Biomedical subjects
Publications and source records attributed to S Davidson.
Endogenous endophthalmitis due to Salmonella typhimurium is reported in a 1-year-old child. Despite vigorous antibiotic therapy, the child's vision deteriorated, and loss of light perception occurred in the infected eye. Endophthalmitis is a very rare complication of salmonellosis, and it should alert physicians because of its severe damage to the eye.
Pseudomonas aeruginosa meningitis following trauma or surgery is associated with a high mortality rate. This high rate is explained both by tissue damage which leads to infection and by the failure of antibacterial therapy. The latter is due to the relatively resistant microorganism and the insufficient penetration of antibiotics into the CSF. We are reporting the successful therapy of a case of postoperative P. aeruginosa meningitis treated with the combination of azlocillin and gentamicin administered systemically together with intraventricular gentamicin.
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Forty-six rehabilitation workers from the Tel Aviv metropolitan area were tested for their views about mentally ill people. It was found that these workers were ambiguous in their attitudes. In some respects they were more tolerant than the general Israeli population. In others, they displayed the same negative views towards the mentally ill as other researchers have found in Israeli society. This ambiguity may be due to the fact that while their professional ideology forces them to express "tolerant" opinions, they nonetheless are influenced by the attitudes prevalent in Israeli culture. Then, too, these negative attitudes may also stem from disappointing professional experience with chronic mentally ill clients. Mainsteam psychiatric professionals could assist these rahabilitation workers by offering more consultative, back-up services.
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The in vitro susceptibility of 40 clinical isolates of Pseudomonas aeruginosa to 10 antipseudomonal antibiotics was determined. Of the strains examined, 100, 90, 85 and 80% were susceptible to netilmicin, amikacin, gentamicin and tobramycin, respectively; 93, 85 and 72% were susceptible to piperacillin, azlocillin and carbenicillin, respectively; and 93, 88 and 84% were susceptible to cefotaxime, moxalactam and cefsulodin, respectively. These data confirm that the newer antipseudomonal antimicrobial agents are more effective against Ps. aeruginosa than the older agents.
The clinical and laboratory date on 115 pediatric patients with bacterial meningitis are presented. Sixty-one were less than 12 mo of age including 13 less than 1 mo of age. Thirty-nine children were treated prior to admission with antimicrobial agents which obscured accurate bacteriologic diagnosis in eight of them. Gram-negative enteric bacteria, mainly Escherichia coli, were recorded in 9 of 13 neonates. Hemophilus influenzae type B accounted for 56 (52%) of all isolated recorded in those greater than 2 mo of age, of which 35% were resistant to chloramphenicol. Seventy-eight patients (73%) recovered completely following 10 to 14 days of antimicrobial therapy. Fifteen patients died, most of whom were less than 1 yr of age, including five neonates. Major neurologic sequelae included subdural effusions, cerebral abscesses and recurrent convulsions. This study, which documents the infrequency of Streptococcus group B and H. influenzae as etiological agents of neonatal meningitis, indicates that treatment of this disease with ampicillin and an aminoglycoside is efficacious. Chloramphenicol may be the drug of choice in the postnatal period, since H. influenzae is partly resistant to ampicillin.
Neonatal hepatitis and biliary atresia are disorders of early infancy that represent variable expressions of one entity. Clinical and extensive laboratory evaluation are unsatisfactory in distinguishing between the two diseases. The usefulness of hepatobiliary ultrasonography in the evaluation of neonatal jaundice is described in four infants. Ultrasonic diagnosis was substantiated by laparotomy, liver biopsy or autopsy. The performance of hepatobiliary ultrasonography is recommended in all cases of neonatal jaundice in order to differentiate between extrahepatic biliary obstruction and neonatal hepatitis.
We determined serum concentrations of beta HCG and testosterone by specific radioimmunoassays in eight cryptorchid and 13 normal newborns in the first 24 h of life. Mean serum beta HCG concentration in the cryptorchid infants (18.9 +/- 9.7 miu/ml) did not differ significantly from the control group (26.7 +/- 7.6 miu/ml). Mean serum testosterone level in the cryptorchid newborns (271 +/- 27 ng/dl) also did not differ significantly from the control group (333 +/- 30 ng/dl). These data suggest beta HCG and testosterone concentrations on the first day of life are of the same magnitude in normal and cryptorchid infants.
Mitogenic preparations of nonviable lysed cells and purified membranes of Mycoplasma pulmonis induced interstitial pneumonia and tracheitis after intranasal administration to pathogen-free rats. The pneumonia, characterized by peribronchial, perivascular, and alveolar wall infiltration by lymphocytes, was indistinguishable from that produced by viable M. pulmonis. Both pathologic and mitogenic effects were significanlty reduced by prior treatment of membranes with heat or proteolytic enzyme. Intranasal administration of the thymus-derived-cell mitogen, concanavalin A, produced interstitial pneumonia but not tracheitis. These results indicate a correlation of mitogenicity and pathogenicity and suggest that activation of thymus-derived lymphocytes is the major cause of the pneumonia resulting from infections with M. pulmonis.
