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Biomedical subjects

E Rubinstein

Publications and source records attributed to E Rubinstein.

At least 91 records · Page 5Linked to original sources
PubMed1996

Cystic fibrosis heterozygote screening in the Orthodox Community of Ashkenazi Jews: the Dor Yesharim approach and heterozygote frequency.

In the community of the Orthodox Jews most of the marriages are arranged a screening program that is aimed at preventing the marriage of two carriers of autosomal recessive disorders is conducted by the Dor Yesharim organization. A random sample of 6,076 individuals of the Orthodox Jewish Ashkenazi community, were screened for the five mutations common in Ashkenazi patients (delta F508, W1282X, G542X, N1303K, 3849 + 10Kb C-->T). Two hundred thirty-two carriers were identified, giving a heterozygote frequency of 1:26. The relative frequencies of the individual mutations in the general population were comparable to those in the patients.

Adolescent↗
PubMed1996

Future prospects and therapeutic potential of streptogramins.

Dramatic changes in the epidemiology and susceptibility patterns of Gram-positive cocci during the last decade have mandated new approaches to the management of many bacterial infections. For example, there has been a sharp increase in the incidence of infections caused by Staphylococcus aureus, particularly those resistant to methicillin (MRSA), and methicillin-resistant coagulase-negative staphylococci, particularly those associated with foreign bodies and indwelling medical devices. Additionally, the worldwide spread of Streptococcus pneumoniae strains resistant to penicillin and macrolides, and the emergence of enterococci (particularly Enterococcus faecium) resistant to vancomycin, teicoplanin and other antibiotics, present further therapeutic problems. New antibacterial agents are urgently required to meet the challenges posed by these epidemiological trends. The semisynthetic streptogramins, a unique class of antibacterials currently under development, offer promise in the treatment of such multiresistant infections. Possible future applications include treatment of infections caused by the following organisms: MRSA, enterococci resistant to vancomycin, macrolides or lincosamides; and beta-lactam-resistant streptococci. They may also prove useful as therapy for children with staphylococcal infection and patients with multiresistant infections who are unable to tolerate vancomycin, including patients with skin and soft tissue infections caused by Gram-positive pathogens, patients with osteomyelitis, foreign body associated infections, endocarditis and sepsis due to Gram-positive bacteria. Clinical trials are required to evaluate the efficacy and tolerability of streptogramins in these settings.

Anti-Bacterial Agents↗
PubMed1996

Regional analysis of functions and demographics of health information managers.

Based on the findings of this study, HIM professionals' tasks or functions tend to vary across regions and in relation to levels of experience. As experience increased for RRAs, the task performed by them tended to be more management related. All other HIM professionals performed tasks that were more related to data collection than management. The most frequent title for the RRA (Director/manager/chief of medical records or HIM) was also more related to management activities while the title for the ART (Coder) was directly related to data collection. The majority of all HIM professionals work in acute care with approximately 3-8 percent working in long term care, ambulatory care, mental health care, and other healthcare settings such as software companies or health departments. The two most important predictors of salary across all regions were years of experience and educational level. When experience and education were controlled for, there was a slight salary advantage for males in the Midwest and West regions.

Data Collection↗
PubMed1996

[Delayed hypersensitivity in man after booster anthrax vaccination].

The purpose of this study was to ascertain the need for boosters after administration of STI anthrax vaccine. Postvaccination dynamics was assessed by observing the intradermic reaction of anthraxine. The study included 138 subjects vaccinated 15 months earlier by subcutaneous injection or 128 subjects vaccinated 24 months earlier by aerosol inhalation. Subjects were tested using the anthraxine test in separate groups on D2, D7, D15, D90, D180, and D365 after administration of the booster via the same route as the primary vaccination. Immediately before administration of the booster residual positive skin reactions were observed in 14.3% of subjects in the subcutaneous vaccination group and 8.3% of subjects in the aerosol vaccination group. After the booster, the proportion of subjects with positive skin reactions increased rapidly. The proportion of positive skin reactions after the booster was not statistically different from the proportion after the primary vaccination. This study provides scientific evidence supporting the need for boosters after anthrax vaccination and demonstrated an absence of sensitization by anthraxine during tests to evaluate response kinetics in subjects after primary vaccination. Several questions remain to be answered concerning the optical booster dose, the most effective timing, and the value of acellular vaccines.

Administration, Inhalation↗
PubMed1996

[Vaccines against anthrax in animals, from Louis Pasteur to our day].

