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Biomedical subjects

E Shahar

Publications and source records attributed to E Shahar.

At least 145 records · Page 8Linked to original sources
PubMed1981

Dopamine-induced paroxysmal supraventricular tachycardia in an infant.

Dopamine is an effective inotropic agent in the management of circulatory collapse. Ventricular dysrhythmias are reported to occur during dopamine infusion. The following report describes an infant with circulatory failure who experienced an episode of paroxysmal supraventricular tachycardia while receiving dopamine. Instability or immaturity of the cardiac conduction system during early infancy may contribute to the induction of an arrhythmia of supraventricular origin.

Dopamine↗
PubMed1981

Neonatal hypernatremic dehydration due to excessively concentrated prepared milk formula.

Excessively concentrated milk formula was administered accidentally to five newborn infants. Diarrhea, dehydration, hypernatremia, and hyperosmolality were present in all of them. Abnormal neurologic manifestations during the acute disease were observed in one infant. On follow-up, psychomotor development and electroencephalographic recordings were normal in four infants. One infant, in whom accelerated growth of head circumference had been noted before the episode of diarrhea, was found to have obstruction of the foramen of Monro at the age of 6 weeks. Possible errors in preparing milk formulas by medical staffing resulting in hypertonic dehydration are stressed in this report.

Animals↗
PubMed1981

Fatal neonatal central nervous system infection caused by Citrobacter diversus.

Citrobacter diversus is a serious, albeit rare, offender of the central nervous system (CNS) in the neonatal period and in early infancy. We report here a case of neonatal CNS infection caused by C. diversus. The course of the illness was one of rapid deterioration, leading to recurrent seizures, coma and death. Since neonatal C. diversus CNS infection carries a grave prognosis, intraventricular administration of gentamicin should be considered.

Citrobacter↗
PubMed1981

Hypovolemic shock at birth due to extensive fetomaternal hemorrhage.

Three cases are described in which fetomaternal hemorrhage caused hypovolemic shock at birth. The etiology was confirmed by a postpartum maternal smear which showed approximately 15% of fetal red cells in the maternal circulation. All infants had severe anemia with hematocrit values of from 11 to 15%. Initial resuscitative measures included cardiac massage and artificial ventilation. Plasma expanders were given in order to restore the effective circulatory volume. Repeated blood transfusions resulted in an increase of blood pressure to normal range in all patients. One infant survived without neurological sequelae. The other two infants died following irreversible hypoxic injuries to vital organs. Early recognition of perinatal posthemorrhagic shock is crucial for recovery, and whole blood and plasma expander transfusions should be used immediately. Early assisted ventilation, administration of type O- whole blood and the autotransfusion of fetal blood are suggested for restoring the effective circulatory volume.

Adult↗
PubMed1981

Neurologic complications of Staphylococcus aureus septicaemia in childhood.

Two previously healthy children experienced serious neurologic complications in the course of severe S. aureus septicaemia. The first patient developed right hemiparesis and stupor due to a left frontal abscess. He recovered completely following surgery. The second patient, admitted with signs of meningeal infection, developed acute bacterial endocarditis followed by late cerebral embolism causing coma and death. In both patients, cerebral CT was a useful rapid diagnostic acid. When the S. aureus septicaemic patient develops acute bacterial endocarditis, regardless of his haemodynamic state, early valve replacement may prevent harmful cerebral embolic phenomena.

Adolescent↗
PubMed1981

Neonatal enterobacter suppurative arthritis and osteomyelitis.

Suppurative arthritis of the right knee and osteomyelitis of the adjacent femur complicated a urinary tract infection in an 18-day-old infant with a posterior urethral valve causing urinary flow obstruction. Initially cephalosporine sensitive Enterobacter caused the urinary tract infection. Shortly following cephazolin therapy, cephalosporine resistant Enterobacter microorganisms were isolated both from the urine and the knee joint fluid. These two infections were successfully treated with a combination of gentamicin and Co-trimoxazole. Gram-negative bacteria should be considered among the pathogens in neonatal osteoarticular infections, particularly if a urinary tract infection co-exists.

Arthritis, Infectious↗
PubMed1979

Acute triclofos poisoning in a preterm infant.

A preterm infant with accidental triclofos sodium poisoning is described. He developed deep coma, severe hypothermia, mild by hypotension and lack of the primitive and deep tendon reflexes. During recovery, the primitive reflexes were the last to appear. The natural course of triclofos poisoning, and its influence on the immature central nervous system of the preterm infant are discussed.

Central Nervous System↗
PubMedDate not supplied

A community-based study of explanatory factors for the excess risk for early renal function decline in blacks vs whites with diabetes: the Atherosclerosis Risk in Communities study.

