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Biomedical subjects

S Levin

Publications and source records attributed to S Levin.

At least 361 records · Page 20Linked to original sources

The peroxidase content and the antibacterial activity of the amniotic fluid.

A possible relationship between the antibacterial activity of amniotic fluid and its peroxidase content was examined. Antibacterial activity, assessed by counting colonies of S. aureus following 24 hour incubation, was present in 76% of the samples studied. It was not related to gestational age. Peroxidase activity, assessed by the O-dianisidine method, was not found in any of the amniotic fluid samples examined.

Amniotic Fluid↗

Thymic deficiency in Down's syndrome.

Children with Down's syndrome (DS) often have small and abnormal thymuses, with lymphocyte depletion, diminution of the cortex, and loss of corticomedullary demarcation--a picture resembling thymic involution. Besides this, they have markedly enlarged Hassall's corpuscles, some surrounded by a sheath of lymphocytes. Patients with DS are known to have increased numbers of respiratory infections; they also have a higher incidence of lymphatic leukemia than do individuals who do not have DS. Studies of cell-mediated (thymic-dependent) immunity demonstrate that children with DS have both diminished numbers of T cells as well as functional deficiency of these cells.

Child↗

Use of antibiotics in the outpatient setting.

Antibiotics with small but definable mortality, such as chloramphenicol, should not be used when safer drugs will suffice. Antibiotics with a low (1 to 5 per cent) morbidity should not be used when safer drugs are available. Therefore, cleocin, minocycline, or oral erythromycin estolate should rarely be used and regular erythromycin base is almost always preferable. Fever should not be treated with antibiotics since they are not antipyretics. "Colds" should not be treated with antibiotics, but antibiotics should be administered to patients with a history of chronic bronchitis, sinusitis, and recurrent otitis as soon as any symptoms begin. Intramuscular antibiotics should not be given except for benzathine penicillin. Use placebos instead of antibiotics when the patient's psyche demands an intramuscular injection. Make certain that the needle, syringe, and solution are sterile. Agents other than penicillin or cephalosporins should be used in patients with a definite history of penicillin allergy. Combination antibiotics or broad spectrum antibiotics like cephelosporins or tetracyclines should not be used when narrow spectrum antibiotics of known efficacy are available for specific syndromes such as streptococcal pharyngitis.

Ambulatory Care↗

Is conception in infertile couples treatment-related? A survey of 309 pregnancies.

309 couples with infertility of 1 to 11 years duration in whom pregnancies occurred during examination or treatment were evaluated. The couples were classified into diagnostic groups according to the main cause of their infertility; anovulatory, mechanical, male, cervical, unexplained, combined. Pregnancies were divided into treatment-related and nontreatment-related. Analysis of results revealed that whereas in infertile patients with a defined cause of infertility, the treatment-related pregnancy rate was 73.1%, in the unexplained infertility group the incidence of treatment-related pregnancies was only 6.6%. We concluded that a meticulous fertility survey should be carried out in each infertile couple in order to detect a specific cause impeding fertility, but if such a cause cannot be found, reassuring of patients and decreasing their anxiety is more effective in inducing pregnancy than nonspecific therapy.

Adult↗

Participation of a histamine-Sepharose-adherent subpopulation of human mononuclear cells in the production of leucocyte migration inhibition factor (LIF) in healthy children.

The separation of mouse splenic T lymphocytes into distinct subpopulations by fractionation on histamine-rabbit serum albumin Sepharose (H-RSAS) columns has been described. The H-RSAS-adherent T cells have been attributed regulatory functions associated with B cell activity, T cell-mediated cytotoxicity and the secretion of mediators such as immuno-interferon. The possibility that H-RSAS-adherent T cells exert a similar regulatory effect on an in vitro parameter of T cell-mediated immunity was investigated by assaying the production of leucocyte migration inhibition factor (LIF) in human blood samples, using the agarose droplet method. Phytohaemagglutinin (PHA) and BCG-purified protein derivative (PPD) were used as stimulants of LIF secretion which was measured as a percentage of inhibition of linear leucocytic migration. In normal individuals a highly significant (P less than 0.001) decrease was demonstrated in the production of LIF by peripheral blood leucocytes depleted of H-RSAS-adherent cells. Migration inhibition dropped from 36 +/- 11.7% to 21.2 +/- 12.9% in eighteen cases tested with PHA and from 29.3 +/- 11.7% to 17.2 +/- 9.8% in twelve cases tested with PPD. These results suggest the existence of a lymphocytic subpopulation involved in LIF production which expresses histamine receptors.

