Search PubMed⌕ Search

Biomedical subjects

E Rubinstein

Publications and source records attributed to E Rubinstein.

At least 235 records · Page 13Linked to original sources
PubMed1984

Appendicitis in the aged. Is it really different?

The case reports, operative findings, and results of surgery in 77 patients aged 60 years and older who underwent surgery for histologically proven acute appendicitis were analyzed. Based on this analysis, it was concluded that the clinical picture of appendicitis in the aged does not differ from that observed in younger patients. However, in the aged the disease course seems to be more rapidly progressing toward perforation and abscess formation. An aggressive diagnostic attitude and early surgery seem the sole means by which mortality and morbidity of appendicitis in the aged can be lowered.

Acute Disease↗
PubMed1984

Furosemide effect on penicillin induced convulsions.

Convulsions were induced in 20 cats by the administration of intravenous penicillin. Furosemide administered together and after penicillin failed to reduce the seizure activity. Penicillin brain concentrations were not reduced by furosemide. Penicillin induced seizures are not affected by furosemide.

Animals↗
PubMed1983

Ethanol metabolism in heavy drinkers after massive and moderate alcohol intake.

Some alcoholics have a regular daily alcohol consumption of more than 100 g. In preliminary observations we had the impression that the claimed alcohol intake in such 'heavy drinkers' was higher than could be accounted for by the ethanol elimination rate as measured routinely at 10 mmol/l (0.5 g/l). We therefore measured the ethanol elimination rate at very high blood ethanol concentrations of 40-80 mmol/l (2-4 g/l) found in eight alcoholics following heavy alcohol intake by measuring the falling blood ethanol concentrations until being less than 1 mmol/l. The elimination rate, on average 83 mumol/min per 1 blood, was about 49% higher than the elimination rate measured at 10 mmol/l in the same subject, being on average 58 mumol/min per 1/blood (paired t-test, P less than 0.05). The elimination rate following the high initial ethanol concentrations remained high until the concentration was below 5 mmol/l. Calculations of elimination rates are based on a number of assumptions concerning the physiologic and metabolic conditions. We examined specifically if the concentration-time curves could be adequately described by assuming metabolism according to a Michaelis-Menten pathway with a low Km value (simulating alcoholdehydrogenase with Km 0.2 mmol/l) or by assuming metabolism by two pathways with an alternative high-Km pathway with Km about 10 mmol/l. It was not necessary, in the statistical analysis, to include an alternative high-Km pathway. On the other hand, the data does give room for up to 50% elimination via such alternative pathways. The elimination rate at the high concentrations corresponded roughly to the claimed daily alcohol intake; furthermore the measured elimination rate at the lower concentrations were similar to values in non-alcoholics.

Alcohol Drinking↗
PubMed1983

Acquired immunodeficiency with reversed T4/T8 ratios in infants born to promiscuous and drug-addicted mothers.

A new syndrome of acquired immunodeficiency has been identified in seven children who were small for gestational age at birth and subsequently have exhibited failure to thrive, lymphadenopathy, parotitis, hepatosplenomegaly, interstitial pneumonia, and recurrent infections. All have a profound cell-mediated immunodeficiency with reversed T4/T8 ratios. Six are hypergammaglobulinemic and one has low IgG levels. The mothers of five of the seven children are sexually promiscuous and/or drug addicts. Three mothers have an immunodeficiency similar to that found in their infants. One of them died at age 33 years with a diagnosis of acquired immunodeficiency syndrome. In five of the children and in three of their mothers, there is evidence of a persistent Epstein-Barr virus (EBV) infection. We speculate that a perinatal or in utero transmission of EBV can induce an "infectious immunodeficiency." The clinical, histopathologic, and immunologic features resemble those described in adult homosexuals and drug addicts.

Acquired Immunodeficiency Syndrome↗
PubMed1983

The effect of ischemia of the dog's colon on transmural migration of bacteria and endotoxin.

