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Biomedical subjects

M Berant

Publications and source records attributed to M Berant.

At least 91 records · Page 5Linked to original sources
PubMed1989

Clinical zinc deficiency during zinc-supplemented formula.

A 2 1/2-month old preterm infant had failure to gain weight with high caloric intake, and had generalized persistent dermatitis and mild diarrhea. The patient was being fed zinc-supplemented cow's-milk-based formula (Osterfeed). High caloric intake of 8 weeks' and topical treatment of 11 weeks' duration were futile. A thorough investigation revealed low serum zinc concentration. Administration of zinc sulfate 150 mg/day resulted in brisk weight gain and complete clearing of skin lesions. The infant maintained normal levels of zinc 4 months after zinc therapy was discontinued, while being fed unmodified cow's milk and a diet of corn flour. The probability that zinc-supplemented formulas do not meet the high zinc requirements of premature infants is raised. The importance of plasma or serum zinc examination in preterm infants with slow growth velocity or failure to gain weight despite adequate caloric intake, with or without skin lesions and diarrhea, is emphasized.

Body Weight↗
PubMed1989

Non-tropical pyomyositis in children--with report of severe neurological complications.

Pyomyositis appears to occur rarely in temperate climate areas, compared with the incidence of the disease in the tropics. Three young adults with pyomyositis have previously been described in Israel, two of them were newly arrived Ethiopian immigrants. We report three Israeli children with pyomyositis, who presented initially with nonspecific abdominal pain; in one child the course was complicated by spinal cord compression due to extension of the infected mass into the spinal canal. All three patients attained full recovery after antibiotic therapy and surgical drainage. Computed tomography was most valuable in establishing the diagnosis and defining the extent of the process.

Abscess↗
PubMed1989

Sandifer syndrome reconsidered.

Three children with Sandifer syndrome are described. One patient was at first erroneously diagnosed as having neurological disease; the two others had true neurological damage, which led initially to misinterpretation of their bizarre dystonic features. Awareness of this entity will spare such children needless investigations and suffering, while giving them the benefit of proper treatment.

Antacids↗
PubMed1989

Familial distal renal tubular acidosis with neurosensory deafness: early nephrocalcinosis.

Nephrocalcinosis was observed in 3 children of one family with distal renal tubular acidosis (dRTA). At presentation, all 3 patients had failure to thrive, rickets, hyperchloremic metabolic acidosis, hypokalemia, hypophosphatemia and hypercalciuria. At a later age, sensorineural hearing impairment was detected. Nephrocalcinosis was diagnosed in the index case at the age of 5 years, when a plain abdominal roentgenogram was first made; in the younger brother and sister, nephrocalcinosis was detected earlier at the age of 4 months and 5 weeks, respectively. All 3 patients required large doses of alkali (7.5-9.5 mEq/kg body weight/day) during infancy and early childhood to correct the acidosis and to prevent progression of the nephrocalcinosis. Contrary to the current notion that in children with dRTA, nephrocalcinosis is observed only after the age of 3 years, it appears that in some instances nephrocalcinosis may develop in early infancy. The occurrence of nephrocalcinosis at a very young age may be a manifestation of a severe genetically transmitted variant of dRTA and emphasizes the need for early diagnosis and optimal treatment of these patients from the first days of life.

Acidosis, Renal Tubular↗
PubMed1989

The neurofibromatosis-Noonan syndrome: genetic heterogeneity versus clinical variability. Case report and review of the literature.

We report on a discordant twin male with neurofibromatosis and manifestations of the Noonan syndrome. He has multiple café-au-lait spots and axillary freckling, relative macrocephaly, ptosis, mid-face hypoplasia, short neck and pulmonic stenosis. The presence of neurofibromatosis associated with Noonan syndrome phenotype in our patient raises the question of a unique disorder sharing characteristics of both conditions.

Adolescent↗
PubMed1989

Intravenous pyelography in children with urinary tract infection and vesicoureteral reflux.

In a previous study of the radiologic evaluation of children with urinary tract infection it was recommended that IVP be performed in all patients with either abnormal ultrasonographic or voiding cystourethrographic findings. However, the benefit from IVP was believed to be questionable in children with normal ultrasonography findings and vesicoureteral reflux of only a low grade (I or II of V). To gain a better understanding of the need for IVP in the radiologic evaluation of such children, the database was expanded and the findings concerning ultrasonography and IVP were analyzed in 52 children with urinary tract infection and vesicoureteral reflux seen during the last 3 years. Of a total of 72 instances of reflux, 44 (61.1%) were of low grade (I or II), 14 of medium grade (III), and 14 of high grade (IV or V). Of the 44 urinary systems with low-grade reflux, results were as follows: renal ultrasonography appeared normal in 38 and in 34 of these, the IVP also appeared normal; in the other four, only minor and negligible changes were seen with IVP. Surgical intervention was not necessary in any of these 38 urinary systems. In six systems with low-grade vesicoureteral reflux but with abnormal ultrasonography findings, IVP results were also abnormal, and surgery was necessary in two instances. Of the 14 urinary systems with medium-grade reflux, ultrasonography appeared normal in ten but in six of these the IVP appeared abnormal.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Spondylometaphyseal dysplasia: further heterogeneity.

