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Biomedical subjects

S Harel

Publications and source records attributed to S Harel.

At least 55 records · Page 3Linked to original sources
PubMed1996

The developmental outcome of children born to heroin-dependent mothers, raised at home or adopted.

In the present investigation we were interested to study the possible role of in-utero exposure to heroin and of the home environmental in the etiology of long-term developmental problems in children born to heroin-dependent parents in comparison to matched controls. The children were examined at .5-6 years of age by a developmental pediatrician and a developmental psychologist using, for the children up to 2.5 years of age, the Bayley Developmental Scales, and for children aged 3-6 years the McCarthy Scales for Children's Abilities. We examined 83 children born to heroin-dependent mothers, and compared the results to those of 76 children born to heroin-dependent fathers and to three control groups; 50 children with environmental deprivation, 50 normal children from families of moderate or high socioeconomic class, without environmental deprivation, and 80 healthy children from kindergartens in Jerusalem. There were five children (6.0%) with significant neurological damage among the children born to heroin-dependent mothers and six (7.9%) children among those born to heroin-dependent fathers. The children born to heroin-dependent mothers had a lower birth weight and a lower head circumference at examination when compared to controls. The children born to heroin-dependent parents also had a high incidence of hyperactivity, inattention, and behavioral problems. The lowest DQ or IQ among the children with cognitive levels above 70 was found in the children with environmental deprivation, next was the DQ or IQ of children born to heroin-dependent fathers, then the DQ or IQ of the children born to heroin-dependent mothers. When the children born to heroin-dependent mothers were divided to those that were adopted at a very young age and to those raised at home, the adopted children were found to function similarly to the controls while those not adopted functioned significantly lower. Our results show that the developmental delay and behavioral disorders observed among children born to drug-dependent parents raised at home may primarily result from severe environmental deprivation and the fact that one or both parents are addicted. The specific role of the in-utero heroin exposure in the determination of the developmental outcome of these children (if they do not have significant neurological damage), seems to be less important in comparison to the home environment.

Abnormalities, Drug-Induced↗
PubMed1996

Clinical characteristics of children referred to a child development center for evaluation of speech, language, and communication disorders.

Speech, language, and communication disorders are prominent reasons for referrals to a child development center. From 1984 to 1988, 1,090 preschool children were referred to our child development center, which serves the Tel Aviv metropolitan area. Of all referrals, 432 (41%) were primarily due to speech, language, and communication problems. After exclusion of those with IQ < 50 and those with non-language-related disabilities, 323 children remained. The children were classified into different subtypes of developmental language disorders and autistic spectrum disorders. The main developmental language disorder subtypes were combined expressive-receptive (49%) and expressive (44%). Central processing deficits were less common, occurring in 20 (7%) of the children. Parents of children with developmental language disorders had educational levels similar to those of parents of children referred to the child development center for other causes. However, parents of children with infantile autism had higher educational levels than parents of children with developmental language disorder or parents of children referred for other causes (P < .001). Our results reflect the distribution of language and related problems in an unselected population of preschool children referred to a child development center.

Autistic Disorder↗
PubMed1996

Urinary excretion of prostacyclin in a rat model of uteroplacental vasculature occlusion: implications for fetal growth retardation.

An experimental model was devised in the pregnant rat to study by a combined high pressure liquid chromatography and radioimmunoassay technique the accumulation of prostanoids (PNs) in the urine after transient-complete or permanent-partial interruption of the maternal-fetal blood flow. After 8 min of complete restriction of the blood flow in the pregnant rat at 18 days of gestation, the urinary concentration of 6-keto-prostaglandin F1 alpha (6k-PGF1 alpha, the stable prostacyclin metabolite) increased from 4.97 +/- 1.27 ng mg-1 creatinine to 8.09 +/- 2.47 ng mg-1 creatinine and 13.02 +/- 4.5 ng mg-1 creatinine after the second and third post-operative day respectively. The urinary concentration of the 2,3-dinor derivative of prostacyclin reached 12.35 +/- 5.44 ng mg-1 creatinine after the second post-operative day and was reduced to 4.71 +/- 1.94 ng mg-1 creatinine after the third post-operative day. The concentration of thromboxane B2 (TxB2, the stable thromboxane A2 metabolite) increased approximately 7-fold and 13-fold over that of the control after the second and third post-operative day respectively. The urinary concentration of the 2,3-dinor derivative of TxB2 (d-TxB2) increased from about 1.42 +/- 0.3 ng mg-1 creatinine to 4.49 +/- 0.9 ng mg-1 creatinine and 7.76 +/- 2.63 ng mg-1 creatinine under the same experimental conditions. Increases in the urinary concentrations of 6k-PGF1 alpha and d-TxB2 to 94 +/- 27.76 ng mg-1 creatinine and 12.05 +/- 2.26 ng mg-1 creatinine, respectively, were observed on the second post-operative day, after the restriction time was increased to 30 min. Permanent-partial occlusion of the maternal fetal circulation resulted in excretion of PNs in the urine to similar levels produced after transient-complete restriction. High concentrations of prostacyclin (range, 0.8 ng min-1 mg-1 wet weight) were produced in vitro by uterine preparations from restricted animals after the second post-operative day. Placenta preparations from restricted animals generally exhibited a lower ability to synthesize PNS (up to 0.006 ng min-1 mg-1 wet weight) compared with uterine tissue but produced more thromboxane than their sham counterparts. The data suggest that the uterus constitutes the main source for urinary PN excretion following short episodes of maternal-fetal blood flow interruption.