The purpose of this investigation was to evaluate the effect of temporary ischemia created during the surgical preparation of the colon for resection on transmural migration of bacteria and passage of endotoxin through the ischemic wall of the canine colon. Eighteen dogs were used: in fourteen the colon was devascularized by ligating all marginal vessels. Aerobic and anaerobic cultures and washings for endotoxin assay were obtained from the surface of the bowel at intervals up to 6 hr after creating the ischemia. Peripheral and portal blood samples were also obtained at equal intervals for bacteriologic cultures and endotoxin assay. Bacterial transmural migration was examined in 10 dogs. In 6 of the dogs biologically marked bacteria were introduced into the colon via a rectal catheter before producing the ischemia. In 4 dogs radioactively labeled endotoxin was introduced into the colon in a similar fashion. In all the dogs, surface cultures, both routine and specific for the marked bacteria, were negative for the whole period of up to 6 hr after creation of ischemia. All portal and peripheral vein cultures were also negative. Transmural migration of endotoxin was investigated in 8 dogs, 4 of which served as controls and underwent a sham operation. In the 4 dogs in which the colon was devascularized endotoxin was discovered in peritoneal washings, and in portal and systemic blood samples, as early as 30 min after the preparation of the bowel was completed. In the control dogs endotoxin assays were negative throughout the experiment. In this model up to 6 hr of ischemia did not result in migration of bacteria through the ischemic wall. Endotoxin, however, entered the peritoneum and the blood very soon after producing the ischemia.

Animals↗
PubMed1983

Endogenous endophthalmitis due to Salmonella typhimurium.

Endogenous endophthalmitis due to Salmonella typhimurium is reported in a 1-year-old child. Despite vigorous antibiotic therapy, the child's vision deteriorated, and loss of light perception occurred in the infected eye. Endophthalmitis is a very rare complication of salmonellosis, and it should alert physicians because of its severe damage to the eye.

Endophthalmitis↗
PubMed1983

The penetration of gentamicin into the vitreous humor in man.

Twenty-two patients received gentamicin intramuscularly or subconjunctivally 35-220 min prior to undergoing ocular surgery. There were no detectable gentamicin levels in the vitreous humor of patients who received the drug systemically. Of the patients who received gentamicin subconjunctivally, three quarters had no detectable gentamicin levels, only three of these patients had therapeutic concentrations in their vitreous humor. These results confirm kinetic drug studies performed in animals in which low or absent vitreal gentamicin levels were observed following systemic and subconjunctival administrations. It is suggested that intravitreal injection of aminoglycosides is required in the treatment of bacterial endophthalmitis.

Adult↗
PubMed1982

Pseudomonas aeruginosa meningitis treated with an azlocillin combination.

Pseudomonas aeruginosa meningitis following trauma or surgery is associated with a high mortality rate. This high rate is explained both by tissue damage which leads to infection and by the failure of antibacterial therapy. The latter is due to the relatively resistant microorganism and the insufficient penetration of antibiotics into the CSF. We are reporting the successful therapy of a case of postoperative P. aeruginosa meningitis treated with the combination of azlocillin and gentamicin administered systemically together with intraventricular gentamicin.

Adolescent↗
PubMed1982

Efficacy of ceftriaxone and gentamicin in an abscess model.

The therapeutic efficacy of ceftriaxone and gentamicin was investigated in a foreign body induced abscess model in the rat by implanting a dialysis tube contaminated with Klebsiella pneumoniae into the subcutaneous tissue. Animals were treated for four days with ceftriaxone, gentamicin, and their combination starting immediately following or 48 h after the implantation. Peak free ceftriaxone and gentamicin abscess fluid levels were 4.3 and 2.6 mcg/ml, which were 7.3% and 37.5% of peak blood levels respectively. Both agents persisted longer in abscess fluid than in blood. Ceftriaxone inhibited the development of abscess formation when administered shortly after the implantation of the contaminated foreign body whereas gentamicin alone was without beneficial effect. When administered after 48 h ceftriaxone was less effective than immediately after implantation and gentamicin was again without any therapeutic effect. The effect of the combination of ceftriaxone and gentamicin was slightly better than ceftriaxone alone. Low oxygen tension may be an explanation for the lack of bactericidal effect of gentamicin. Ceftriaxone may be more suitable for the therapy of closed space infections caused by susceptible microorganisms than gentamicin.

Abscess↗