The spondylometaphyseal dysplasias are a very heterogeneous group of disorders. Only one has been clearly defined, namely, the spondylometaphyseal dysplasia--Kozlowski type, known also as the "common type." This disorder is inherited as an autosomal dominant trait. In this report we describe an Arabic-Moslem kindred with spondylometaphyseal dysplasia, not of the common type, with an autosomal dominant mode of inheritance, indicating further heterogeneity.

Adult↗
PubMed1988

The use of carbon dioxide fiberoptic laser catheter for atrial septostomy.

The development of optical fibers capable of transmitting laser energy has encouraged the experimental use of laser irradiation for the treatment of acquired cardiovascular disorders. One of the key questions is which combination of laser source, energy parameters, and transmitting fiberoptic would be best suited for intravascular use. In most experiments argon, neodymium-YAG, and excimer lasers, coupled to suitable optical fibers, have been used. We now describe the use of a carbon dioxide fiberoptic laser catheter for the creation of an atrial septal defect. Silver halide infrared transmitting fibers were inserted into standard 6 French cardiovascular catheters. This laser catheter system, capable of transmitting several watts of pulsed CO2 laser energy, was initially used to create atrial septal defects in isolated dog hearts to determine the best energy parameters. Atrial septostomy was later performed successfully in four of five anesthetized dogs. The thermal damage extended 50 to 60 micron beyond the "holes" created by the laser irradiation in the interatrial septum. Thus, pulsed CO2 laser irradiation, delivered through optical fibers, can create an atrial septal defect.

Animals↗
PubMed1988

Thiamin status of the offspring of diabetic rats.

Erythrocyte transketolase activity and thiamin pyrophosphate effect were examined in the offspring of streptozotocin-diabetic rats. Thiamin reserve was found to be significantly reduced in litters of untreated diabetic rats as compared to control and to insulin-treated diabetic rats. Supplementation of the untreated diabetic dams throughout pregnancy with oral thiamin was associated with a significantly improved thiamin status of the litters. We conclude that, due to enhanced fetal glucose turnover during diabetic gestation, a fetal thiamin deficiency state may evolve; this condition can be remedied with maternal thiamin supplementation.

Animals↗
PubMed1988

Role of renal prostaglandins in bile-induced diuresis in the dog.

To clarify the possible role of renal prostaglandins (PGs) in the phenomenon of bile-induced diuresis in the dog, we studied the effect of in situ unilateral infusion of bile on kidney function and PGs excretion, before and after PG-synthetase inhibitor administration in anesthetized dogs. The contralateral intact kidney served as control. In the first group of 6 dogs, infusion of bile diluted 1:20 resulted in a significant increase in urinary flow (117%; p less than 0.05), sodium (61%; p less than 0.01), potassium (26%; p less than 0.05), PGE2 (240%; p less than 0.05) and PGF2 alpha (137%; p less than 0.05) excretion rates. Further significant increases in urinary flow, sodium and PGE2 excretion rates were noted with infusion of bile diluted 1:10. All parameters returned to basal levels upon cessation of bile infusion. Significant linear correlation coefficients (p less than 0.005) were found between PGE2 excretion rates and urinary flow (r = 0.72), sodium (r = 0.91) and potassium (r = 0.88) excretion rates. In a second group of 6 dogs, intravenous administration of PG-synthetase inhibitor abolished the increase in renal PGs excretion and the increments in the rates of urinary flow and solute excretion in response to bile infusion. These findings support the notion that the acute diuretic and natriuretic effect of bile, and presumably that of cholemia is mediated, in part, through stimulation of renal PGs synthesis.

Animals↗
PubMed1988

Effect of cow's milk on jejunal mucosal macromolecular barrier in suckling guinea pigs.

The assumption that fresh cow's milk may have a direct effect on jejunal mucosal macromolecular permeability was tested in 14-day-old suckling guinea pigs, by in situ luminal perfusion of a proximal jejunal segment with horseradish peroxidase administered either in 0.9% NaCl or in cow's milk. For positive control, a group of guinea pigs previously sensitized to beta-lactoglobulin was similarly perfused with horseradish peroxidase in 0.9% NaCl or in cow's milk at 14 days of age. A segment of the wall of the perfused jejunal loop was processed for peroxidase staining and for examination of the extent and routes of macromolecular absorption by light and electron microscopy. Mucosal exposure to cow's milk was associated with penetration of tracer material across the jejunal epithelium only in the lactoglobulin-sensitized guinea pigs. In guinea pigs with a first-time exposure to cow's milk, no entry of tracer material beyond the brush border surface of the enterocytes was seen. Thus, whereas we could observe absorption of bystander antigens during antigenic challenge of the mucosa in sensitized animals, we found no evidence of a presumptive "permeability factor" in cow's milk that can disrupt the mucosal macromolecular barrier by an acute direct action.

