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Biomedical subjects

E Rubinstein

Publications and source records attributed to E Rubinstein.

At least 253 records · Page 14Linked to original sources
PubMed1982

Estimating the effects of nosocomial infections on the length of hospitalization.

Increased length of hospitalization due to nosocomial infections has generally been calculated from the arithmetic mean of the differences in hospital stay of persons with nosocomial infections and their matched control patients. This method may yield estimates inflated by a few extreme values. Data from a prospective study of nosocomial infections in patients hospitalized in surgical and orthopedic services in a large hospital in Israel are used to illustrate a modified statistical approach to this problem. The geometric mean of the ratio of length of hospitalization of 57 patients with nosocomial infections to matched control patients was determined. The increased mean hospital stay was estimated at 4.5 days for urinary tract infection, 11.9 days for surgical wound infection, and 25 days for "double infection." These figures were lower than those derived from calculation of the arithmetic mean of excess hospital stay and suggest that this modification should be incorporated in future studies of this nature.

Adult↗
PubMed1982

Colposcopic pattern of cervicitis, dysplasia and pre-invasive cancer of the uterine cervix.

The great majority of cervical neoplasia begin in the transformation zone between the squamous and the columnar epithelium, i.e. within the area in which metaplasia takes place. This process, both normal and atypical, can be studied colposcopically. Colposcopy increases the diagnostic accuracy and therapeutic success in cervical neoplasia as it is the only method that permits a topographical study of cervical lesions, and indicates the location of neoplastic epithelial proliferation.

Adolescent↗
PubMed1982

Gentamicin and cefsulodin efficacy in a rat abscess model.

The pharmacokinetics and therapeutic efficacy of gentamicin and cefsulodin were studied in an abscess model in the rat induced by Pseudomonas aeruginosa and a foreign body. Both agents reached therapeutic concentrations in the abscess fluid and its ultrafiltrate and persisted longer in the abscess fluid than in blood. Gentamicin did not prevent the development of abscesses or reduce the bacterial inoculum when administered immediately following the induction of the abscesses. Cefsulodin sterilized 82.7 per cent of abscesses in 61.5 per cent of injected rats. Low oxygen tension present in the abscess was probably responsible for the inefficacy of gentamicin in this model, while not significantly diminishing the antibacterial activity of cefsulodin.

Abscess↗
PubMed1982

Comparative susceptibilities of 40 strains of Pseudomonas aeruginosa to 10 antipseudomonal antimicrobial agents.

The in vitro susceptibility of 40 clinical isolates of Pseudomonas aeruginosa to 10 antipseudomonal antibiotics was determined. Of the strains examined, 100, 90, 85 and 80% were susceptible to netilmicin, amikacin, gentamicin and tobramycin, respectively; 93, 85 and 72% were susceptible to piperacillin, azlocillin and carbenicillin, respectively; and 93, 88 and 84% were susceptible to cefotaxime, moxalactam and cefsulodin, respectively. These data confirm that the newer antipseudomonal antimicrobial agents are more effective against Ps. aeruginosa than the older agents.

Anti-Bacterial Agents↗
PubMed1982

Bacterial meningitis. A follow-up study of 115 children.

The clinical and laboratory date on 115 pediatric patients with bacterial meningitis are presented. Sixty-one were less than 12 mo of age including 13 less than 1 mo of age. Thirty-nine children were treated prior to admission with antimicrobial agents which obscured accurate bacteriologic diagnosis in eight of them. Gram-negative enteric bacteria, mainly Escherichia coli, were recorded in 9 of 13 neonates. Hemophilus influenzae type B accounted for 56 (52%) of all isolated recorded in those greater than 2 mo of age, of which 35% were resistant to chloramphenicol. Seventy-eight patients (73%) recovered completely following 10 to 14 days of antimicrobial therapy. Fifteen patients died, most of whom were less than 1 yr of age, including five neonates. Major neurologic sequelae included subdural effusions, cerebral abscesses and recurrent convulsions. This study, which documents the infrequency of Streptococcus group B and H. influenzae as etiological agents of neonatal meningitis, indicates that treatment of this disease with ampicillin and an aminoglycoside is efficacious. Chloramphenicol may be the drug of choice in the postnatal period, since H. influenzae is partly resistant to ampicillin.

Aminoglycosides↗
PubMed1982

Screening of urinary pathogens obtained from catheterized patients for mannose-specific lectin: clinical implications.

The adherence of bacteria to the uroepithelium is mediated partially by a lectin present on the bacterial surface and can be blocked by mannose derivatives. The presence of the bacterial lectin was sought in the urine of 170 catheterized patients. Sixty-one percent of the isolated Escherichia coli, 55% of the isolated Klebsiella sp. and 11% of the isolated Proteus sp. agglutinated yeast cells and thus had lectin on their surfaces. In most instances the agglutination could be blocked by mannose. Lectin-bearing E. coli were significantly more sensitive to cephalothin and sulfamexazole-trimethoprim than the other isolates, and they were isolated from the urine of patients who were catheterized for shorter periods of time (mean 4.0 days) and who had not received antibiotics or short antibiotic courses.

Aged↗
PubMed1982

Salmonella and Shigella adherence to the intestine of mice.

