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Biomedical subjects

J Benjamin

Publications and source records attributed to J Benjamin.

At least 91 records · Page 5Linked to original sources

Peritonitis in continuous ambulatory peritoneal dialysis patients in southern Israel.

We report our experience of peritonitis in a group of continuous ambulatory peritoneal dialysis (CAPD) patients in the south of Israel during a 3-year period. During this period, 51 patients were treated with CAPD, comprising a total of 999 patient months of treatment. One hundred and forty-three episodes of peritonitis occurred in 42 patients. When the patients were divided into high risk and low risk groups, the overall incidence was one episode every 5.7 months in the high risk group and one episode every 13.2 months in the low risk group. Gram-positive organisms accounted for 62.2% of the infections, and coagulase negative Staphylococcus for 35% of infections. The recurrence rate was 12%. Catheter removal was required in seven patients, and three patients were transferred to hemodialysis because of recurrent infections. We conclude that CAPD is a safe and viable modality of treatment for end-stage renal disease in our patient population.

Adult↗

Prostaglandins, H2-receptor antagonists and peptic ulcer disease.

Peptic ulcer develops when offensive factors overwhelm defensive processes in the gastroduodenal mucosa. Offensive factors include NSAIDs, hydrochloric acid-peptic activity, bile reflux, and some products of the lipoxygenase pathway such as leukotriene B4; whereas defensive processes are largely mediated by prostaglandins through poorly understood mechanisms uniformly termed cytoprotection. Cytoprotection, a physiological process working through the products of arachidonic acid metabolism, may result from the net effect of the protective actions of prostaglandins versus the damaging actions of leukotrienes. Some prostaglandins also have antisecretory effects. Therefore the peptic ulcer healing effects of prostaglandin analogues, all of which have significant antisecretory activity, may be more due to their antisecretory effects than primarily to their effects on mucosal defences. Certain drug-induced gastroduodenal lesions, e.g. NSAID-induced ulcers, which are often unresponsive to H2-receptor antagonists, have been healed and their recurrence prevented by the use of PGE1 and PGE2 analogues. All the prostaglandin analogues investigated to date in humans have the potential for inducing abortion, an important side effect which may limit their worldwide use. The optimal prostaglandin analogue for ulcer healing should not induce abortion and should be potently cytoprotective. The predominant damaging agent in the development of peptic ulcer disease is gastric hydrochloric acid. Thus, the worldwide established efficacy and safety of H2-receptor antagonists such as cimetidine, ranitidine, famotidine and most recently of roxatidine acetate suggest that these agents have become the standard by which other forms of anti-ulcer therapy should be judged.

Histamine H2 Antagonists↗

Biomechanical evaluation of various forms of fixation of transverse patellar fractures.

A study was undertaken to evaluate the strength and ease of application of four different forms of patellar fracture fixation. Modified tension band, screw fixation, Lotke longitudinal anterior band (LAB), and Magnusson wiring were examined using a Materials Testing System. Using cadaver lower extremities, the tibia was mounted in a fixed base and the tibiofemoral joint was fixed at 36 degrees. Tension was applied to the patella through the quadriceps tendon and fracture displacement was measured with linear motion transducers. Based on the results, we recommend screw fixation for transverse patellar fractures in patients with adequate bone stock. In patients with patellar fractures with comminution and/or osteopenia, modified tension band fixation is recommended. Simple wiring techniques alone may not provide sufficient fixation to allow immediate range of motion.

Biomechanical Phenomena↗

Renal disease associated with toluene inhalation.

A 32-year old woman developed severe quadriparesis, hypokalemia, and distal renal tubular acidosis following paint sniffing for one week. A review of literature indicated that a spectrum of renal diseases may develop in association with inhalation of toluene-containing substances. Toluene inhalation should be considered in the differential diagnosis in any young patient who presents with an unexplained renal disorder.

Acidosis, Renal Tubular↗

Sudden death of a champion athlete. Autopsy findings.

