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Biomedical subjects

R B Sack

Publications and source records attributed to R B Sack.

At least 163 records · Page 9Linked to original sources
PubMed1982

Colonization of the oropharynx with Gram-negative bacilli in children with severe protein-calorie malnutrition.

Oral pharyngeal isolation of Gram-negative bacteria was compared in four groups of Bengali children; acutely ill, severely malnourished outpatients swabbed on hospital admission; ill but less severely malnourished outpatients from the same area as the malnourished children; orphans also less severely malnourished but not acutely ill; and well controls drawn from a priviledged socioeconomic group. The expected weight for height percentage (National Center Health Statistics/Center for Disease Control median) of the four groups was respectively 67, 91, 97, and 97%. Isolation of Gram-negative bacteria from 74 of 87 (85%) severely malnourished children was significantly greater (p less than 0.01) compared to 43 of 113 (38%) outpatients, to 20 of 93 (22%) orphans, and to five of 51 (10%) controls. A total of 71 malnourished children under 5 yr of age (90%) had higher rates of Gram-negative throat colonization than did 16 older children (63%) (p less than 0.01). Thus there was an increased rate of Gram-negative colonization in severely malnourished children especially among the younger age group. In the subset of ill children, Gram-negative pharyngeal colonization was significantly associated inversely with nutritional indices and age. The high rate of such carriage may be partly responsible for the increased susceptibility of Gram-negative infection demonstrated in these children.

Body Height↗
PubMed1982

Berberine inhibits intestinal secretory response of Vibrio cholerae and Escherichia coli enterotoxins.

Berberine, an alkaloid from the plant Berberis aristata, which has been known since ancient times as an antidiarrheal medication in India and China, inhibited by approximately 70% the secretory responses of the heat-labile enterotoxins of Vibrio cholerae and Escherichia coli in the rabbit ligated intestinal loop model. The drug was effective when given either before or after enterotoxin binding and when given either intraluminally or parenterally; it did not inhibit the stimulation of adenylate cyclase by cholera enterotoxin and caused no histological damage to intestinal mucosa. Berberine also markedly inhibited the secretory response of E. coli heat-stable enterotoxin in the infant mouse model. Although the mechanism of action of the drug is not yet known, these data provide a rationale for its apparent clinical usefulness in treating acute diarrheal disease.

Adenylyl Cyclases↗
PubMed1982

Kinetics of early cholera infection in the removable intestinal tie-adult rabbit diarrhea model.

The colonization of the small intestine of adult rabbits challenged with 5 X 10(7) cells of Vibrio cholerae strain Ogawa 395 has been examined in the removable intestinal tie-adult rabbit diarrhea (RITARD) model. During the first 6 h of infection, numbers of both free and adherent vibrios increased at a rate representing a generation time of about 71 min. Detectable fluid output in response to infection began at about 4 to 5 h postchallenge, and overt diarrhea was observed as early as 11 h. By 8 h after challenge, adherent V. cholerae reached a saturation concentration on the intestinal epithelium of approximately 5 X 10(8) cells per g of intestine, whereas numbers of free cells continued to increase at an exponential rate for at least 12 to 14 h. The concentration of adherent cells remained relatively constant at the saturation level during this period. This saturation level was similar in all parts of the small intestine. The concentration of adherent organisms increased significantly in moribund animals, suggesting that factors responsible for the earlier saturation equilibrium began changing as animals neared death.

Adhesiveness↗
PubMed1982

Seroepidemiology of heat-labile enterotoxigenic Escherichia coli and Norwalk virus infections in Panamanians, Canal Zone residents, Apache Indians, and United States Peace Corps volunteers.

Serum antibody titrations against the heat-labile enterotoxin (LT) of Escherichia coli were carried out on Panamanians, U.S. citizens resident in the Panama Canal Zone, Apache Indians living on the reservation in Whiteriver, Arizona, and Peace Corps volunteers before they traveled overseas. Antibody titers to Norwalk virus were also carried out on serum from Panamanian and Canal Zone residents. A high prevalence of low-titer LT antibodies was found in infants and adults from Panama, the Canal Zone, and Whiteriver. Panamanian children aged 1 to 5 years had the highest LT antibody titers. Peace Corps volunteers had a low prevalence and titer of LT antibodies. Prevalence and titer of antibodies to Norwalk virus were generally higher in Panamanians compared with Canal Zone residents of the same age. In the populations we studied, various modes of transmission and mechanisms of immunity likely explain the differences which we observed in antibody prevalence and titer to these two enteric pathogens.

Adolescent↗
PubMed1981

Biweekly prophylactic doxycycline for travelers' diarrhea.

A double-blind study to determine the efficacy of biweekly oral doxycycline in the prevention of travelers' diarrhea was conducted among 46 Peace Corps volunteers during their first six weeks in Honduras. The volunteers took either 100 mg of doxycycline per dose or a placebo for three weeks and were observed for an additional three weeks. There was no significant difference in the number of persons with travelers' diarrhea in the two groups (eight of 24 in the doxycycline group and 10 of 22 in the placebo group) in the three weeks when the drug was taken. However, significantly fewer episodes (P less than 0.05) of travelers' diarrhea occurred in the doxycycline group than in the placebo group at the end of the second, third, and fourth weeks. Enterotoxigenic Escherichia coli (ETEC) was the most common pathogen identified. ETEC from 13 (62%) of 21 stool samples were resistant to doxycycline. Biweekly doxycycline was only marginally effective in preventing travelers' diarrhea and did not prevent diarrhea secondary to doxycycline-resistant ETEC.

Adult↗
PubMed1981

Travelers' diarrhea in panamanian tourists in Mexico.