CONTEXT: The explanation for the excess risk for diabetic renal disease in blacks is uncertain. OBJECTIVES: To compare the incidence of early renal function decline in black and white adults with diabetes and to examine possible explanatory factors for racial differences. DESIGN: Prospective cohort study. SETTING: Four US communities participating in the Atherosclerosis Risk in Communities study. PARTICIPANTS: Community-based sample of 1434 diabetic adults aged 45 to 64 years. MEASUREMENTS: Detailed baseline assessment using structured interview, results of physical examination, and laboratory measurements. MAIN OUTCOME: Development of early renal function decline defined by an increase in serum creatinine of at least 35.4 micromol/L (0.4 mg/dL) during 3 years of follow-up. RESULTS: During 3 years of follow-up, early renal function decline developed in 45 blacks (28.4 per 1000 person-years [PY]) and 25 whites (9.6 per 1000 PY). After adjustment for age, sex, and baseline serum creatinine level, early renal function decline was more than 3 times as likely to develop in blacks than whites (odds ratio, 3.15; 95% confidence interval, 1.86-5.33). Additional adjustment for education, household income, health insurance, fasting glucose level, mean systolic blood pressure, smoking history, and physical activity level reduced the relative odds in blacks to 1.38 (95% confidence interval, 0.71-2.69), corresponding to a 82% reduction in excess risk. CONCLUSIONS: These data suggest that early renal function decline is 3 times more likely to develop in blacks than whites and that potentially modifiable factors, including lower socioeconomic status, suboptimal health behaviors, and suboptimal control of glucose level and blood pressure, account for more than 80% of this disparity.

Black People↗
PubMedDate not supplied

Rehabilitation of communication impairment in dystonia musculorum deformans.

Augmentative and alternative communication (AAC) aids were used in three young, intellectually normal patients with dystonia musculorum deformans (DMD) who had severe speech and writing impediments. These aids included speech therapy, communication boards, and voice synthesizers for verbal communication and typewriters, memowriters, and computer software and printers for written communication. At times customized accessing was needed which required specific adaptive modifications. Implementation of the AAC aids system was determined effective for DMD patients in view of the intellect-sparing nature of the disorder. Improvement was hampered by the progressive nature of the disease and by the emotional stress of accepting the long-term use of AAC. Correct and early diagnosis of communication impediments are crucial for the appropriate AAC aids prescription and implementation. An AAC protocol is suggested to meet the special communication needs of DMD patients.

Adolescent↗
PubMedDate not supplied

Neonatal Guillain-Barré syndrome.

A term female infant had the clinical manifestations and accompanying electrophysiologic studies to fulfill the criteria of Guillain-Barré syndrome. At birth, she presented with generalized hypotonia, paucity of lower limb movements, and diminished muscle stretch reflexes. At 3 weeks of age, motor nerve conduction studies demonstrated evidence of demyelination and axonal involvement. Progressive clinical improvement was observed beginning at the age of 2 weeks with subsequent normalization of clinical examinations and nerve conduction studies. To our knowledge, this patient is the youngest reported with Guillain-Barré syndrome.

Female↗
PubMedDate not supplied

Obstructive hydrocephalus-induced parkinsonism. I: Decreased basal ganglia regional blood flow.

A 17-year-old male developed acute parkinsonism after obstruction of a ventriculoperitoneal shunt with subsequent hydrocephalus. Following a previous shunt replacement, he developed florid parkinsonism which was associated with Parinaud syndrome. The initial single-photon emission computed tomography of the brain using 99mTc-hexamethylpropylenamine oxime demonstrated decreased cerebral blood flow in the regions of the left caudate and putamen. The patient underwent shunt revision with minimal improvement and therefore levodopa/carbidopa (Sinemet 100/25) was administered. Subsequently, he experienced almost complete recovery which may have been correlated with probable improvement of the basal ganglia regional cerebral blood flow. Parkinsonism associated with ventriculoperitoneal shunt obstruction is a rare but reversible disorder that is responsive to shunt replacement and antiparkinsonian drug administration. Cerebral perfusion studies may prove to be of value in delineating the pathophysiology of this complication.

Adolescent↗
PubMedDate not supplied

Uncommon neurologic complications of burns in infants: a parkinsonian extrapyramidal disorder and massive cerebral infarction.

We report uncommon neurologic complications of moderate to severe burns in two infants aged 13 and 19 months, respectively. The first patient suffered a 25% total body surface area burn to her lower limbs; 3 days later she became mute and irritable, with increasing rigidity of limbs and trunk. Her face was expressionless and she also had mild dysphagea. Muscle-stretch reflexes were brisk and accompanied by episodes of coarse jitteriness. A diagnosis of an extrapyramidal parkinsonian disorder was made. The infant was treated with amantadine hydrochloride, and she recovered completely over a period of 2 months. The second infant was admitted with an extensive burn to his trunk and limbs; 3 days later he became comatose and had intractable seizures, which were more prominent over his right side. Dysphasia and right-sided hemiplegia became apparent; these conditions were and remained permanent, accompanied by focal seizures and a marked cognitive delay. Although relatively uncommon, central nervous system involvement may be a hazardous complication of burns in infants, who thus represent a high-risk group.

Amantadine↗