Hypoferremia: adaptation to disease?
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Adaptation, Physiological↗
Biomedical subjects
E Weinberg
Publications and source records attributed to E Weinberg.
[Economic valuation (cost-benefit analysis) of protective vaccination against Newcastle disease in poultry].
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Animals↗
Distribution of a neutral cardioplegic vehicle during the development of ischemic myocardial contracture.
During prolonged ischemic cardiac arrest successful myocardial protection depends upon uniform delivery of cardioplegic solutions to all regions of the heart. Accordingly, we studied the regional and transmural distribution of a neutral crystalloid (dextran-saline) solution during normothermic (37 degrees C) ischemia in 18 isolated blood-perfused dog hearts (isovolumic left ventricle). In the baseline state, coronary perfusion pressure was 100 mmHg. At the onset of ischemia and every 15 min throughout ischemia, we infused 100 ml of crystalloid solution (37 degrees C) at a perfusion pressure of 100 mmHg and the distribution of crystalloid solution was assessed (radioactive microsphere technique). The hearts were reperfused after 60 min (n = 9) or 90 mins (n = 9) of ischemia. In the baseline pre-arrest state the left ventricle (LV) received 67 +/- 1.0% of the total coronary blood flow; the LV subendocardial to subepicardial flow ratio was 1.33 +/- 0.18, the LV end diastolic pressure was 7.5 +/- 0.4 mmHg, and mean transmural myocardial adenosine triphosphate (ATP) was 16.4 +/- 1.1 microM/g DW. At the onset and throughout the first 45 mins of ischemia (n = 9), regional and transmural distribution of the crystalloid solution was similar to that of coronary blood flow during the baseline state; there was no change in LV end diastolic pressure, but there was a moderate fall in ATP content (7.26 +/- 1.6 micron/g DW). After 75 mins of ischemia (n = 9), despite the development of ischemic contracture (LV end diastolic pressure exceeded 20 mmHg in all 9 hearts) and marked ATP depletion (2.76 +/- 0.5 microM/g DW), there was an increase in crystalloid solution delivery to the LV as a whole and the subendocardium in particular (the LV received 82 +/- 2.0% and the subendocardial to subepicardial flow ratio was 1.75 +/- 0.1). Even in a subgroup with severe contracture during ischemic arrest (LV end diastolic pressure greater than 60 mmHg, n = 4) there was no reduction in crystalloid solution delivery. Thus, the presence of ischemic contracture does not preclude delivery of crystalloid solution to the LV subendocardium.
Adenosine Triphosphate↗
Results of a survey concerning application for residency training.
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Choice Behavior↗
Performance of transfer students.
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Education, Medical↗
Tentative interpretive criteria for in vitro antibacterial susceptibility testing with imipenem.
Imipenem is a member of a new class of highly potent beta-lactam antibiotics, carbapenems, with a very broad antibacterial spectrum. This study was undertaken to determine tentative interpretive criteria for in vitro susceptibility testing with 10-micrograms imipenem disks. A careful examination of the zone diameters and the corresponding MICs for 489 clinical isolates by regression-line analysis and the error rate-bounded classification scheme suggested the following guidelines: greater than or equal to 16 mm with an MIC correlate of less than or equal to 4 micrograms/ml for susceptible, 14 to 15 mm (8 micrograms/ml) for moderately susceptible, and less than or equal to 13 mm (greater than or equal to 16 micrograms/ml) for resistant. Lack of cross-resistance between imipenem and broad-spectrum cephalosporins such as cefotaxime and ceftazidime argues against their use as class disks to predict in vitro susceptibility of bacterial species to carbapenems.
Bacteria↗
The influence of pressure overload left ventricular hypertrophy on diastolic properties during hypoxia in isovolumically contracting rat hearts.
