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Biomedical subjects

M Auerbach

Publications and source records attributed to M Auerbach.

34 records · Page 2Linked to original sources
PubMed1988

Effects of influenza A virus on human neutrophil calcium metabolism.

Bacterial superinfection in influenza A virus-related illness may in part be explained by virus-induced neutrophil dysfunction. We here provide evidence that this effect is related to abnormal calcium metabolism of virus-infected cells. Neutrophils exposed to influenza virus for 0.5 h at 37 degrees C showed depressed O2- generation and release of radiolabeled arachidonic acid upon stimulation with FMLP. The peak cytosolic Ca2+ level achieved by virus-infected neutrophils after FMLP stimulation was significantly depressed as is efflux of 45Ca2+. This deficient Ca2+ mobilization could not be attributed to alterations of inositol phosphate production or Ca2+ influx in response to FMLP, both of which were unaffected by prior virus infection. Given these findings, the immediate effects of influenza virus on neutrophil Ca2+ metabolism were examined. The virus itself caused a rise in cytosolic Ca2+ and an efflux of 45Ca2+ without any corresponding 45Ca2+ influx. Total cell Ca2+ however was not depleted as measured by atomic absorption. Influenza virus, therefore, causes neutrophil activation leading to significant perturbations in Ca2+ metabolism and later to impaired mobilization of Ca2+ stores. This system offers a model for phagocyte deactivation and an opportunity to define control mechanisms of signal transduction.

Arachidonic Acid↗
PubMed1988

Clinical use of the total dose intravenous infusion of iron dextran.

Eighty-seven patients with anemia and absent bone marrow hemosiderin were given treatment with total dose intravenous infusions of iron dextran. The effect of rate of infusion and premedication with diphenhydramine, aspirin, and methylprednisolone on acute and delayed reactions was assessed. All patients were monitored for 72 hours after infusion. Two patients reacted to the test dose. One responded with generalized body pain that lasted approximately 5 minutes. In one an anaphylactoid reaction developed, which was promptly terminated by intravenous methylprednisolone, subcutaneous epinephrine, and intravenous diphenhydramine. Transient delayed adverse reactions easily controlled by nonsteroidal anti-inflammatory drugs occurred in 37 patients. The most common delayed reaction was a syndrome characterized by arthralgia, myalgia, and fever. Seven subjects had a chronic disease in addition to anemia with absent bone marrow iron. In all seven normal hemoglobin and hematocrit values were attained after treatment. The results of our experience with total dose intravenous iron dextran therapy suggest that it be the preferred method of replenishment in clinical situations where parenteral administration of iron is indicated. An unexpected benefit was the efficaciousness of this method of administration in patients with iron deficiency and coexisting chronic disease. A protocol for its administration is proposed.

Anaphylaxis↗
PubMed1986

Systemic babesiosis. Another cause of the hemophagocytic syndrome.

Hemophagocytosis is a pathologic finding in a variety of infectious diseases associated with peripheral pancytopenia. In addition, hemophagocytosis is a prominent finding in malignant histiocytosis, a primary disorder of the monocyte-macrophage system. Systemic babesiosis is a rare parasitic disorder associated with intraerythrocytic parasites in the peripheral blood. There has been no description of the marrow findings in this disorder. A patient is described who had systemic babesiosis and prominent hemophagocytosis that disappeared after appropriate antiparasitic therapy. Systemic babesiosis should be considered in the differential diagnosis of hemophagocytosis.

Babesiosis↗
PubMed1984

Fibrinogen proteolysis and platelet alpha-granule release in preeclampsia/eclampsia.

Serial measurements of the plasma concentration of fibrinopeptide A, thrombin-increasable fibrinopeptide B (reflecting B beta 1-42), desarginyl fibrinopeptide B, beta thromboglobulin, and platelet factor 4 were made before, during, and after delivery in patients with preeclampsia/eclampsia. The data were correlated with routine coagulation studies, hematologic and renal status, as well as with the clinical manifestations. In 11 patients with mild preeclampsia, there were small increases in the fibrinopeptides at the time of delivery, but no other hematologic changes. In 5 patients with severe preeclampsia/eclampsia, there were marked increases in plasma levels of fibrinopeptides and platelet alpha granule proteins, which correlated in time with the clinical manifestations. When the changes in these patients were compared with those occurring in patients undergoing intraamniotic hypertonic saline infusion, it was noted that: (1) patients with severe preeclampsia/eclampsia usually presented when plasmin action on fibrinogen exceeded that of thrombin; (2) in patients with preeclampsia/eclampsia the increase in fibrinopeptides lasted from 3 to 7 days, rather than for several hours as occurred after the infusion of hypertonic saline, indicating a more persistent stimulus to intravascular coagulation in preeclampsia/eclampsia; (3) severe thrombocytopenia and increased platelet protein levels were seen in these patients and were disproportionate to the degree of increase in the fibrinopeptide A level, suggesting that a mechanism other than thrombin must have contributed to the platelet changes; and (4) in two patients with severe preeclampsia/eclampsia, high desarginyl fibrinopeptide B levels preceded renal insufficiency, possibly reflecting fibrin II formation in renal vessels.

Adolescent↗
PubMed1981

Measurement of desarginine fibrinopeptide B in human blood.

