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Biomedical subjects

S Dollberg

Publications and source records attributed to S Dollberg.

At least 55 records · Page 3Linked to original sources
PubMed1994

Effect of insulated skin probes to increase skin-to-environmental temperature gradients of preterm infants cared for in convective incubators.

Thermal support systems for premature infants that are based on skin servocontrol depend on accurate measurement of skin surface temperature. We examined prospectively the effect of probe insulation to alter measured skin temperature in 10 preterm infants. The use of insulated probes resulted in significant alteration in incubator servocontrol, with lower incubator air temperatures and higher skin-to-environment temperature gradients.

Equipment Design↗
PubMed1993

A noninvasive transcutaneous alternative to rectal thermometry for continuous measurement of core temperature in the piglet.

Deep body temperature is an important and accepted index of health status in newborn infants. There are no easily used accurate methods for continuous deep body temperature measurements. Oral and tympanic membrane temperatures correlate well with rectal temperature but are not easily adapted to continuous measurement. We devised a noninvasive transcutaneous temperature sensor for continuous deep body temperature measurement that relies on the principle that, under steady state conditions, the temperature at the thermally insulated surface of a warm body, i.e. a zero heat loss surface, will be in equilibrium with the warmest part of the body. We used a standard clinical temperature probe placed between the skin and the mattress and attached to the skin with a foam adhesive disk. We used standard skin temperature probe attachment disks, which are also designed to provide thermal insulation to the skin temperature probe. We tested the hypothesis that this transcutaneous temperature would track body temperature as indicated by rectal temperature. In six anesthetized (pentobarbital) newborn piglets (1600 +/- 200 g) placed on their abdomen in a convectively warmed infant incubator, we measured continuously the following temperatures for 5 h: transcutaneous over lower and upper abdomen, brown fat, rectal, and descending aorta. To examine the influence of environment, we varied the incubator air temperature between 32 degrees and 36 degrees C. Both transcutaneous temperatures tracked the rectal temperature, within 0.2 degree C for transcutaneous over lower abdomen and within 0.3 degree C for transcutaneous over upper abdomen.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗
PubMed1992

The prevalence of valvular regurgitation in children with structurally normal hearts: a color Doppler echocardiographic study.

To determine the prevalence of valvular regurgitation in children (from birth to 14 years old) with structurally normal hearts, the records of 1360 consecutive patients referred for echocardiographic and Doppler examination were analyzed. A total of 461 (33.9%) patients were found to have structurally normal hearts. Flow patterns across the four valves were examined by pulsed, continuous-wave, and color Doppler imaging techniques. Regurgitation was detected in 124 (26.9%). Pulmonic regurgitation was most commonly found and was detected in 101 (21.9%) patients, tricuspid regurgitation in 29 (6.3%), and mitral regurgitation in 11 (2.4%). Aortic regurgitation was not found. Regurgitation of one valve occurred in 106 (23.0%) patients and of two valves in 18 (3.9%) patients. No patient had regurgitation of more than two valves. The prevalence of pulmonic regurgitation increased significantly with age (p less than 0.0001), whereas the prevalence of mitral, tricuspid, and bivalvular regurgitation did not change with age. Valvular regurgitation was trivial or mild in 87% of patients. Thus mild valvular regurgitation is commonly found in children with structurally normal hearts.

Adolescent↗
PubMed1992

Eicosanoids in hypoxic insult to neonatal rabbit bowel.

Eicosanoids, derivatives of arachidonic acid, play a role in several inflammatory diseases of the bowel. To determine whether prostaglandin E2 (PGE2), leukotriene B4 (LTB4), and leukotriene C4D4E4 (LTC4D4E4), have a role in hypoxic insult to the intestine, we examined the levels of these mediators in a hypoxic neonatal rabbit model. One group of animals underwent hypoxic insult postnatally, the second group did not undergo hypoxia and served as a control. The levels of PGE2, LTB4, and LTC4D4E4 were determined by radioimmunoassay. PGE2 in the hypoxic group was 1,779 +/- 142 pg/mg protein (mean +/- SD) as opposed to 2,380 +/- 197 pg/mg protein in the control group (p less than 0.02). LTB4 level was 5,446 +/- 3,492 pg/mg protein in the hypoxic rabbits and 3,362 +/- 2,570 pg/mg protein in the control group (p less than 0.03). There was no statistically significant difference in the level of LTC4D4E4 between the two groups. Our study shows that hypoxia shifts the arachidonic acid metabolism toward enhanced lipoxygenase activity with a resultant increase in LTB4 levels and a concomitant decrease in cyclooxygenase activity with reduced PGE2 levels in the bowel. The shift in the balance between these eicosanoids may play a role in the pathogenesis of ischemic-hypoxic bowel diseases by enhancing the inflammatory response in the intestine, and simultaneously, diminishing cytoprotection.