We tested the hypothesis that there is an enhanced susceptibility in hypertrophied cardiac muscle to develop decreased diastolic distensibility of the left ventricle in response to hypoxia. The effects of brief hypoxia (3 minutes) were studied in rats with and without chronic left ventricular pressure overload hypertrophy using an isolated buffer-perfused and isovolumic (balloon-in-left ventricle) heart preparation with excised pericardium and vented right ventricle. We compared hypertrophied hearts from hearts from hypertensive uninephrectomized Wistar-Kyoto rats (n = 12) with normotensive uninephrectomized age-matched controls (n = 13). Coronary flow was held constant and adjusted so that an identical flow per gram left ventricular weight was achieved in both groups. The left ventricular balloon volume was adjusted to produce an initial left ventricular end-diastolic pressure of 10 mm Hg in both groups and was held constant thereafter so that changes in left ventricular end-diastolic pressure during hypoxia represented changes in diastolic chamber distensibility. Under aerobic conditions, left ventricular systolic pressure was 66% higher in the hypertrophied hearts than in the controls, but there was no difference in the rate or extent of left ventricular relaxation as estimated by the exponential time constant of pressure decay and the asymptote to which pressure decayed. In response to hypoxia, left ventricular end-diastolic pressure was significantly higher in the hypertrophied hearts than in the controls (37 +/- 5 vs. 22 +/- 5 mm Hg, P less than 0.001). In response to hypoxia, the rate of left ventricular relaxation was depressed to a comparable degree in both groups, but there was a greater upward shift in the asymptote to which pressure decayed in the hypertrophied hearts. Hypoxia-induced coronary vasodilation as assessed by the change in coronary vascular resistance was similar in the hypertrophied and control hearts (2.9 +/- 0.5 vs. 2.3 +/- 0.9 mm Hg/[(ml/min)/g], NS). The degree of hypoxia-induced anaerobic metabolism as estimated by the coronary arterial-venous lactate concentration difference was also similar in both groups (-0.72 +/- 0.23 vs. -0.73 +/- 0.16 mM/liter, NS). It is concluded that brief hypoxia results in a greater decrease in diastolic distensibility of the left ventricle in the presence of chronic pressure overload hypertrophy than in its absence.
Animals↗
Comparative ototoxicity of netilmicin, gentamicin, and tobramycin in cats.
Netilmicin, a semisynthetic aminoglycoside antibiotic, is less ototoxic in a variety of species than other aminoglycosides currently in therapeutic use. In this study, mixed-breed cats (four/group) were given daily sc injections of netilmicin (20, 40, and 80 mg/kg), gentamicin (20 and 40 mg/kg), or tobramycin (20, 40, and 80 mg/kg) for up to 30 weeks or until ototoxicity was observed. The animals were examined throughout the study for effects on cochlear and vestibular function. Hematologic, serum chemical, and drug-serum (24-hr postdose) assays were performed at approximate monthly intervals during the dosing period. The cochleae, kidneys, and liver were examined microscopically. The mean number of dose days required to produce vestibulotoxic effects, demonstrated by impaired righting reflex or locomotor ataxia, was from 41 to 61 in cats dosed with tobramycin (40 and 80 mg/kg) or gentamicin. No vestibular dysfunction was observed in any of the netilmicin 20-mg/kg-dosed cats, in two cats each of the tobramycin 20-mg/kg and netilmicin 40-mg/kg groups, and in one netilmicin 80-mg/kg-dosed animal. Histologic examination of the cochleae revealed degeneration of the hair cells and supporting sensory structures in the majority of cats dosed with gentamicin at 20 and 40 mg/kg and tobramycin at 40 and 80 mg/kg. Less than 50% of the tissues from cats of the tobramycin 20-mg/kg and netilmicin 40- and 80-mg/kg-dosed groups had similar degenerative cochlear changes. No cochlear damage was noted in any of the cats given netilmicin at 20 mg/kg. Results of the clinical laboratory determinations were generally unremarkable. Proximal tubular degeneration was the principal finding observed in the kidneys of the animals. Under the conditions of this study, at least a twofold (vestibular) to fourfold (cochlear) relative safety margin for ototoxicity was established in favor of netilmicin over tobramycin and gentamicin.
Animals↗
Simultaneous expression of early and late histone messenger RNAs in individual cells during development of the sea urchin embryo.