The in vivo adherence of [14C]glucose-labeled Shigella and Salmonella strains to the intestine of the mouse was investigated. Salmonella strains adhered significantly better to the small bowel mucosa than to the large bowel, while Shigella strains adhered significantly better to the colonic mucosa than to the small bowel mucosa. A mannose-sensitive lectin-bearing Salmonella strain adhered significantly better to the jejunal mucosa than did a mannose-resistant variant. A mannose-sensitive Shigella strain adhered significantly better to the colonic mucosa than did the mannose-resistant strain. The addition of a mannose derivative diminished but did not abolish the adherence of the mannose-sensitive strains. These findings suggest that different segments of the intestine may have different receptors for bacteria regardless of their pathogenicity. Adherence may depend, in part, on the presence of mannose-sensitive lectin on the bacterial surface. Mannose derivative can partially inhibit bacterial adherence to the intestinal epithelium. Despite the lack of pathogenicity of Salmonella and Shigella in the mouse, this model can be further used for studying the adherence process, as well as the therapeutic measures that interfere with it.

Animals↗
PubMed1981

The pattern of age-specific tuberculin hypersensitivity in two groups of South African schoolchildren.

In epidemiological studies on tuberculosis we have observed a decrease in the prevalence of positive tuberculin reactions around the age of 13. This decrease was apparent in a variety of populations studied. Statistical analysis of the tuberculin testing data demonstrates the significance of the decrease in the proportion of positive reactors at age 13 and also of a reduction in size of reactions. The possibility of suppression of the delayed hypersensitivity reaction at about puberty is considered.

Adolescent↗
PubMed1981

Prediction of creatinine clearance from serum creatinine concentration based on lean body mass.

An equation for predicting endogenous creatinine clearance (CrCl) in adults and children (with both stable and unstable renal function) from serum creatinine concentration is presented. The predictions are compared with four other available estimating methods, bases on values in 110 subjects with renal impairment of widely differing degrees. In patients with stable and with unstable renal function the corelaion between measured and predicted CrCl was better with the new equation. In patients with rapid changing renal function the new equation resulted in accurate predictions CrCl within a few hours after the change, as opposed to several with the other methods. The elimination rate constant of the aminoglycoside antibiotic amikacin correlated more precisely with CrCl values estimated from the new equation that with those measured doing 24 hr or with the other prediction methods.

Acute Kidney Injury↗
PubMed1981

Insensitivity of peptidoglycan biosynthetic reactions to beta-lactam antibiotics in a clinical isolate of Pseudomonas aeruginosa.

The enzymatic reactions (transpeptidases/ that catalyze the attachment of newly synthesized peptidoglycan to the preexisting cell wall sacculus of both Escherichia coli and Pseudomonas aeruginosa have been shown to be very sensitive to most beta-lactam antibiotics. Biosynthetic studies carried out with a clinical isolate of P. aeruginosa resistant to carbenicillin and cefsulodin showed that the in vitro reactions were also insensitive to most beta-lactam antibiotics (up to 50 micrograms/ml) and only cefotaxime or its tetrazolyl analog, compound LY 97962, had an inhibitory effect at 0.01 microgram/ml. The pattern of beta-lactam binding proteins obtained upon exposure of intact or presonicated cells to radioactively labeled compound LY 97962 or penicillin G indicates that: (i) intact cells of the clinical isolate are 10 to 50 times less permeable to the antibiotics than is the wild-type strain X-48; (ii) beta-lactam binding proteins Ia, Ib, and III of the clinical isolate showed poor affinity for penicillin G and cefsulodin, but were similar to the wild type in their affinity for cefotaxime and compound LY 979062. The two strains also differed in several of their outer membrane components. These results suggest that the insusceptibility of this clinical isolate is due to a combination of outer membrane impermeability and intrinsic insensitivity to most of the beta-lactams on the part of the enzymes which catalyze expansion and growth of peptidoglycan.

Anti-Bacterial Agents↗
PubMed1981

Increase of the intestinal absorption of gentamicin and amikacin by a nonionic surfactant.

This study was concerned with the effect of Cetomacrogol (polyethylene glycol 1000 monocetyl ether), a nonionic surfactant, on the absorption of gentamicin and amikacin from the gastrointestinal tract of rats. A 200-mg dose of Cetomacrogol coadministered orally with 10 mg of gentamicin resulted in a mean peak gentamicin blood concentration of 14.1 microgram/ml, compared with 67.8 microgram/mg when the same gentamicin dose was administered intramuscularly. The area under the curve after administration of the oral mixture was 23% of that after the intramuscular dose. The rectal administration of the mixture resulted in a mean peak gentamicin blood level of 8.2 micrograms/ml, compares to 16.5 microgram/ml when the mixture was administered orally. A 50-mg dose of amikacin coadministered orally with 200 mg of Cetomacrogol resulted in a mean peak amikacin blood level of 13.3 microgram/ml, compared to 310 microgram/ml when this amikacin dose was administered intramuscularly. Cetomacrogol augments the intestinal absorption of gentamicin and amikacin in rats. If the toxicity of the combination in humans is limited, the combination may be potentially clinically useful.

Amikacin↗