Biomedical subjects

R Dagan

Publications and source records attributed to R Dagan.

274 records · Page 16Linked to original sources

PubMedDate not supplied

Complications of splenectomy. Comparative study of elective, urgent and incidental splenectomy.

In 160 patients who had undergone elective, urgent or incidental splenectomy, an assessment was made of the possible relationship between the reason for splenectomy and the postoperative course. In patients who had incidental splenectomy, the postoperative complication rate (56.6%), the hospitalization time (20.8 days), and the mortality rate (10%) were higher than among those who had elective or urgent surgery. Our results indicate that splenic injury sustained during abdominal surgery should be treated conservatively, by topical hemostasis or by suturing, in order to avoid complications related to splenectomy.

Adolescent↗

PubMedDate not supplied

Epidemiology of pediatric meningitis caused by Haemophilus influenzae B, Streptococcus pneumoniae and Neisseria meningitidis in Israel.

Bacterial meningitis remains a serious cause of morbidity and mortality in childhood. We report 3 year data on meningitis caused by Haemophilus influenzae b, Streptococcus pneumoniae and Neisseria meningitidis in Israeli children younger than 13 years of age. The data were obtained prospectively through an active surveillance system involving all 25 centers in which children are hospitalized. A case was defined by: a) culture positive cerebrospinal fluid; or b) positive blood culture with > 10 cells. During the study period, 482 cases of meningitis due to the three organisms were identified. Of these, 58%, 20% and 22% were caused by H. influenzae b, S. pneumoniae and N. meningitidis, respectively. The male/female ratio was 1.5:1. An over-representation of the non-Jewish population was seen only in cases caused by S. pneumoniae. The median age was 11 months and 59% of all cases occurred by the age of 12 months. The median age was 10, 12 and 36 months and the age-specific incidence for children aged 0-4 years was 18.5, 5.3 and 5.2 per 100,000, respectively, for H. influenzae b, S. pneumoniae and N. meningitidis. The chance of being hospitalized with meningitis during the first 5 years of life was estimated at 146.2 per 100,000. Meningitis was seasonal: 59% al all cases occurred during fall and winter and only 18% during summer. A total of 2,097 hospitalization days were required when extrapolated to a population in which 100,000 live births occur yearly. The case fatality rate was 2.2%, 5.9% and 6.3% for H. influenzae b, S. pneumoniae and N. meningitidis, respectively, with a higher fatality in females and non-Jews.

Adolescent↗

PubMedDate not supplied

The use of ultrasound in children with pain around the hip and thigh.

The use of ultrasound in the evaluation of effusion of the hip is well established. We performed ultrasound examinations on 87 children who presented with a limp and with pain in the hip region. We confirm the diagnostic value of ultrasound in detecting an effusion in the hip. Furthermore, ultrasound examination revealed effusion in two cases (psoas myositis), an unexpected effusion in the contralateral hip in two cases, and the cause of the pain in eight cases without effusion.

Bone Diseases↗

PubMedDate not supplied

Early severe dehydration in young breast-fed newborn infants.

Six breast-fed infants living in a dry desert climate area presented at ages 4-11 days with severe dehydration. In all cases, dehydration was associated with inadequate breast milk production by the mothers. In contrast to earlier reports on dehydration in breast-fed infants, five of the mothers were from a low socioeconomic background and three were multiparas, including two mothers who had previous experience with breast-feeding. In two infants severe bacterial infections were documented. Two mothers had small retracted nipples. As in earlier reported instances, sodium concentration in breast milk was elevated in all five mothers in whom it was measured, and three babies had severe hypernatremia. Successful relactation was achieved in three cases with a decrease in the milk sodium concentration. These data demonstrate that severe dehydration in breast-fed infants may occur as early as the first week of life and may affect even infants of experienced multiparous mothers who are well motivated for breast-feeding. It seems that hypernatremia in these infants is secondary to poor fluid intake and increased insensible water loss rather than to elevated milk sodium, since there was no direct correlation between milk sodium concentration and serum sodium levels. Following fluid resuscitation, relactation can be achieved in motivated mothers.

Breast Feeding↗