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Biomedical subjects

C Shaer

Publications and source records attributed to C Shaer.

8 recordsLinked to original sources

Eating disorders in adolescents and young women with spina bifida.

This is the first report of the association of spina bifida and eating disorders. Five patients were diagnosed rather late in the course of their illness. They all had been overweight premorbidly and had been urged to lose weight for years in order to improve their mobility. As they dieted, they experienced their weight loss as a source of power that could somehow compensate for their losses and neurologic limitations. They responded to a multidisciplinary intervention. Clinicians taking care of patients with spina bifida need to be cognizant that they may be at risk of developing an eating disorder. Such awareness should influence the quality of nutritional counseling (prevention aspect) and the clinical assessment of sudden weight loss (early intervention).

Adolescent↗

Latex allergy in children.

Natural latex, a product of the tropical rubber tree, Hevea brasiliensis, has been shown to cause allergic reactions in an increasing number of individuals. Severity of reaction has ranged from mild contact dermatitis to anaphylaxis. Individuals with spina bifida, congenital urogenital anomalies, health care workers, and those employed in the rubber industry are at highest risk for immediate hypersensitivity to latex. Health care workers should be aware of this high risk to minimize exposure of patients.

Child↗

Evoked potentials in infant brainstem syndrome associated with Arnold-Chiari malformation.

This study evaluated the contribution of brainstem auditory evoked potentials (BAEPs) and median nerve somatosensory evoked potentials (SEPs) to the assessment of brainstem dysfunction in infants with myelomeningocele and Arnold-Chiari malformation. 16 infants under one year of age were studied. Six had infant brainstem syndrome (IBS). 11 had abnormally prolonged I-V interwave latency (brainstem transmission time, BSTT); BSTT did not differentiate those patients with and without IBS. The cortical 'N20' component of the median-nerve SEPs was absent or had low amplitude and prolonged latency in all six patients with clinical signs of brainstem dysfunction and in four without. Median-nerve SEPs were normal in the patients without IBS. There was a significant difference between patients with and without IBS. Median-nerve SEPs may be a helpful measure of brainstem function in infants with Arnold-Chiari malformation.

Arnold-Chiari Malformation↗

Rubber-specific IgE in children with spina bifida.

We attempted to determine the prevalence and clinical significance of rubber-specific IgE in a prospective case control study of 32 preoperative children with spina bifida, compared with 45 outpatient controls and 35 age-matched preoperative controls without spina bifida. A latex-specific radioallergosorbent test was positive in 11 of the 32 spina bifida patients (34%), compared with 1 (2%) and 4 (11%) of the respective controls (p less than 0.05). Within the spina bifida group 5 of 11 antibody-positive patients had a history of rubber-associated, intraoperative or otherwise idiopathic allergic episodes and 1 of 21 antibody-negative patients gave such a history (p = 0.012). Children with spina bifida have a significantly greater likelihood than controls of having IgE specific for rubber antigens. In addition, the presence of rubber-specific IgE is associated with a higher frequency of rubber-associated, intraoperative or idiopathic allergic reactions.

Adolescent↗

Renal scarring and vesicoureteral reflux in children with myelodysplasia.

The records of 180 myelodysplasia patients followed from 3 to 18 years were reviewed. Studies included cystography to evaluate vesicoureteral reflux and dimercapto-succinic acid renal scintigraphy to identify acute inflammation and renal scarring. Scarring was noted in 28 of 180 patients (15.5%), of whom 68% were girls. Of the patients with renal scarring 75% had associated reflux and 40% over-all were identified as having reflux. Management of patients with vesicoureteral reflux included clean intermittent catheterization, antibiotic prophylaxis and anticholinergics when indicated. Only 17 of 72 patients (24%) had ureteral reimplantation. Surgical indications included persistent high grade reflux and/or progressive upper tract damage. Reflux resolved in 62% of those on medical management. Resolution was not dependent on grade of reflux (as compared to primary reflux). Twenty-one patients are stable and being followed with persistent reflux. In 7 patients new renal scars developed during aggressive medical management, 5 of whom underwent subsequent surgical correction.

Child↗

Type I hypersensitivity to rubber.

Seven patients with type I hypersensitivity reactions to rubber are reported. Radioallergosorbent testing with crude latex antigen was positive in 6/7 patients. Five patients had coexisting spina bifida, and all had undergone surgery before the development of rubber allergy. Rubber allergy is a new phenomenon that should be in the differential diagnosis of idiopathic anaphylaxis and urticaria.

Adolescent↗

Intraventricular hemorrhage in the newborn beagle puppy. A limited model of intraventricular hemorrhage in the premature infant.

The term beagle puppy has been used extensively as an experimental model of intraventricular hemorrhage (IVH) in the preterm infant. Fourteen variables were selected which were considered theoretically important to both the model and the preterm infant, and the data were subjected to discriminant analysis. Use of only three variables in combination correctly predicted whether an animal would sustain germinal matrix hemorrhage: baseline blood pressure, Pco2, and temperature. The model does not involve ischemia, which appears to be the sentinel but not singular insult in the IVH of preterm infants.

Animals↗

Latex allergy in spina bifida patients: prevalence and surgical implications.

We interviewed 93 consecutive children with spina bifida who were scheduled for operation to document (a) the prevalence of latex sensitivity, (b) predictors of anaphylactic reaction, and (c) the risk of type I hypersensitivity reaction perioperatively. Of these patients, 9.7% were clinically allergic. Radioallergosorbent testing (RAST) was 89% sensitive. All patients with known latex allergy were premedicated, and rigorous efforts were made to avoid latex exposure. No intraoperative anaphylactic reactions were noted. One postoperative reaction occurred in a history-positive, RAST-negative patient. We conclude that operation can be performed safely in patients with latex allergy.

Adolescent↗