The authors outline the history of vaccination against anthrax in animals, from the end of the 19th century to the present time. The three main steps in the production of specific vaccines are described in detail: production of vaccines from live, encapsulated bacteria, followed by vaccines from live, unencapsulated bacteria and, finally, subunit vaccines. Advantages and disadvantages of these three types of vaccine, some of which are still in use today, are described and discussed.

Animals↗
PubMed1995

Non random activation of endogenous interleukin-2, (IL-2), IL-2 receptor alpha and IL-2 receptor beta genes after transfection of mouse fibroblasts with a cDNA for the alpha chain of the human IL-2 receptor.

Mouse fibroblasts do not ordinarily express components for the interleukin-2 receptor (IL-2R alpha, beta, and gamma). An analysis of these cells by reverse transcription followed by polymerase chain reaction, however, indicates the presence of transcripts specific for the IL-2R beta and gamma genes. Transfection of the cDNA for the alpha chain of the human IL-2R into LTK- mouse fibroblast cell line (L3 cells) leads, in long-term cultures, to the formation of transcripts of endogenous mouse IL-2, IL-2R alpha and beta genes, as detected by Northern blotting. Based upon the results of the binding of 125I-labeled IL-2 to the transfected cells, three IL-2-binding proteins of 55 kDa, 65 kDa and 75 kDa were expressed by the transfected cells. The 65-kDa and 75-kDa proteins bound IL-2 in the presence of monoclonal antibodies for the IL-2R alpha chain. These polypeptides assembled to form high-affinity IL-2R, as shown by Scatchard binding analyses. The receptors were functionally active, since the expression of H-2k major histocompatibility complex antigens on the surface membranes of L3 cells was enhanced by exposing the cells to IL-2. Activation of the IL-2 gene was also observed in long-term cultures of L alpha beta cells, another LTK- transfectant expressing the human IL-2R alpha chain. This type of gene activation was not observed in LTK- fibroblasts transfected with cDNA for human IL-2 or IL-2R beta genes. In L3 and L alpha beta cells, transcription of the endogenous IL-2 gene was suppressed by cyclosporin A and enhanced by cycloheximide. These data may have implications for gene therapy of cancer cells.

Animals↗
PubMed1995

Prevalence of antibodies against hepatitis A virus among new immigrants in Israel.

Israel, located in a region endemic for hepatitis A virus (HAV), recently absorbed a large population of immigrants who came from the former USSR. To assess the risk of high morbidity in this population a serosurvey of HAV antibodies was undertaken. Serum samples were collected from 965 new immigrants, of whom 664 came from the European, non-endemic region, and 301 from the Asian and Caucasian endemic regions of the former Soviet Union. They were compared to 240 Israelis. Each population was divided into six age groups: 1-9, 10-19, 20-29, 30-39, 40-49, and 50 years of age and older. The Asian/Caucasian immigrants and the Israeli population were found to share similar characteristics. In both groups, antibodies to HAV (anti-HAV) were present in the 1-9-year-old age group and reached maximum prevalence (90% and 86.7%, respectively) in the 20-29-year-old age group. In contrast, among the European immigrants anti-HAV was first found in the 10-19-year-olds and peaked (93%) in the age group of 50 years and older. It is concluded that immigrants originating from the European part of the former USSR may require vaccination against hepatitis A.

Adolescent↗
PubMed1995

Double-blind randomized study of 1 g versus 2 g intravenous ceftriaxone daily in the therapy of community-acquired infections.

In a multicentre, double-blind, randomized study involving four general hospitals in Israel, the efficacy and safety of ceftriaxone 1 g/day i.v. was compared to that of 2 g/day i.v. in the treatment of moderate to severe community-acquired infections requiring hospitalization. Two hundred and twenty-two patients were enrolled; 112 received intravenous ceftriaxone 1 g/day, and 110 received 2 g/day. The two groups were matched demographically, and their mean APACHE II score (10 points) and mean duration of successful therapy (7 days) were identical. The sites of infection in the 1 g and 2 g groups respectively were lower respiratory tract in 57 versus 51 patients, urinary tract in 31 versus 40 patients, and soft tissue in 24 versus 19 patients. There were no significant differences in clinical outcome between the 1 g and 2 g groups, the outcome being cure in 91% versus 86% of patients, improvement in 3% versus 3% of patients, failure in 3% versus 8% of patients, and relapse in 3% versus 3% of patients. The findings of this study indicate that ceftriaxone 1 g/day is as effective as 2 g/day in the treatment of moderate to severe community-acquired infections. The low-dose form is a more economical means of treating these infections.

