Search PubMed⌕ Search

Biomedical subjects

M Shapiro

Publications and source records attributed to M Shapiro.

At least 145 records · Page 8Linked to original sources
PubMed1995

Efficacy of topical gentamicin treatment after 193-nm photorefractive keratectomy in an experimental Pseudomonas keratitis model.

BACKGROUND: The treatment of Pseudomonas keratitis has many limitations, and further investigation to identify more effective approaches is required. We therefore studied the possible contribution of the debridement effect of 193-nm excimer laser on Pseudomonas keratitis in rabbit eyes. METHODS: Pseudomonas keratitis was induced in 30 rabbit eyes by inflicting controlled central corneal scratches and applying a drop of Pseudomonas aeruginosa suspension. After 24 h, one cornea of each animal was photo-ablated (excimer laser: fluency 90 mJ/cm2, 10 Hz, 213 pulses), yielding 50 microns of tissue ablation, while the follow cornea served as control. Five groups of six animals each were formed and received: a subconjunctival injection of gentamicin 20 mg (group 1), topical 14 mg/ml gentamicin hourly (group 2) or every 2.5 h (group 3), or NaCl 0.9% hourly (group 4) for 8 h. In group 5, animals were sacrificed without additional treatment. After 9 h corneas were excised, homogenized, serially diluted, and plated on agar blood plates. The numbers of colony-forming units (CFU) per cornea were statistically evaluated (Mann-Whitney test). RESULTS: In control eyes, a greater decrease of CFU was observed in group 2 than in group 3 (P = 0.03). In laser-ablated eyes, there was no difference in CFU between groups 2 and 3. Comparison of the excimer-treated and control eyes revealed a greater number of bacteria (CFU) in controls only in group 3 (P = 0.02). CONCLUSION: Our study suggests that controlled debridement of cornea with excimer laser may improve the effect of topical antibiotics.

Administration, Topical↗
PubMed1995

Disseminated Nocardia transvalensis infection resembling pulmonary infarction in a liver transplant recipient.

Infections due to Nocardia transvalensis are extremely rare: only four disseminated infections with this pathogen have been reported, three of which ended fatally. This is the first report of a liver transplant recipient with Nocardia transvalensis infection. The patient had disseminated infection with pulmonary involvement, which presented as pulmonary infarction. Despite a ten-day delay in the administration of correct therapy, he responded rapidly to trimethoprim-sulfamethoxazole. The pitfalls of differentiating nocardial infection from pulmonary thromboembolism in solid organ transplant recipients and the diagnostic considerations unique to liver transplant recipients are discussed.

Bacteremia↗
PubMed1995

Aeromonas hydrophila myonecrosis accompanying mucormycosis five years after bone marrow transplantation.

A 36-year-old man, five years after bone marrow transplantation for aplastic anemia, was admitted with myonecrosis of the forearm after he had immersed his hand in sewage water several days prior to his admission. Blood cultures and specimens taken from the necrotic tissue of the arm all grew Aeromonas hydrophila. Following extension of the infection, the patient underwent amputation of the arm but ultimately died of cerebral mucormycosis. The epidemiology of Aeromonas infections is discussed and the literature of Aeromonas myonecrosis is reviewed.

Adult↗
PubMed1995

Bacteriuria following extracorporeal shock-wave lithotripsy in patients whose urine was sterile before the procedure.

During 10 months at our hospital, 413 patients underwent extracorporeal shock-wave lithotripsy (ESWL). The occurrence of complications was examined in the 126 (30.5%) of these patients who had sterile urine before the procedure and who had neither indwelling catheters nor stents. No patient received prophylactic antibiotics. After ESWL, nine patients (7%) developed bacteriuria, which was usually transient and required no therapy. Seven of the nine cases developed within 2 weeks of ESWL. In no case did other complications follow bacteriuria. Patients in whom bacteriuria was suspected because of fever all proved to have sterile urine. Our results indicate that patients whose urine is sterile before ESWL do not need antimicrobial prophylaxis.

Adolescent↗
PubMed1995

Group A streptococcus bacteremia at the Hadassah Medical Center in Jerusalem.

Streptococcus pyogenes bacteremia occurred in 104 patients over a 6-year period, during which time the annual incidence remained constant. The clinical and epidemiologic characteristics are described for 90 of these patients. Of the 90 patients, 90% had community-acquired infection, and 77% had an underlying illness predisposing them to infection. Skin infection was the cause of bacteremia in 61% of the cases. Septic shock developed in 13 patients. The overall mortality rate was 15%. An increased likelihood of death was associated with septic shock and diabetes mellitus.

