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Biomedical subjects

M Modan

Publications and source records attributed to M Modan.

At least 109 records · Page 6Linked to original sources
PubMed1983

Errors in computing drug doses.

The 85 members of the pediatric and neonatal divisions of a medical centre were tested for their ability to calculate the appropriate volumes of drugs commonly administered to pediatric patients. Of a total of 680 computations 43 (6.3%) were wrong. Half the errors would have led to either a 10-fold overdose or a dose a 10th of that prescribed. Significantly more of the errors (p less than 0.01) were made by the nurses in the neonatal division (11.5%) than by those in the pediatric division (3.4%). A deficiency in the in-service training of the nurses in the neonatal division appeared to contribute to the higher proportion of errors in this group. There was also a trend towards a greater chance of error as the length of professional experience increased. All medical personnel involved in the ordering and administration of drugs should be taught computing skills and be evaluated routinely.

Humans↗
PubMed1983

Viral antibodies in maternal and cord sera.

Viral antibodies were determined in paired maternal and cord blood sera of 258 consecutive deliveries. Antibodies to Epstein-Barr virus (EBV), cytomegalovirus (CMV), herpes simplex type 1 (HSV-1), adenovirus (ADV), and varicella zoster (VZV) were tested by indirect immunofluorescence and to rubella (RUB) by hemagglutination inhibition. Analysis of the overall pattern of differences between maternal and cord blood showed a highly significant difference for all six viruses. Analysis regarding individual viruses showed significantly higher titers to CMV and RUB in cord blood, a higher titer to VZV in maternal blood, and similar levels of antibodies to EBV, HSV-1, and ADV in maternal and cord blood. Infants with one or more risk indicators (weight less than 3 kg, Apgar score less than or equal to 7, clinical jaundice, meconium-stained amniotic fluid, respiratory distress syndrome) were defined as "at risk." Infants free of such indicators were defined as "normal." Significantly lower antibody levels to all six viruses were found in both maternal and cord blood of the "at risk" as compared to the "normal" group, while the ratios between the maternal and cord blood levels remained similar. Birth defects were found to have no effect on antibody titers. These results indicate an efficient and selective transfer through the placenta of certain viral antibodies and the possible association of lower antibody production with the presence of risk indicators in the infants.

Antibodies, Viral↗
PubMed1983

Idiopathic hypercalciuria: a familial generalized renal hyperexcretory state.

Twenty-two children with idiopathic hypercalciuria (IH) as well as their parents and siblings were compared to 29 control children and their parents and siblings. Urinary calcium excretion following calcium deprivation or calcium loading was significantly higher in parents and siblings of the IH children than in the corresponding controls. Significantly higher rates of glomerular filtration and increased urinary excretion of sodium potassium and phosphate were found in all family members in the IH group as compared to controls. Significant positive correlations of the five variables studied (glomerular filtration and urinary excretion of calcium, phosphate, sodium, and potassium) were noted within individuals and also within families, both in the IH and the control groups, notwithstanding the lower mean levels in the latter. Serum concentrations of calcium, phosphate, potassium, and sodium were similar in the IH and controls. The distributions of all urinary variables in both the IH and control groups were unimodal with considerable overlap of the two groups, suggesting that IH may be a single entity, possibly representing the upper end of normality. Our data seem to indicate that IH is more likely to be due to nutritional than to genetic factors, since maintenance of sodium potassium homeostatis in the face of increased excretion necessitates increased ingestion of these electrolytes, while increased sodium ingestion is known to be associated with increased urinary excretion of calcium, potassium, and phosphate.

Adult↗
PubMed1983

Transfer of viral antibodies from mother to infant.

Antibody titers to Epstein-Barr virus (EBV), cytomegalovirus (CMV), herpes simplex virus (HSV) Type 1, varicella-zoster virus (VZV) and rubella virus (RV) were determined in maternal and in newborn cord sera in 258 consecutive deliveries. Infants born with one or more of the following risk factors--weight less than 2.5 kg, Apgar score less than 7, clinical jaundice, meconium-stained amniotic fluid, birth defects and respiratory distress syndrome--were considered to be at risk. Similar geometric mean titers (GMT) of antibodies to EBV and HSV were seen in cord blood. Anti-VZV maternal antibody levels were significantly higher than those of cord blood (P less than 0.01). Levels of antibody to CMV and RV, the two viruses most implicated in fetal damage were significantly higher in cord blood than in maternal blood (P = 0.02, and P less than 0.001, respectively). Lower GMTs of antibodies to all five viruses were found in both maternal and cord sera of the group of infants at risk, as compared with infants without risk factors, while the ratio of maternal to cord blood antibody levels remained similar. It appears that inefficient production of antibodies correlates with the presence of risk factors in the newborn.

