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Biomedical subjects

D Huminer

Publications and source records attributed to D Huminer.

At least 19 recordsLinked to original sources
PubMed1999

Home intravenous antibiotic therapy for patients with infective endocarditis.

Although home intravenous antibiotic therapy (HIAT) is increasingly being used for various infectious diseases, outpatient treatment of infective endocarditis (IE) is still uncommon. Recently, the American Heart Association recommended outpatient treatment of endocarditis only for infections with streptococci that are highly susceptible to penicillin. Herein, the experience with HIAT in patients with IE due to a diversity of pathogens is presented. During a 3-year period, 37 patients with IE who were in a stable condition and were cooperative were enrolled in a service for HIAT after completion of diagnostic procedures. Of the 37 patients, 21 were male; mean age was 64.3 years (range 20-87 years); in most cases (26/37), IE involved a native valve. Causative organisms were Streptococcus spp. (20), Staphylococcus spp. (10), Enterococcus spp. (2), Enterobacter spp. (1), and Erysipelothrix rhusiopathiae (1), while three were unknown. The most common antibiotics used were ceftriaxone and vancomycin. Almost three-quarters of the intravenous lines were peripheral. The mean duration of HIAT was 26.2 +/- 8.5 days, with 92% of the patients cured by it. Most complications were minor. Six patients were rehospitalised and two of them required valve replacement. In half of the rehospitalised patients, the complication was unrelated to HIAT. Surprisingly, almost all of the complications necessitating rehospitalisation occurred in patients with streptococcal IE and most involved native valves. HIAT may be suitable for IE due to a diversity of pathogens and involving prosthetic as well as native heart valves, provided there are proper patient and antibiotic selections, good follow-up, and vigilant monitoring of complications.

Adult↗
PubMed1998

Lipoamide dehydrogenase deficiency: a newly discovered cause of acute hepatitis in adults.

Lipoamide dehydrogenase deficiency is a rare disease, manifested in early childhood by lactic acidemia, progressive neurological damage and death in most cases. We report a case of lipoamide dehydrogenase deficiency in a 34-year-old Ashkenazi-Jewish woman. The deficiency manifested as acute hepatitis without cognitive impairment or acidosis. The patient's brother also had lipoamide dehydrogenase deficiency, diagnosed at the age of 20, and manifested as hepatocellular damage, lactic acidemia and myoglobinuria. We assume that the trigger for this hepatocellular damage was prolonged fasting, and that otherwise the patient might have gone undiagnosed. Other cases in Ashkenazi Jews of mild lipoamide dehydrogenase deficiency with hepatocellular injury but without central nervous system involvement are reviewed.

Acute Disease↗
PubMed1997

Five-year prospective study of bacteraemic urinary tract infection in a single institution.

In order to determine the epidemiology, microbiology, and outcome of bacteraemia originating in the urinary tract in hospitalised patients, a prospective study was conducted in a large general hospital in Israel. Data from all patients with bacteraemia were collected prospectively, and a subgroup of patients with bacteraemia secondary to urinary tract infection was analysed. There were 702 episodes of bacteraemia secondary to urinary tract infection during a five-year period (33.9% of all episodes of bacteraemia). The mean age of the patients was 76 years, and the male:female ratio was 0.9:1.0. The most common pathogens were Escherichia coli (52%), Klebsiella spp. (14%), and Proteus spp. (9%). Pseudomonas spp. were isolated from 8% of all patients, from 19% of those who had received antibiotics, and from 15% of males. Enterococcus spp. were isolated from 4% of males but from no females. Five percent of the episodes were polymicrobial, and 16% of the infections were hospital acquired. On logistic multivariate regression analysis, predictors of mortality were: hospitalisation in a medical department, hospital-acquired infection, inappropriate empiric antibiotic treatment, presence of decubitus ulcer(s), respiratory or renal failure, and elevated urea and decreased albumin levels.

Adolescent↗
PubMed1995

Multiple symmetric lipomatosis presenting with polyneuropathy.

We describe an unusual case of multiple symmetric lipomatosis (MSL) that presented with severe polyneuropathy, and review the literature. To the best of our knowledge, this is the first description of polyneuropathy as the presenting sign of MSL and the first report of this syndrome in Israel. MSL has to be included in the differential diagnosis of unexplained polyneuropathy.

Aged↗
PubMed1994

Mycoplasma and Chlamydia in adenoids and tonsils of children undergoing adenoidectomy or tonsillectomy.

