Serum antibodies to lipopolysaccharide and natural immunity to shigellosis in an Israeli military population.
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Biomedical subjects
Publications and source records attributed to C Block.
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Recent development of new shigella vaccines has renewed interest in the current epidemiology of shigellosis in endemic regions. A prospective epidemiologic study of 5,774 soldiers was carried out in the Israel Defense Forces, between the months of May and September 1984. Shigellosis was found to be responsible for half the diarrhea epidemics and only rarely presented as sporadic cases of diarrhea. The epidemics occurred after exposure to field conditions, whereas under fixed military base conditions the finding of a case of shigellosis generally was not associated with an epidemic spread of the disease. It was concluded that, in this population, effective shigella vaccines may provide an important means of preventing epidemics of shigellosis in military units operating outside of permanent bases.
During 1982, a new A(H3N2) influenza virus subtype, A/Philippines/2/82, was identified, and this strain was combined with previous A(H1N1) and B influenza virus strains in the trivalent inactivated vaccine recommended for the 1983-1984 influenza season. Prior to the widescale use of this vaccine in Israel, a group of 106 young male soldiers was vaccinated under controlled conditions. Before vaccination, antibody titers greater than or equal to 1:40 were found in 14.1% against A/Philippines (H3N2), 18.1% against A/England/333/80 (H1N1), and 13.3% against B/Singapore/222/79. Two weeks following vaccination, 78.9% of the vaccinees for whom repeated blood samples were available, had antibody titers in this range for A/Philippines (H3N2), 92.9% for A/England (H1N1), and 80.0% for B/Singapore. The vaccine was only mildly reactogenic, and there were no cases of absence from work following vaccination. Thus the antibody response of young subjects to a single dose of a vaccine containing a new A(H3N2) subtype was found to be satisfactory, and the side effects experienced were minimal.
Defects in polymorphonuclear neutrophil (PMN) adherence and chemotaxis in neonates are thought to be an important cause of their increased susceptibility to overwhelming bacterial infection. Few studies of these functions have been carried out in stressed neonates who are at even greater risk of infection. PMN adherence and chemotaxis were examined in 33 stressed neonates with acute lower respiratory illness, 13 healthy neonates, and 43 healthy adults using whole blood PMN adherence and chemotaxis assays. PMN chemotaxis was significantly decreased in stressed neonates (locomotion index of 38.4 +/- 9.7 micron) compared with that of healthy neonates (48.9 +/- 12.8 micron, p less than 0.01) or adults (61.6 +/- 11.9 micron, p less than 0.001). PMN chemotaxis was studied during illness and recovery in 13 of the 33 stressed neonates and showed significant improvement during recovery (41.6 +/- 9.9 and 53.2 +/- 11.9 micron, respectively, p = 0.012). PMN adherence was decreased in stressed neonates (1.4 +/- 1.6%) compared with that of adults (12.3 +/- 11.4%, p less than 0.01) but was similar to that of healthy neonates (1.1 +/- 1.4%). These findings suggest that further impairment of PMN chemotaxis in stressed neonates helps account for their increased susceptibility to overwhelming bacterial infection.
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A 33-year-old fish fancier developed a protracted skin infection that ultimately was found to be caused by Mycobacterium marinum. The organism was isolated from the lesion as well as from infected fish taken from his home aquarium. The lesion resolved after a six-week course of oral sulfamethoxazole and trimethoprim. Forty-four additional cases of culture-proved M marinum skin infections acquired from aquariums and reported in the English-language literature are reviewed. Almost universally, the lesions remained circumscribed and were either single nodular (14 patients) or multiple sporotrichoid (31 patients). Diagnosis was supported by acid-fast smears (15 patients) and isolation of the organism from skin lesions (43 patients) or from fish (two cases). In vitro studies, as well as clinical outcomes, suggest sulfamethoxazole-trimethoprim or ethambutol hydrochloride plus rifampin to be the drugs of choice.
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Passive dilatation, advocated in the past by a number of gastroenterologists as the initial therapy for achalasia, has fallen into disrepute in the last 15 years. Our recent experience with five achalasia patients, four of whom were judged too fragile for esophageal myotomy or forcible dilatation, indicates the need for reappraisal of bougienage therapy.
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A multicentre study of antibiotic susceptibility was performed in South Africa. Sensitivity to cephalothin, cefamandole, tobramycin and gentamicin was tested on a variety of aerobic and anaerobic bacteria. Two disc susceptibility techniques were used, i.e. the Kirby-Bauer technique (aerobes) and the broth-disc method (anaerobes); minimum inhibitory concentrations (MICs) were determined according to the International Collaborative Study techniques, and regression lines for individual centres were constructed. Satisfactory lines were obtained for cephalosporins, but, in some centres, problems were experienced with the aminoglycosides. Variations in MICs for Haemophilus influenzae were probably due to an inoculum effect. Accumulative percentage tables of the number of strains inhibited were compiled, and the comparative performance of the antibiotics was assessed.
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