Antibodies, Viral↗
PubMed1983

Amniotic fluid fluorescence polarization value at physiological temperature: a marked improvement in assessing fetal lung maturity.

Determination of fetal lung maturity by measurement of the fluorescence polarization (P) value of the amniotic fluid at room temperature has become the method of choice in an increasing number of perinatal units because of its simplicity and relatively high predictive value. Nevertheless, its power to discriminate between cases with and without hyaline membrane disease (HMD) needs improvement. To this end, we assessed the discriminative power of the P value at the physiological temperature of 37 degrees C (P37) as compared with the power at 25 degrees C (P25). The study group consisted of 288 consecutive cases at risk for preterm delivery. Samples from all 288 cases were measured at 25 degrees C and samples from 112 of these were measured concurrently at 37 degrees C as well. HMD occurred in 27 infants of the total group, nine of whom belonged to the subgroup tested at both temperatures. When sensitivity was fixed at 100% the specificity of P37 was 97% as compared to 79% for P25 (p less than 0.001). The percentage of cases with infants free of HMD who had borderline P values was also significantly smaller: 1% vs 21%, respectively (p less than 0.001). Although data on more HMD cases are needed to establish the precise threshold of lung maturity for P37, we conclude that P37 is a considerably better discriminator for fetal lung maturity determination than P25.

Amniotic Fluid↗
PubMed1982

Some epidemiologic aspects of carcinoma of the vulva in Israel.

A nationwide study of squamous cell carcinoma of the vulva in Israeli Jewish women has been conducted for a comparison of the incidence, the age pattern and the ethnic distribution of squamous cell carcinoma of the vulva to those of squamous cell carcinoma of the cervix. The mean annual incidence rates by age in squamous cell carcinoma of the vulva rise continuously to age 70 + while in squamous cell carcinoma of the cervix a plateau is reached at age 40 to age 69. In contrast to the relatively low incidence of squamous cell carcinoma of the cervix in Israeli Jewish women, the age-specific incidence rates of squamous cell carcinoma of the vulva are similar to those of white women in the United States. On the other hand, there is a trend to a higher incidence of both squamous cell carcinoma of the cervix and squamous cell carcinoma of the vulva in the North African ethnic group of Israeli Jewish women.

Adult↗
PubMed1982

Long-lasting cerebral functional changes following moderate dose x-radiation treatment to the scalp in childhood: an electroencephalographic power spectral study.

EEG tracings were compared in 44 young adults who received scalp x-radiation treatment for tinea capitis during childhood and 59 non-irradiated control subjects. The irradiated subjects were exposed, over 20 years previously, to a mean dose of 130 rads to the brain. Visual analysis of the EEG revealed an insignificant excess of abnormalities among the irradiated subjects compared to the controls. Power spectral density function analysis showed increased power values among the irradiated subjects, particularly in the beta wave frequencies. This finding provides further evidence for suspecting that x-irradiation during brain maturation may cause long-lasting damage to the brain tissue.

Adolescent↗
PubMed1982

Intracranial neoplasms in children: the effect of computed tomography on age distribution.

In a review of all children with brain neoplasms evaluated at a large pediatric center during a three-year period following the introduction of computed tomography (CT), a change was observed in the age distribution at the time of clinical presentation as compared with a previous series evaluated prior to the introduction of CT. In children under six years of age, there was a highly significant trend for earlier diagnosis; within this age group, relatively more children were diagnosed in the first two years of life. Between six and twelve years of age, there was no change in frequency of brain tumor diagnosis between the two series. Above age twelve, there was again noted a highly significant increase in detection of brain tumors in the more recent series. These differences between the two series may be attributed, at least in part, to earlier referral and diagnosis since the advent of CT, although other factors cannot be excluded as possible causes of the differences.

Adolescent↗
PubMed1982

Reduction of mortality in general medical in-patients by low-dose heparin prophylaxis.