Adult↗
PubMed1995

Ceftazidime monotherapy vs. ceftriaxone/tobramycin for serious hospital-acquired gram-negative infections. Antibiotic Study Group.

We compared ceftazidime monotherapy with ceftriaxone/tobramycin in a prospective, randomized clinical trial that included 580 patients with serious hospital-acquired infections. One-half of the patients had an underlying disease with a rapidly or ultimately fatal prognosis; 40% were nursed in intensive care units. Clinical response among patients with pneumonia (73% in the ceftazidime group vs. 65% in the ceftriaxone/tobramycin group), septicemia (73% vs. 59%), and complicated urinary tract infections (80% vs. 76%) showed that there were no significant differences in efficacy between the two regimens. Pseudomonas aeruginosa was the most prevalent pathogen and was effectively eradicated by both treatments. The odds of bacteriologic cure with either study regimen were equal. Mortality was similar in both treatment groups. Ceftazidime monotherapy was not associated with a higher incidence of development of resistance or superinfection. Both regimens were well tolerated; no patients receiving ceftazidime evidenced nephrotoxicity, compared with nine who received the combination. We conclude that ceftazidime may be used as monotherapy in the empirical treatment of patients with serious nosocomial infections.

Adult↗
PubMed1995

Fungal endocarditis.

Fungal endocarditis has become an important infection associated with medical progress and a modern lifestyle. The most common organisms isolated from patients with fungal endocarditis are: Aspergillus spp.; Candida spp. and Torulopsis glabrata. Men are more frequently affected than women and predisposing factors include: previous cardiac surgery, antibiotic use and hyperalimentation, long-term i.v. catheters. Common clinical findings in patients with endocarditis include: fever, changing murmurs, peripheral emboli which are characteristically large and chorioretinitis. Characteristic laboratory findings are absent and positive blood cultures are obtained only in a relatively small number of patients. Characteristically, Aspergillus spp. almost never grow in blood cultures and must be isolated from removed emboli, from the diseased valve or from infected foreign bodies. Overall survival in patients with fungal endocarditis is rather poor, and hardly exceeds 50%. In general, a combined surgical-medical approach would yield the best results. New therapeutic modalities are needed in order to improve the prognosis of fungal endocarditis.

Endocarditis↗
PubMed1995

Propylene glycol toxicity caused by prolonged infusion of etomidate.

We describe a case of propylene glycol toxicity due to intravenous administration of etomidate for cerebral protection. A continuous etomidate infusion was titrated to burst suppression of the electroencephalogram during surgical resection of a large intracranial arteriovenous malformation. The etomidate formulation used (Amidate, Abbot) contains etomidate 2 mg/ml in a 35% propylene glycol vehicle. A total of 5 g/kg of the solvent was given during 12 h. Adverse effects of propylene glycol were observed including hyperosmolality with an increased osmolal gap, hemolysis, hemoglobinuria, and metabolic acidosis. Normalization of these metabolic and ionic alterations occurred after 12 h of discontinuation of the infusion. The potential toxicity of the solvent should be considered during long-term administration of etomidate.

Acidosis↗
PubMed1995

Rapid bioassay for detection of Bacillus anthracis in mice.

A rapid-bioassay method (RBA) of diagnosing anthrax was developed in mice. A standard RBA consisted of intraperitoneal inoculation of a suspected culture or of a suspension of raw infected animal tissues in four pairs of mice. At 60, 120 and 180 min after inoculation, two mice were killed and smears and impression smears were made from the peritoneal fluid, heart blood, spleen, liver, and kidneys, and then fixed, stained and microscopically examined. Encapsulated rods seen in microscopy confirmed the diagnosis. The remaining pair of mice was kept for a 10-day observation period and served as a control. In the experiments described in this study, RBA showed a high efficiency. A vegetative culture of 18-20 h of Bacillus anthracis growth demonstrated encapsulation in mice as early as 120 min after inoculation; a culture of 3-5 or 6-12 h of growth showed encapsulation at 60 min. Old spores gave encapsulation at 180 min, but, if previously plated for 6 h, encapsulation was observed as early as 60 min after inoculation. Inoculation of raw infected tissues gave positive results at 120 min. As compared with the challenged controls, no deviations between the results of RBA and the final diagnosis of anthrax were observed, but RBA appears to be 7-17 times more rapid. Some variations of the standard RBA are also suggested.

Animals↗
PubMed1995

Intestinal elimination of sparfloxacin, fleroxacin, and ciprofloxacin in rats.

