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Biomedical subjects

E Israel

Publications and source records attributed to E Israel.

174 records · Page 10Linked to original sources
PubMedDate not supplied

Do the pelvic lymph nodes predict the parametrial status in cervical cancer stages IB-IIA?

The aim of this study was to determine whether the pelvic lymph nodes would predict the parametrial status in patients with cervical cancer stages IB1-IIA submitted to radical surgery and pelvic lymphadenectomy. To this end, we evaluated the relationship between positive and negative pelvic lymph nodes and their parametria. Our final purpose was to use this information to recommend the tailoring of the parametrial resection according to the status of pelvic lymph nodes to decrease the morbidity related with radical paratrectomy. From January 1996 to December 2001, 107 consecutive patients with cervical cancer stages IB1 and IIA were primarily treated by radical hysterectomy type III with systematic pelvic lymphadenectomy in a prospective study. Parametria were studied in two sections: the first included the tissue adjacent to the cervix, and the second the distal 2/3. Lymph nodes were routinary processed. Twenty-two patients (20.6%) had positive pelvic nodes and 16 patients (14.9%) had parametrial involvement, mostly by direct extension. Eight patients with positive pelvic nodes (36.4%) had parametrial involvement, whereas among 85 patients with negative pelvic nodes only eight patients (9.4%) had parametrial involvement (P < 0.001), most in internal parametria (62.5%). The sensitivity of pelvic lymph nodes for parametrial involvement was 50% and the positive predictive value was 36.4%, whereas the specificity was 84.6%; and the negative predictive value 90.6%. In the group of negative pelvic lymph nodes, only two patients (2.3%) had parametrial involvement beyond internal parametria. The univariated and multivariated analysis of prognostic factors was always significant but without a significant independent factor for positive parametria. Pelvic lymph nodes appear as good predictors of parametrial status, especially in node-negative patients, and could be used to decrease the paratrectomy in radical surgery.

Adult↗
PubMedDate not supplied

Effect of polymorphism of the beta(2)-adrenergic receptor on response to regular use of albuterol in asthma.

BACKGROUND: Regular use of inhaled beta-adrenergic agonists may have adverse effects in some asthma patients. Polymorphisms of the beta(2)-adrenergic receptor (beta(2)-AR) can affect its regulation; however, results of smaller studies of the effects of such polymorphisms on response to beta-agonist therapy have been inconsistent. METHODS: We examined the possible effects of polymorphisms at codons 16 (beta(2)-AR-16) and 27 (beta(2)-AR-27) on response to albuterol by genotyping 190 asthmatics who had participated in a trial of regular versus as-needed albuterol use. RESULTS: During the 16-week treatment period, patients homozygous for arginine (Arg/Arg) at beta(2)-AR-16 who used albuterol regularly had a small decline in morning peak expiratory flow (AM PEF). This effect was magnified during a 4-week run-out period, when all patients returned to as-needed albuterol only. By the end of the study, Arg/Arg subjects who had used albuterol regularly had an AM PEF 30.5 +/- 12.1 liters/min lower (p = 0.012) than Arg/Arg patients who had used albuterol as needed only. Subjects homozygous for glycine at beta(2)-AR-16 showed no such decline. Evening PEF also declined in the Arg/Arg regular but not in as-need albuterol users. No significant differences between regular and as-needed treatment were associated with polymorphisms at beta(2)-AR-27. CONCLUSIONS: Polymorphisms of the beta(2)-AR may influence airway responses to regular inhaled beta-agonist treatment.

Adolescent↗
PubMedDate not supplied

Treatment of chronic stable asthma with drugs active on the 5-lipoxygenase pathway.

It is now established that 5-lipoxygenase products are synthesized and released in the airway during asthmatic reactions. The importance of these products in the asthmatic response has been established through study of the effects of 5-lipoxygenase inhibitors and leukotriene D4 receptor antagonists in patients with chronic stable asthma. In this study we review the data demonstrating that chronic administration of zileuton, an inhibitor of 5-lipoxygenase, is associated with improved airway function, decreased asthma symptoms and decreased need for asthma medication use in patients with mild to moderate asthma.

Adrenergic beta-Agonists↗
PubMedDate not supplied

HIV antibody seroprevalence among childbearing women surveyed in Maryland.