The effect of prophylactic low-dose heparin on mortality was tested in 1358 consecutive patients admitted to the medical wards of an acute care hospital. Eligibility for treatment or exclusion was ascertained on admission by predefined contraindications. Eligible patients with even-number hospital records were assigned to treatment (5000 U twice daily), those with odd-number records served as controls. Because determination of eligibility was open to bias, evaluation of treatment was based on comparison of the total even-number group (669 patients, of which 411 were treated with heparin), and the total odd-number group (689 patients, none treated with heparin). Mortality was significantly lower in the even-number group-7.8% (52 of 669 patients) versus 10.9% (75 of 689 patients) in the odd-number group; the difference increased consistently with length of hospitalization (p = 0.025). The estimated reduction in mortality attributable to heparin was 31.1%. We believe that low-dose heparin prophylaxis is appropriate in all immobilized medical patients who are not at risk of bleeding.

Adult↗
PubMed1982

Pretreatment prognostic factors and hospitalization periods in childhood acute lymphoblastic leukemia.

Pretreatment prognostic factors and hospitalization periods were analyzed in 57 consecutive children who had acute lymphoblastic leukemia diagnosed between 1967 and 1977, and who were followed up for at least two years. We investigated possible correlations between white blood cell (WBC) count, organomegaly and mediastinal enlargement at diagnosis, as well as age and sex, with the length of first remission and survival. Children presenting with a combination of all of the following four risk factors--WBC count greater than or equal to 50,000/mm3, enlarged mediastinum, spleen and liver greater than or equal to 3 cm below the costal margin--comprised a poor-prognosis group, in which boys predominated. Age in this small group of patients had no correlation with prognosis. On the other hand, no specific risk factor was predictive for survival in the 48 children who had less than four of the risk factors. In this better-prognosis group, children less than 2 yr and greater than 10 yr had a higher relapse rate than those of intermediate ages, and girls had a significantly better prognosis than boys. These results indicate that age and sex are intercorrelated with the above risk factors, so that analysis of the effect of a single risk factor or even a combination of two factors can be misleading. In the light of these findings, an interpretation of the discrepancies in the literature is suggested. Of interest, too, is the poor prognosis and the high frequency of T-cell leukemia among Arab children. Finally, we stress the importance of day-care facilities that enable shorter hospitalization periods and improve the quality of life.

Antibiotics, Antineoplastic↗
PubMed1982

The mechanism of benign hereditary neutropenia.

Benign familial (hereditary) leukopenia and neutropenia (BFLN) have been reported in some ethnic groups, including black Americans and Yemenite Jews. The bone-marrow response of 34 Yemenite Jews (with and without neutropenia) to an intravenous injection of 200 mg of hydrocortisone sodium succinate was studied and compared with the response of 18 healthy control subjects. The mean +/- SEM of the increments in polymorphonuclear cells (PMNs) following injection of hydrocortisone in Yemenite Jews (2,413 +/- 245/mm3 in neutropenic subjects and 2,187 +/- 343/mm3 in nonneutropenic subjects) were significantly lower than in the control subjects (4,431 +/- 467/mm3), without significant differences among the subgroups of the Yemenite Jews. The decreases in monocytes, lymphocytes, and eosinophils were similar in all groups. No correlation was found between baseline PMN levels and the increments following hydrocortisone administration. These results suggest a lowered bone-marrow response to hydrocortisone in subjects with BFLN, indicating some defect in PMNs release from the bone-marrow storage pool to the peripheral blood. It seems that this defect characterizes all members of the ethnic group, whether they have "overt" neutropenia or not.

Adult↗
PubMed1981

Herpesvirus type 2 in adenocarcinoma of the uterine cervix: a possible association.

Sera from 16 Jewish patients with histologically confirmed adenocarcinoma of the uterine cervix (AUC) and 32 control subjects matched by age and ethnic origin were examined for herpesvirus type 1 (HSV-1) and type 2 (HSV-2) neutralizing antibodies. Titers were determined by means of the quantitative plaque reduction neutralization test on VERO cell monolayers, using HSV-1 strain VR3 and HSV-2 strain. Significantly increased levels of antibodies against both virus strains were found in the AUC patients as compared with the controls. The trends in the AUC series resembled those in a previous similar case-control study of squamous cell carcinoma of the uterine cervix (SUC). Thus, the previously observed association between HSV-2 and SUC is true for AUC as well, despite differences in the clinical and epidemiologic characteristics of the two malignancies.

Adenocarcinoma↗