Search PubMed⌕ Search

Biomedical subjects

A Gedalia

Publications and source records attributed to A Gedalia.

At least 55 records · Page 3Linked to original sources
PubMed1992

Abdominal pain with free peritoneal fluid detected by ultrasonography as a presenting manifestation of acute rheumatic fever.

The clinical and laboratory data for an 8 year old girl with abdominal pain as a presenting manifestation of acute rheumatic fever are reported. An abdominal investigation with ultrasonography carried out at the same time showed free peritoneal fluid. These findings support the proposal that the abdominal pain classically described in acute rheumatic fever is one of the manifestations of the inflammatory process. It is suggested that in patients with abdominal pain, fever, and increased erythrocyte sedimentation rate in whom the diagnosis is not clear, an abdominal investigation with ultrasonography could be helpful in establishing the correct diagnosis.

Abdominal Pain↗
PubMed1992

Brucellosis induced avascular necrosis of the femoral head in a 7 year old child.

The case is reported of a 7 year old Bedouin girl who presented with a three week history of fever and limp. Initial tests for rheumatoid factor, antinuclear antibodies, and brucella were negative. Two weeks after admission Brucella melitensis was cultured from bone marrow and synovial fluid samples. The patient improved after treatment with doxycillin and streptomycin, but radiographs of the right hip showed avascular necrosis of the right femoral head. A mild limp and limitation of motion in the right hip persisted 18 months after admission.

Brucella↗
PubMed1991

[Parathyroid adenoma in a child].

Parathyroid adenoma presenting as primary hyperparathyroidism is rare in childhood. We report a case in a 9-year-old Bedouin girl. The diagnosis was based on hypercalcemia, which was found accidentally, and elevated serum parathyroid levels. Ultrasonography, scintigraphy, computerized tomography and magnetic resonance imaging failed to detect the lesion. The diagnosis was only established at exploratory operation, when an adenoma was removed from the right upper pole of the thyroid.

Adenoma↗
PubMed1990

[Hypocalcemia associated with heart failure in infants].

A 2.5-month-old girl and a 34-day-old boy with clinical and X-ray signs of heart failure, and hypocalcemia as well, are presented. Cardiologic investigation revealed no organic causes and in both cases the signs of heart failure resolved only when calcium levels were restored to normal.

Female↗
PubMed1990

[Intracranial hemorrhage complicating acute disseminated staphylococcal disease in a child].

Acute disseminated staphylococcal disease may develop in previously healthy children below the age of 15 years. It progresses rapidly and may cause death in a significant number. The diagnostic criteria are infection in 2 or more anatomical sites and isolation of a coagulase-positive Staphylococcus aureus from the blood or from a site of infection. We present an 11.5-year-old boy with disseminated staphylococcal disease with evidence of cellulitis, osteomyelitis and endocarditis. He developed intracranial hemorrhage as a complication and survived, but with mild residual hemiparesis. Nervous system involvement, such as meningitis and brain abscess, have been described in this particularly severe disease. This is the only known report of intracranial hemorrhage as a complication of the disease.

Acute Disease↗
PubMed1990

[Childhood brucellosis in the Negev].

33 children (22 girls) with brucellosis seen between 1972-1988 were studied retrospectively. All but 1 were Bedouins. The mean age at diagnosis was 9.8 years (range: 17 months-17 years). Duration of illness prior to diagnosis was less than 1 week in 13 (39%), 1-4 weeks in 8 (24%) and 1-3 months in 10 (30%). In 2 cases the symptoms lasted 6 and 8 months, respectively, before diagnosis. Presenting symptoms included fever (85%), articular involvement (65%), hepatomegaly (45%) and splenomegaly (33%). Less common manifestations were anorexia (30%) and weight loss (15%) cases. Meningoencephalitis developed in 2 patients and uveitis and glomerulonephritis in 1 each. Diagnosis was based on positive agglutination titers (greater than 160), which were found in all. Brucella melitensis was isolated in blood cultures in 8 of the 33. 18 were treated with tetracycline and 9 with tetracycline and streptomycin, all of whom responded well. 3 of the 6 treated with trimethoprimsulphamethoxazole were only cured when therapy was changed to tetracycline in 2 and tetracycline plus streptomycin in 1. All patients recovered without sequelae. We conclude that brucellosis due to Brucella melitensis is endemic among the Bedouin of the Negev. An increased incidence of brucellosis among hospitalized children has been noted in the past 2 years, indicating the need for diagnostic awareness.

Adolescent↗
PubMed1990

Congenital insensitivity to pain with neuroparalytic keratitis.

Congenital insensitivity to pain is a well-defined entity in the group of sensory deficiency syndromes. To the best of our knowledge, unilateral neuroparalytic keratitis associated with congenital insensitivity to pain has not been reported. We report such a case to alert clinicians to this potentially blinding problem.

Child, Preschool↗
PubMed1990

[Reflex sympathetic dystrophy in children].

