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Biomedical subjects

C M Kunin

Publications and source records attributed to C M Kunin.

At least 199 records · Page 11Linked to original sources
PubMed1967

Distribution of cell receptors and simple sugar inhibitors during encephalomyocarditis virus-cell union.

Encephalomyocarditis (EMC) virus was studied for ability to agglutinate erythrocytes of various species. Human, rat, and guinea pig erythrocytes, as well as those from young rabbits, were readily agglutinated. Cells from older rabbits absorbed virus poorly, and showed little agglutination. Uptake of virus by rabbit brain also diminished with age. Various mouse tissues absorbed virus about equally well. Hemagglutination-inhibition studies demonstrated that a number of simple sugars, particularly glucose and galactosamine, interfered with uptake of virus by cells. Dextran sulfates were highly active inhibitors of EMC hemagglutination. Attempts to localize the site of action of the sugars on virus or cell are described. Treatment of virus with periodate or p-chloromercurobenzoate, and acetylation of virus, inhibited hemagglutination, but acetylation of semipurified receptor did not. Clarification of the nature of the virus-cell union will require studies to identify possible specific sugars in the virus capsid and the cell receptor.

Amino Sugars↗
PubMedDate not supplied

Report of a symposium on use and abuse of antibiotics worldwide.

A collaborative symposium of the Quality of Care and Technologies Programme of the World Health Organization's Regional Office for Europe and the Department of Hospital Epidemiology of the University Hospital, Freiburg, was held in Freiburg, FRG, in September 1988 to consider the use and abuse of antibiotics worldwide. Participants from developing countries provided estimates of use of antibiotics and problems of resistance in their countries. Because much of the information either is anecdotal or may not be representative of the vast, heterogenous populations in these countries, it is difficult to provide exact guidelines for the use of antibiotics. There is a need for better etiologic definition of the causes of acute respiratory tract infection and diarrheal disease and for surveillance of resistant bacterial strains. Because of the difficulty of making an etiologic diagnosis, a set of empiric guidelines has been developed for diagnosis and management of common conditions. Recommendations for the use of antibiotics must take into account the economics, medical manpower, social constraints, and emergence of resistant bacteria in both developed and developing countries. There is a need to establish a coordinated, worldwide network to obtain representative data and to organize clinical trials pertinent to the conditions of both developed and developing countries to define the best antimicrobial agent(s), the dosage, and duration of treatment for specific conditions.

Anti-Bacterial Agents↗
PubMedDate not supplied

The path to new FDA guidelines for clinical evaluation of anti-infective drugs.

This article describes the current collaborative effort of the U.S. Food and Drug Administration and the Infectious Diseases Society of America to generate new general and disease/organism-specific guidelines for the evaluation of anti-infective agents. The description includes examples of proposed changes from draft documents. If approved and implemented, the envisioned changes should enable investigators and sponsors to improve the quality of clinical trials of anti-infective drugs. The ultimate goal is to provide physicians with the best information about new drugs and thus to enhance the care of patients with infectious diseases.

Anti-Infective Agents↗
PubMedDate not supplied

Dosage schedules of antimicrobial agents: a historical review.

Methods that may be used to design rational dosage schedules of antimicrobial agents are reviewed. Most current schemes are empiric and have not been tested in humans by classic dose-response trials. In some instances, agents whose half-lives in serum differ by as much as 10-to 18-fold are usually given at the same dosage, with the same interval between doses. New derivatives given less frequently may thus appear to be equal in effectiveness to the parent compound given on a standard dosage schedule. Basing of dosage schedules on achievable levels and pharmacokinetic behavior may not be satisfactory. The minimal inhibitory and minimal bactericidal concentrations are measured in vitro under static conditions that differ significantly from the in vivo environment. Dilution end points may cause further deviations from in vivo conditions because of the removal of constituents from serum and body fluid. Concentrations of drug in blood, body fluids, or urine do not necessarily reflect either the distribution of drug in tissues or the kinetics of interaction between the drug and the target microorganism. The lack of continuity in so-called discontinuous dosage is more apparent than real. A system of "kinetic buffers" exists in the body, and some microorganisms can attenuate the effect of intermittent doses. Intermittent dosage schedules are advantageous compared with continuous administration because of improved penetration of drug into tissues, convenience of administration, and better compliance among patients. The magnitude of the dose is limited by potential toxicity. Large doses may be wasteful if smaller amounts are equally effective.

Anti-Bacterial Agents↗
PubMedDate not supplied

Evaluation of antibiotic usage: a comprehensive look at alternative approaches.

Current problems related to the use of antibiotics in the United States are summarized. In 1979, pharmaceutical manufacturers shipped +1.55 billion worth of anti-infective drugs. It is estimated that in approximately one-half of all cases that involve administration of antibiotics in the hospital, either the medical condition does not require antibiotic treatment, the most effective and least expensive drug is not chosen, or the correct dosage or duration of therapy is not prescribed. Much of the high cost of antibiotic therapy can be attributed to the use of expensive antibiotics of the cephalosporin and aminoglycoside groups and to the excessive duration of antibiotic prophylaxis in surgery. This review presents methods that assess the magnitude of the problem by audit and analyzes the corrective approaches that have been suggested. The major issues of concern related to the use of antibiotics are the complex series of considerations that lead physicians to prescribe antibiotics and the problem of patient expectation and compliance. Excessive usage of antibiotics must be viewed as part of the problem of overusage of all drugs and laboratory procedures.

Anti-Bacterial Agents↗