Cell Adhesion↗

Pseudohypoaldosteronism.

Three children, two of whom were siblings, had pseudohypoaldosteronism. The features of this condition include failure to thrive, hyperkalemia, metabolic acidosis, salt wasting, elevated peripheral renin activity, and increased plasma aldosterone concentration. Hyperplasia of juxtaglomerular apparatus was seen in a renal biopsy specimen from one of these patients. Administration of large quantities of salt normalized the serum electrolyte abnormalities and permitted normal growth. Furthermore, the serum electrolyte abnormalities were prevented by administration of increased amounts of salt to one of these children from birth.

Aldosterone↗

'Bedniks'.

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Bed Rest↗

An in-vitro immunological assay for diagnosis of coeliac disease.

Production of leucocyte-migration-inhibition factor (L.I.F.) by peripheral-blood lymphocytes in response to challenge with gluten fractions was studied in 55 patients with coeliac disease and in 32 controls. 96% of the patients with coeliac disease demonstrated significant L.I.F. reaction in response to gluten fractions irrespective of their dietary status. Only 2 out of 32 controls had a positive reaction. This was in response to the B2 or B3 fraction, but never to both. The agarose microdroplet method of L.I.F. assay is reliable and technically simple enough for use in most clinical laboratories. The assay of L.I.F. production by peripheral-blood lymphocytes in response to gluten fractions, would be a useful adjunct in the diagnosis of gluten-sensitive enteropathy.

Adolescent↗

Asherman's syndrome--a self-limiting disease?

Intrauterine adhesions (Asherman's syndrome) may follow curettage in a recently pregnant uterus. Treatment consisting of dilatation and curettage and possibly the insertion of an intrauterine device usually is started early. The success rate is high. Very few cases of spontaneous recurring menstruation have been reported, and none of them have been based on hysterosalpingographic evidence of adhesions. The pregnancy outcome is generally poor in those cases of assumed spontaneous resolution. We present a case of spontaneous restitution of a functional uterine cavity and normal menstruation following Asherman's syndrome. Subsequent pregnancy was uneventful. A short review of the literature is presented, and the possible self-limiting character of the disease is discussed.

Adult↗

Pseudomonas maltophilia pseudosepticemia.

During a 17 month period, 25 hospitalized adult patients had blood cultures reported as positive for Pseudomonas maltophila. Review of the hospital records suggested that these were contaminants and that blood for coagulation studies and for cultures that were subsequently positive had been drawn simultaneously. The source of contamination appeared to be black-top evacuated collection tubes used for coagulation studies in adults. Cultures of the liquid anticoagulant tubes yielded a pure growth of greater than 10(5) colony forming units (CFU)/cc of Ps. maltophilia on blood agar. Mock trials demonstrated that following venipuncture by syringe, inoculation of contaminated black-top tubes prior to inoculation of blood culture bottles would yield false-positive blood cultures (pseudosepticemia). One patient being treated for streptococcal prosthetic valve endocarditis and having frequent coagulation studies with blood obtained via direct venipuncture into evacuated collection tubes was found to have superinfection of his prosthetic valve with Ps. maltophilia at autopsy. Prosthetic valve infection may have occurred after reflux of contaminated anticoagulant from an evacuated collection tube directly into the vein. Contaminated evacuated collection tubes are a potential source of confusion in the diagnosis of infection as well as a potential source of true infection.

Adult↗