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Biomedical subjects

C M Kunin

Publications and source records attributed to C M Kunin.

At least 109 records · Page 6Linked to original sources
PubMed1978

Clinical investigators and the pharmaceutical industry.

Virtually all new drugs are introduced, evaluated, and marketed under the control of the pharmaceutical industry and general supervision of the Food and Drug Administration (FDA). The clinical investigator must look to the pharmaceutical industry for support of studies of drugs, and the industry, in turn, needs the investigator to evaluate agents before FDA approval and to present findings in the medical media. A survey of members of the infectious Disease Society of America has shown heavy dependence on the pharmaceutical industry for support of applied studies of antibacterial and other chemotherapeutic agents. More than half the respondents believed that industry support was essential, about one third felt it was useful, and about one quarter would prefer other sources of support. Several proposals are presented to clarify the relations between investigators and the pharmaceutical industry and to provide for a broad-based clinical infectious disease consortium to provide research funds and plan educational programs in the field of infectious disease.

Animals↗
PubMed1978

Enzymuria as a marker of renal injury and disease: studies of N-acetyl-beta-glucosaminidase in the general population and in patients with renal disease.

Urinary excretion of N-acetyl-beta-D-glucosaminidase (NAG) was shown to be reproducible in random urine specimens when expressed as the ratio of NAG to milligrams of urinary creatinine. The enzyme/creatinine ratio in 815 healthy people was relatively constant throughout childhood and adult life except for the first two years after birth and in individuals 56 years or greater. High ratios in the young children may be explained by low urinary creatinine excretion probably related to small body mass and reduced glomerular filtration rate at this age. The ratio was increased in adult uremic patients and children and adults with a variety of neurologic and obstructive lesions of the voiding mechanism. The presence of bacteriuria did not appear to increase the ratio. Significant enzymuria (greater than 2 SD above the mean for age and sex) was detected in 38 of 81 children with well-characterized renal disease. Among patients with predominantly glomerular disorders there was a close relationship between activity of the disease and enzymuria. In patients with tubulointerstitial disease enzymuria was frequent even in the absence of proteinuria. One of the highest enzyme/creatinine ratios was observed in a child with cystinosis. These studies indicate that NAG enzymuria is a sensitive indicator of activity of renal disease and may prove to be a suitable screening test for significant renal disease or injury in childhood.

Acetylglucosaminidase↗
PubMed1977

Oral cephalosporins.

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Administration, Oral↗
PubMed1977

Pseudomonas aeruginosa bacteremia in a dialysis unit. 1. Recognition of cases, epidemiologic studies and attempts at control.

Infections commonly occur in patients undergoing dialysis and have been related to diminished host resistance of uremic patients, the arteriovenous fistulas and bacteriologic contamination of dialysis fluids. The occurrence of four cases of bacteremia due to Pseudomonas, three of which were type 7, and the presence of this serotype in the dialysis fluids suggested an important association between infection and growth of bacteria in the fluids. Attempts to reduce levels of bacteria in the dialysis fluid were unsuccessful using dialysate free of glucose in clinical trial, despite in vitro studies demonstrating poor growth of Pseudomonas in this medium. A filter placed with the recirculating system was only partially successful. The second paper of this series traces the portal of entry of bacteria from dialysate to the blood through reutilized coils.

Cross Infection↗
PubMed1977

Evaluation of a vented drainage system in prevention of bacteriuria.

A vented urinary drainage system was compared to an otherwise identical non-vented system in a prospective, randomized, double-blind study. Among the 316 female patients evaluated there was a significant reduction in the rate of bacteriuria after 10 days using the vented system (66 per cent in the non-vented group versus 26 per cent in the vented group, p less than 0.05), while no significant difference could be demonstrated among the 190 male patients. We used urine hemoglobin as an indicator of mucosal trauma that might predispose to bacteriuria and no significant difference could be shown between the 2 drainage systems.

Adolescent↗
PubMed1977

Persistent effect of antibiotics on Staphylococcus aureus after exposure for limited periods of time.

Persistent suppression of bacterial growth by certain antibiotics was tested by periodic counts of viable organisms in a culture of Staphylococcus aureus that had been incubated in media containing drugs for limited periods of time and then removed by centrifugation. During short (2 hr) periods of exposure of test cultures to penicillin G, cephalothin, erythromycin, clindamycin, vancomycin, and tetracyline, effects on the growth of S. aureus were produced that persisted after removal of the drug for periods of 1.7-4.1 hr. A persistent antibiotic effect was not observed with gentamicin. The persistent effects of penicillin G and erythromycin were directly related to duration of exposure and concentration of drug, up to a point of maximal response. The maximal durations of bacterial suppression after exposure to penicillin G and erythromycin were approximately 2 and 5 hr, respectively. These effects were observed over a wide range of inocula.

Anti-Bacterial Agents↗
PubMed1977

Distribution of gentamicin and amikacin in rabbit tissues.

Rabbits were injected intramuscularly with gentamicin and amikacin (15 mg of base per kg), and the antibiotic levels in tissues were determined 20 h after either a single or multiple injections. Disk diffusion assays, with Bacillus subtilis ATCC 6633, were carried out both on homogenates and on supernatants deproteinized with trichloroacetic acid. Both assays indicated that the kidney is the major site of antibiotic deposition. Antibiotic levels increased after multiple doses. Gentamicin levels in other tissues were higher than those of amikacin. The assay of trichloroacetic acid-treated material was more sensitive than the assay of the total homogenate.

Amikacin↗
PubMed1976

Uptake of antibiotics by human erythrocytes.

Human erythrocytes have been used as a model system for the study of uptake and release of antibiotics. Penicillin G, dicloxacillin, tetracycline, and minocycline were all taken up by the cells, but each showed a characteristic ratio of distribution between the extracellular and intracellular compartments. Comparison of the penicillin analogues indicated that dicloxacillin, the more lipid-soluble compound, reached higher intracellular concentrations than did penicillin G. Use of human plasma as the incubation medium markedly decreased antibiotic uptake and enhanced antibiotic egress from preloaded cells. These effects were related to the binding of drugs to serum proteins. In vivo studies in which penicillin G was injected intravenously by bolus and was then given by constant infusion showed that intraerythrocytic concentrations of drug after 2 hr approached or exceeded those in plasma. These results can be explained, in part, by the fact that the slower rate of efflux of penicillin G from the cells than of clearance from plasma serves to maintain the high initial levels of drug for a longer period.

Anti-Bacterial Agents↗