Animals↗
PubMed1996

[Bilateral operculum syndrome].

The bilateral operculum syndrome, is a unique developmental syndrome. It is characterized by spastic paralysis of the muscles of the face, pharynx, and of mastication, as well as by epilepsy and mental retardation. Imaging studies show bilateral, structural abnormalities in the frontal, perisylvian region consistent with polymicrogyria. These children are usually diagnosed as suffering from cerebral palsy, but in the bilateral operculum syndrome, intelligence is relatively preserved despite the severe motor involvement. Misdiagnosis may lead to improper estimation of rehabilitation potential preventing appropriate therapy, especially in the field of alternative communication. We present a 3-year-old boy, apparently the first case of this syndrome to be described in Israel.

Brain↗
PubMed1995

[Joubert syndrome].

Joubert syndrome was first described in 1969 and 100 cases have been published so far. It includes: partial or complete agenesis of the vermis, episodic hyperpnea, ataxia, a disorder of ocular movement and mental retardation. It is autosomal recessive and there are descriptions of families with involvement of multiple children, both boys and girls. Since dysmorphic signs are not prominent in this syndrome, diagnosis is often delayed. To the best of our knowledge, Joubert syndrome has not been previously described in Israel. We present a family with 3 siblings with this syndrome. Increased awareness will lead to earlier diagnosis, proper developmental treatment, and accurate genetic counseling.

Abnormalities, Multiple↗
PubMed1995

[Epidemiology of developmental disorders in children in Tel Aviv].

We assessed the prevalence of developmental disorders, the need for intervention, potential for rehabilitation, and also characterized the risk factors, from files of 1,944 children referred during 1981-1990. The study group consisted of 4.3% of the children born in Tel Aviv during this period. Referral was highest between the ages 3-4 years and the causes for referral were language, speech and communication disorders (38%), global developmental delay (20%), motor disorders (16%), and behavioral and emotional problems (15%). Developmental disorders were more prevalent in boys (M/F ratio 1.8:1). 84% had at least 1 risk factor, either pre/perinatal, social or genetic. 66% had a social risk factor requiring involvement of a community social worker, or a parent with a chronic disease. The principal genetic risk factors were a developmental problem in a sibling, and parental consanguinity. The most common perinatal risk factors were birth weight under 2500 grams, hyperbilirubinemia of the newborn and severe asphyxia. Prognosis was good: 83% had normal intelligence and only 10% had severe disability. Upon discharge from the development center at the age of 5 years only 18% required special schooling, but 63% were referred for continuation of rehabilitation services. This study provides multi-disciplinary information that allows planning of requirements for diagnostic, therapeutic and rehabilitation services in the human, logistic and economic fields.

Child↗
PubMed1995

Unprovoked seizures and developmental disabilities: clinical characteristics of children referred to a child development center.

