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Biomedical subjects

L Leitner

Publications and source records attributed to L Leitner.

13 recordsLinked to original sources

[Meningococcal disease in western Galilee].

79 patients with meningococcal disease were evaluated retrospectively between 1972-1986. All the neisseria isolated were sensitive to penicillin but resistant to sulphonamides. Most of the infections (54%) were caused by serogroup B strains. Clinical features included fever (98%), vomiting (65%), and headache (60%). Purpura appeared in 95% and severe neurological features in 25%. Most patients (83%) were children less than 10 years old. The incidence was 1.4/100,000 in the non-Jewish population and 2.3/100,000 in the Jewish population. The overall mortality was 23%, but about 50% in the Jewish population (10 deaths in 18 cases). In kibbutzim the incidence (7.5/100,000) and mortality were especially high. The need for awareness of the disease and the importance of early diagnosis and aggressive treatment are emphasized.

Adolescent

[Alternating rifampicin and ceftriaxone for Neisseria meningitidis eradication in contacts].

Following the occurrence of a case of meningococcal disease in a kibbutz, extensive preventive measures were instituted, consisting of alternate courses of rifampicin (10 mg/kg for 2 consecutive days) and ceftriaxone (single IM injection of 125 mg). Throughout the observation period Neisseria meningitidis was absent from oropharyngeal secretions of all those treated, but was found in those of an untreated control group. The alternate use of rifampicin and ceftriaxone should be considered for the long-term prevention of the occurrence of oropharyngeal carriers of Neisseria meningitidis.

Carrier State

[Alveolitis caused by furnishing a medical office].

This article reports on the occurrence of an exogenous-allergic alveolitis that developed in a colleague who moved into new consulting rooms and an apartment. The diagnosis was established on the basis of typical X-ray picture, typical pulmonary function test findings, typical BAL and the histological findings established in transbronchial pulmonary biopsy material. The putative cause was moulds, the source of which could not be completely identified. In the history of an exogenous-allergic alveolitis, domestic allergens should be taken into account, even when such apparent sources of allergens as room humidifiers or pet birds are not present.

Adult

[Occupational disability evaluation: comparison of subjective assessment with an objective point system].

Our assessments of working disability in 83 expertize on silicosis suffers were subsequently compared with a computer-aided scoring system. In 57% of the cases, full agreement was found; in 14% our estimates were higher and in 20% lower than the computer-aided scores. We investigated the reasons for the discrepancies, and attempted an assessment of computer-aided establishment of medical expertize.

Austria

An outbreak of typhoid fever due to contamination of the municipal water supply in northern Israel.

An outbreak of typhoid fever followed a large outbreak of dysentery in northern Israel. Both outbreaks resulted from contamination of a drilled well that supplied water to the municipal water system. The well was contaminated with sewage from a broken main-pipe coming from Shefaram (an Arab town). The outbreak of typhoid involved 77 persons, of whom 75 were hospitalized. In 67, phage-type C1 (the phage type dominant in Shefaram since the 1950s) was isolated. The incubation period was relatively long, between 12 and 40 days (median 22) following exposure. Over 50% of the cases were children aged 0 to 14, and only two patients were older than 35 years; the sex ratio among the patients was 1:1. The incidence rate in Shefaram was 2.3 times higher than in the Krayot (outlying suburbs of Haifa). This difference was due mainly to the high incidence in young females in Shefaram. The opposite was observed during the outbreak of dysentery, when the attack rates of the disease were higher in the Krayot. Relapses occurred in 12% (9 cases). This outbreak demonstrates the potential that still exists for serious outbreaks due to contamination of the municipal water supply.

Adolescent

Use of a combined DTP-polio vaccine in a reduced schedule.

A five-year serologic follow-up and a four-year monitoring of the polio and pertussis morbidity in an area immunized with a 2 + 1 dose schedule of a combined DTP-Po vaccine have shown that: the individual protection against polio measured by the presence of neutralizing antibody persists at a very adequate level five years after the first booster; after three years of a steady high proportion of children with pertussis antibody, a considerable drop is observed and in about 28% of individuals agglutinin levels of less than 1:20 were found five years after booster; the community protection against paralytic poliomyelitis and pertussis is satisfactory up to four years after the introduction of the program. Continuation of immunization with a 2 + 1 dose schedule at a maximal coverage and close seroepidemiologic surveillance are necessary in order to draw definite conclusions, because of the potentially strong impact of very dynamic ecological factors present in our geopolitical area upon the agent-host interrelationship.

Agglutination Tests

[Angiotensin converting enzyme in lung diseases].

The aim of the study was to test the validity of ACE-determination for the differential diagnosis of pulmonary diseases. First details of the method, then the determination of the reference scale are discussed. The ACE-activity in the serum in 60 patients with sarcoidosis and 80 patients with other pulmonary diseases was measured. The sensitivity with which sarcoidosis can be established by means of the ACE-activity is to be examined. No positive correlation between the activity of the enzyme and the x-ray staging could be established, but active diseases requiring treatment could be distinguished from inactive forms to an unexpectedly high degree of reliance in our group of patients. The fact that in some cases of other pulmonary diseases--especially those connected with hepatopathy--higher ACE-activity is found as well, reduces the validity of the method. The determination of ACE comes up to all the criterias of a feasible, clinical-chemical method of analysis: practicability, reliance, high sensitivity and accuracy in a selected group, easy repetition. In some cases a typical x-ray result and corresponding clinical examination may provide the diagnosis of active sarcoidosis without further invasive methods of investigation; observation of the course of disease and adjustment of therapy are possible by means of the control of the ACE.

Alveolitis, Extrinsic Allergic

A modified schedule for routine pertussis immunization.

As part of a study with a quadruple inactivated vaccine (diphtheria-pertussis-tetanus-polio), the serologic response to the pertussis antigen was investigated in infants at the age of routine immunization, inoculated with one of the following two regimens: either 0.5 ml vaccine at 2 and 3 1/2 months and a booster six months later, or an identical dose of vaccine given at 2, 4 and 6 months and a booster at the age of 12 months. A pertussis agglutination titer of greater than or equal to 1:10 was considered an immune response to the administration of the antigen. Two basic doses of pertussis antigen induced an immune response in about 92% of children, which was very close to that following three basic doses. A 100% seroconversion was observed in both groups one month after the booster dose, and geometric mean values were high in both regimens. At one and two years after the booster, the pertussis agglutinins were present in 100% of children of both groups, with higher geometric mean values in the group given the three basic doses regimen.

Age Factors