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Biomedical subjects

E Tirosh

Publications and source records attributed to E Tirosh.

At least 37 records · Page 2Linked to original sources
PubMed1998

The differences in health concerns between mothers and health care professionals in a preventive community set up.

To assess the degree to which mothers, nurses and pediatricians share common concerns regarding infants' health and well-being a cross-sectional survey with stratified demographic sampling was conducted. A 12-item questionnaire pertaining to health concerns was administered to 22 mothers of infants between 1 and 18 months of age, treated at six Well Baby community clinics with 36 nurses and 25 pediatricians. Mothers and health care professionals expressed significantly different concerns. Pediatricians and nurses shared a more similar order of concerns. However, they too differed on the degree of concern related to some of the health issues, i.e. nurses perceived the issues related to feeding, behaviour, skin, sleep and daily routines as significantly more important than did pediatricians. Additional efforts should be devoted to improve and clarify communication between mothers and health care professionals.

Adult↗
PubMed1998

Apnoea-associated heart rate changes among preterm and full-term infants exposed to hyperthermia.

Heart rate (HR) changes associated with apnoea (> 3 s) were analysed in 10 preterm infants (30.6 +/- 1.5 weeks) at post-conceptional age of 40 +/- 1.5 weeks and 10 full-term (FT) infants (39 +/- 1 weeks) before, during and after exposure to increased environmental temperature (5 degrees C above normothermia). A significantly increased HR was found in the study group during the baseline (normothermia), heating, cooling and final normothermic phase compared with the control infants. No significant difference was found between the groups during the hyperthermic stage. A significant relative increase in HR was found among the preterm infants but not among FT infants during central apnoea at the hyperthermia phase. Our results indicate that HR control during apnoea in preterm infants is more labile then among FT infants while being exposed to increased environmental temperature.

Apnea↗
PubMed1998

Behavioural problems among visually impaired between 6 months and 5 years.

The prevalence and types of behavioural problems among legally blind children were assessed by employing a cohort study design in a well defined geographic area. One hundred and eighty two children between the ages of 6 months and 5 years were consecutively assessed over a period of 13 years. A standardized ophthalmological, neurodevelopmental and physical examination, a parental interview and video recording were employed. Diagnostic classification was based on the DSM-III-R criteria (American Psychiatric Association, 1987). Behavioural problems were documented in 49%. In 61% of these, three disorders were identified: (1) overanxious (n = 14), (2) oppositional with or without attention deficit hyperactivity (n = 15), and avoidant with or without stereotypy (n = 26). The first category is associated with partial sightedness and the third with neurodevelopmental deficits. The prevalence of behavioural problems among blind children is high and therefore a careful psychological monitoring and assistance should be offered to them and their parents.

Blindness↗
PubMed1998

Learning disabilities with and without attention-deficit hyperactivity disorder: parents' and teachers' perspectives.

Our objective was to delineate the educational and behavioral differences between learning disabled children with and without attention-deficit hyperactivity disorder (ADHD). A restrospective (TROHOC) multimeasure comparative design was employed. Parents' and teachers' questionnaires (ANSER system) pertaining to attention-activity, associated behaviors, and scholastic achievements were compared. Parents' questionnaires failed to distinguish between the two groups. Teachers' questionnaires were significantly more sensitive. Significant correlations between educational achievements and attention-activity and associated behaviors scores among children with learning disabilities were evident, no such correlations were found in the group with learning disability with ADHD. The factor analysis identified different educational and behavioral aggregates with language related difficulties and externalizing behaviors more typically aggregated in the learning disabled group with ADHD and recall deficit and internalizing/neurotic behaviors in the group with learning disability only. ADHD appears to be an associated comorbidity and not necessarily a specific learning deficit. However, children with learning disability with ADHD possibly have a different underlying neurocognitive pattern than their peers with learning disabilities only.

Attention Deficit Disorder with Hyperactivity↗
PubMed1998

Language deficit with attention-deficit disorder: a prevalent comorbidity.

The aim of this study was to delineate the prevalence and behavioral patterns of children with attention-deficit and language problems as compared to children with attention-deficit hyperactivity disorder (ADHD) only. Out of a cohort of 3208 children 6 to 11 years old, 5.2% were identified as having a primary ADHD. A teacher's behavioral questionnaire, pediatric interview and assessment, IQ, attention tests, and language evaluation were employed. A 45% rate of language problems was identified. This comorbidity is more prevalent among girls (P = .02). Sequencing and short-term memory were significantly related to attention-deficit and language problems, but the attention scores were not. Language performance was the best predictor of group assignment and was superior to IQ in that regard. Correlation analysis revealed a different behavioral pattern for the two groups. It appears that a significant proportion of children with ADHD have a language comorbidity not reflected by IQ assessments; therefore, language tests should be considered as part of their routine assessment. Children with attention-deficit and language problems appear to have a different neurocognitive pattern underlying their problems as compared with their peers with ADHD only.

