Search PubMed⌕ Search

Biomedical subjects

R Gutman

Publications and source records attributed to R Gutman.

64 records · Page 4Linked to original sources
PubMedDate not supplied

Carriage of methicillin-resistant Staphylococcus aureus by non-hospitalized subjects in Israel.

The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in the anterior nares and axilla was studied in 920 non-hospitalized subjects: 350 drug addicts, 350 individuals presenting at a hospital emergency room for various reasons, and 220 hospital health care workers. S. aureus was isolated from 105 (11.4%) subjects, in six (6.3%) of whom the isolates were methicillin-resistant. The isolation rate of the organism and the prevalence of resistant strains in the different subgroups were, respectively: drug-addicts, n = 32 (9.1%), n = 2 (6.9%); emergency room patients, n = 36 (10.2%), n = 1 (3.2%); and hospital health care workers, n = 37 (16.8%), n = 3 (8.5%). Our findings suggest that MRSA remains uncommon in the community, while the prevalence of S. aureus carriage (including methicillin-resistant strains) in hospital personnel is quite similar in divergent geographical areas.

Adult↗
PubMedDate not supplied

A nodule of adrenocortical tissue within a human placenta: light microscopic and immunocytochemical findings.

A case of adrenocortical tissue within a human placenta is described, this being the second example of such a phenomenon. Immunocytochemistry showed that the adrenal tissue reacted positively for DHEA-S but negatively for 17-OH progesterone and cortisol. This suggests that the heterotopic adrenal tissue resembled metabolically the fetal zone of the adrenal cortex.

Adrenal Cortex↗
PubMedDate not supplied

Cutaneous manifestations of infection with Corynebacterium group JK.

Multiple necrotic soft tissue lesions were observed in the groin of a granulocytopenic patient with Corynebacterium group JK septicemia. Complete healing followed vancomycin therapy. Review of the English-language literature disclosed that skin and soft tissue manifestations were seen in one-quarter of the patients with Corynebacterium group JK septicemia, all of whom were granulocytopenic; in no case of endocarditis were similar findings reported. The majority of lesions consisted of local infections at sites of previous bone marrow biopsy, intravascular catheter insertion, or perianal fissure; they preceded septicemia and were designated primary lesions. Less often, skin and soft tissue manifestations--including papular skin rash, soft tissue abscesses, and necrotic soft tissue lesions--developed in patients with established septicemia and were considered secondary.

Adult↗
PubMedDate not supplied

Varied presentations of sporadic group A streptococcal bacteremia: clinical experience and attempt at classification.

The epidemiologic, clinical, and laboratory aspects of group A streptococcal bacteremia were studied in 33 patients seen at two urban hospitals in the Tel Aviv (Israel) area, over an 8-year period. Most patients (two-thirds) were female. Clinically significant bacteremia was observed in 26 patients, two of whom acquired their infection (puerperal sepsis) during hospitalization. A portal of entry, mainly cutaneous, was recognized in 61% of the patients, and a chronic underlying condition was observed in 69%. The case-fatality rate was 27%, with death occurring predominantly in patients admitted with shock or cryptogenic bacteremia. Our clinical experience and literature review show that the presentation of group A streptococcal bacteremia is diverse, with transient bacteremia of uncertain clinical significance on one end of the spectrum and overwhelming sepsis on the other. A practical classification of the various clinical forms of group A streptococcal bacteremia is proposed.

Adult↗
PubMedDate not supplied

Etiology of acute pelvic inflammatory disease proven by laparoscopy.