Few data are available on the risk of seizures in young children with developmental problems. A retrospective evaluation of 1,946 children 0-5 years of age referred to the Tel Aviv Child Development Center (CDC) between 1981 and 1990 was performed. The study was undertaken to determine the cumulative risk of unprovoked seizures in children referred to a CDC and to assess the risk factors associated with seizures in these children. The center serves the Tel Aviv area for a variety of developmental disabilities. Cumulative risk of seizures and risk factors were assessed using Kaplan-Meier methodology. Unprovoked seizures occurred in 58 patients (3%), including 10 with a single seizure and 48 with two or more seizures. Risk factors for seizures included cerebral palsy (CP) (relative risk [RR] = 28.7), neonatal seizures (RR = 15.2), mental retardation (MR) (RR = 7.8), febrile seizures (RR = 7.7), autism (RR = 3.2), and prematurity (RR = 2.7). The cumulative risk of seizures by age 5 years in children with MR, CP, and MR plus CP was 8%, 47%, and 68%, respectively, compared with 1% in those without MR or CP. On multivariate analysis, CP, MR, prior febrile seizures, and prematurity were associated with an increased risk of seizures. The risk of experiencing unprovoked seizures by age 5 in children with developmental disabilities is 3%, which is fourfold greater than that of the general population. Much of this increased risk is limited to selected subgroups with major disabilities. However, if neither MR nor CP is present, the 1% risk of developing unprovoked seizures by age 5 in children with other developmental problems is not substantially different from that expected in the general population.

Cerebral Palsy↗
PubMed1995

Maternal directiveness and infant compliance at one year of age: a comparison between mothers and their developmentally-delayed infants and mothers and their nondelayed infants.

Maternal directiveness and infant compliance at one year of age were observed in social interactions between mothers and their handicapped and nonhandicapped infants. Eleven nondelayed, typically developing infants, and nine developmentally delayed infants, matched for chronological age, were observed in a free play situation with their mothers. Mothers of the delayed infants attempted to direct their children's play significantly more than those with nondelayed infants, and they engaged more frequently in social play involving physical contact with their infants. Nondelayed infants complied with their mothers' directives more than the developmentally delayed infants. Further study of infant capabilities and maternal affect and behaviors with this age group is suggested.

Cooperative Behavior↗
PubMed1994

Cranial auscultation in two children with intracranial vascular malformation.

Although most bruits heard over the skull in children are innocent, they might represent the sign of a treatable intracranial vascular pathology. Nevertheless, cranial auscultation is not routinely carried out during physical examination at a young age. Two children with vascular malformations are described in whom a cranial murmur was an early sign of intracranial vascular pathology. Routine cranial auscultation during physical examination of children is recommended.

Auscultation↗
PubMed1993

Gangliosides stimulate synthesis of prostaglandin E2 and prostacyclin in fetal rat brain hemispheres after episodes of global intrauterine ischemia.

The ability of brain preparations from 20-day-old rat fetuses to synthesize prostanoids in vitro before and after interruption of the maternal-fetal blood flow was examined using a radioimmunoassay technique. Synthesis of thromboxane B2 (TxB; the stable thromboxane A2 metabolite) decreased with increasing restriction time; conversely, it was elevated with reperfusion. Synthesis of 6-keto prostaglandin F1 alpha (PGF; the stable prostacyclin metabolite) and prostaglandin E2 (PGE) prostanoids remained unchanged after 20 min restriction and through a 2 hr reperfusion period. Intraperitoneal administration of GM1 (45 mg/kg) into the pregnant rat, 3 hr before restriction, stimulated synthesis of PGE and reduced synthesis of TxB. A prostanoid vasoactive index (PVI), which reflects the relative proportion of the three prostanoids synthesized and asserts the vasoactive potential of the brain tissue, was established. A rise in this value was attained after intrafetal administration into the peritoneal cavity of either GM1, GM3, or isopropyl-GM1 (AGF44) gangliosides, each given at 40 micrograms dose in 5 microliters volume, and N-dichloroacetyl-sphingosine (LIGA20; 15 micrograms/5 microliters) ganglioside analog, 1 hr before restriction. The effect was primarily due to an increase in the capacity of fetal brain tissue to synthesize PGE and, to a lesser extent PGF, vasodilating prostanoids. The N-methyl-D-aspartate (NMDA) receptor-blocker MK801 (6.6 micrograms/2 microliters) and the platelet activating factor (PAF) receptor antagonist BN52021 (0.1 mumol/2 microliters), given by the same route, effectively raised by 60-80% the vasodilating potential of the brain tissue following ischemia.(ABSTRACT TRUNCATED AT 250 WORDS)

6-Ketoprostaglandin F1 alpha↗
PubMed1993

Protracted clinical course for patients with Canavan disease.

Before the establishment of N-acetylaspartic aciduria due to aspartoacylase deficiency as the cause of Canavan disease, diagnosis was based on the characteristic clinical features and spongiform encephalopathy, a pathological response shared by a number of other unrelated conditions. Thus confusion exists in the literature about the phenotype of spongiform encephalopathy (Canavan disease), with reports of 'juvenile' and 'congenital' forms, as well as the classical infantile type. In this report, six of 22 patients with infantile-onset Canavan disease survived beyond six years of age. This phenotypical pattern might be the result of better medical management and care, rather than evidence of genetic heterogeneity.