The transition from early (E) to late (L) histone gene expression in developing sea urchin (Strongylocentrotus purpuratus) embryos was examined for H2B, H3, and H4 mRNAs by in situ hybridization of class-specific probes. Hybridization patterns indicate that the shift from E to L mRNAs occurs gradually and simultaneously in all blastomeres. Thus, during the transition the ratio of L to E mRNAs is similar in most cells. This suggests that no sudden changes in histone composition occur in individual cells which might be related to alterations in gene expression associated with differentiation of cell lineages. Around the midpoint of the transition, clusters of cells progressively appear which contain little, if any, E or L histone mRNA. This modulation of expression is coordinated for the three late genes examined because most individual cells contain either high or low levels of all three mRNAs. At blastula stage these clusters of unlabeled cells appear to be randomly distributed throughout the embryo. Subsequently the unlabeled regions expand and are found predominantly in aboral ectoderm as these cells cease to divide. Thus, the L/E histone mRNA ratio is not differentially regulated in diverse cell lineages, and the major differences in total histone mRNA content among individual cells may be related to cell cycle and/or the cessation of division.
Animals↗
Evaluation of three broth disk methods for testing the susceptibility of anaerobic bacteria to imipenem.
Imipenem is a member of a new class of highly potent beta-lactam antibiotics, carbapenems, with an antibacterial spectrum that includes nearly all currently known aerobic and anaerobic bacterial species of clinical significance. Although relatively stable in most standard laboratory media used for antimicrobial susceptibility testing, imipenem undergoes rapid inactivation in thioglycolate broth, a recommended medium for susceptibility testing of anaerobic bacteria by the broth disk method. In the current study, a panel of 36 anaerobic bacteria consisting of 28 clinical isolates and eight quality control strains was used to determine the suitability and accuracy of the broth disk methods with brain heart infusion, Schaedler, and anaerobic broths, in comparison to the reference agar dilution method, for the anaerobic susceptibility testing of imipenem. To achieve single test concentrations of approximately 8, 16, and 64 micrograms/ml for imipenem, cefoxitin, and piperacillin, respectively, which correspond to the MIC breakpoints of the test drugs, four 10-microgram imipenem disks, three 30-microgram cefoxitin disks, and three 100-microgram piperacillin disks were used in 5 ml of broth. The correlation between the reference agar dilution method and each of the three broth disk elution procedures evaluated was excellent, for imipenem (100% agreement) and somewhat less so for cefoxitin and piperacillin. Therefore, brain heart infusion, Schaedler, and anaerobic broths, but not thioglycolate broth, are suitable for anaerobic susceptibility testing of imipenem by the disk elution method.
Bacteria, Anaerobic↗
In vitro antibacterial activity of norfloxacin and other agents against ocular pathogens.
302 clinical isolates representing 16 bacterial species most often implicated in ocular infections were tested in vitro against norfloxacin and a panel of antibacterial agents. On the basis of the 90% minimal inhibitory concentration (MIC90) data, norfloxacin was 4-32 times more active than the next best antimicrobial tested against Citrobacter freundii, Escherichia coli, Morganella morganii, Proteus mirabilis, Proteus vulgaris, Haemophilus influenzae, Neisseria gonorrhoeae and Staphylococcus epidermidis, with overall MIC90 less than or equal to 1 mg/l. Norfloxacin was equal in activity to polymyxin B against Klebsiella pneumoniae (MIC90 = 1 mg/l), and it ranked second to both polymyxin B against Pseudomonas aeruginosa and cotrimoxazole against Staphylococcus aureus, (MIC90 = 2 mg/l in each case). Along with neomycin and cotrimoxazole, norfloxacin (MIC90 = 1 mg/l) ranked second to gentamicin and tetracycline against Moraxella species. Compared to erythromycin (MIC90 less than or equal to 0.125 mg/l), norfloxacin (MIC90 less than or equal to 16 mg/l) was considerably less active against streptococci. Overall, norfloxacin was the most active agent in both potency and antibacterial spectrum against the test organisms. These results suggest the potential use of norfloxacin in the treatment of superficial bacterial infections of the eye.