BACKGROUND: Only a few studies have investigated the etiology of acute pelvic inflammatory disease (PID) in laparoscopy-proven cases using pelvic samples for culture. Most of these studies were conducted in North America and Scandinavia. GOAL OF THE STUDY: To study the microbial etiology of laparoscopy-proven acute pelvic inflammatory disease in Israeli women. STUDY DESIGN: A prospective survey of women admitted to a hospital for treatment of acute pelvic inflammatory disease. All diagnoses were laparoscopy confirmed. Specimens for culture were obtained from the pelvic cavity via the laparoscope, and two serum samples were sent for serologic studies. RESULTS: Forty patients were studied. Their mean age was 34.4 years of age, and 27.5% had a history of PID. Chlamydia trachomatis infection was diagnosed in 14 (35%) patients (group A). Facultative and/or anaerobic bacteria were isolated from pelvic specimens of 7 (17.5%) patients (group B), one of these patients also had positive chlamydial serology. Mycoplasma hominis was cultured from a pelvic specimen of one woman, and herpes simplex virus grew from a pelvic sample of another patient in whom C. trachomatis was also found. In 19 (47.5%) women, the microbial etiology could not be determined (group C). In no case was Neisseria gonorrhoeae isolated. Stage I (mild) PID was diagnosed most often in group A (75% vs. 14% in group B [P < 0.02]), whereas the opposite was true for stage III (severe) PID (71.4% in group B vs 25% in group A [P = 0.07]). Tubal abscess was mainly diagnosed in group B patients (57% vs 16.6% in group A [P = 0.09]). CONCLUSION: In Israel, C. trachomatis is the most common cause of PID, while gonococci are rarely involved in this infection.

Acute Disease↗
PubMedDate not supplied

Thyroid function and serum IGF-1 in children before and after liver transplantation.

We report results of serum thyroid hormone and IGF-1 concentrations in 20 children, 1.2 to 13.6 years old, with various degrees of chronic liver dysfunction (CLD), before and after successful orthotopic liver transplantation (OLT). Ten children presented with moderate chronic liver disease (CLD-M) with prothrombin time (PT) > 50% and serum albumin concentration > 3 g/dl; 7 children had severe chronic liver disease (CLD-S) with PT < 50% and serum albumin concentration < 3 g/dl; and 7 children who had received an OLT, who had normal liver function at the time of the study. Four of the latter group were also studied before OLT. Patients with CLD-M had normal mean +/- SD serum levels of total T3 (2.0 +/- 0.7 nmol/l), total T4 (125 +/- 25.9 nmol/l) and fT4 concentrations (16 +/- 2.8 pmol/l). In contrast, children with CLD-S showed a significant decrease in thyroid hormones together with normal basal TSH values (T3 0.8 +/- 0.0 nmol/l; T4 45.6 +/- 19.5 nmol/l; fT4 7.4 +/- 1.1 pmol/l; TSH 3.8 +/- 0.9 mU/l). Patients who received a successful OLT showed mean peripheral thyroid hormone concentrations significantly higher than CLD-S patients (T3 1.7 +/- 0.7 nmol/l, p < 0.005; T4 92.8 +/- 18.2 nmol/l, p < 0.001; fT4 14.5 +/- 3.1 pmol/l, p < 0.001). A significant correlation was found between thyroid hormone levels and PT or serum albumin. In the nine patients with CLD-M and CLD-S in whom serum IGF-1 concentration was measured, values found (mean +/- SD 0.08 +/- 0.05 U/ml) were below the 95% confidence limit of matched controls.

Adolescent↗
PubMedDate not supplied

Growth hormone--insulin-like growth factor-I (IGF-I) axis in prepubertal children with chronic renal failure.