Bacteremia↗
PubMed1995

Efficacy of an inactivated hepatitis A vaccine in pre- and postexposure conditions in marmosets.

A two-part challenge study was done in marmoset monkeys to confirm the efficacy of an inactivated hepatitis A vaccine. In part 1 (preexposure), 7 marmosets received a single low dose of vaccine (360 ELISA units [EL.U.]) and were challenged orally with wild type hepatitis A virus (HAV) either 1 or 6 months later. In part 2 (postexposure), 8 marmosets were challenged orally with HAV and then half each were inoculated with a single dose of 360 or 1440 EL.U. of vaccine 2 days later. The suboptimal immune response elicited by the low vaccine dose in the preexposure group was sufficient to induce complete protection against oral challenge with heterologous HAV in all marmosets that had responded serologically. In the postexposure group, the 360-EL.U. dose of vaccine resulted in partial protection against hepatitis A disease, whereas the 1440-EL.U. dose of vaccine elicited complete protection against disease and virus excretion.

Animals↗
PubMed1995

Experimental hepatitis E in pregnant rhesus monkeys: failure to transmit hepatitis E virus (HEV) to offspring and evidence of naturally acquired antibodies to HEV.

In an attempt to reproduce experimentally the fulminant hepatitis of pregnant women infected with hepatitis E virus (HEV), 4 nonpregnant and 6 pregnant rhesus monkeys in the first, second, or third trimester of pregnancy were inoculated intravenously with approximately 10(5.5) ID50 of HEV. Comparison of biochemical, histopathologic, and serologic profiles in pregnant and nonpregnant monkeys did not reveal an increase in the severity of hepatitis in the pregnant animals. Hematology and serum clinical chemistry values were in the normal range in all animals during the study. No evidence of neonatal infection with HEV was found in offspring. Two rhesus monkeys (1 pregnant, 1 nonpregnant) had naturally occurring anti-HEV antibodies prior to inoculation as detected by a standard ELISA and confirmed by a competition ELISA with hyperimmune chimpanzee serum. These animals demonstrated an anamnestic response when they were challenged with HEV.

Animals↗
PubMed1995

Right ventricular end-diastolic volume as a measure of preload.

Right ventricular (RV) end-diastolic volume index (RVEDVI) measured by a modified thermodilution pulmonary artery catheter has been proposed as an improved measure of cardiac preload, compared with pulmonary capillary wedge pressure (PCWP). This study compared the correlation of RVEDVI and PCWP with cardiac index (CI) to determine which parameter better reflected ventricular preload. Modified thermodilution catheters were placed in 38 critically ill patients. Hemodynamic parameters were recorded in these patients at 2- to 4-hour intervals for 1 to 7 days. Complete data sets (1,008) were obtained. Regression analysis was performed comparing PCWP, RVEDVI, RV ejection fraction (RVEF) to CI in the entire group and in individual patients. Because mathematical coupling may exist between RVEDVI and CI, the correlation between these variables was corrected for mathematical coupling using the method described by Stratton. Simple regression analysis of data from all patients, uncorrected for mathematical coupling, yielded a significant correlation between CI and RVEDVI (r = 0.60, p < 0.0001), RVEF (r = 0.37, p < 0.0001), and PCWP (r = 0.01, p < 0.001). Correction for mathematical coupling between RVEDVI and CI resulted in a minor changes of the correlation coefficient to 0.56. In individual patients, a significant, uncorrected correlation (p < 0.05) was found between RVEDVI and CI in 27 of the 38 patients, whereas 11 patients had a significant correlation between PCWP and CI. RVEDVI correlated more closely with CI than did PCWP, even after correlation for mathematical coupling. In both the group as a whole and in individual patients, RVEDVI was a better indicator of cardiac preload.

Adolescent↗
PubMed1995

Increased incidence and severity of Streptococcus pyogenes bacteremia in young children.

