensively during the last 10 years. The large clinical trials do not support routine prophylaxis or therapeutic administration of low-dose aspirin in high-risk pregnant patients. We report on 87 Israeli women who were recruited for the CLASP study (a collaborative trial for the prevention and treatment of pre-eclampsia and intrauterine growth restriction). Of these women, 41 were treated with 60 mg aspirin daily, and 46 with placebo. The fetal circulation was evaluated by repeated Doppler flow waveform measurements of the umbilical artery and descending aorta from 20 to 34 weeks of gestation. The peak-systolic/ lowest-diastolic velocity ratio, pulsatility index and resistance index were calculated. No significant differences in Doppler measurements were observed for any of the indices between the aspirin and placebo groups. There were no statistically significant changes in the flow parameters during the course of pregnancy in any of the women studied, nor was there a correlation between waveform analysis and pregnancy outcome. Thus, based on the present results, it appears that low-dose aspirin does not improve fetal circulation parameters.
Adult↗
Isolated persistent fetal bradycardia in complete A-V block: a conservative approach is appropriate. A case report and a review of the literature.
Persistent fetal bradycardia is rarely encountered during pregnancy. When it is associated with a complete atrio-ventricular (A-V) block, it may prove dangerous to the fetus or newborn. The prenatal diagnosis is vital because it necessitates close follow-up during pregnancy to detect fetal compromise and proper preparation for delivery. We describe a woman who was found to be suffering from systemic lupus erythematosus during pregnancy. The fetus was diagnosed as having persistent fetal bradycardia due to complete A-V block at 28 weeks of gestation and was delivered at term with conservative management. The problems entailed in managing pregnancy and delivery of such fetuses are discussed.
Adult↗
Interleukin 1beta in serum of women with preterm uterine contractions.
Preterm delivery is a major obstetric and public health problem, accounting for 50-70% of all perinatal deaths. An enzyme-linked immunoassay (ELISA) test was used to determine serum interleukin 1b (IL-1b) levels in 32 women with preterm contractions compared with 26 women in term labour and 11 normal preterm pregnant women. Women with preterm contractions (with or without treatment) had significantly lower mean serum levels of IL-1b (23.5 pgr/ml) compared with women in term labour (218 +/- 57 pgr/ml), but similar levels to pregnant women not in labour at the same weeks of gestation.
Journal Article↗
Grand multiparity-is it an obstetric problem?
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Letter↗
Overall cost in the treatment of otitis media.
BACKGROUND: Numerous antimicrobial agents are available for treatment of otitis media (OM); however, little is known about the relative cost effectiveness of these drugs. METHODS: We developed a noninvasive, observational model to assess the total costs (direct and indirect) associated with commonly used antibiotics in the therapy of OM. We also gathered data on recurrence rates, which can significantly affect costs. RESULTS: The average total cost of treating an episode of OM in this study was $115.80. Treatment of a recurrent OM episode was significantly more costly than treatment of an initial episode ($124.64 vs. $107.81, P = 0.0001). This study suggests that significant costs are associated with OM treatment and that antibiotic price constitutes only a small portion of this cost. Recurrence rates appeared to vary with various antibiotic treatments. CONCLUSION: We conclude that recurrence is a major determinant of OM treatment costs. Drugs associated with lower rates of recurrence will usually be the most cost-effective treatment options.
Anti-Bacterial Agents↗
Pharmacoeconomic impact of factors affecting compliance with antibiotic regimens in the treatment of acute otitis media.
BACKGROUND: The total cost of treating otitis media in the United States alone is estimated at > 3.5 billion dollars annually. Therefore treatment approaches that reduce the cost of managing otitis media can have a large impact on overall health care costs. METHODS: In this study cost effectiveness factors of various antimicrobial agents, such as adverse events and overall patient acceptance, were examined. RESULTS: Decreased patient acceptance and higher incidence of adverse events had a negative impact on the cost of treatment. Amoxicillin/clavulanate, cefprozil, erythromycin/sulfisoxazole and trimethoprim/sulfamethoxazole were found to be associated with decreased patient acceptance compared with cefixime. Cefixime also had the lowest number of adverse events of any of the drugs used. Amoxicillin had the lowest total cost for a single course of treatment, exclusive of costs of recurrence, which were examined in a previous study. CONCLUSION: This study concluded that in cases in which several antibiotics may be clinically effective, comparative tolerability and patient acceptance data should be considered for selection of appropriate therapy. High compliance and lower morbidity can result in lower costs and better quality of life.
Acute Disease↗
Diagnosis, prophylaxis, and treatment of headaches in the athlete.
BACKGROUND: Headaches are a common entity in the ambulatory population. Physicians involved in sports medicine must be able to accurately diagnose headaches in athletes and whether they are exacerbated by exertion. Many medications have proven or theoretical negative effects on athletic performance. Thus, we should consider all aspects of medical management and determine which therapy is least intrusive to the athlete's performance. We planned this review because of the small number of papers available on the effects of various medications on athletic performance. METHODS: We used MEDLINE to search from 1992 to current citations, using the medical subject headings of headache, prophylaxis, treatment, review, athletes, and exercise, alone or in combination. RESULTS: Fifty-two articles were identified and deemed appropriate for inclusion in this review. CONCLUSIONS: Acute therapy for tension headaches in the athletic population is best done with nonsteroidal anti-inflammatory drugs. Prophylaxis of chronic, recurrent tension headaches is best accomplished by night-time tricyclic antidepressants (especially nortriptyline) or selective serotonin reuptake inhibitors. Acute therapy for athletes with migraines is best managed with sumatriptan or DHE 45 and prophylaxis can be accomplished with verapamil, antidepressants, or valproate. Exertional, cluster, and structural/infectious headaches are also discussed briefly.
Analgesics, Non-Narcotic↗
Scar revision.
BACKGROUND: Scars of cosmetic or functional importance may form following cutaneous surgery, trauma, or inflammation. Many factors interplay in the formation of these scars. Knowledge and proper planning can help eliminate these consequences. Various scar revision techniques, both surgical and nonsurgical, are now available for treating undesirable scarring. OBJECTIVE: To review the various scar revision options for the various types of scars. LEARNING OBJECTIVE: After reading this review the participant should have a better approach and understanding of the appropriate scar revision techniques.
Cicatrix↗