We report the autopsy findings after the sudden death of a champion swimmer. The athlete was asymptomatic and had only recently retired from a sport in which he had been the South African captain for 4 years and the national record holder in the 400 m medley event. He died suddenly shortly after returning from a 5 km run. At autopsy there was histological evidence of hypertrophic cardiomyopathy.

Adult↗

Glutamine metabolism in metabolic acidosis.

In chronic metabolic acidosis in the rat, there is increased ammoniagenesis, gluconeogenesis and renal extraction of glutamine with induction of renal phosphate-dependent glutaminase (PDG). Because the stimulus for these changes is not yet clear and also because acute acidosis is the more common clinical problem, the present study deals mainly with the metabolism of glutamine in acute metabolic acidosis. When acute metabolic acidosis is produced in rats by administration of mineral acid or by causing them to swim, thus inducing a severe lactic acidosis, a factor is found in the plasma which stimulates renal glutamine uptake and ammoniagenesis in vivo as well as in vitro. Acute acidosis does not induce synthesis of PDG in the kidney but causes a change in enzyme kinetics. The plasma factor not only enhances glutamine entry into cells, but apparently causes a conformational change in PDG, as shown by an increase in V1.0mM/Vmax. Intestinal metabolism of glutamine is also stimulated in vivo and in vitro by the plasma factor of acute acidosis.

Acidosis↗

Etiology of acute conjunctivitis in children.

To determine the etiology of acute conjunctivitis in children seen in pediatric practice, 99 patients with conjunctivitis and 102 age-and season-matched controls were cultured for aerobic bacteria including Haemophilus influenzae, and for viruses, Chlamydia trachomatis, and mycoplasmas. Agents statistically associated with conjunctivitis included H. influenzae (42% vs 0%), Streptococcus pneumoniae (12% vs 3%), and adenoviruses (20% vs 0%). One of these three etiologic agents was isolated from 71 (72%) of the patients. Simultaneous infection with two pathogens was uncommon. Staphylococcus aureus was equally prevalent in diseased and control eyes; one strain of C. trachomatis was isolated from a control eye. Although there were variations in the clinical features of viral and bacterial conjunctivitis, differentiation in an individual patient was difficult. An adenovirus was isolated from 11 (65%) of 17 patients who had pharyngitis in addition to conjunctivitis. H. influenzae was isolated from 14 (74%) of 19 children who had both otitis and conjunctivitis. Adenovirus conjunctivitis was common in the fall and H. influenzae in winter.

Acute Disease↗

'1001' Campylobacters: cultural characteristics of intestinal campylobacters from man and animals.

The cultural characteristics of 1220 Campylobacter strains from a variety of sources are described. Forty-two were identified as Campylobacter fetus ssp. fetus (Véron & Chatelain, 1973), 1120 as members of the C. jejuni/C. coli group, and 58 did not conform to any known description. Sixteen of the latter strains had the basic characteristics of C. fetus but were atypical in certain other respects. The other 42 strains had the thermophilic characteristics of the jejuni/coli group, but were resistant to nalidixic acid and had other features in common; it is possible that they represent a new species. They were isolated from 19% of locally caught wild seagulls but only occasionally from other animals and man.Growth at 25 degrees C clearly distinguished strains of C. fetus from those of the jejuni/coli and the nalidixic acid-resistant thermophilic (NARTC) groups. Maximum growth temperature was less reliable for this purpose, and 43 degrees C was found to be better than the traditional 42 degrees C. By arranging the results of three tests (tolerance to 2,3,5-triphenyltetrazolium chloride, growth at 30.5 and 45.5 degrees C) serially in the form of a schema comprising nine categories, the jejuni/coli strains fell into two main groups resembling the Institute Pasteur C. jejuni and C. coli type strains, but these groups could not be clearly defined owing to the existence of strains with intermediate characteristics.Most of the strains from cattle resembled C. jejuni, whereas those from pigs resembled C. coli; poultry strains occupied a more intermediate position. Strains from man and other animals were of mixed types, but most human strains resembled C. jejuni rather than C. coli. The type distribution pattern that most nearly matched that of human indigenous strains was given by a half-and-half mixture of strains from cattle and poultry.

Animals↗