Thrombin converts fibrinogen to fibrin in two steps. First fibrinopeptide A and fibrin I are formed and then fibrinopeptide B (B beta 1-14) and fibrin II. Since it is postulated that fibrin II is important in the genesis of thrombosis, it is of interest to measure fibrinopeptide B in peripheral blood samples. Previous difficulties in interpreting fibrinopeptide B immunoreactivity in plasma resulted from crossreaction of fibrinogen and of plasmin digest peptides B beta 1-42 and B beta 1-21 and from rapid loss of fibrinopeptide B immunoreactivity resulting from cleavage of arginine 14 by blood carboxypeptidase B. We have obviated these difficulties by removing fibrinogen from plasma by precipitation with ethanol and peptides B beta 1-21 and B beta 1-42 by adsorption on bentonite. Fibrinopeptide B is then converted to a desarginine fibrinopeptide B, which is measured in a new specific assay. Studies of the kinetics of fibrinopeptide cleavage showed that when whole blood was allowed to clot in vitro, fibrinopeptide A was cleaved more rapidly than fibrinopeptide B. In 18 patients on an acute care medical ward, desarginine fibrinopeptide B levels were lower than fibrinopeptide A levels and did not correlate with the levels of fibrinopeptide A or B beta 1-42. Desarginine fibrinopeptide B levels were less than 1 pmol/ml in all but two patients. In six patients receiving intraamniotic infusions of hypertonic saline to induce abortion, desarginine fibrinopeptide B levels increased 10-fold from the preinfusion mean level of 0.4 pmol/ml and then decreased. The pattern of changes resembled that of the fibrinopeptide A levels rather than of the B beta 1-42 levels. On the basis of these data it is suggested that plasma desarginine fibrinopeptide B levels reflect fibrin II formation in vivo.

Cross Reactions↗
PubMed1980

[Selective caesarean section for breach presentation - bearings on morbidity of survivors neonatal period (author's transl)].

The authors have continued their own analysis of deliveries from breech presentation by studying childhood morbidity of 1,094 single infants who had survived the neonatal period, between 1966 and 1975. Particular attention was given to the impact of selective caesarean section on primiparae, beyond completion of the 36th week of pregnancy. The two reported periods between 1966 and 1971 as well as between 1972 and 1975 were compared for that purpose. -The frequency of caesarean sections went up from 11.6 to 52.2 per cent. Severe parturitional trauma, such as fractures or plexal paralysis, were prevented, but hypoxia was aggravating. No accurate assessment was possible of the full role played by hypoxia and of its importance. A conspicuously high number of children delivered by caesarean section exhibited neurological symptoms, during the first days after birth and even up to the date of leaving hospital. No relationship was found to exist between morbidity and parity. Conclusions with great relevance to practice were drawn from these findings.

Birth Injuries↗
PubMed1979

[The effect of preventive cesarean section in breech presentation on perinatal mortality].

This study is based upon 1229 infants delivered from breech presentations who were investigated for the influence of the prophylactic Caesarean section carried out with primiparae after their 36th week of pregnancy in 1972, on perinatal mortality. The periods under report, i. e., 1966 to 1971 and 1972 to 1975, were compared with one another. The incidence of Caesarean sections carried out in breech presentations increased from 11.6% to 52.2%. With a premature birth rate of 22.1% and 20.9%, respectively, the uncleaned perinatal mortality decreased from 109.2% to 96.5%, whereas the cleaned one dropped from 73.3% to 64.2%. As to mature infants delivered vaginally or by Caesarean section, there was no significant difference in death rates. The worse prognosis for breech presentation infants given birth by pluriparae could be confirmed. The high portion of underweight infants amounting to 78.0% and 82.9%, respectively, in the total number of perinatal deaths illustrates the main problem of the breech presentation births.

Birth Weight↗
PubMedDate not supplied

Quality of well being in panic disorder: the assessment of psychiatric and general disability.

BACKGROUND: Panic disorder is a common and debilitating anxiety disorder which significantly disrupts the lives of patients and their family members. Recent epidemiological studies and analyses of data from clinical trials suggest that patients with panic disorder suffer significant work and social dysfunction. The authors hypothesized that this dysfunction could be characterized using both a well-validated, generalized scale of functioning and a specifically designed scale for assessing function in psychiatric patients and that these findings would correlate with symptomatology. METHOD: Fifty-six patients with panic disorder were characterized using the Sheehan Disability Scale, the Anxiety Sensitivity Index, and the Spielberger State Trait Anxiety Scale. Measures of health related quality of life from the Quality of Well Being Scale were compared with ratings for matched, historical, and population controls. RESULTS: Patients with panic disorder lost 39 quality-adjusted days for each year that they lived with the disorder. This decrease in quality of life is similar to what is observed in patients with non-insulin dependent diabetes. Diminished quality of life is correlated with the number of panic attacks, state anxiety, and depressive symptoms. These patients also demonstrated significant dysfunction in Sheehan total disability and subscale scores, including work-related functioning. CONCLUSIONS: This study demonstrates that the specific disabilities inherent in panic disorder can be linked to declines in quality of life as measured by the Quality of Well Being Scale and by measures of work-related dysfunction. Such an association between disease specific measures and a generalized measure of health related quality of life may offer clinicians a new tool to understand panic disorder and to conceptualize it within the broader context of disease and disability.

Adult↗
PubMedDate not supplied

Changes in home health care delivery.

The Taylor hypothesis suggests that the effect of DRGs is an episodic increase in referrals to home health care agencies of both chronically ill and acutely ill patients. These patients will need to recuperate from the acute illness that caused their hospitalization in the first place. The New Jersey experience indicates that the tightening reimbursement system will permit a shorter episode of home care services than in the past few years. Agencies will have to provide seven-day, twenty-four-hour service. At the same time, they will have more difficulty justifying seven-day intervention to the Medicare program. Understanding the full effects of the change in health care delivery reimbursement on patient care and nursing care will require research and investigation.

Certification↗