The early post-partum period is one of the few times of life stress for which health care professionals recommend alcohol consumption. In this study, a group of nursing mothers who had delivered normal full-term, first-born infants were examined during the 1-month period following childbirth. Data were collected on alcohol consumption patterns prior to and during pregnancy and following childbirth. Most women reported abstaining or decreasing consumption during pregnancy. Those who continued to drink during pregnancy reported drinking on social occasions, rather than when depressed or bored. During the post-partum period, a number of women began drinking. By far the most common post-partum drinking situation was during or prior to breast feeding. Reportedly, many women were advised to drink by nurses and doctors in order to relax and to aid the letdown reflex. Several factors seem worth noting. First, professional advice may be based on misinformation. Animal studies have suggested that alcohol inhibits the letdown reflex and may interfere with nursing. Secondly, because alcohol has been shown to enter the milkstream, attention should be given to possible harmful effects of alcohol (on the newborn) during nursing. Nurses could easily incorporate up-to-date information into their nursing practice.
This paper describes the structure, composition, function and treatment methods in an adolescent unit containing 16-20 patients, at the Shalvata Psychiatric Center. Treatment is based on organizing the adolescents in a group setting with organized activities. Description of group therapy with the adolescents, their families and group sessions of the team receives special emphasis. Our objectives went beyond a symptomatic improvement and were towards strengthening and integrating the personality. Emphasis was thus placed on creating a therapeutic and educational milieu conducive to new developmental as well as corrective emotional experiences, rather than on economy in length of hospitalization and therapeutic hours invested. This demanded considerably more investment in terms of period of hospitalization and number of personnel than was the usual practice with adult patients in the hospital.
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Suppurative arthritis of the right knee and osteomyelitis of the adjacent femur complicated a urinary tract infection in an 18-day-old infant with a posterior urethral valve causing urinary flow obstruction. Initially cephalosporine sensitive Enterobacter caused the urinary tract infection. Shortly following cephazolin therapy, cephalosporine resistant Enterobacter microorganisms were isolated both from the urine and the knee joint fluid. These two infections were successfully treated with a combination of gentamicin and Co-trimoxazole. Gram-negative bacteria should be considered among the pathogens in neonatal osteoarticular infections, particularly if a urinary tract infection co-exists.
In the history of psychiatry, one can discern conflicting trends with regard to hospitalization of people suffering from severe mental disturbances. From the beginning of the 19th century, the standard method for dealing with such people has been to take them away from their homes and work and put them in hospitals. However, since the discovery of antipsychotic drugs in the 1950's, there has developed a new movement to treat mentally disturbed people in their communities, either avoiding hospitalization altogether, or at least greatly shortening it. In many hospitals there has been a synthesis of these two trends, reflected in an upgrading of the importance of the rehabilitation function. In Shalvata Psychiatric Center, a medium-sized psychiatric hospital in Hod Hasharon, Israel, a two-year pilot project to introduce a centralized Rehabilitation Service was recently completed. The present Rehabilitation Service is based on the rehabilitation/activity therapy model in which the hospital is conceptualized as a setting in which patients may develop or recover social and vocational skills needed to function adequately in the community. It has drawn on existing, motivated staff from all mental health professions represented at the hospital, and works closely with all in-hospital wards and the day hospital. The authors discuss six areas of vocational and social rehabilitation with which the Rehabilitation Service has attempted to deal: 1. activity therapy/rehabilitation groups, 2. vocational guidance unit, 3. after-care therapeutic social club, 4. in-hospital rehabilitation consultation, 5. liaison activities with community-based facilities, 6. job placement.
In Israel, where there exists a highly developed network of vocational rehabilitation services for discharged psychiatric patients, there are few organized programs of social rehabilitation. Accordingly, two years Shalvata Psychiatric Center, a medium-sized psychiatric hospital near Tel Aviv, opened a therapeutic social club in its satellite community clinic in the town of Raanana. The authors describe the establishment of the club and various critical facets of the on-going club experience. The club program appears to fulfill a variety of highly important therapeutic needs, and its positive results conform with those reported elsewhere. Among the rehabilitation benefits which can be attributed to such therapeutic clubs are: (1) a rich source of social stimulation, (2) the opportunity to help members improve their repertoire of social skills, (3) the separation of members from their overburdened families several evenings each week, (4) crisis intervention possibilities, and (5) continuous aftercare contact between professional mental health workers and a high risk population. One important result may be the reduction of the re-hospitalization rate among former patients who participate in the club.
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