Reflex sympathetic dystrophy (RSD) in children is a clinical syndrome characterized by pain in the extremities associated with hyperesthesia and vasomotor changes. The symptoms frequently result in serious impairment in function of the involved extremity. Treatment should be initiated as soon as possible and include intensive physical therapy; analgesics and transcutaneous nerve stimulation can be added as needed. Compared with the adult, childhood RSD is of unknown etiology and has a better prognosis. RSD has attracted little attention in clinical pediatric practice and in pediatric textbooks and the literature, so the diagnosis may be missed. We report 2 girls with RSD, aged 12 and 15 years, respectively, who were successfully treated with conservative measures; both recovered, with no sequelae.

Adolescent↗
PubMed1990

Inflammatory sacroiliitis in childhood.

A 27-month-old boy and a 10-month-old girl with unilateral inflammatory sacroiliitis are described. Both presented with refusal to walk or to stand. Increased erythrocyte sedimentation rate and negative HLA-B27 were found in both cases. There were no laboratory findings to suggest an underlying rheumatic disease. Radiograms of the sacroiliac (SI) joints, lumbosacral spines and the hip joints were normal. Joint/bone scan revealed increased radionuclide activity over the involved SI joints in both cases. Computerized tomograms of the SI joints were abnormal in one patient. Both patients improved with aspirin, recovered and had no sequelae. Inflammatory sacroiliitis appears to be transient and benign. It is a rare event in young children. Possibly some of them are being treated as though they had septic arthritis.

Arthritis↗
PubMed1989

[Limp as a presenting symptom of psoas muscle inflammation].

Inflammatory irritation of the psoas muscle in children is rare. The initial diagnosis may be difficult because of the similarity between the symptoms of psoas muscle inflammation and septic hip joint. We present a boy and a girl, both 3.5 years old, with psoas muscle inflammation, whose initial clinical and laboratory findings could be explained by either septic hip joint or osteomyelitis. Both presented with fever and limp. 1 developed an acute abdomen within 3 days and at operation a retrocecal periappendicular abscess was found. In the other, left lower quadrant, abdominal pain developed 4 days following admission and ultrasonic findings indicated a left psoas muscle abscess. We suggest that psoas muscle inflammation should be added to the differential diagnosis of limp in children. Early correct diagnosis can be established by proper physical examination, including rectal examination, and with the aid of diagnostic tools such as ultrasound, computerized tomography or both.

Child, Preschool↗
PubMed1989

[Spider bite in a child].

A 4-year-old girl was admitted 30 hours after being bitten by a black widow spider. The presenting symptoms were restlessness, profuse perspiration, severe abdominal pain and fever, while hypertension, hematuria and ECG changes developed later. Treatment was with intravenous fluids only, and she recovered completely and was discharged after a week. According to the literature, management includes muscle relaxants, such as methocarbamal and diazepam, and intravenous calcium gluconate is recommended by some. We found pharmacological intervention unnecessary in this case, but in severe cases and in pregnancy black widow antiserum is indicated. The overall mortality rate 5-10%.

Animals↗
PubMed1989

Dark skin discoloration of finger joints in juvenile arthritis.

We examined the frequency of a known but poorly described finding, darkened skin over the proximal interphalangeal joints in patients with polyarticular juvenile arthritis. Examining a consecutive group of patients we found that 77% showed this sign. It reflects the presence of or previous episodes of inflammation of these joints. The reason for this finding is unknown.

Adolescent↗
PubMed1989

[Articular involvement as a presenting symptom of malignancy in childhood].

The clinical and laboratory features of 6 children with arthritis or arthralgia as presenting manifestations of malignancy are described. 4 of the 6 had leukemia, 1 had a neuroblastoma and 1 had histiocytosis-X. The diagnosis of malignancy was made 2 days to 2.5 months after onset of symptoms. Although all patients presented with limp, the clinical courses suggested the need to consider leukemia and the other malignancies in the differential diagnosis.

Arthritis↗
PubMed1986

Pitfalls in diagnosis of arthritis in children.

Arthritis occurs quite frequently in childhood. By clinically recognizing arthritis, using the proper studies for evaluation, and then carefully weighing the diagnostic evidence, the primary care physician will avoid the common pitfalls in diagnosis of chronic arthritis in children.

Arthritis↗
PubMed1985

Hypermobility of the joints in juvenile episodic arthritis/arthralgia.

It has been suggested that hypermobility of the joints may predispose children to the development of arthritis or arthralgia. To determine the normal frequency of hypermobility, 260 normal schoolchildren (5 to 17 years of age) were examined. In addition, 34 patients with juvenile rheumatoid arthritis (JRA) and 32 children with juvenile episodic arthritis/arthralgia (JEA) were tested. Any child who met at least three of the following criteria was considered to have joint hypermobility: (1) passive apposition of the thumbs to the flexor aspect of the forearms; (2) passive hyperextension of the fingers so that they lie parallel with the extensor aspect of the forearms; (3) hyperextension of the elbows greater than 10 degrees; (4) hyperextension of the knees greater than 10 degrees; (5) flexion of the trunk with knees extended so the palms rest on the floor. Thirty-two (12%) of 260 normal schoolchildren and 21 (66%) of 32 with JEA had hypermobility. Further, a significantly higher proportion (23 of 126) of normal girls than normal boys (nine of 134) had hypermobility (chi 2 = 8.0, P less than 0.005). Hypermobility was not common in children with JRA. These findings support the hypothesis that hypermobility may be an important factor in the cause of JEA.

Adolescent↗