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Biomedical subjects

R Dagan

Publications and source records attributed to R Dagan.

At least 253 records · Page 14Linked to original sources

Atypical bacterial infections explained by a concomitant virus infection.

Because both viral and bacterial infections are common during early childhood, dual infections are not unexpected. However, the clinical manifestation of such combined infections may be, difficult to interpret, and they are often misdiagnosed as "atypical bacterial infection." Five patients with concomitant viral-bacterial infections are described. In all five cases, virus detection enabled the physicians to better understand an otherwise puzzling clinical presentation. In view of the recent progress in rapid viral diagnoses and the potential of antiviral drugs, the possibility of dual infection should be investigated more often.

Bacterial Infections↗

Infections in hypothermic infants younger than 3 months old.

Hypothermia in infants is associated with considerable morbidity and mortality. Infection is thought to occur frequently and to carry a poor prognosis in infants with hypothermia. The medical records of 51 infants less than 3 months of age hospitalized from 1976 through 1981 with rectal temperatures of 34 degrees C or less were reviewed. Infections were diagnosed in 27 of the 51 infants. Infections were associated significantly with the presence of bradycardia, anemia, abnormal leukocyte counts, abnormal serum glucose levels, and uremia, especially if two or more of these variables were present. Morbidity and mortality were higher among infected than among noninfected infants. No rapid reliable indicators for the presence or absence of infection in an individual infant with hypothermia were found despite the differences noted between the two groups. Until new techniques for the detection of bacterial infections became available, we suggest that antibiotics be given to all infants younger than 3 months of age with hypothermia on admission to the hospital.

Blood Glucose↗

The isolation of enteroviruses from blood: a comparison of four processing methods.

Blood from 28 children hospitalized with symptomatic enterovirus infections was processed by four different methods in an effort to define optimum conditions for detecting viremia. Enteroviremia was demonstrated in 11/28 children. Virus was isolated by method 1 (serum) in 7/11 children and by method 2 (mononuclear leukocytes) in 9/11, but in only 3/10 and 3/11 children by methods 3 and 4 (granulocytes and plasma-mixed leukocytes, respectively). In four children, the only blood isolate was from mononuclear leukocytes, and in two, serum was the only positive blood preparation. This suggests that viremia can be often detected in hospitalized children with enterovirus disease and shows that the methods used for processing blood may significantly influence the isolation rate.

Adolescent↗

Necrotizing enterocolitis beyond the neonatal period.

Necrotizing enterocolitis (NEC) is usually considered to be a neonatal disease, and is rarely described beyond the newborn period. During the last 15 years, 19 infants from the Negev region, Israel, with NEC were beyond the neonatal age group (range = 34-616 days, median = 90 days). Of this group only 16% were born prematurely, and only 16% had perinatal or neonatal pathology. Diarrhea and dehydration preceding NEC were common as was malnutrition. Bacteremia was detected in 42%. The mortality rate was 90%. Malnutrition, supposedly contributed to the formation of NEC and to the high mortality rate among these infants.

Age Factors↗

Infant feeding practices among Bedouins in transition from seminomadic to settlement conditions in the Negev area of Israel.

Infant feeding practices among 353 Bedouin families in transition from seminomadic to settlement conditions in the Negev area of Israel were compared with those of 302 Jewish families from the same area. Over 99% of the Bedouin infants were initially breast-fed, in contrast to 79% of the Jewish infants; none of the Jewish infants continued to be breast-fed by the end of the first year of life, while 63% of the Bedouins were. Rice was the first solid food to be introduced to Bedouin infants, while fruits and vegetables were the first solids introduced to the Jewish infants. Rice was not an important constituent of the Jewish infants' diet. By the age of 6 months, 93% of the Jewish infants were eating fruits and vegetables, 78% meat, 49% bread and 55% eggs, in contrast to 20, 13, 8 and 18% among the Bedouins, respectively. Introduction of meat lagged significantly among the Bedouin infants, taking place after the 8th month of life for greater than 50%. Bedouin infant-feeding practices resembled those prevalent among rural populations in developing countries. It is likely that with increasing modernization this pattern will gradually disappear and will be replaced by that prevalent among Western populations.

Adult↗

Cell mediated immunity and effects of "thymic humoral factor" in 15 patients with SSPE.

