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Biomedical subjects

I Paz

Publications and source records attributed to I Paz.

27 records · Page 2Linked to original sources
PubMed1993

Are children born small for gestational age at increased risk of short stature?

OBJECTIVE: To assess the height outcome of newborns born small for gestational age. DESIGN: A historical prospective study. SETTING: A cohort of 1758 newborns born at a single university hospital maternity ward and subsequently examined at the military draft medical board at age 17 years. PARTICIPANTS: Newborns whose weight at birth was below the third percentile were defined as small for gestational age. Their body measurements at age 17 years were compared with those of their peers who were appropriate for gestational age. MEASUREMENTS/MAIN RESULTS: The adjusted mean +/- SEM height for boys born small for gestational age vs peers born appropriate for gestational age was 169.9 +/- 1.5 vs 175.4 +/- 0.8 cm (P < .0001); and for girls, 159.4 +/- 1.3 vs 163.1 +/- 0.8 cm (P < .0005). In addition, the risk for height attainment below the 10th percentile was significantly increased for newborns born small for gestational age. The adjusted odds ratio was 4.13 for boys (95% confidence interval, 1.66 to 10.25; P < .0006) and 3.32 for girls (95% confidence interval, 1.38 to 8.05; P < .0005). CONCLUSION: Infants born small for gestational age may be at increased risk for short stature in late adolescence.

Adolescent↗
PubMed1991

Neonatal hyperbilirubinemia and physical and cognitive performance at 17 years of age.

To estimate the effect of neonatal hyperbilirubinemia on long-term cognitive ability in full-term newborns with a negative Coombs test, we performed a 17-year historical prospective study of 1948 subjects. Intelligence tests and medical examinations performed at the military draft board were stratified according to serum bilirubin concentration. A logistic regression analysis was used to adjust for the confounding effects of gestational age, birth weight, Apgar score, ethnic origin, socioeconomic class, paternal education, birth order, and the administration of phototherapy and exchange transfusion. No direct linear association was shown between neonatal bilirubin levels and intelligence test scores or school achievement at 17 years of age. However, the risk for low intelligence test scores (IQ score less than 85) was found to be significantly higher (P = .014) among full-term male subjects with serum bilirubin levels above 342 mumol/L (20 mg/dL) (odds ratio, 2.96; 95% confidence interval, 1.29-6.79). This association was not observed among female subjects. We conclude that severe neonatal hyperbilirubinemia, among full-term male newborns with a negative Coombs test, could be associated with lower IQ scores at 17 years of age.

Adolescent↗
PubMed1991

Apgar scores and cognitive performance at 17 years of age.

The association between low Apgar scores (7 or less) at 1 and 5 minutes and cognitive performance in late adolescence was assessed. A 17-year follow-up of 1942 subjects was performed. The intelligence test scores at 17 years of age were matched with 1- and 5-minutes Apgar scores. A multiple linear regression analysis was used to control for the possible confounding effect of perinatal factors (birth weight, gestational age, serum bilirubin levels, birth order) and demographic characteristics (ethnic origin, paternal education, social class). The sensitivity and positive predictive value of a low 1-minute Apgar score were 8 and 8% and of a low 5-minute Apgar score 1.5 and 5%, respectively. Low Apgar scores are poorly correlated with long-term intellectual outcome.

Adolescent↗
PubMedDate not supplied

Noninvasive validation of tobacco smoke exposure in late pregnancy using end-tidal carbon monoxide measurements.

