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Biomedical subjects

F Goldstein

Publications and source records attributed to F Goldstein.

At least 55 records · Page 3Linked to original sources
PubMed1990

In vitro activities of 15 oral beta-lactams against Klebsiella pneumoniae harboring new extended-spectrum beta-lactamases.

The activities of 15 oral beta-lactams against Klebsiella pneumoniae harboring new extended-spectrum beta-lactamases were studied. All compounds were affected by these enzymes, especially by the SHV derivatives. Except for ceftibuten, the compounds with the greatest intrinsic activity were more affected by the presence of these enzymes than were older compounds with moderate intrinsic activity.

Anti-Bacterial Agents↗
PubMed1990

[Prospective evaluation of modalities of ceftazidime prescription].

Between November 1987 and October 1988, we have prospectively studied 101 hospital prescriptions of ceftazidime, a third generation cephalosporine, including all the health care departements of St Joseph hospital. A standard questionnaire was used to collect the date: dosage, length, and conditions of prescriptions. We observed that this antibiotic is correctly prescribed concerning dosage, length of prescription, and is adapted to bacteriological findings. The striking results were a high proportion of empirical prescriptions (48%) comparing to less than 10% 6 months before the beninning of this study. 75% of these empirical prescriptions being later on confirmed by bacteriological exams.

Aged↗
PubMed1987

Immunosuppressant therapy of inflammatory bowel disease. Pharmacologic and clinical aspects.

The history of immunosuppressant drug use, both azathioprine (Aza) and 6-mercaptopurine (6-MP), in inflammatory bowel disease (IBD) over the past 20 years is briefly reviewed. The two drugs appear identical in their pharmacologic and biologic effects. Azathioprine is converted to 6-MP while in the body. Conflicting reports on the effectiveness of Aza have been published. The major National Cooperative Crohn's Disease Study (NCCDS) has found no advantage in Aza over placebo. In contrast, 6-MP was found to be effective in a large randomized trial. The shortcomings of the NCCDS reports are discussed with possible explanations for their negative findings. Our own studies, dating from 1968, are reviewed with 38 patients having been treated for up to 18 years, always in combination with small doses of steroids. Our results with Aza are similar to those of Present and Korelitz with 6-MP; about 70% of previously intractable patients improved substantially. Both Aza and 6-MP bring about healing and closure of most fistulas. Side effects can be serious but are usually manageable and, to some extent, preventable by appropriate dosage schedules. Since Aza has been approved for another benign, presumably autoimmune disease--rheumatoid arthritis--and because of its extensive use in other autoimmune diseases, we prefer to use Aza in selected patients with Crohn's disease who have failed to respond to more conventional modes of therapy. The use of immunosuppressants in ulcerative colitis is less clearly indicated.

Adolescent↗
PubMed1987

Predominance of capsular polysaccharide type 5 among oxacillin-resistant Staphylococcus aureus.

The relationship between capsular polysaccharide types 5 and 8 and resistance of Staphylococcus aureus to oxacillin was studied with a collection of 406 clinical isolates from six French hospitals. Of 175 type 5 isolates, 84 (48%) were resistant to oxacillin. In contrast, only 8 of 160 type 8 isolates (5%) and 5 of 71 nontypeable isolates (7%) were resistant to oxacillin. Therefore, capsular typing of clinical isolates of S. aureus may facilitate the choice of first-line antibiotic therapy.

Bacterial Capsules↗
PubMed1987

Favorable effects of sulfasalazine on small bowel Crohn's disease: a long-term study.

Due to conflicting reports in the literature regarding the efficacy of sulfasalazine for Crohn's disease (CD) involving small bowel alone, we reviewed the treatment results of our systematic sulfasalazine treatment in CD over a 23-yr period. We identified 28 patients with CD of small bowel alone treated between 1 and 23 yr by means of sulfasalazine alone and who went into complete clinical remission. Of these, 12 also showed total regression of radiographic abnormalities, 12 showed partial regression, while four patients still await radiographic reexamination. While our data do not permit a precise estimate, it seems that about 25% of patients with small bowel CD respond to sulfasalazine alone. Reasons are discussed why our data are at variance with some and in accord with other reports. While our study of necessity could not be carried out in double-blind fashion, patients served as their own controls, having previously failed to respond to other treatment modalities or no treatment. We conclude that sulfasalazine should be tried in the treatment of CD of small bowel because of its relatively low toxicity and reasonably high efficacy.

Adolescent↗
PubMed1986

Transposable resistance to trimethoprim and 0/129 in Vibrio cholerae.

Vibrio cholerae biotype el tor strain BM2508, resistant to trimethoprim, 0/129, streptomycin and spectinomycin was isolated from the faeces of a child with severe diarrhoea. Resistance to trimethoprim and 0/129 was due to a dihydrofolate reductase type I and resistance to streptomycin-spectinomycin to a 3'',9-aminoglycoside-aminocyclitol adenylyltransferase. The resistance genes were not transferable to Escherichia coli and, as inferred from ultracentrifugation in cesium chloride-ethidium bromide and agarose gel electrophoresis of crude bacterial lysates, were located on the chromosome. The resistance genes were transposed to multiple sites of plasmids belonging to incompatibility groups 6-C and P, introduced in BM2508 and were subsequently transferred to E. coli (rec-), Salmonella typhimurium, V. cholerae and V. parahaemolyticus strains where they re-transposed into the chromosome. Analysis of plasmid DNA from the transconjugants by agarose gel electrophoresis following digestion with HindIII and by Southern hybridization using a ColEl::Tn7 probe indicated the presence of a 14-kilobase transposon, Tn1527, closely related to Tn7. The emergence of Tn1527 in V. cholerae may lead to prophylactic and therapeutic failures due to trimethoprim resistance and to bacterial misidentification because of cross resistance to 0/129.