Anti-Bacterial Agents↗
Acute severe asthma. A prospective study of the precipitating factors in 40 children.
A prospective study was undertaken to determine the factors precipitating acute severe asthma in children attending the Red Cross War Memorial Children's Hospital, Cape Town. A comparison in terms of recent exposure to possible precipitating factors was made between 40 known asthmatics presenting with acute severe asthma and 40 known asthmatics who were clinically well. Exposure to known allergens had occurred in 7 cases. The time of onset of symptoms bore no relationship to meteorological changes in temperature, humidity or average pressure. Drug compliance in both groups was of the order of 50%. The majority of severe asthma attacks were associated with infection of the respiratory tract. The importance of infection as a precipitating factor in a severe asthma attack is discussed with reference to the cholinergic, adrenergic and immunological mechanisms.
Acute Disease↗
Effectiveness of the antimicrobial removal device, BACTEC 16B medium, and thiol broth in neutralizing antibacterial activities of imipenem, norfloxacin, and related agents.
The Antimicrobial Removal Device (ARD), BACTEC 16B medium, and Thiol broth were evaluated for their effectiveness in reducing the activity of imipenem (IPM), cefoxitin, moxalactam, and ceftazidime in blood samples. In addition, the capability of the ARD and Thiol broth to bind norfloxacin and the ARD to bind oxolinic and nalidixic acids in urine samples was investigated. At the highest concentrations of the drugs tested (32 micrograms/ml for the four beta-lactams and 256 micrograms/ml for the three quinolinecarboxylic acids), there was at least a 95% reduction in the in vitro activity of each of the antibacterial agents for treated versus untreated samples. Of the compounds tested in the ARD system, the organic acids were more completely removed than were the beta-lactams. The Thiol broth was more effective than the ARD and the BACTEC 16B medium in inactivating imipenem, but it had no effect on the antibacterial activity of norfloxacin.
Anti-Bacterial Agents↗
In vitro antibacterial activity of norfloxacin (MK-0366, AM-715) and other agents against gastrointestinal tract pathogens.
A comparison was made of the in vitro activities of norfloxacin and of nine other orally administered antibacterial agents against 180 clinical isolates representing the bacterial species most frequently implicated in infections of the gastrointestinal tract in humans. The 90% minimal inhibitory concentrations showed norfloxacin to be 4, 15, 4, 17, 17, 17, and 33 times more active than the next best compound tested against Campylobacter fetus subsp. jejuni, Escherichia coli, Salmonella spp., Shigella spp., Vibrio cholerae, Vibrio parahaemolyticus, and Yersinia enterocolitica, respectively, with an overall 90% minimal inhibitory concentration of less than or equal to 0.5 micrograms/ml. Norfloxacin was least active against Clostridium difficile (90% minimal inhibitory concentration, 128 micrograms/ml). These results should encourage further evaluation of norfloxacin as a potential chemotherapeutic agent in the treatment of enteric bacterial infections for which antibiotic therapy is indicated.
Anti-Bacterial Agents↗
Tentative interpretive standards for disk diffusion susceptibility testing with norfloxacin (MK-0366, AM-715).
Norfloxacin is a new orally absorbed quinoline derivative structurally related to nalidixic acid but showing an expanded antibacterial spectrum which includes Enterobacteriaceae, Pseudomonas aeruginosa, Streptococcus faecalis, and staphylococci, among other susceptible bacterial species. The application of the regression line and error rate-bounded methods of analysis to the minimal inhibitory concentration and zone size data collected on 413 clinical isolates favored the selection of a 10-micrograms disk content and the adoption of the following interpretive zone size breakpoints for antimicrobial susceptibility testing with norfloxacin: greater than or equal to 17 mm for susceptible, 13 to 16 mm for intermediate, and less than or equal to 12 mm for resistant categories. It is proposed that isolates with minimal inhibitory concentrations of less than or equal to 16 and greater than or equal to 32 micrograms/ml be considered susceptible and resistant to norfloxacin, respectively. Differences in the antibiotic disk contents and in vitro antibacterial spectra and pharmacokinetic properties, together with the much lower rates of cross-resistance reported between norfloxacin and related drugs, strongly argue against the use of the "class disk" concept in this instance and suggest that the 10-micrograms norfloxacin susceptibility disk should be tested separately.
