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Biomedical subjects

S Segev

Publications and source records attributed to S Segev.

34 records · Page 2Linked to original sources
PubMed1988

Failure of influenza vaccination in the aged.

A cohort of 127 nursing home residents aged 60-98 years were vaccinated during the winter of 1985-86 with the A-Chile 1/83 (C), A-Philippines 2/82 (P), and B-USSR (B) commercial influenza vaccines. Before vaccination 40%, 23%, and 69% were susceptible to influenza Ac, Ap, and B, respectively [hemagglutinin inhibition (H.I.) titer less than 1:40]. One month following initial vaccination, 32 patients [25%] remained unprotected against two or all three vaccine strains. These patients were revaccinated with the same influenza vaccine and followed up. At five months 11%, 19%, and 23% of the initial cohort were still unprotected against Ac, Ap, and B strains, respectively. We conclude that two conventional influenza vaccines administered one month apart leave unprotected 30% of healthy elderly people who are initial influenza vaccine failures.

Aged↗
PubMed1988

Antibiotic cost reduction by providing cost information.

Antibiotic cost information was added to the computerized print-out for each patient of microbiology culture results, next to the antibiotic susceptibility list. During the first six months of this addition, the average monthly cost of antibiotics decreased by 16.5% ($7636) compared to the 12 months period preceding the study period. The average antibiotic cost per admission decreased by 15.7% ($1.61) and the average antibiotic cost/hospital day decreased by 10.6% ($0.23). Antibiotic savings were highest in the Department of Obstetrics and Gynaecology (21.7%) and lowest in the Department of Paediatrics (10.8%). Two-thirds of the average savings were initiated by the house-staff and the remainder by infectious disease consultants. The effect of this system on the level of medical care remains to be studied.

Anti-Bacterial Agents↗
PubMed1988

The efficacy and safety of spiramycin in the treatment of nongonococcal urethritis in men.

Twenty-five male patients with nongonococcal urethritis including 15 chlamydial infections, were treated with spiramycin for ten days. All but four patients had been treated previously, mostly with tetracyclines. Chlamydia trachomatis was cultured in seven patients and was detected in three additional men by immunofluorescent smear. Five other patients had antibodies to chlamydia, and one patient yielded a positive culture for Ureaplasma urealyticum and Mycoplasma hominis. A successful clinical response was observed in 64% of the patients; C. trachomatis was eradicated from six of seven patients with positive cultures and the three positive direct smears were negative after treatment. It is concluded that spiramycin can be used effectively for the therapy of acute nongonococcal urethritis, as well as in patients who have failed to respond to previous treatment with tetracyclines and erythromycin.

Adult↗
PubMed1988

Quinolones, theophylline, and diclofenac interactions with the gamma-aminobutyric acid receptor.

Epileptic seizures and hallucinations, which are rare in patients receiving quinolones, have been observed more frequently in patients receiving both quinolones and either theophylline or nonsteroidal anti-inflammatory drugs. Inhibition of gamma-aminobutyric acid (GABA) binding to the GABA receptor, resulting in general excitation of the central nervous system, may be the underlying mechanism of these adverse phenomena. We demonstrate here that ciprofloxacin displaced a GABA-like substance (muscimol) from the GABA receptor when administered in concentrations of greater than 10(-4) M. These concentrations were lower than those needed by pefloxacin, ofloxacin, and nalidixic acid to reach a concentration that inhibits 50% of binding. The combination of ciprofloxacin and theophylline was additive in reducing the level of muscimol binding to the GABA receptor, whereas a diclofenac-ciprofloxacin combination had no effect. The concentrations of both ciprofloxacin and the other quinolones used were much higher than those observed in human serum and cerebrospinal fluid in a clinical setting; however, different human GABA receptor affinities, preexisting GABA excitation, or underlying central nervous system disease may amplify the excitatory side effects observed by the co-administration of quinolones and theophylline. Attention should be paid to the possible epileptogenic activity of the simultaneous administration of quinolones with aminophylline, nonsteroidal anti-inflammatory drugs, or other unpredictable drugs.

Animals↗
PubMed1988

Ceftizoxime vs. cefotaxime--a comparative randomized multicenter study.