To determine whether residents of developing countries are unlikely to acquire travelers' diarrhea, 64 Panamanians of widely divergent socioeconomic strata were studied during a 15-day tour through Mexico. Twenty-three (36%) tourists experienced 27 episodes of travelers' diarrhea that were caused by seven different pathogens. The most commonly identified etiologic agents were rotavirus (26%), Norwalk virus (15%), and Campylobacter fetus (11%), whereas enterotoxigenic Escherichia coli was not frequently associated with travelers' diarrhea. Acquisition of travelers' diarrhea was correlated directly with high socioeconomic status. Varying levels of immunity to enteropathogens that are endemic in Panama may explain the different isolation rates of pathogens.

Adolescent↗
PubMed1981

Traveler's diarrhea associated with rotavirus infection: analysis of virus-specific immunoglobulin classes.

An enzyme-linked immunosorbent assay for the detection of rotavirus-specific immunoglobulin G (IgG), IgM, and IgA antibodies was used in a serological study of Traveler's diarrhea. The antigenically related simian rotavirus (SA-11) was used as antigen in this study. Serum was obtained from two groups of volunteers before travel (pre-travel) and at various times after arrival at their destination (post-travel). One group consisted of 47 American Peace Corps volunteers who traveled to Honduras, and the second group consisted of 66 Panamanian travelers who visited Mexico. An association between rotavirus and Traveler's diarrhea was found in each group with 36% of American Peace Corps volunteers and 30% of Panamanians with diarrhea demonstrating a greater than or equal to 4-fold increase in rotavirus antibody titers in the post- as compared to the pre-travel specimens. While no rotavirus-specific IgM antibody was detected in any serum tested, increases in specific antibody were found in both the IgG and IgA immunoglobulin classes.

Adult↗
PubMed1981

Simple adult rabbit model for Vibrio cholerae and enterotoxigenic Escherichia coli diarrhea.

We developed an adult rabbit model for enteric infection by Vibrio cholerae and enterotoxigenic Escherichia coli. The cecum of each animal was first ligated to prevent it from retaining fluid secreted by the small intestine. A temporary reversible obstruction (a slip knot tie) of the small bowel was introduced at the time of challenge and removed 2 h later. With this modification, we were able to elicit a massive and usually fatal cholera-like diarrhea in adult (3.5- to 6-lb [1.6- to 2.7-kb]) animals challenged with V. cholerae. Animals challenged with enterotoxigenic E. coli also developed diarrhea which was severe and watery but less explosive and less rapidly fatal than that produced by V. cholerae. The susceptibility of animals in this model to infection by V. cholerae was similar to the susceptibility of infant rabbits challenged intraintestinally. The death rate was almost 25% when 10(3) Vibrio cells were given and 90% or more when the dose was greater than or equal to 10(6) cells per animal. We designated this procedure the RITARD (for removable intestinal tie-adult rabbit diarrhea) model.

Animals↗
PubMed1980

Disease due to enterotoxigenic Escherichia coli in Bangladeshi adults: clinical aspects and a controlled trial of tetracycline.

The clinical characteristics of disease due to enterotoxigenic Escherichia coli (ETEC) were determined in 88 adult males admitted to a hospital in Dacca, Bangladesh, with moderate to severe dehydration. Persons infected with ETEC strains producing both heat-labile toxin (LT) and heat-stable (ST) toxin had more dehydration and acidosis, longer duration of illness, and greater stool volume than persons infected with strains producing only ST. Tetracycline therapy, evaluated in 63 cases, resulted in slightly earlier termination of illness in patients with LT-ST strains but had no effect on illness in the patients with ST strains. In both groups of patients tetracycline shortened the duration of excretion of organisms. Because of its limited effectiveness and the generally excellent response of ETEC diarrhea to rehydration therapy alone, tetracycline is not warranted for use in treatment of ETEC diarrhea in adults in this population.

Adult↗
PubMed1980

Detection of Escherichia coli enterotoxins in stools.

We determined whether enterotoxigenic Escherichia coli diarrhea could be diagnosed by direct examination of stools for heat-labile (LT) and heat-stable (ST) enterotoxins. The Y-1 adrenal cell and an enzyme-linked immunosorbent assay (ELISA) detected LT in 85 and 93%, respectively, of stool specimens obtained from adults with acute diarrhea from whom an LT- and ST-producing organism had been isolated. Furthermore, the ELISA assay detected LT in 8 of 35 stool specimens from which no LT-producing E. coli had been isolated. The infant mouse assay was utilized to detect ST in these stool specimens and was found to be an insensitive method, showing positive results in only 36% of the specimens from which an ST-producing organism was isolated. Further studies are warranted to determine the diagnostic value of direct detection of LT in stools, especially by the ELISA method.

Adolescent↗
PubMed1979

Relationship between enterotoxin production and serotype in enterotoxigenic Escherichia coli.

We examined the relationship between serotype and enterotoxin production in 109 enterotoxigenic Escherichia coli strains isolated from 109 patients with severe cholera-like diarrhea in Dacca, Bangladesh. Of 69 strains producing both heat-labile and heat-stable toxins, 59 (86%) belonged to the one of four O serogroups, and 56 (81%) of these strains belonged to one of six O:K:H serotypes. In contrast, 34 strains producing only heat-stable toxin were distributed among 15 O serogroups, and six strains producing only heat-labile toxin were distributed among six O serogroups. Twelve strains producing heat-labile and heat-stable toxins and five strains producing heat-stable toxin were found which had the same serotype (O78:K-:H12) and biotype. It appears that at least in one geographic setting E. coli strains producing both heat-labile and heat-stable toxins are more restricted in their O groups and O:K:H serotypes than E. coli that produce only heat-stable toxin and that certain serobiotypes may commonly include strains which produce both toxin types.

Bacterial Toxins↗