Animals↗
PubMed1987

Bidirectional flow in congenital ventricular septal defect: a Doppler echocardiographic study.

The purpose of this study was to demonstrate the value of combined two-dimensional and pulsed Doppler echocardiography (echo) in localizing and recording bidirectional flow in congenital ventricular septal defect. Eight children, aged 8 months to 16 years, with clinical signs of a ventricular septal defect, underwent two-dimensional and pulsed Doppler echo study prior to cardiac catheterization. The ventricular septal defect was documented anatomically by two-dimensional echo in all eight patients. Flow patterns in systole and diastole through the ventricular septal defect and on both sides of the defect were carefully studied. In all eight children, systolic, high velocity, pathologic, left to right flow was documented when the sampling volume was positioned on the right ventricular side of the defect. When the sampling volume was positioned inside the defect, to and fro flow, left to right in systole and right to left in diastole, was observed. In children with moderate to large defects, the diastolic flow had a peak in early diastole. Increased pressure in the right ventricle over the left ventricle during the same period was demonstrated by cardiac catheterization and coincided with the Doppler flow. The direction of flow across the defect was affected by the size of the defect and the magnitude of the net shunt. Two-dimensional and pulsed echo Doppler were shown to be useful in demonstrating the ventricular septal defect and estimating its size and hemodynamic significance noninvasively.

Adolescent↗
PubMed1987

Acute hepatic failure after open-heart surgery in children.

Acute hepatic failure (AHF) combined with acute renal failure (ARF) is a well-known complication of open-heart surgery in adults. The occurrence of this complication in two children after open-heart surgery for correction of congenital heart disease is reported. Hypotension occurred during the operation and was treated by catecholamine vasopressors. AHF set in during the postoperative course; it was manifested by impaired consciousness, hypoglycemia, hyperbilirubinemia, hyperammonemia, elevated liver enzymes and prolongation of the prothrombin time with failure of hemostasis. ARF also developed in both children. One of the patients survived the acute episode of hepatic failure. The importance of early diagnosis, routine close monitoring, and appropriate selection of vasopressors is emphasized.

Acute Disease↗
PubMed1987

False aneurysm of the right ventricle due to endocarditis in a child.

An eight-year-old boy with supravalvular pulmonic stenosis, supravalvular aortic stenosis, and ventricular septal defect developed Staphylococcus aureus endocarditis. The infection was complicated by formation of a false aneurysm of the right ventricular outflow tract, which was demonstrated by contrast echocardiogram. Surgical treatment was successful. This is a unique case of false aneurysm of the outflow tract of the right ventricle, because it is secondary to endocarditis without known previous trauma to the right ventricular wall.

Child↗
PubMed1987

Five-year survey of changing patterns of susceptibility of bacterial uropathogens to trimethoprim-sulfamethoxazole and other antimicrobial agents.

We analyzed the antibiotic susceptibility of 5,348 urinary isolates of Escherichia coli, "Klebsiella aerogenes," and Proteus mirabilis grown in three laboratories from 1980 to 1985. A continuous rise in resistance to trimethoprim-sulfamethoxazole was observed; 63% of the strains from inpatients in 1984 and 51% of those from outpatients in 1985 were resistant to this drug. Isolates from outpatients in 1985 were mostly susceptible to nitrofurantoin (mean susceptibility, 92%) and to oral cephalosporins (mean susceptibility, 84%). As for isolates from inpatients, none of the antimicrobial agents now used was satisfactory for initial chemotherapy, indicating a need for new antibacterial strategies.

Ampicillin↗
PubMed1987

Polycystic kidneys as the presenting feature of tuberous sclerosis.

Tuberous sclerosis is an inherited neurocutaneous disorder characterized by seizures, mental retardation, cutaneous lesions and visceral hamartomas. We describe a 17-year-old boy in whom polycystic kidneys of the adult type were fortuitously detected on routine check-up. The patient enjoyed good health and had no evidence of renal dysfunction. Closer scrutiny of his past history and his physical and laboratory findings disclosed that he had tuberous sclerosis. Our case adds to the scant reported experience with the association of tuberous sclerosis and adult-type polycystic kidneys, and suggests that a search of additional manifestations of tuberous sclerosis is warranted in children in whom adult-type polycystic renal disease is detected.

Adolescent↗