Because blood specimens from newborns reflect the antibody status of the mother, seroprevalence rates among childbearing women are obtainable from analysis of the specimens. A blinded survey of human immunodeficiency virus (HIV) antibody seroprevalence among childbearing women was conducted in Maryland. The survey used 31,273 dried filter paper blood spot specimens obtained from newborns screened for hereditary disorders. Overall, 99 specimens were positive on two enzyme-linked immunoassays and on Western blot, providing a seroprevalence rate of 0.32 percent. The rate for child-bearing women residing within the City of Baltimore, 0.7 percent, was significantly higher than the rate for those residing elsewhere in Maryland, 0.1 percent. The statewide rate for nonwhite women, 0.8 percent, was higher than for white women, 0.007 percent. No statistically significant associations were found with residence in an inner city area, as opposed to residence in other areas of the city; birth weight group; reported health of the infant; or the infant having received a transfusion.

Adolescent↗
PubMedDate not supplied

An outbreak of acute infectious nonbacterial gastroenteritis in a high school in Maryland.

An outbreak of acute infectious nonbacterial gastroenteritis (AING) occurred in a high school in Maryland in 1984. Thirty-six percent of students surveyed met the case definition of gastroenteritis, as did 24 percent of school employees. Eating lunch in the cafeteria on January 30 was significantly associated with illness. After controlling for other food items consumed during the January 30 lunch, only the sandwiches were significantly associated with illness, but the source of the contamination was not identified. Four of 17 serum pairs from sick students and none of the 8 serum pairs from exposed controls (a nonsignificant difference) showed at least a 4-fold rise in antibody titre to Norwalk virus between acute- and convalescent-phase specimens. This outbreak of AING is believed to be the first to implicate epidemiologically sandwiches as vehicles of transmission. The outbreak highlights the need for investigators to look for a viral etiology in gastroenteritis outbreaks.

Adolescent↗
PubMedDate not supplied

Virus-mediated abrogation of chicken lymphocyte responsiveness to mitogenic stimulus.

We have found that various sorts of virus particles, including avian leukosis and sarcoma viruses, Sendai virus, Friend leukemia virus and murine mammary tumor virus, are able, upon coincubation with chicken peripheral lymphocytes and either Concanavalin A (Con A) or phytohemagglutinin (PHA), to inhibit the mitogenic responses that normally follow. Such inhibition is not dependent on the use of infectious virus, and can be documented by using particles whose infectivity has been abolished by irradiation with ultraviolet light. Lymphoid cells that had been preincubated with viruses at concentrations approximating 10 particles per cell and for only 2 hours were inhibited by as much as 83% in ability to respond to the lectins employed. These results appear to be mediated, at least in part, by a virus-induced factor with the capacity to abrogate the responsiveness of freshly obtained lymphocytes to mitogenic stimulus. This factor is devoid of interferon activity, as tested in a vesicular-stomatitis-virus plaque reduction assay.

Animals↗
PubMedDate not supplied

[Differential expression of relevant Rous sarcoma tumor antigens in cultured cells].

Chickens bearing tumours induced by Rous sarcoma virus (RSV) are able to mount a cellular immune response against antigens associated with these neoplasms. Cultured Rous sarcoma (RS) cells, derived from the wings of chickens bearing tumors induced by RSV, were consistently more susceptible in cytotoxicity assays to killing by the splenic lymphocytes of RS-bearing chickens than were chicken embryo fibroblast (CEF) cells which had been transformed in vitro by RSV. In contrast, extracts (3M KCI-derived) and supernatant fluids of transformed CEF were equally or more capable of eliciting blastogenic responsiveness in circulating lymphocytes of birds with tumors than were similar extracts and supernatant fluids obtained from cultured RS cells. As measured by lymphocyte stimulation, the expression of this anti-tumour response was in some cases only short-lived, and varied between animals in terms of time following inoculation with RSV. These findings point to a differential expression of relevant RS-tumour antigens in these various cell types, and indicate that the use of various experimental techniques may yield quite different results.

Animals↗
PubMedDate not supplied

Antibiotic therapy for Lyme disease in Maryland.