Anti-Bacterial Agents↗
Quaternary heterocyclylamino beta-lactams. II. The in vitro antibacterial properties of L-640,876, a new type of beta-lactam antibiotic.
A new semisynthetic cephalosporin antibiotic designated 7-beta-(1-benzylpyridinium-4-yl)-amino-3-[( (1-methyl-1H-tetrazol-5-yl) thio]methyl)ceph-3-em-4-carboxylate (L-640,876) was compared for antibacterial activity in vitro with mecillinam, cefoxitin and cefotaxime. The antibacterial spectrum of L-640,876 and the effect of culture medium composition and inoculum size on activity are most similar to those of mecillinam. In some cases the inoculum effect on MICs correlated with instability of the compound to certain beta-lactamases and in others to the presence of ionized compounds such as sodium chloride in the medium. On balance, L-640,876 was superior to mecillinam in potency and breadth of spectrum.
Amdinocillin↗
Quaternary heterocyclylamino beta-lactams. V. L-640,876 treatment of induced enterotoxigenic colibacillosis (scours) in calves and piglets.
A new semisynthetic cephalosporin antibiotic designated L-640,876, 7-beta-(1-benzylpyridinium-4-yl)amino-3-[( (1-methyl-1H-tetrazol-5-yl)thio] methyl)ceph-3-em-4-carboxylate, was highly active in vitro against 110 enteropathogenic strains of Escherichia coli and Salmonella species of animal origin. The MIC90 was 0.125 microgram/ml for the E. coli strains, 2 micrograms/ml for the S. choleraesuis strains and 4 micrograms/ml for the S. typhimurium strains. In colostrum-fed calves infected with E. coli strain B44, L-640,876 administered by gavage at 30 mg/calf (0.67 mg/kg) twice a day for 3 days, starting at 20-hour post-inoculation, eliminated the diarrhea and reduced the mortality from 82% in the infected, nonmedicated calves to 11% in the infected, medicated calves (P less than 0.05). In colostrum-fed piglets infected with E. coli strain P155, L-640,876 administered by gavage at 12.5 or 20 mg/piglet (10 or 16 mg/kg) twice a day for 3 days, starting at 6-hour post-inoculation, eliminated the diarrhea and reduced the mortality from 79% in the infected, nonmedicated to 25% in the infected, medicated piglets (P less than 0.05). Thus, L-640,876 was highly effective in restoring the calves and piglets to good health by eliminating diarrhea and reducing mortality.
Animals↗
Comparison of the antibacterial activity of norfloxacin (MK 0366, AM 715), a new organic acid, with that of other orally absorbed chemotherapeutic agents.
425 randomly selected, fresh clinical isolates were tested for susceptibility to norfloxacin and other orally absorbed agents, i.e. amoxicillin, ampicillin, carbenicillin (available commercially as the indanyl ester), cefaclor, cinoxacin, erythromycin, nalidixic acid, penicillin G, tetracycline, trimethoprim and co-trimoxazole. The results have shown norfloxacin to be the most potent agent in vitro against representative members of the family Enterobacteriaceae, Staphylococcus aureus, Pseudomanas aeruginosa, Acinetobacter spp., Neisseria gonorrhoeae and Haemophilus influenzae. Ninety percent of the isolates in these groups of bacteria were inhibited by less than 1 mg/l, 2 mg/l, 8 mg/l, 32 mg/l, 0.06 mg/l and 0.25 mg/l of norfloxacin, respectively. Although norfloxacin inhibited most streptococci and Ureaplasma at a concentration of 8 mg/l or less, penicillin G proved to be the most active against Streptococcus pygenes and Streptococcus pneumoniae; trimethoprim was the most active against Streptococcus faecalis, and tetracycline the most active against Ureaplasma.
Acinetobacter↗