Animals↗
PubMed1992

A 2-year prospective study of very low birthweight infants.

A prospective 2-year follow-up study was carried out on 68 of the 69 surviving very low birthweight (VLBW) infants (< 1,501 g) born in Bikur Holim Hospital in the years 1985-87. The aims were a) to determine the incidence of major disability, and b) to compare the 2-year outcome of VLBW infants without major disability with that of a control group of full-term small-for-gestational-age infants, using the Mental Development Index (MDI) of the Bayley Scales. Mean birthweight of the VLBW infants was 1,234 +/- 216 g and mean gestational age was 30.7 +/- 2.4 weeks. Their neonatal mortality during the study period was 29.8%. Major disability was diagnosed in 11/68 infants (16%). At age 2 years there was no significant difference between the mean MDI of the VLBW infants without major disability (97.7 +/- 19.5) and that of the controls (99.7 +/- 17.0). These data, representing the outcome of VLBW infants from a community-based hospital with neonatal intensive care facilities, are comparable in incidence of major disability with data of large tertiary centers. Cognitive ability of VLBW infants without major disability at age 2 years was equivalent to that of their full-term peers.

Analysis of Variance↗
PubMed1992

Is cord blood erythropoietin a marker of intrapartum hypoxia?

A sensitive assay was used to compare the biological activity of cord serum erythropoietin in two groups of infants born with or without labor-induced hypoxia. The mean cord serum erythropoietin activity in 161 infants delivered after vaginal labor was 116 +/- 36 mU/mL, and was indistinguishable from that observed in 23 infants delivered by preplanned, elective cesarean section, 114 +/- 12 mU/mL (P = .75). The bioassay measured effective erythropoietin activity, including the contribution of potentiators in serum. These results indicate that duration and intensity of labor are insufficient to cause a significant increase in effective erythropoietin activity.

Cesarean Section↗
PubMed1991

The effects of high parity and socioeconomic status on obstetric and neonatal outcome.

We studied the interaction of social status and high parity in 15,102 consecutive births in one inner-city hospital, of which 1874 (12.4%) occurred in mothers who had given birth to seven or more infants (Grand multiparae). Group 1 consisted of 1258 grand multiparae from a socioeconomically stable and homogeneous ultra-orthodox Jewish community in Jerusalem, and group 2, included all other grand multiparae of relatively greater age and lower socioeconomic status. A significantly higher rate of small for gestational age, low birth weight and preterm infants was found in group 2 compared with group 1. The results suggest that grand multiparity is not of itself a risk factor, but reflects the confounding effect of environmental conditions.

Adult↗
PubMed1990

[Intraosseous emergency infusion].

Difficulties in establishing an intravenous line in the critically ill child may lead to failure and thus endanger life. The technique of intraosseous infusion, once common, was abandoned in the early 1950s, but is now being reintroduced. It is safe, does not require prior skills, has few complications and may be lifesaving. Substances absorbed through the bone marrow are delivered into the blood circulation as soon as after intravenous injection. A critically ill, preterm neonate who needed emergency fluids and in whom intraosseous infusion was given, is presented.

Blood Transfusion↗
PubMed1990

Genetics of conotruncal malformations: review of the literature and report of a consanguineous kindred with various conotruncal malformations.

Genetic predisposition in congenital heart disease is considered to be a component of multifactorial inheritance. Recently, monogenic inheritance in conotruncal malformations has been suggested. We describe a consanguineous kindred with various conotruncal malformations, the presence of which lends support to the idea that this spectrum of malformation is monogenically inherited. Theoretical background and experimental and clinical data are reviewed and discussed.

Consanguinity↗
PubMed1990

Acute pyelonephritis due to a Kluyvera species in a child.

A Kluyvera sp. was recovered from the urine of a previously healthy 5-year-old child with clinical and laboratory evidence of acute pyelonephritis. This pathogen is usually a saprophyte and even when recovered in humans it is ordinarily considered an opportunistic pathogen. Only two other cases of Kluyvera infection have been described in immunocompetent individuals. The case presented further supports the finding that this bacterium can cause severe disease even in previously healthy, immunocompetent children.