The recommended treatment of Lyme disease is evolving and important questions remain unanswered, such as (a) Are inexpensive oral regimens effective in curing acute illness and preventing arthritic, neurologic, and cardiac manifestations or are much more costly, and potentially toxic, intravenous antibiotics required? (b) Are relatively short 2- to 3-week courses of antibiotics sufficient or are prolonged regimens of a month, or more, better? This study reviews antibiotic therapy prescribed by Maryland physicians for the 283 cases reported in 1991 that meet the Centers for Disease Control and Prevention's case definition for Lyme disease. The purpose of the review was to obtain baseline information on the antibiotics being used by physicians in practice to treat patients that they believe have Lyme disease. The most frequently prescribed antibiotics for either the 60 percent of patients presenting with erythema migrans or the 40 percent with arthritic, neurologic, or cardiac manifestations were oral doxycycline (47 percent), tetracycline (11 percent), and amoxicillin (13 percent). Seventy-one percent of therapeutic courses were for 2 to 3 weeks. Amoxicillin was used in two-thirds of children younger than 8 years. Sixty (21 percent) received intravenous therapy, of which ceftriaxone, with or without other antibiotics, was almost always (95 percent) used. Intravenous therapy was more frequently given to those with arthritic, neurologic, and cardiac manifestations than to those with erythema migrans (odds ratio = 3.7) and to those with these systemic symptoms along with erythema migrans than to those with erythema migrans alone (odds ratio = 3.8). The average course was 2 days longer in treating those with arthritic, neurologic, or cardiac manifestations than in treating those with erythema migrans alone(P = 0.05).An epidemiologic assessment of antibiotics prescribed by the physicians in Maryland to treat Lyme disease in 1991 shows the choices, dosage, and duration of drugs generally followed those most frequently recommended in the literature. Also, it shows that efforts to educate physicians should be directed more towards the diagnosis rather than the treatment of Lyme disease.

Administration, Oral↗
PubMedDate not supplied

Congenital syphilis in Maryland, 1989-1991: the effect of changing the case definition and opportunities for prevention.

BACKGROUND: The reported incidence of congenital syphilis in the United States rose dramatically during the 1980s. Although lack of prenatal care has been associated with congenital syphilis, little has been published regarding missed opportunities for prenatal intervention. GOAL OF THIS STUDY: To determine whether congenital syphilis increases in Maryland between 1989 and 1991 resulted from a true increase in congenital syphilis incidence or a change in the surveillance case definition, and to describe missed opportunities for prenatal intervention. STUDY DESIGN: This was a retrospective cohort study. RESULTS: When the revised case definition was used, a 473% increase in the number of cases was seen. Among infants who met the revised definition, 45% of mothers had received no prenatal care. Among those whose mothers had received prenatal care, opportunities to intervene were missed for 53%. CONCLUSIONS: Although a true increase in congenital syphilis incidence occurred before 1990, the increase reported in Maryland between 1989 and 1991 was primarily due to the change in case definition. Many cases of congenital syphilis could have been prevented with early and adequate prenatal care.

Adolescent↗
PubMedDate not supplied

Case characteristics and trends in pediatric tuberculosis, Maryland, 1986-1993.

OBJECTIVE: To identify case characteristics and trends in the incidence of pediatric tuberculosis (TB) in Maryland during the national resurgence of the disease. METHODS: The authors conducted a retrospective review of the 248 cases of TB in children ages 19 and younger reported to the state registry between 1986 and 1993. RESULTS: The incidence of pediatric TB in Maryland, while showing a downward trend between 1986 and 1993, was characterized by a bimodal pattern, with one peak in children younger than age 5 and another peak in adolescents. Certain case characteristics differed significantly according to age: adolescents with TB were more likely to have positive AFB smears, positive cultures, and cavitary X-rays than children in the 0-4 age group. On the other hand, PPD results did not differ significantly by age. Children with TB came from households in zip code areas for which the median family income was lower and the rate of unemployment was higher than comparable statewide figures. CONCLUSIONS: Study findings indicate that (a) the general decline in adult TB in Maryland was accompanied by a decline among children; (b) age-specific case characteristics continue to be useful in clinical decision making for children with suspected TB; and (c) a state TB registry may prove useful not only in tracking disease trends and monitoring statewide control efforts but also in confirming case characteristics, all of which are important disease control issues in a time of fiscal downsizing.

Adolescent↗