Attention Deficit Disorder with Hyperactivity↗
PubMed1998

The relationship between sleep and temperament revisited: evidence for 12-month-olds: a research note.

This study measured the sleep attributes of 30 normal 12-month-old children with a computerized movement detector (Actigraph). Data on the child's temperament was based on the Carey Toddler Temperament Questionnaire, which the mother completed. The main finding was that rhythmic children went to sleep earlier and had longer sleep duration; however, their sleep pattern was not more efficient compared to children with irregular rhythmicity. The results of the present study provide only limited evidence to the association between the regulation of sleep-wake cycles and the temperamental characteristics of the child. Hence it may be concluded that within non-referred low-risk infants, temperament does not discriminate between good and poor sleepers. Alternatively, however, the marginal relationship between sleep and temperament demonstrated in the present study may reflect the limitation of maternal perception as a source for temperament assessment.

Circadian Rhythm↗
PubMed1997

Children's attitudes toward peers with disabilities: the Israeli perspective.

Attitudes toward peers with disabilities were compared in two groups of elementary school children, Israeli (2845 children) and Canadian (1831 children), using the Chedoke-McMaster Attitudes Toward Children with Handicaps (CATCH) scale. Israeli children expressed significantly more positive general attitudes (P=0.0001). The more favourable attitudes were seen in both areas evaluated by the CATCH, the cognitive and the affective-behavioural. In both groups, children who had had previous experience with a disabled person expressed more positive attitudes (P=0.001). An effect of gender was seen in the Canadian but not in the Israeli children. Cultural factors appear to play a role in modelling children's attitudes toward their disabled peers and therefore should be considered before educational programmes are implemented.

Attitude↗
PubMed1997

Relationship between left-handedness and allergic symptomatology.

Handedness and health parameters were assessed in 70 infants. Video recordings were employed for handedness analysis. The infants' growth and health were periodically followed up from birth and information was retrieved from medical records. A significant association between left-handedness and allergy score was found (P < .05). Age (P < .02) and sex (P < .01) appear to be significant covariates. It appears that the possible association between left-handedness and immune-based diseases among adults applies to infants as well. A possible biologic marker for allergy should be incorporated in future research.

Age Factors↗
PubMed1996

The parachute reactions in normal and late walkers.

To study the relationship of the parachute responses to the age of independent walking, three groups of infants were prospectively examined: a normal sitting, normal walking group; a late sitting, normal walking group; and a late sitting, late walking group. All other spheres of the neurodevelopmental examination were normal. It was found that when the parachute responses appeared by age 10 months in the late sitting infants, most of them would achieve independent walking by 15 months. A delay in the parachute reaction in these infants predicted a delay in walking.

Child Development↗
PubMed1996

Sleep architecture as related to temperature changes in neonates at term.

Sleep architecture was assessed under different environmental temperatures in 10 full-term and 10 preterm infants who reached term. Five 30-min periods of baseline, normothermia heating, peak temperature, cooling and normothermia were analysed. A significant decrease in the proportion of active sleep (AS) and an increase in quiet sleep (QS) was noted among the full-term infants during the heating and peak temperature conditions, whereas, among the preterm infants, a similarly significant difference was noted during the heating and cooling stages of the study, but not during the stage of peak temperature. This differential response to environmental hyperthermia is possibly related to maturational factors. This phenomenon may be related to the increased vulnerability of low birth weight infants to apnoea and sudden infant death syndrome.

Body Temperature↗
PubMed1996

Apnea of infancy, seizures, and gastroesophageal reflux: an important but infrequent association.

Seventeen infants between 3 and 37 weeks of age were sequentially admitted for investigation of apnea of infancy or apparent life-threatening events associated with suspected regurgitation. They all underwent an overnight polygraphic study, including esophageal pH monitoring. In nine infants, gastroesophageal reflux was diagnosed. In five of them, the reflux was associated with apnea. However, unassociated episodes of apnea and gastroesophageal reflux occurred (7.1 times and four times, respectively) more frequently than associated episodes. In two of the five infants, a seizure preceded both reflux and apnea and might have acted as a trigger for the apparent life-threatening events. Infants with apparent life-threatening events or apnea of infancy frequently demonstrate gastroesophageal reflux that cannot be consistently related to their events. However, when the association is demonstrated, a common epileptic convulsive etiology should be considered.

Blood Gas Analysis↗
PubMed1995

CPAP treatment of obstructive sleep apnoea and neurodevelopmental deficits.