One hundred and fourteen hospitalized patients with moderate or severe infections were assigned at random, in four medical centers, to receive either ceftizoxime or cefotaxime, administered intravenously in a dosage of 1 to 2 g every 8 h. Of 96 patients evaluable for efficacy, 24 (25%) had bacteremia, 46 (48%) had urinary tract infections and 9 (9%) had pneumonias. Half the patients had been treated ineffectively by other antibiotics prior to the study drug treatment. The overall clinical efficacy was 90% in both treatment groups and 83% in both groups with bacteremia. All patients with urinary tract infection were cured by both agents. Bacteriological eradication rate was 95% in both groups. Adverse reactions, though mild, were more frequent in the cefotaxime group (13.5%) than in the ceftizoxime group (6.8%); superinfection rate was higher in the ceftizoxime group. Both antibiotics were highly and equally efficacious in the therapy of severe infections in hospitalized patients.

Adult↗
PubMed1988

Gastrointestinal phycomycosis in acute nonlymphatic leukemia.

A 37-year-old patient with acute nonlymphatic leukemia developed gastrointestinal phycomycosis during failure in bone marrow production. The clinical presentation was of acute typhlitis. Laparotomy revealed a necrotic mass in the region of the iliocecal valve, and on histologic examination hyphae of phycomycetes with invasion of the blood vessels were seen. The patient died as a result of widespread infection.

Acute Disease↗
PubMed1988

Quiescent Q fever endocarditis exacerbated by cardiac surgery and corticosteroid therapy.

Q fever endocarditis occurs in up to 11% of patients infected by Coxiella burnetti. Major clues for the diagnosis are culture-negative endocarditis, hepatic involvement, rash, and thrombocytopenia. Characteristically, the diagnosis is delayed. In our patient, Q fever endocarditis occurred without previously recorded signs of infection. Fever, rash, and hepatic involvement all occurred following aortic valve replacement. The histologic picture of the excised valve was consistent with endocarditis, and serologic tests disclosed elevated IgA and IgG antiphase 1 antibody titers against C burnetti, compatible with Q fever endocarditis. It is assumed that the exacerbation of quiescent Q fever endocarditis was caused by cardiac surgery and steroid therapy.

Adult↗
PubMed1987

Drug interactions of ciprofloxacin with other non-antibiotic agents.

Interactions between ciprofloxacin and other non-antibiotic agents occur; some can be predicted from in vitro results and general pharmacodynamic rules, whereas other interactions appear to be unpredictable. In the absorptive phase, neither food nor ranitidine, a histamine (H2)-receptor blocker, alters the absorption of ciprofloxacin. Pirenzipine, a cholinergic agent, and N-butyl-scopolaminium bromide delay the absorption of ciprofloxacin, whereas metclopramide accelerates absorption. Both magnesium- and aluminum-containing antacids significantly decrease the absorption of ciprofloxacin, probably through formation of a chelate complex. Patients receiving ciprofloxacin and theophylline simultaneously have higher serum theophylline levels than do recipients of theophylline alone. The interaction is probably due to the inhibition by ciprofloxacin of hepatic microsomal enzymes that metabolize theophylline. Ciprofloxacin does not displace bilirubin from albumin; thus, interactions resulting from displacement of highly protein-bound agents by ciprofloxacin are unlikely. Ciprofloxacin and other quinolones inhibit gamma-aminobutyric acid receptors through reduction of their binding capacity and thus may potentiate convulsions induced by other agents. Cimetidine, a cytochrome P450 antagonist, affects metabolizable quinolones, and it is likely that it may affect ciprofloxacin's disposition after prolonged use. Currently, the only clinically significant interactions are the inactivation of ciprofloxacin by antacids and an increase in theophylline blood levels in the presence of ciprofloxacin. In the future, attention should be paid to other possible interactions.

Administration, Oral↗
PubMed1987

Human Exserohilum and Bipolaris infections: report of Exserohilum nasal infection in a neutropenic patient with acute leukemia and review of the literature.

A neutropenic patient with acute myeloid leukemia developed nasal and perinasal infection caused by the fungus Exserohilum rostratum. Early amphotericin B treatment along with marrow recovery resulted in resolution of the infection. A review of other previously reported cases of Exserohilum and Bipolaris infections show a favourable outcome in most patients who receive systemic antifungal treatment with amphotericin B.

Agranulocytosis↗
PubMed1985

Stress induced analgesia: its opioid nature depends on the strain of rat but not on the mode of induction.