An increase in the incidence and severity of bacteremia caused by group A streptococci was noted in 1993 and 1994 in the Hadassah University Medical Center, Jerusalem. During the 6-year period 1987 to 1992, 12 children with group A streptococcal bacteremia were hospitalized, whereas in 1993 and 1994 there were 17 patients, 5 of them with 1 each of the following severe clinical manifestations: meningitis and septic shock; streptococcal toxic shock syndrome; septic shock; pleural empyema; and fatal outcome. Our 29 patients with group A streptococcal bacteremia were younger than those reported in the literature: 10 (35%) were < 3 months of age; 17 (59%) were < 1 year old. Most children were previously healthy and only 3 had an underlying immunodeficiency predisposing to infection (1 case each): leukemia; Di George syndrome; and congenital nephrotic syndrome. Two children were recovering from varicella. The skin was the most common site of primary infection (16 of 29). The average white blood cell (WBC) count was 18 150 cells/mm3 (range, 2200 to 34,200). The cases were not related epidemiologically and were caused by a variety of M-protein types. Polymerase chain reaction amplification of the genes encoding exotoxins A (speA) and C (speC) was done on 19 isolates and disclosed 2 strains positive for speA and 5 positive for speC. One of the speA-positive isolates was from the single patient with toxic shock syndrome.

Age Distribution↗
PubMed1995

DNAdraw: a program for preparing DNA and protein data for publication.

DNAdraw is a Macintosh program designed to prepare DNA and protein data for publication. In additional to providing standard ways of highlighting data, e.g., fonts, styles and shading, DNAdraw has special features for formatting sequence data and for handling aligned sequence data. Output for the program is to a PostScript printer. A simple example is presented to illustrate DNAdraw formatting and highlighting, and an example for aligned data is given. This new version of the program that has been written for other machines is the first to run under a Graphical User Interface (GUI) and incorporates many new features.

Amino Acid Sequence↗
PubMed1995

Symmetry and synkinesis during rehabilitation of unilateral facial paralysis.

We evaluated biofeedback rehabilitation in patients with severe chronic unilateral facial paralysis, who had intact facial-motor innervation (House grades 3 to 5). Recovery of facial function was characterized (1) by grading facial movement symmetry, and (2) by counting the number of muscles exhibiting synkinesis during maximal execution of selected facial movements (e.g., smiling). Facial function in 21 patients typically improved by one House grade. Facial symmetry recovered rapidly during the first 5 months of treatment, and then improved more slowly. However, during this latter period, examination of the relationship between symmetry and synkinesis (visualized by a graph plotting symmetry grades on the x-axis, against the number of synkinetic muscles on the y-axis) indicated that overall facial control was improving even when House grading suggested that it was not. Such information should aid facial retraining and may clarify understanding of underlying rehabilitation mechanisms.

Adult↗
PubMed1995

A double-blinded, randomized, controlled clinical trial to compare cefazolin and cefonicid for antimicrobial prophylaxis in clean orthopedic surgery.

A double-blind, prospective randomized study was performed to compare cefazolin and cefonicid given for prophylaxis to 102 patients undergoing orthopedic surgery. Risk factors (e.g., age, sex, type of operation performed) among the two groups were similar. All patients had foreign material (prosthesis or other hardware) inserted at operation. There was a total of 6 infections (3 wound and 3 urinary tract) in 6 patients among the 48 receiving cefazolin (12.5%), whereas no infections were observed among the 54 patients who received cefonicid. Cefonicid, given once daily, provides protection against postoperative infection that is not inferior to cefazolin. A larger study is needed to confirm whether cefonicid is indeed superior to cefazolin.

Adolescent↗
PubMed1995

Technical report. Optimizing probe selection in directed heteroduplex analysis using HDprobe 1.1.

Directed heteroduplex analysis (DHDA) has proven to be a powerful technique for rapid geotyping in human populations. This strategy should also have widespread utility in differentiating closely related organisms of medical and public health importance through identification of DNA sequence polymorphisms. Identifying an optimal probe sequence for use in DHDA has required empirical testing of both the positive and negative strands of a number of potential probes. To identify optimal probes more efficiently, a computer program has been developed that predicts the number of potential stable and unstable mismatches between a probe and its target sequences in DHDA. This information can then be used to predict--from among a group of potential probes--which one will be the most successful in differentiating closely related homologues of a targeted gene sequence. This approach was tested on a number of probe and target sequences derived from the mitochondrial NADH dehydrogenase subunit 4 gene of the West African black fly, Simulium damnosum sensu lato. The number of unstable mismatches predicted to occur in a given heteroduplex by the computer program was found to be important in differentiating closely related species. Therefore, this strategy is useful in identifying informative probes in the development of new DHDA-based assays.

Animals↗