OBJECTIVE: To determine whether exposure to tobacco smoke in late pregnancy can be reliably estimated by measuring carbon monoxide (CO) in the mother and newborn breath. STUDY DESIGN: Sixty-eight mothers and their healthy term singleton newborns, delivered at a university-affiliated community hospital in Jerusalem, were enrolled. End-tidal CO (corrected for inhaled air [ETCOc] was measured with a portable automated bedside CO analyzer. ETCOc, cotinine, and carboxyhemoglobin (COHb) levels were compared in 17 smoking, 31 passively exposed, and 20 nonsmoking mothers and their offspring. RESULTS: The mean +/- SD ETCOc was significantly higher in women who smoked than in passively exposed and nonsmoking mothers (8.42 +/- 5.65 vs 1.95 +/- 0.98 vs 1.33 +/- 0.84 ppm. p < 0.0001, respectively). Newborns whose mothers smoked had higher ETCOc levels than those of infants of passively exposed and nonsmoking mothers (10.0 +/- 7.7 vs 2.51 +/- 1.4 vs 1.74 +/- 0.98 ppm, p < 0.0001, respectively). The number of cigarettes smoked by the mother was significantly correlated with maternal ETCOc (r = 0.755, p < 0.00001), and neonatal ETCOc (r = 0.805, p < 0.00001). Maternal ETCOc was highly correlated with neonatal ETCOc (r = 0.857, p < 0.00001), cotinine (r = 0.645, p < 0.00001), and COHb (r = 0.9, p < 0.00001) levels. Birth weight was significantly associated with neonatal ETCOc (p < 0.006) and maternal ETCOc (p < 0.007). CONCLUSION: ETCOc levels in the newborn are well correlated with maternal smoking. Measurements of newborn ETCOc may be used as a noninvasive means to estimate exposure to maternal tobacco smoke immediately before delivery. These measurements will be useful for patient education and research.

Birth Weight↗
PubMedDate not supplied

[Cytomegaloviruses in the bronchoalveolar lavage fluids of immunocompromised patients: microbiological results and clinical significance].

We have evaluated the microbiologic output and clinical significance of the detection of cytomegalovirus in 111 bronchoalveolar lavage specimens from immunosuppressed patients with pneumonitis. The samples were simultaneously processed by conventional tube culture and the rapid shell-vial centrifugation culture assay. Cytomegalovirus was recovered from 30 specimens (27%). The rapid shell-vial procedure was more sensitive than the tube culture, but in two cases cytomegalovirus was isolated only in tube cultures. Cytomegalovirus was considered clinically significant in only 3 from 13 HIV positive patients. All culture positive, HIV negative patients received treatment with ganciclovir. However, ganciclovir was never used on culture negative, HIV negative patients and cytomegalovirus related morbi-mortality was not found in these patients. A prospective study is needed to conclude if a cytomegalovirus negative culture also has a treatment exclusion value in HIV positive patients.

Bronchoalveolar Lavage Fluid↗
PubMedDate not supplied

Effect of phototherapy for neonatal jaundice on cognitive performance.

Phototherapy for neonatal hyperbilirubinemia was introduced to our medical center in March 1971. To assess the influence of phototherapy on subsequent cognitive outcome, we compared the intelligence test scores at 17 years of age of subjects born 4 months before and 10 months after the introduction of phototherapy. The intelligence quotient score (mean +/- SE) at 17 years for 84 subjects with severe neonatal hyperbilirubinemia was 108 +/- 2 for those treated by phototherapy and 107 +/- 2 for controls matched for gestational age and birth weight. The confounding effect on intelligence quotient scores of perinatal factors (bilirubin concentrations, gestational age, birth weight, Apgar score) and demographic characteristics (ethnic origin, socioeconomic status, paternal education) was taken into account in a multiple logistic regression analysis by using a General Linear Models procedure. Phototherapy was found to have no independent effect on intelligence quotient scores after adjustment for the effect of confounding factors. We conclude that for full-term newborn infants with neonatal hyperbilirubinemia, phototherapy had neither a beneficial nor an adverse effect on intellectual ability in late adolescence.

Adolescent↗
PubMedDate not supplied

Prenatal ritodrine administration and the incidence of respiratory distress syndrome in premature infants.

UNLABELLED: Prenatal exposure to ritodrine may be associated with a lower incidence of RDS in premature infants, independent of its effect on prolongation of pregnancy. OBJECTIVE: The purpose of this study was to assess the neonatal respiratory outcome of premature infants according to whether their mothers were treated prenatally with ritodrine. STUDY DESIGN: A retrospective review was done of all 247 infants born at 34 weeks of gestation or less in our hospital during a 6-year period. A multivariate logistic regression was used to adjust for possible confounding variables. RESULTS: Among the ritodrine-exposed infants respiratory distress syndrome developed in 9.5% (4/42) compared with 28% (57/205) in the unexposed group (p < 0.012; adjusted odds ratio 4.88, 95% confidence interval 1.27 to 18.70). The gestational age and birth weight were similar in the two groups. The incidence of transient tachypnea of the newborn and other neonatal complications was not statistically different between the two groups. CONCLUSION: Ritodrine was associated with a significantly lower incidence of respiratory distress syndrome in premature infants, independent of the effect of ritodrine on prolongation of pregnancy.

Female↗