Biomedical subjects
Publications and source records attributed to H Steinitz.
Considering the fact that various epidemiological situations in Public Health departments arise everyday life, many different proposals are made for Public Health and sanitary measures, e.g. throat culture, antibiotic treatment and, in particular, readmission to community institutions.
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Liver abscess is the most frequent complication of intestinal disease caused by entamoeba histolytica. Noninvasive procedures are nowaday most important in establishing the diagnosis: sonography, scintigraphy and computer tomography (CT). Sonography is rather precise and should be used in the first place. Recently it became possible to demonstrate specific antigens to amoeba in the pus of the abscess or in liver biopsy material; this procedure has been proven to be dependable and fast in establishing a diagnosis. Serological methods like indirect hemagglutination tests usually show positive results in high titers. The clinical picture, serological and immunological diagnostic procedures as well as demonstration of intrahepatic defects by sonography and/or scintigraphy usually help to establish a diagnosis fastly; only in a few cases will it be necessary to do computer tomography additionally. Metronidazole, tinidazole and other nitroimidazoles have led to a considerable decrease of lethality, which used to be rather high before. Treatment of the intestinal disease caused by amoebae should not be forgotten. Cortisone is contraindicated.
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Abdominal pain, nausea, flatulence and diarrhea are the main clinical symptoms in chronic amebiasis; diarrhea and constipation may alternate in many cases, whereas constipation alone does occur only rarely. These symptoms may persist over years, with long asymptomatic intervals. In most cases cysts of entameba histolytica can be demonstrated in the feces, accompanied rather often by dientameba fragilis in Israel. 835 carriers of entameba histolytica were found among our patients between 1968 and 1974. Patients exhibiting 3 of the above mentioned clinical symptoms and having entameba histolytica in the stools are defined to be suffering from chronic recurrent amebiasis; 371 (= 44%) of our patients could be classified in this group. In spite of the fact, that the number of cases of acute amebiasis and its complications in Israel has been reduced considerably in the past, chronic amebiasis continues to be a clinical and epidemiological problem, its incidence being scarcely diminished.
The incidence of death caused by cirrhosis of the liver has increased in Israel during the last 20 years as it has in other parts of the world; still the incidence is much lower than in most countries. Increasing alcoholism and higher rates of hepatitis probably play a role, however in many cases the cause of cirrhosis remains in the dark.
In the autumn of 1975 five cases of poliomyelitis occurred within 6 weeks in German children of families of low socioeconomic class. They lived in two districts of Freiburg with close familial and occupational contacts. One child had been immunised against polio once orally several years ago and none of the others were immunised. The clinical course and results of investigations of the environment are reported. Included is the state of immunisation of 472 school beginners in Freiburg schools and the antibody levels of 284 children aged 1 to 10 years from Freiburg and the adjoining areas.
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Antigenic differences between the influenza C strains C/1233/47 (Taylor), C/Paris/1/67 and strains isolated in Johannesburg 1967 have been reported (Pereira, 1969). Our experiments performed with chicken immune sera did not differentiate clearly between the strains C/Paris/1/67 and C/Jhb/4/67, however, antigenic differences between the strains C/1233/47 and the strains isolated in 1967 could be confirmed. These antigenic differences were found to be of approximately the same degree as those observed between the strains influenza B/Berlin/55 and influenza B/Belfast/61. A serological survey showed that the prevalence of such influenza B strains was clearly delineated in a change of the predominant antibody related to age. In contrast, antibody patterns to the three influenza C strains were similar in all age groupds, most antibody carriers being detected with the C/1233 strain, and revealed to evidence for antigenic drift. Antibody distribution in sera obtained from paediatric hospitals of two cities was nearly the same with the highest prevalence reached in children aged 6-7 years. Low titered non-specific inhibitors of haemagglutination to the strains isolated in 1967 were present in some animal and human sera which could be completely adsorbed with kaolin.
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