Reports by several investigators have shown that both opioid and non-opioid analgesia can be induced by non-pharmacological manipulations such as the administration of electric shock, and that such analgesia depends on shock parameters, the affective state of the animal and the region of the body shocked. We tested several manipulations which have been reported to induce opioid analgesia using a local strain of rats (CR). Such manipulations included the used of 30 min of intermittent footshock (3 mA, 1 s on, 5 s off), brief shock to the forepaws, transpinal electroconvulsive shock (ECS) and tail shock induced helplessness. Administration of either naloxone or naltrexone to rats of the CR strain failed to attenuate the analgesic effect of these manipulations and in some cases even enhanced analgesia. The existence of functional opioid analgesia systems in CR rats was evident from the fact that electrical stimulation of the periaqueductal gray area produced naloxone sensitive analgesia. In additional experiments we compared the analgesic effect of brief continuous (3 min) footshock, prolonged intermittent footshock (30 min) and ECS in young (less than 75 days of age) and old (greater than 75 days of age) rats of the Sabra strain. Young Sabra rats showed naloxone sensitive analgesia following all 3 manipulations while adult rats displayed analgesia which was naloxone insensitive. Furthermore, no decrement in learning, indicative of helplessness, could be demonstrated in young Sabras following 3 min of shock which induced naloxone sensitive analgesia.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1985

Footshock-induced analgesia: neurochemical correlates and pharmacological profile.

The administration of electric shock to the feet of rats can produce either opioid, naloxone-sensitive analgesia or non-opioid, naloxone-insensitive analgesia. In our hands opioid analgesia could be elicited in young Sabra rats (75 days of age) by all analgesia induction methods while older rats of the same strain and rats of the Charles River-derived strain (CR) showed only naloxone-resistant analgesia. We therefore compared the effects of 2 different footshock parameters, 3 min continuous shock (3 mA) and 30 min intermittent shock (30 min, 1 s on 5 s off) on the responsiveness to noxious stimuli and on brain enkephalins and humoral (H-) endorphin content in these strains of rats. As previously reported, only young Sabra rats showed opioid analgesia whereas all other animals displayed naloxone-resistant effects. In contrast, no differential effects on brain opioids could be seen in these species. Thus, 30 min of shock produced a significant increase in brain enkephalins and a noticeable albeit non-significant increase in brain H-endorphin. A slight non-significant increase was seen following brief footshock. To assess the nature of non-opioid analgesia further we examined the effects of both reserpine and a series of antagonists on the analgesia produced by 3 and 30 min of either brief or prolonged shock. Pretreatment with reserpine caused a significant attenuation of non-opioid analgesia with both shock parameters while none of the antagonists administered (methysergide, phentolamine, phenoxybenzamine, yohimbine, theophylline, diphenhydramine and scopolamine) were effective.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1985

Footshock-induced analgesia: its opioid nature depends on the strain of rat.

Previous studies have indicated that stressful footshock can induce both opioid, naloxone-sensitive, and non-opioid, naloxone-insensitive forms of analgesia, depending on stimulation parameters used with 30 min of intermittent footshock (3 mA, 1 s on, 5 s off) producing opioid analgesia and 3 min of continuous shock (3 mA) producing non-opioid analgesia. Using a local strain of Charles River (CR)-derived rats we conducted a parametric investigation of footshock-induced analgesia applying both AC and DC scrambled shock ranging from 1 to 4 mA, continuous shock of 1, 3 and 5 min in duration and intermittent shock lasting 1, 3, 5, 10, 20, 30 and 80 min. All shock parameters produced potent analgesia. In no case did 10 mg/kg of naloxone block this analgesia. Varying the dose of the antagonist (0.1-10 mg/kg) and testing the animals at different points in the diurnal cycle did not result in the emergence of naloxone-sensitive anangesia. Based on the assumption that non-opioid systems may mask the activity of opioid analgesia systems, we attempted to either enhance opioid analgesia by: preventing enkephalin degradation by the use of D-phenylalanine; increasing the entry of blood-borne opioids into the brain by the use of DMSO; and the attenuation of non-opioid analgesia by the use of reserpine. In no case did a naloxone-sensitive component of analgesia emerge. To test whether the animals possess an intact opioid analgesia system, both electrical stimulation of, and injection of opiates into the periaqueductal gray (PAG) were examined. Both procedures produced analgesia which was reversed by naloxone.(ABSTRACT TRUNCATED AT 250 WORDS)

Analgesia↗