Imad R. Makhoul, MD, DSc, Polo Sujov, MD, Leon Ardekian, DDS, Imad Kassis, MD, Tatiana Smolkin, MD, Imad Abu-Elnaa'j, DMD, Ada Tamir, DSc and Dov Laufer, DMD
Background: Factors influencing the oral flora of premature infants have not been adequately investigated.
Objective: To investigate the effects of gestational age and of anti-bacterial therapy on the oral flora of premature infants.
Methods: Oral cultures were obtained at age 1 day and age 10 days from 65 premature infants, divided into three groups: a) 24 neonates of 30-34 weeks gestation who did not receive ABT, b) 23 neonates of 30-34 weeks gestation who received ABT, and c) 18 neonates < 30 weeks gestation who received ABT.
Results: Oral bacterial colonization increased from day 1 to day 10 of life. In 24-34 week neonates, gestational age did not affect early bacteremia or oral colonization at birth. Neither gestational age nor ABT affected late bacteremia or oral colonization at day 10. In 30-34 week neonates with ABT, the oral flora consisted mainly of non-Escherichia coli gram-negative bacteria, whereas those who did not receive ABT grew mainly alpha-hemolytic streptococci, Klebsiella pneumoniae and E. coli in neonates < 30 weeks who received ABT the oral flora were mainly coagulase-negative staphylococci. Oral colonization with anearobes was zero and colonization with fungi was minimal.
Conclusions: Acquistion of oral bacteria rose from day 1 to day 10 of life, regardless of gestational life or ABT. On day 10 of life, the spectrum of oral bacterial flora changed following ABT and consisted mainly of coagulase-negative Staphylococcus and non E. coli garm-negative bacteria. Oral colonization showed few fungi but no anaerobes. These microbiologic observations merit attention when empirical anti-microbial therapy is considered in premature infants suspected or having late-onset sepsis.
Freda DeKeyser, RN, PhD, Malka Avitzour, MPH, Dorraine Day Watts, PhD, RN, Arthur L. Trask, MD and Michael Muggia-Sullam, MD
Background: Trauma is viewed by many as a global problem. The phenomenon of similar outcomes within differing healthcare delivery systems can illuminate the strengths and weaknesses of various trauma systems as well as the effects of these characteristics on patient outcome.
Objectives: To compare and contrast demographic and injury characteristics as well as patient outcomes of two urban/suburban trauma centers, one in Israel and the other in the United States.
Methods: Study data were obtained from the trauma registries of two trauma centers. Demographic variables, injury characteristics and outcomes were compared statistically between registries.
Results: Significant differences between the registries were found in demographic variables (age), injury characteristics (Injury Severity Score and mechanism of injury), and outcome (mortality and length of stay). Age and Injury Severity Score were found to be significant predictors of outcome in both registries. The Glasgow Coma Score was found to contribute to patient outcomes more than the ISS. Differences were found in the relative impact of injury and demographic factors on outcomes between the registries. After including the influence of these factors on patient outcomes, significant differences still remained between the outcomes of the trauma centers.
Conclusions: Despite possible explanations for these differences, true comparisons between centers are problematic.
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Mickey Scheinowitz, PhD, Arkady-Avi Kotlyar, PhD, Shachar Zimand, MD, Ilan Leibovitz, MD, Nira Varda-Bloom, Dan Ohad, Iris Goldberg, PhD, Santiego Engelberg, MD, Nafthali Savion, PhD and Michael Eldar, MD
Background: Previous studies have demonstrated myocardial salvage by basic fibroblast growth factor administration following chronic myocardial ischemia or acute myocardial infarction.
Objectives: To study the effect of bFGF on left ventricular morphometry following coronary occlusion and reperfusion episode in rats.
Methods: bFGF (0.5 mg) or placebo was continuously administered for a period of one week using an implanted osmotic pump. Animals were sacrificed 6 weeks after surgery and myocardial cross-sections were stained with Masson-trichrome and with anti-proliferating cell nuclear antigen antibody.
Results: LV area, LV cavity diameter, LV cavity/wall thickness ratio, and injury size were unchanged compared with control animals. Proliferating endothelial cells were significantly more abundant in injured compared with normal myocardium, but with no differences between animals treated or not treated with bFGF.
Conclusions: One week of systemic bFGF administration following coronary occlusion and reperfusion had no additional effect on LV geometry or cellular proliferation in rats.
Andre Keren, MD and Shmuel Banai, MD
Shmuel C. Shapira, MD, MPH
Dan Miron, MD, Raul Raz, MD and Authony Luder, MD
Jacob Lavee, MD and Yoav Paz, MD
Richard Fabian Schumacher, MD and Luigi D. Notarangelo, MD
Eilon Shany, MD, David Greenberg, MD and Eliezer Shahak, MD
Nir Cohen, MD, David Keret, MD, Eli Ezra, MD and Franklin Lokiec, MD
Jacob Ablin, MD, Shaltiel Cabili, MD, Ayala Lagziel, PhD and Hava Peretz, PhD
Shomron Ben Horin, MD, David Luria, MD, Michael Glikson, MD and Avi Livneh, MD
Gabriela Gayer, MD and Rivka Zissin, MD
Simon Strauss, MBChB and Dan Leibovici, MD