Biomedical subjects
M Shohat
Publications and source records attributed to M Shohat.
Trisomy 18 mosaicism in an adult with normal intelligence.
A healthy 30-year-old woman was discovered unexpectedly to have trisomy 18/normal chromosome mosaicism. She was ascertained because of a history of three spontaneous abortions following the birth of a healthy son. Trisomy 18 was present in 18% of her lymphocytes and 2% of her cultured skin fibroblasts. She had several minor malformations associated with trisomy 18 syndrome. She is, to our knowledge, the first person who has clinical stigmata of trisomy 18 but has normal intelligence and leads a normal family life.
Childhood asthma and growth outcome.
To study the ultimate growth variables of children with asthma we analysed the military medical records of 54,041 boys and 38,102 girls at the age of 17 years. History of asthma was found in 2252 boys and 1158 girls, who were then categorised according to three grades of severity. Analysis of their growth was made separately for each sex and for each grade of severity of clinical disease. Boys who suffered from mild asthma that subsided before adolescence were significantly taller, heavier, and fatter than their respective controls. There was a slight decrement in all three growth variables in correlation with increased severity. The most severely affected patients had retarded height and weight in comparison with the mildly affected children, but the differences were not significant. The same tendency was found in the girls. Children with asthma will ultimately reach normal height and weight. Those who are mildly affected tend to be even taller and heavier than adolescents without asthma. The severity of the asthma influences final growth.
Preterm blood counts vary with sampling site.
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The effect of lumbar puncture procedure on blood glucose level and leukocyte count in infants.
Blood glucose level, urea concentration, and total white blood cell count were determined both before and 10-15 minutes after lumbar puncture (LP) procedure in 26 infants suspected of having meningitis. There was a significant (p less than 0.001) increase in the peripheral white blood cell (WBC) count (mean +/- standard deviation) from 10,960 +/- 3,500 cells/microliter before to 13,300 +/- 3,970 cells/microliter following the LP procedure, due to relative rise in the neutrophils and lymphocytes. Blood glucose levels did not change significantly following this procedure (85.3 +/- 13.4 mg/dl and 84.1 +/- 12.6 mg/dl respectively). An LP procedure does not impair correct cerebrospinal fluid glucose/blood glucose determination but may cause elevation of peripheral WBC count.
Efficacy of topical application of glucocorticosteroids compared with eosin in infants with seborrheic dermatitis.
Two therapeutic regimens for seborrheic dermatitis in infancy were compared. Fifteen infants were treated with topical glucocorticosteroid (flumethasone pivalate 0.02 percent) and fifteen with aqueous solution of the staining agent eosin 2 percent. Following two days of treatment a similar degree of healing was noted in both groups, and after ten days almost complete healing of the lesions was observed in all of the infants.
Diagnosis, management, and prognosis of asthma in children.
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[Infantile overweight and adult obesity: recent advances].
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[Gastrointestinal blood loss following cow's milk feeding in infancy].
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Long-term results of cryotherapy for active stages of retinopathy of prematurity.
Between 1976 and 1980, retinopathy of prematurity (ROP) stage III (moderate) (fibrovascular proliferation) developed in 29 eyes (confluent fibrovascular proliferation of 3 clock hours in extension) of 17 preterm babies. The eyes were treated by cryopexy to the avascular retina. Analysis of the visual function and anatomic results in these eyes, five to eight years postoperatively, revealed very good visual function and only a few anatomic abnormalities. Comparison of these eyes with those of two groups of age- and birth-weight-matched preterms (one with less severe ROP, not treated by cryopexy, and the other with no ROP) showed that the degree of myopia was significantly higher in the cryotreated group. Although not statistically significant, there was a higher incidence and a greater degree of astigmatism in this study group.
Adrenocortical suppression by topical application of glucocorticosteroids in infants with seborrheic dermatitis.
Fifteen infants with seborrheic dermatitis were treated with topical glucocorticosteroids (flumethasone pivalate 0.02%). Early morning plasma cortisol levels were determined prior to treatment, during the 10-day treatment period, and 2 days after its termination. The mean plasma cortisol level prior to treatment was 8.8 +/- 3.4 micrograms%; after 2 days of application there was a significant decrease of the mean to 2.5 +/- 1.3 micrograms% that persisted throughout the treatment period. Two days after termination of treatment, the mean plasma cortisol level rose to 7.1 +/- 3.7 micrograms% but in five infants was still less than 5 micrograms% and in two less than 2 micrograms%, the latter two having shown the greatest involvement of the skin. The possibility of pituitary/adrenocortical inhibition similar to that observed with the systemic administration of glucocorticosteroids and the potential associated risks should be considered when treating cases that would require extensive application of flumethasone pivalate in infants.
Deciduous tooth eruption in children who fail to gain weight.
In order to investigate the usefulness of the number of erupted deciduous teeth (NET) as a growth parameter, we studied deciduous tooth eruption (DTE) in 46 infants between the ages of 6 and 30 months, who failed to gain weight. The cause of the failure to thrive was intrauterine growth retardation in 17 children, and undetermined in 29. In these babies, height and head circumference were significantly below the mean as well. However, NET was almost unchanged when compared to NET of Israeli children of the same age. These findings support the view that DTE is an independent process, unrelated to other anthropometric measurements. Thus, NET may not be used as a clinical parameter of physical development.
Retinopathy of prematurity: incidence and treatment.