Acute Disease↗
PubMed1990

Epidemiology of neonatal jaundice in the Jerusalem population.

Of 10,122 singleton babies born from January 1, 1984 to March 31, 1988, we compared 1,154 term infants with high serum bilirubin levels (greater than 12.9 mg/dl) to 1,154 infants with low serum bilirubin levels (less than or equal to 12.9 mg/dl) randomly selected from the remaining 8,968 subjects. We found that a high bilirubin level was significantly associated with male sex; maternal diabetes (chronic and gestational); pregnancy-induced hypertension; previous sibling with neonatal jaundice; delivery by cesarean section, vacuum, or forceps; epidural anesthesia; mother with blood type O; first delivery; cephalohematoma; short gestation; lower birth weight; and lower birth order (p less than 0.01); and older maternal age, low percentile for birth weight, and the percentage of weight loss during hospitalization (p less than 0.05). Variables with significantly different frequencies in control and study groups were used in a multivariate analysis, thus further refining the data by the use of logistic regression. Teenage mothers (less than or equal to 19 years old) had the lowest risk, whereas older mothers (greater than 35 years old) had the highest risk of all age groups for having an infant with neonatal jaundice. First delivery and previous sibling with neonatal jaundice were also risk factors. Male sex, short gestation, and delivery by vacuum extraction were other notable risk factors. Our results suggest that, even among industrialized Western societies, risk factors may interact differently to produce higher neonatal serum bilirubin levels. The importance of a risk factor may also be dependent upon its relative prevalence in a parturient population.

Female↗
PubMed1990

Disappearance of IgM antibodies to hepatitis A virus after an acute infection in children and adolescents.

The kinetics of IgM antibodies to hepatitis A virus (HAV) following an acute infection, were studied in 17 children. Antibodies disappeared in two patterns, one group at 113 +/- 18 days after the acute infection in the children, and the second group at 283 +/- 90 days. The same two patterns of kinetics were seen in adults. We conclude that IgM anti-HAV antibodies can be found in the sera of children for over 6 months after the acute infection, as was observed in adults.

Acute Disease↗
PubMed1990

A randomized, controlled application of the Wallaby phototherapy system compared with standard phototherapy.

The feasibility and efficacy of a fiberoptic blanket (Wallaby Phototherapy System) for the treatment of physiologic jaundice was compared with conventional phototherapy. Forty-two full-term infants with nonhemolytic jaundice were included in the study. Infants in the study group were treated with the fiberoptic blanket and the infants in the control group were placed under a standard phototherapy unit. Both the fiberoptic blanket and the standard phototherapy unit delivered an average irradiance of 7.0 +/- 0.5 muw/cm2/nm. Incremental changes in serial plasma bilirubin levels compared with the initial bilirubin concentration did not differ between the study and control groups. For infants whose initial plasma bilirubin concentration exceeded 200 mumol/L, a statistically significant difference was found in both study and control groups between the average bilirubin level at initiation of phototherapy and the average bilirubin level at termination of treatment. We conclude that phototherapy delivered by the fiberoptic blanket is safe and has efficacy comparable to that of conventional phototherapy, providing a convenient alternative phototherapy application strategy that obviates the need for eye patches and facilitates maternal handling of the infant during therapy.

Bedding and Linens↗
PubMed1989

Is teenage pregnancy a neonatal risk factor?

Maternal characteristics and neonatal outcome of 421 primiparas aged 15-19 years who delivered at Bikur Cholim Hospital in Jerusalem were examined. The study group included 190 teenage mothers from the Mea Shearim community who marry young and who receive extensive social and economic support. The control group included 231 teenage mothers from other areas of Jerusalem, characterized by a predominantly low social class, Oriental ethnic origin, and a high rate of out-of-wedlock births (28.6%). The Mea Shearim mothers had a significantly lower incidence of low birth weight (less than 2500 g) infants compared to the control group (6.3% vs. 14.7%, p less than 0.01). The differences could not be explained by maternal age distribution, ethnicity, smoking, or marital status. These results suggest that in a community that provides extensive social and economic support and good access to free prenatal care of high standard, teenage pregnancy is not a neonatal risk factor.

Adolescent↗