The intestinal transepithelial elimination of sparfloxacin and fleroxacin was compared with that of ciprofloxacin in a rat model following a single parenteral administration of 25 mg of each of the antibiotics per kg of body weight. All three fluoroquinolones were eliminated through the small intestine. Ciprofloxacin was eliminated in the proximal jejunum at a rate of 1.97 +/- 0.70 micrograms/cm2, while the elimination rates of fleroxacin and sparfloxacin were 0.64 +/- 026 and 0.21 +/- 0.10 micrograms/cm2, respectively, over a 90-min collection period. In the ileum, the elimination rates of ciprofloxacin, fleroxacin, and sparfloxacin over the same period were 1.44 +/- 0.77, 1.00 +/- 0.33, and 0.41 +/- 0.26 micrograms/mc2, respectively. These data suggest that these fluoroquinolones undergo a transepithelial elimination process in the small intestine. This route of elimination may be important in the therapy of bacterial diarrhea.

Animals↗
PubMed1995

Effect of allogeneic polymorphonuclear neutrophils on staphylococcal sepsis in mice.

The antibacterial and host-damaging properties of locally injected allogeneic polymorphonuclear neutrophils (PMN) were studied in vivo. Peritoneal PMN were obtained from donor mice 24 h after i.m. infection with sublethal (SD) and lethal (LD) dose of Staphylococcus aureus. These donor PMN were mixed with S. aureus and injected i.m. into normal recipient mice. Normal donor PMN and PMN obtained from SL-infected donor mice did not induce the mortality of SL-infected recipient mice but protected LD-infected recipients (5.8% mortality vs. 29.4%). PMN obtained from LD-infected donor mice caused ca. 77% mortality in SD-infected recipients. In survivors, during the first 3 h infection, serum tumor necrosis factor (TNF) concentrations were higher than those in nonsurvivors and then decreased. In contrast, TNF level in nonsurvivors continued to be increased until death. PMN from LD-infected donors had the highest spontaneous chemiluminescence response (CL), the shortest time of peak and the lowest level of intracellular CL against S. aureus. These donor PMN exhibited increased phagocytosis and decreased killing of S. aureus than that of PMN of SD-infected donor mice. Early stimulation of PMN functions such as bacterial internalization and respiratory burst may result in decrease of their tissue-damaging properties.

Animals↗
PubMed1995

Chordomas and chondrosarcomas of the cranial base: results and follow-up of 60 patients.

The management of chordomas and chondrosarcomas involving the cranial base remains controversial. The options for therapy include biopsy, partial resection, radical resection, and various forms of radiotherapy. In this article, we analyze the outcome of 60 patients with cranial base chordoma or chondrosarcoma treated with extensive surgical resection between 1984 and 1993. Forty-six patients had chordomas, and 14 had low-grade chondrosarcomas; 50% of these patients had been treated previously. Preoperative studies included computed tomography, magnetic resonance imaging, cerebral angiography, and balloon occlusion test of the internal carotid artery, as indicated. Magnetic resonance imaging was performed on all patients during follow-up. The surgical approaches used for tumor resection were predominantly the following: subtemporal, transzygomatic, transcavernous, and transpetrous apex; subtemporal and infratemporal; extended frontal; and extreme lateral transcondylar. Staged operations with a combination of approaches were used when necessary (52% of cases) to remove a tumor more completely. Statistical analysis was done by the chi 2 test and correlation matrix. Sixty-seven percent of the patients had total or near-total resection. Twenty percent of the patients received postoperative radiotherapy. Eleven patients died during the postoperative follow-up period, nine with chordomas and two with chondrosarcomas. Three patients died because of systemic complications within 3 months after surgery, five died because of tumor recurrence, one died from unrelated causes, and two died from late complications of radiotherapy. The recurrence-free survival rate for all tumors was 80% at 3 years and 76% at 5 years. Chondrosarcomas had a better prognosis than chordomas (recurrence-free survival rates, 90% at 5 years and 65% at 5 years, respectively; P = 0.09). Patients who had undergone previous surgery had a greater risk of recurrence (5-year recurrence-free survival rate, 64%) than did patients who had not undergone previous surgery (5-year recurrence-free survival rate, 93%; P < 0.05). Patients with total or near-total resection had a better 5-year recurrence-free survival rate (84%) than did patients with partial or subtotal resection (64%) (P < 0.05). Postoperative leakage of cerebrospinal fluid was the most frequent complication (30% of patients) and was found to increase the risk of permanent disability. Patients who had undergone previous radiotherapy had a greater risk of death in the postoperative period (within 3 months of their operations) and during follow-up. However, total or near-total resection did not increase the rate of postoperative disability.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