The incidence of retinopathy of prematurity in infants with a birthweight less than or equal to 2500 g admitted to a tertiary neonatal intensive care unit between 1977 and 1983 was 20% of all survivors. There was a reciprocal relation between birthweight and the incidence of the disease, with an incidence of 68% in infants weighing less than or equal to 1000 g at birth. Cryotherapy of the avascular retina was performed if the acute disease progressed rapidly during stage 3 and the amount of fibrovascular proliferation was mild to moderate with signs of plus disease (presence of appreciable posterior pole vascular tortuosity and dilatation and the presence of engorgement of iris vessels). This method of treatment was performed in 4% of all survivors: in 26% of infants weighing less than or equal to 1000 g at birth and 5% of infants weighing 1001-1500 g. No infants had cicatricial disease greater than stage 2 on follow-up. The absence of any severe cicatricial disease or blindness in this large group of high risk infants suggests that when indicated and performed on the avascular retina cryotherapy may be an important method of treatment.
[Retinopathy of prematurity--updated].
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On the maturation rate of the neutrophil.
Fifty-three maturing bone marrow cells of the granulocyte cell series stained with Giemsa stain and magnified 1,000 times were scanned by a "computerized microscope" consisting of a LSI-11/23 microprocessor and a black-and-white video camera attached to a "frame grabber ." Each sampled cell was digitized into 70 X 70 pixels, each pixel representing 0.04 micron of the real image. The pixel gray values ranged between 0 and 255. Zero stood for white, 255 represented black, while the numbers in between stood for the various shades of gray. The cells represented six different stages of granulocytic maturation: myeloblast, promyelocyte, myelocyte, metamyelocyte , band form, and polymorphonuclear granulocyte. A discriminant analysis program selected 19 features best distinguishing between the six different cell types and computed five canonical discriminant functions defining a Space in which maturation was studied. In the Space, distance between two cells serves as a measure of similarity. The closer two cells are, the more similar they are and vice versa. This measure was applied here to express the degree of similarity between the neutrophil maturation classes, and since they represent states in the neutrophil life history, it is applicable also as a yardstick for the quantitation of differentiation. In the Space, the life history of a cell is represented by a trajectory originating in the myeloblast and terminating in the granulocyte state. Displacement along the trajectory represents cell maturation that is expressed relatively to the least differentiated state of the myeloblast. The further a cell from this state the more mature it is. The same yardstick also serves for differentiation rate estimates represented in the Space by displacement velocities that are derived from the known "transit times" of a cell in each state. The methodology is also applied for cell production estimates. Unlike other "computerized microscopes" serving for cell classification, the instrument described in this study is primarily a cell-comparator providing a precise measure of similarity between any two cells.
Osmotic fragility of erythrocytes in newborn infants treated by phototherapy.
In order to determine the in vivo effect of phototherapy on the erythrocytes' osmotic fragility, we have tested 10 preterm infants treated by continuous phototherapy, for jaundice of prematurity. Heparinized blood was obtained daily, starting before the initiation of phototherapy and ending 24 h after stopping the treatment. The osmotic fragility was tested in duplicate immediately, after 1 h incubation at 40 degrees C and after 24 h incubation at 4 degrees C in darkness. The erythrocytes of the preterm infant during and at the end of phototherapy showed a normal osmotic fragility pattern. Comparing the consecutive curves in each infant did not show any population of osmotically differing erythrocytes. Heating or cooling the erythrocytes did not alter these results. It is concluded that phototherapy does not increase the in vivo osmotic fragility of erythrocytes in newborn.
Neonatal polycythemia: II. Definition related to time of sampling.
The mathematical relationship between blood viscosity and hematocrit levels was studied in 93 venous blood samples drawn within the first 6 hours of life from 20 full-term infants with weight appropriate for gestational age. A highly significant linear correlation (r = .948) between the logarithm of the viscosity at all the shear rates examined and the Hct was found. This indicates an exponential relationship between the blood viscosity and the Hct levels for every value of the Hct greater than 42%. A new dynamic definition of neonatal polycythemia, which takes into consideration the time of sampling, is suggested. By determining the mean + 2 SD, the upper limit of the normal Hct at the age of 2 hours was 71% and at the age of 6 hours was 68%.
Neonatal polycythemia: I. Early diagnosis and incidence relating to time of sampling.
The dynamic changes occurring in hematocrit and blood viscosity within the first 18 hours of life were studied in 50 full-term infants who were vaginally delivered and had weight appropriate for gestational age. In all cases, the cord was clamped within 30 seconds and cord blood was collected from the vein and artery. Subsequently, samples were taken from a peripheral vein at ages 15 minutes, and 2, 4, 6, and between 12 to 18 hours. Both the Hct and blood viscosity reach their peak at age 2 hours. The incidence of neonatal polycythemia varied greatly with age. Thus at the age of 2 hours, ten infants (20%) were polycythemic, whereas by age 6 hours only six (12%) of these infants were still polycythemic and by age 12 to 18 hours only one infant (2%) was polycythemic. A linear correlation was found between cord Hct levels and peripheral venous Hct levels by age 2 hours. None of the infants with cord blood Hct levels less than or equal to 56% had developed polycythemia, whereas ten of the 12 infants with cord Hct levels greater than 56% developed polycythemia. In this particular group of infants, cord blood Hct levels may be used for the screening of neonatal polycythemia.