Anti-Bacterial Agents↗
PubMed1985

Intralesional steroid therapy of pyoderma gangrenosum.

Treatment of pyoderma gangrenosum complicating ulcerative colitis has in the past been frustrating and usually unsuccessful, frequently resulting in colectomy. Intralesional steroid therapy has been used off and on in a few patients, but the treatment is not widely known to gastroenterologists. We report two patients successfully treated for early pyoderma gangrenosum by intralesional injection of triamcinolone acetonide (Kenalog, 40 mg injection) together with conventional doses of systemic steroids. A single series of injections was sufficient to bring about healing of the lesions in both patients. The treatment permitted early discharge of patients from the hospital, and the skin lesions were completely healed within 2 months. The lesions have not recurred in follow-up examinations of 11/2 and 21/2 years, respectively. We hope that other physicians will find this approach equally effective.

Adolescent↗
PubMed1985

Variability of IncHI1 plasmids from Salmonella typhi with special reference to Peruvian plasmids encoding resistance to trimethoprim and other antibiotics.

In spite of extensive DNA homology among IncHI1 plasmids, ApaI and XbaI restriction digests of plasmids from Peruvian Salmonella typhi varied considerably from other IncHI1 plasmids isolated previously. IncHI1 plasmids appear to be undergoing a process of modular evolution, probably by sequential acquisition of resistance determinants.

Chloramphenicol↗
PubMed1984

The relationship between the branched chain amino acids and their alpha-ketoacids in maple syrup urine disease.

Plasma branched chain amino acid levels and their respective ketoacid analogues were determined in seven maple syrup urine disease patients ranging in age from 12 h to 12 years. One hundred one pairs were analyzed. There was a high degree of correlation between the amino acid and its ketoacid analogue at every amino acid level. The coefficient of correlation (0.84) was highest for leucine-alpha-ketoisocaproic acid. The ratio of ketoacid analogue to amino acid, (0.87), was also the greatest for leucine. The close correlation implies that adequate monitoring for therapy can be accomplished by the use of the technically simpler and more rapid determination of the plasma branched chain amino acids.

Amino Acids, Branched-Chain↗
PubMed1983

Early gastric cancer in a United States hospital.

Early gastric cancer (EGC) confined to mucosa and submucosa, described by Japanese physicians over 20 years ago, yields about 90% 5-year postoperative survival. EGC has been increasingly reported from centers outside Japan, but rarely from the United States. Between 1976-1981, EGC was found in six patients or about 8.5% of all gastric carcinomas diagnosed in our hospital. Diagnoses were established by following suspicious upper gastrointestinal series or negative x-rays in patients with dyspepsia by means of gastroscopy and gastroscopically obtained biopsies, brush, and/or wash cytology. All six patients underwent subtotal gastrectomy with histological findings of EGC not invading the muscularis and with no metastases. So far no tumor recurrences have been found in these six patients. The results suggest that EGC as defined by Japanese investigators occurs in our hospital and presumably across the United States more often than heretofore appreciated. Previous fatalistic attitudes toward diagnosing gastric cancer should be replaced by efforts at early diagnosis. Patients with symptoms suggestive of gastric carcinoma, including unexplained dyspepsia, should undergo early upper gastrointestinal x-ray and endoscopic examinations with biopsies and cytological tests of any suspicious raised, flat, or depressed area.

Aged↗
PubMed1982

[Comparative study of ceftriaxone, cefotaxime and moxalactam against 150 Gram negative strains (author's transl)].

The in vitro activity of ceftriaxone, a new cephalosporine derivative was compared with two other "third generation" cephalosporins, cefotaxime and moxalactam. 150 strains of Gram negative bacilli were used in this study. Ceftriaxone as cefotaxime and moxalactam were very active against most of the 104 multiresistant Enterobacteriaceae. Ceftriaxone was the most active against Proteus providencia with a mean MIC of 0.007 microgram/ml. Cefotaxime and ceftriaxone were less active than moxalactam against Enterobacter with MIC higher or equal to 32 micrograms/ml. The three cephalosporins had an almost identical activity against carbenicillin resistant Pseudomonas with an MIC higher than 4 micrograms/ml. MIC against Acinetobacter were higher or equal to 16 micrograms/ml. Moxalactam was the most active against Bacteroides fragilis with a mean MIC of 0.5 micrograms/ml; ceftriaxone and cefotaxime had a mean MIC of 2 to 4 micrograms/ml.

Acinetobacter↗
PubMed1981

Bile reflux gastritis and esophagitis in patients without prior gastric surgery, with pilot study of the therapeutic effects of metoclopramide.

We reviewed our upper endoscopic records over a 27-month period, retrospectively for 23 months and prospectively for four months and identified patients with substantial bile reflux. Patients with prior gastrectomies were excluded. Of the remaining 36 patients, 23 had prior cholecystectomies. Bile reflux gastritis and esophagitis were found in the majority of patients with bile reflux and occurred more often than is generally appreciated. Patients were seen with a fairly consistent and protracted clinical pattern, usually with severe early postprandial epigastric pain, tenderness and frequent heartburn. Cholecystectomy appeared to be a most important predisposing factor. The correct diagnosis can only be made by upper gastrointestinal endoscopic inspection and biopsies. A pilot therapeutic trial of metoclopramide suggests beneficial effects of this drug in the majority of afflicted patients. A randomized controlled trial of metoclopramide is being prepared to define more clearly the role of this drug in bile reflux gastritis and esophagitis.

Adult↗