Adolescent↗
PubMed1993

Anxiety during pregnancy at the time of the Gulf War: comparison of anxiety of Israeli women with normal pregnancies and those with "at-risk" pregnancies.

81 pregnant women were interviewed at the time of the Gulf War. One group was interviewed before the missile attacks began in Israel, and the second group during the period of the attacks. Of the women interviewed, 53 women had "high-risk" pregnancies and 28 had normal pregnancies. Despite the hypothesis that women with "at-risk" pregnancies would report a greater rise in anxiety during the missile attacks, it was found that the women with normal pregnancies reported a significantly greater rise in anxiety during missile attacks. It is suggested that the already-stressed "high-risk" group "shut out" the additional anxiety generated by the dangers from the missile attacks.

Adult↗
PubMed1993

Computed tomography scan of the brain in pediatric neurology practice--an 8-year experience.

Computerized tomography scans of the brain were retrospectively studied in 1,979 children. Abnormalities were found in 45.1% of the examinations. The most common radiologic findings were enlarged ventricles (28.1% of the examinations) and enlarged subarachnoid space (14.7%). Referral diagnosis associated with high rate of radiological abnormalities included: congenital anomalies (71.7% of radiological abnormalities), cerebral palsy (70.7%), central nervous system infection (60.9%), suspicion of brain tumor (58%), and psychomotor retardation (55.6%). On the other hand, convulsive disorders (34.4% of radiologic abnormalities), learning disabilities (15.9%), and headache (11%) were associated with a relatively low rate of radiologic abnormalities.

Adolescent↗
PubMed1992

Regulation of arachidonic acid metabolism in the perinatal brain during development and under ischemic stress.

Oxygen deprivation following cessation of blood flow to vital organs such as brain, heart, and kidney is a ubiquitous human disease, invariably leading to devastating consequences. Studies in experimental models support the contention that membrane permeability is altered, ion fluxes impaired, and energy stores depleted under these circumstances. Certain lipids such as diglycerides (DG) and arachidonic acid (AA), both of which are important cellular second messengers, appear to increase during ischemia. At this point, the contribution of these and other lipids to cell deregulation, loss of function, and ultimate death has not been clarified because no precise link between lipid alterations as detected in ischemia and subsequent cellular processes has been made. In this report we examine the origin of lipid-derived second messengers in fetal rat brain prelabeled with [3H]AA and study the fate of various lipids upon obstruction of the fetal-maternal circulation. The data support the possibility of a phospholipase A2-mediated deacylation of poly-phosphoinositides (poly-PI) to form free AA and a phospholipase C-mediated hydrolysis of PC to form DG during ischemia.

Animals↗
PubMed1992

Assessment of craniocerebral asymmetries in children by computed tomography.

Computed tomographic (CT) scans of 32 children (mean age 2.8 +/- 2.5 years) with a wide range of craniocerebral asymmetry (CCA) were analyzed. Hemiparesis and epilepsy were the main clinical presentations. Two-thirds of the patients had brain infarcts. The degree of cerebral and ventricular asymmetry was evaluated by ratios obtained by linear measurements. The patients were divided into two groups according to the index of maximal asymmetry. The incidence of hemiparesis and the width of the cerebral ventricles did not differ in the two groups. This may be due to the fact that most of our patients suffered from perinatal insult to the brain, allowing time for remodeling and plastic changes to occur. The use of measurable structural parameters in craniocerebral asymmetry offers a basis for comparable radiological assessment.

Asphyxia Neonatorum↗
PubMed1992

Nitric oxide, an inhibitor of lipid oxidation by lipoxygenase, cyclooxygenase and hemoglobin.

The present study demonstrated that nitric oxide, which is an important mammalian metabolite, can inhibit oxidation by lipoxygenase, cyclooxygenase and hemoglobin. The inhibition is manifested as a lag-phase that is reversible. The inhibitory effect of nitric oxide on lipoxygenase and cyclooxygenase seems to derive from i) the capability of .NO to reduce the ferric enzyme to the ferrous form, which is inactive; ii) competition for the iron site available for exogenous ligands; and iii) the radical scavenging ability of the nitroxide radical. Nitric oxide may act as a modulator of the arachidonic acid cascade and in the generation of oxygen-active species.

Animals↗