Four boys aged 6-16 years with neurodevelopmental deficits were treated with CPAP for obstructive sleep apnoea. Their diagnoses were: Obesity with mild mental retardation, (2) attention deficit hyperactivity disorder, (3) epilepsy associated with left hemiparesis and (4) mild mental retardation due to fragile X syndrome. Previous therapeutic attempts, including adenotonsillectomy, amitriptyline and methylphenidate in our patients prior to CPAP treatment were unsuccessful. A follow-up period of 12-48 months demonstrated a number of clinical benefits such as improvement in sleep quality and daily arousal, and a decrease in the frequency of seizures and episodes of pneumonia. Polysomnographic studies indicated a significant improvement in sleep parameters such as apnoea frequency, awakenings, sleep efficiency and arterial oxygen saturation. Side effects were mild and readily alleviated. CPAP is a feasible therapeutic intervention in intractable obstructive sleep apnoea of childhood, even when associated with neurodevelopmental deficits.

Adolescent↗
PubMed1995

Apparent life-threatening event: a neurologic perspective.

Of 46 infants who were investigated for apparent life-threatening events, central nervous system disorders were diagnosed in seven (15%). Convulsive disorders, intraventricular hemorrhage and hydrocephalus, absent corpus callosum, and development deficits were found. In four of the seven, no neurologic deficit was suspected before the event. Electroencephalographic studies (overnight in two) would have identified the disorder in all four. Electroencephalography is therefore a recommended routine procedure in investigation of apparent life-threatening events. Central nervous system disorders should be routinely ruled out in cases of apparent life-threatening event, even in the absence of clinical clues.

Brain Diseases↗
PubMed1994

Unexpected death in infancy. An epidemiologic study in the Haifa district, Israel.

The incidence of unexpected death in infancy (UDI) (2 weeks-12 months) in the Haifa area is 1.17 per 1000 live births. We found a significant interethnic difference between Israeli Jews and Arabs. The incidence among Arabs was 4 per 1000, but was only 0.77 per 1000 among Jews (p < 0.01). When the UDI Jewish group was compared to both the group of infants dying of known causes and the surviving group, the only significant factors related to UDI were found to be: young maternal age and low maternal education. No such association was evident among Arabs. Following logistic regression analysis, low maternal age and low socioeconomic status, but not ethnicity, were significantly associated with UDI as compared to the non-UDI infants. In comparison to non-UDI, UDI was significantly more prevalent during the cold season. UDI incidence has apparently been stable over the past 15 years. Demographic risk factors are similar to those reported from other communities, and ethnicity is possibly mediated through those factors.

Age Distribution↗
PubMed1994

Fine motor deficit: an etiologically distinct entity.

The prevalence of risk and adverse factors associated with fine motor disorder (n = 35) were compared with gross motor deficit (n = 158), global developmental delay (n = 336), and combined fine and gross motor deficit among 1,241 children up to 3 years of age identified in the Haifa health district. A significantly increased preponderance of males was observed among the study group as compared to the group with gross motor deficit. Intranatal problems were significantly increased among children with fine motor deficits as compared to those with gross motor deficits as were minor physical anomalies, seizures, and behavioral deficits. Less significant differences were observed between the study group and children with global developmental delay or fine and gross motor deficit. The different risk factor profiles indicated that the children with fine motor deficits constituted an etiologically distinct group highly associated with early antepartum, possibly genetic, origins.

Brain Damage, Chronic↗
PubMed1994

Relationship between the parachute reactions and standing and walking in normal infants.

Assumption of the vertical position and independent walking are potentially hazardous motor milestones in the developing infant. It has been presumed that the parachute reactions evolved to protect infants from injury during this developmental stage. To determine the relationship between the appearance of the upper and lower parachute reactions and the developmental milestones of unsupported standing and independent walking, 190 normal infants were prospectively studied. The upper parachute reaction was found to precede the lower by less than a month (mean age of appearance: 8.9 and 9.2 months, respectively). More than one-half of the cohort achieved standing without either the upper (49%) or lower parachute reaction (57%); however, no independent walking occurred without the upper parachute reaction, and only 2 of 190 infants (1%) walked independently without the lower parachute reaction. Onset of walking occurred about 4 months after the appearance of the upper parachute reaction. The significance of these findings is discussed.

Accidental Falls↗
PubMed1994

Relationship of sweat electrolytes to apparent life-threatening events (ALTE): a case control study.

Twenty infants aged 25 days to 6 months who were consecutively investigated for apparent life-threatening events (ALTE) with negative results and 20 matched normal controls underwent an iontophoresis sweat test. A statistically significant elevated sweat potassium level (22.1 +/- 8.9 versus 12.4 +/- 6.5 mol/l) was noted in the ALTE patients compared with the control group (p < 0.001). No difference was found, however, between sweat sodium and chloride levels in the two groups. Na/K ratio in sweat was significantly different between the groups (p < 0.001). A between-groups discriminant analysis, using Na/K ratio as a discriminant variable, resulted in 80% accuracy in group assignment. A significant increase in sweat potassium concentration at night compared with day time was evident in ALTE patients. Elevated sweat potassium levels specifically characterized infants who experienced ALTE and may possibly indicate an underlying mechanism involving enhanced sympathetic activity.

Circadian Rhythm↗