Cell mediated immunity (CMI) in 15 patients with subacute sclerosing panencephalitis (SSPE) was assessed by E-rosette formation, leucocyte migration inhibition factor (LIF) production, and proliferative responses to mitogens. In eleven patients, one or more of these parameters were impaired. These defects varied among the different patients and no consistent or uniform pattern of immune deficiency could be demonstrated. Although no single patient had a generalized reduction of all the T-cell functions, a diminished percentage of E-rosetting cells was the most frequent abnormal parameter (7 out of 15 patients). There was no correlation between the clinical state of the patients and the immune defects. Thymic humoral factor (THF), a thymic hormone, reconstituted at least one CMI impaired function especially the reduced levels of E-rosette forming cells in 7 out of 9 patients. It seems unlikely that a generalized cell-mediated defect is the underlying cause of this disease, but immunomodulatory therapy should be considered in some selected cases.

Child↗

Growth and nutritional status of Bedouin infants in the Negev Desert, Israel: evidence for marked stunting in the presence of only mild malnutrition.

Growth and feeding practices of 353 Bedouin infants from the Negev Desert, Israel, were compared to those of 302 Jewish infants from the same area and to American standards. These two populations differed in their cultures and educational backgrounds. The use of medical and health services was lower among the Bedouin population. The feeding practices of the Bedouin infants were markedly different from those of their controls. The Bedouin infants show a progressive decrease in weight, length, and head circumference (means of all three parameters were around the 5th percentile) while the Jews were comparable to Americans. The nutritional status was assessed by three different anthropometric measurements. The weight to length ratio showed that 88% of Bedouin and 96% of Jewish infants were above the 10th percentile. Tricep skinfold measurements showed that 96% of the Bedouins and 99% of the Jews were above the 5th percentile. The midarm circumference to head circumference ratio was in the range between 0.280 and 0.310 (mild malnutrition range) while that of the Jews was above 0.310 (well-nourished range). These data show marked stunting in the presence of only mild malnutrition. This observation argues against the general belief that marked stunting is the result of prolonged severe malnutrition. Differences in cultural and genetic backgrounds, as well as different feeding practices and increased morbidity, could contribute to this phenomenon.

Anthropometry↗

Relationship of breast feeding versus bottle feeding with emergency room visits and hospitalization for infectious diseases.

Breast-feeding habits of 480 Jewish infants visiting a pediatric emergency room (ER) with infectious diseases were compared to those of 502 healthy infants visiting maternal-child health centers (MCH). (These centers are attended by almost 100% of the Jewish infant population.) Among infants under 5 months of age with acute gastroenteritis and upper respiratory infections, breast feeding was significantly less prevalent than among age-matched infants in the MCH group (22.6%, 18.5% and 53.4% respectively, P less than 0.0001). Infants with acute otitis media and lower respiratory tract infections showed the same trend although the numbers were small. A very short breast-feeding period of 2 weeks or less was more prevalent among the ER group and was associated with increased hospitalization rate. These data emphasize the importance of breast milk in reduction of ER visiting and hospitalization rate.

Bottle Feeding↗

[Infantile rumination].

In a 3-month-old baby with recurrent vomiting, infantile rumination syndrome was diagnosed on the basis of the typical behavior, absence of any physical or radiological findings and failure of pharmacological treatment. The therapeutic approach, which consisted of daily visits to the clinic by the mother and effective psychological support by the pediatrician and the nurses, caused prompt improvement and indicated the importance of diagnosis and treatment in the ambulatory clinic.

Ambulatory Care↗

Permanent tetraplegia as a consequence of tetanus neonatorum. Evidence for widespread lower motor neuron damage.

It is generally believed that no permanent neurological damage is found among survivors of tetanus neonatorum. Newborns dying shortly after the onset of tetanus also lack significant neurological abnormalities. In adults a variety of neuromuscular lesions have been reported; however, a uniform pathological picture is absent. We report a case of a newborn with severe tetanus in whom striking evidence of anterior horn neuronal damage was documented, causing permanent nonprogressive tetraplegia. We suggest that the mechanism responsible for this lesion involves the retrograde axoplasmic flow of tetanus toxin reaching the spinal cord via nerve endings in the infected umbilical cord stump.

Atrophy↗

Subglottic mucocele in an infant.

A subglottic mucocele caused partial obstruction of the upper airways. The radiologic findings were asymmetrical narrowing of the subglottic area with a mass arising from its posterior wall simulating a subglottic hemangioma. Surgical treatment was successfull.

Glottis↗