UNLABELLED: The hypothalamic-pituitary insulin-like growth factor I (IGF-I) axis was evaluated in 12 children with chronic renal failure (CRF) aged 3.2 to 16.5 yr (mean 9.5) on chronic dialysis, and in 13 renal transplantation patients aged 7.5 to 15.0 yr (mean 11.1). Height standard deviation score (SDS) was -2.8 +/- 0.5 (mean +/- SE) and -3.0 +/- 0.3 SDS (p = NS), and growth velocity was 3.7 +/- 0.4 and 1.5 +/- 0.3 cm/year (p < 0.01), respectively. Mean nocturnal growth hormone (mean GH) and number of pulses > 5 ng/ml in CRF and transplantation children were 4.2 +/- 0.8 vs 2.4 +/- 0.3 ng/ml, p = 0.08 and 1.7 +/- 0.2 vs 1.0 +/- 0.2, p < 0.05, respectively. In transplant children there was a positive correlation between mean GH and growth velocity (p < 0.02). GH peak response and the area under the curve post GH releasing hormone test were significantly higher in CRF and transplant children treated with deflazacort (new steroid derived from prednisolone) vs transplant children treated with methylprednisone. Mean serum IGF-I levels were -0.5 +/- 0.2 SDS for chronological age (CA) in CRF patients and +0.8 +/- 0.2 SDS(CA) in transplant patients, p = NS. In the latter, serum IGF-I values were positively correlated with growth velocity (p < 0.02) and negatively correlated with methylprednisone dose (p < 0.05). CONCLUSIONS: Patients with CRF and growth retardation have a higher number of GH peaks and slightly elevated mean GH levels compared to transplant patients. After renal transplantation GH secretion may be influenced by glucocorticoids as shown by the lower GH response to GHRH which improved with deflazacort and the inverse correlation between methylprednisone dose and IGF-I levels.

Adolescent↗
PubMedDate not supplied

Cellular pharmacology of doxorubicinol alone and combined with verapamil in pancreatic cancer cell lines.

The cellular accumulation/retention and cytotoxicity of doxorubicinol (DOXOL) were determined in three pancreatic cancer cell lines, which display primary or intrinsic resistance to doxorubicin (DOX). The studies reported here were performed in the presence and in the absence of verapamil, a calcium antagonist which we have previously shown to potentiate the cytotoxicity of DOX in our panel of pancreatic cancer cell lines. The accumulation/retention of DOXOL, as assayed by HPLC, was not enhanced by 6.6 microM verapamil in these cell lines. No aglycone metabolites were detected in any of the cell lines. The DOXOL cytotoxicity was enhanced 2.0 to 2.9-fold in two of the cell lines. The dose-related accumulation of DOX, as compared to that of DOXOL, was 7.5 to 10-fold greater at 0.1 microM, 3.6 to 6.5-fold greater at 1.0 microM, and 1.9 to 2.4-fold greater at 10 microM. In contrast, for two of our more sensitive cell lines, DOX was 25 to 27 times more cytotoxic than DOXOL. The present study suggests that (a) verapamil's effect on the cytotoxicity of DOX is not mediated by changes in the accumulation/retention nor the cytotoxicity of DOXOL; (b) metabolism of DOXOL does not influence its cytotoxicity nor that of DOX; and (c) DOXOL'S lower antitumor potency as compared to DOX cannot be fully explained by differences in intracellular accumulation.

Adenocarcinoma↗
PubMedDate not supplied

Dissociation of the verapamil-induced enhancement of doxorubicin's cytotoxicity from changes in cellular accumulation or retention of doxorubicin in pancreatic cancer cell lines.

The poor response of pancreatic adenocarcinoma to conventional chemotherapy has prompted us to search for innovative treatment approaches. Verapamil, a calcium channel blocker, has been reported to increase the doxorubicin sensitivity of several tumor models with acquired resistance, often in association with decreased efflux resulting in increased net accumulation/retention of doxorubicin. The cell lines used in the present study, PANC-1 of human origin and two cell lines of hamster origin, WD PaCa and PD PaCa, exhibit primary or intrinsic doxorubicin resistance. Verapamil caused a dose-dependent enhancement of doxorubicin's cytotoxicity in the pancreatic cancer-cell lines studied. In PANC-1, WD PaCa, and PD PaCa, respectively, the enhancement was 10.4-, 281.01-, and 15.8-fold at 6.6 microM verapamil and 1.1-, 8.8-, and 6.3-fold at 1.0 microM verapamil. Of note is the finding that the verapamil enhancement of sensitivity to doxorubicin was most marked in our most drug resistant cell line (WD PaCa). However, minimal to no effect on the accumulation or retention of doxorubicin was documented. In addition, the intracellular metabolism of doxorubicin was not found to be altered by verapamil. The present study raises questions concerning the nature and mechanism(s) of primary anthracycline resistance.

Adenocarcinoma↗