The prevalence of mycoplasmal and chlamydial infection was assessed in 83 children undergoing adenoidectomy, tonsillectomy, or both procedures for recurrent adenotonsillitis or obstructive symptoms. Throat smears (surface specimens) and minced adenoids and tonsils (core specimens) were cultured for Mycoplasma spp and for Chlamydia spp. Isolation rates in adenoidal specimens were as follows: Mycoplasma hominis, surface 7.1% core 2.9%; and Ureaplasma urealyticum, surface 1.4%, core 2.9%. Mycoplasma hominis was also found in tonsillar specimens: surface 14.3%, core 20%. Chlamydia trachomatis was isolated only from a single core adenoidal specimen. The rate of mycoplasma isolation was significantly higher in children with recurrent adenotonsillitis (34.5%) than in those with obstructive symptoms (3.7%). Our findings document colonization of genital mycoplasmas in adenoids and tonsils of children with recurrent adenotonsillitis. Further studies are needed to evaluate the possible pathogenetic role of these microorganisms in adenotonsillar infection.

Adenoidectomy↗
PubMed1993

[Relapse of multiple myeloma in extramedullary sites].

Multiple myeloma was diagnosed in a 69-year-old man with pathological hip fracture, who had increased plasma cells in the bone marrow, osteolytic lesions in bones, low level of monoclonal protein (IgAK) in serum and urine, and anemia, hypercalcemia and renal insufficiency. He was treated for 1 year with chemotherapy with good results. 6 months after cessation of treatment the disease relapsed with multiple extramedullary plasmacytomas in skin and subcutaneous areas, right eyebrow, right knee, sternum and right axilla, but repeated bone marrow examinations were without evidence of disease activity. Chemotherapy was resumed but the patient died 1.5 years after the relapse with severe jaundice due to multiple liver plasmacytomas and pelvic masses.

Aged↗
PubMed1993

Mycobacterium simiae infection in Israeli patients with AIDS.

Mycobacterium simiae is an environmental organism that has rarely been associated with human disease. In Israel M. simiae is frequently isolated from clinical specimens, and it usually colonizes damaged lungs. Until now, only two cases of AIDS patients with M. simiae infection have been reported, and these patients were coinfected with Mycobacterium avium complex. Two Israeli patients with AIDS complicating hemophilia developed prolonged fever that was unresponsive to therapy with broad-spectrum antibiotics. One of them had cavitary pulmonary infiltrates. M. simiae was isolated from blood in both cases and from sputum and bone marrow in one case. The identity of the mycobacterium was confirmed at three reference laboratories. Both patients died of the infection. Thus, the possibility of M. simiae infection should be considered for AIDS patients who live in areas where this mycobacterium is prevalent.

AIDS-Related Opportunistic Infections↗
PubMed1992

Seroepidemiologic study of toxocariasis and strongyloidiasis in institutionalized mentally retarded adults.

Serologic surveys for Toxocara canis and Strongyloides sp., as well as stool examinations for intestinal parasites, were conducted in a home for mentally retarded adults. Evidence of parasitic infection was found in 30 (28.3%) of 106 residents; nine (8.5%) had positive toxocaral serology (enzyme-linked immunosorbent assay[ELISA]), 1 (0.9%) had positive serology for Stronglyoides sp. (ELISA), and 21 (19.8%) had parasites in stool (including Stronglyoides stercoralis in the patient with positive serology). Most of the residents with positive toxocaral serology lived in the same apartment and used to play with dogs. Parameters found to be significantly associated with positive toxocaral serology were pica behavior and eosinophilia (P less than 0.05). Mental retardation requiring institutionalization appears to be a risk factor for toxocariasis and other parasitic infections in adults as it is for children.

Adult↗
PubMed1991

The role of estrogen receptors in the development of gallstones and gallbladder cancer.

The preponderance of gallstones in fertile women suggests that female sex hormones play a role in the pathogenesis of cholelithiasis. In a pilot study we found estrogen receptors and high concentrations of estrogen in gallbladders of persons who underwent cholecystectomy for cholelithiasis. This finding, as well as previous reports on estrogen receptors in diverse human tumors, support the hypothesis that estrogen influences the development of gallstone disease and gallbladder carcinoma.

Bile↗
PubMed1989

HIV infection in 1968.

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Acquired Immunodeficiency Syndrome↗