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Biomedical subjects

S Sofer

Publications and source records attributed to S Sofer.

At least 91 records · Page 5Linked to original sources
PubMed1985

Pulmonary oedema following choking: report of two cases.

Two children, aged 3 1/2 and 5 1/2 years, are described. Both developed pulmonary oedema (PE) following a short episode of choking on a sweet and an orange, respectively. On admission diagnosis was made by chest X-ray. One child was asymptomatic despite PE while the other showed only mild respiratory distress. Both children recovered spontaneously and chest X-rays showed a return to normal within 24 h. The mechanism of PE production is discussed. It is suggested that oedema formation occurs during the obstruction and that it is due to hypoxia and the severe negative pleural pressure resulting from attempts to inspire against the obstructed airway. both hypoxia and severe negative pleural pressure cause an increase in pulmonary capillary pressure and transduration of fluid across the capillary membrane.

Airway Obstruction↗
PubMed1985

Criteria map audit of scorpion envenomation in the Negev, Israel.

A criteria map audit is a medical record audit in which quality of care is evaluated according to algorithmically arranged criteria. Thus, a particular criterion is applied to the patient record only if other criteria have been met. For example, if a stung child's condition is severe but not life threatening and if he has had a positive skin test for antivenom sensitivity then he should receive antivenom only after receiving adrenaline and hydrocortisone. We used a modified criteria map audit to determine both the clinical picture of scorpion envenomation and quality of care process in 94 children. Related outcomes of care measured included mortality, persistent morbidity, allergic reaction to scorpion antivenom and length of stay in hospital. Scorpion stings in the Negev region are usually due to the yellow scorpion, L. quinquestriatus, and usually occur in the summer months on the extremities in exposed male children under 10. The clinical picture is more severe when the scorpion is yellow, when the child is younger and when the sting is on the trunk or head. Symptoms apparently mediated by the central nervous system (2.6 findings/child) were more frequent than parasympathetic symptoms (2.3 findings/child). Treatment with antivenom and specific therapy for complications led to very low persistent morbidity and mortality in symptomatic cases, but was also accompanied by a longer hospital stay (64% equal to or greater than 3 days) than for asymptomatic cases (18% equal to or greater than 3 days). Testing for antivenom sensitivity was omitted in an unacceptably high percentage of cases (69%) and its omission led to an allergic reaction in 4 out of 40 cases (10%). Inadequacy in treatment of 7 secondary clinical problems ranged from 71% for hypertension to 29% for seizures (mean 46%). Persistent morbidity was negligible and mortality was 1.2%. We conclude that criteria map audit can be used to describe the clinical and epidemiological picture of a clinical problem while at the same time providing an audit of the process of care.

Adolescent↗
PubMed1984

Pulmonary edema secondary to chronic upper airway obstruction. Hemodynamic study in a child.

A 22-month-old girl with the syndrome of hypoventilation, pulmonary hypertension, cor pulmonale and pulmonary edema due to adenoidal hypertrophy is described. Adenoidectomy resulted in relief of all symptoms and signs within 24 h. Hemodynamic study using pulmonary artery catheter showed that the pulmonary artery pressure returned to normal 48 h after relief of the obstruction. The normal left ventricular end-diastolic pressure, measured throughout the period of obstruction, in the presence of severe pulmonary edema, could suggest a non-cardiogenic "low pressure" pulmonary edema. However, the highly negative pleural pressure which existed during upper airway obstruction indicated an elevation of transmural left ventricular end diastolic pressure (compared to pulmonary wedge pressure) and thus, suggested that the pulmonary edema in this syndrome is secondary to both - right and left heart failure.

Female↗
PubMed1984

Pulmonary edema following relief of upper airway obstruction.

In six pediatric patients, pulmonary edema (PE) appeared on chest x-ray film following intubation for upper airway obstruction (UAO). In spite of the x-ray appearance of PE, there was generally no concomitant physiologic or clinical decline. Only one of the patients required positive airway pressure following intubation. We conclude that PE on chest x-ray film following intubation for UAO is not uncommon, and may not be a harbinger of clinical and/or physiologic deterioration.

Airway Obstruction↗
PubMed1984

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↗
PubMed1983

Radial ray aplasia and renal anomalies in father and son: a new syndrome.

We describe a father and his son with bilateral absence of radius and thumb. Both have short stature, external ear malformation, and renal anomaly. In the son a high frequency of chromosome breaks in lymphocytes was found. We compare this familial syndrome to Fanconi anemia and other radial ray aplasia syndromes and conclude that we are dealing with a different entity, which apparently is inherited as a dominant trait.

Adult↗
PubMed1983

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↗
PubMed1983

Bacterial tracheitis--an old disease rediscovered.

During a 3-year period, seven children with bacterial tracheitis were admitted to the intensive care unit of the Winnipeg Children's Hospital. The illness was characterized by fever, toxicity, and stridor. Respiratory difficulty was secondary to copious thick purulent tracheal secretions. In the majority of patients the illness was caused by Staphylococcus aureus, and the rest had Hemophilus influenzae infection. Viral studies in five patients were negative. Most patients required endotracheal intubation and frequent tracheal toilet to prevent serious airway obstruction. In our ICU, bacterial tracheitis accounted for about 14 per cent of admissions with infectious upper airway obstructive illness, while epiglottis and croup accounted for 55 per cent and 31 per cent, respectively. Only 5 per cent of children with croup admitted to the hospital were admitted to the ICU. Bacterial tracheitis has reappeared, at least in North America, as an important and serious cause of obstructive upper airway disease in children and must be recognized early in order to prevent catastrophic airway obstruction.

Airway Obstruction↗
PubMed1983

Effect of urine osmolality on the antibacterial activity of gentamicin.

Gentamicin is often used for the treatment of urinary tract infection. The dosage recommendations for gentamicin in this condition have not been properly determined, nor has the issue of whether one should maintain an increased urine flow been resolved. Urinary concentrations of gentamicin were measured in mongrel dogs 0-4 hours (early samples) and 24-28 hours (late samples) after a single 2 mg/kg i.m. dose by R.I.A. The MBC of gentamicin against an E. coli strain was determined in broth medium and in dog urine. Urinary concentrations of gentamicin ranged from 6.2 to 1161 micrograms/ml in early samples and from 0.2 to 12.5 mu/ml in late samples, depending on urine osmolality. MBC of gentamicin in heart-brain broth was 1.5-3.0 micrograms/ml whereas in urine it ranged from 0.045-0.09 to 50-100 micrograms/ml; MBC of gentamicin in dilute urine was lower than in concentrated urine (r = 0.85, P less than 0.01). However "late" dilute and concentrated urine samples allowed bacterial growth. Use of gentamicin in urinary tract infection could therefore require smaller than the recommended doses for systemic infections. Also, it seems reasonable to advise the avoidance of urine of extreme osmolalities. A study in patients should verify the clinical relevance of the findings of this study.

Animals↗
PubMed1982

Aplasia cutis congenita in two sibs discordant for pyloric atresia.

We report two sibs who were the products of a consanguineous mating, and who had an extensive form of aplasia cutis congenita (ACC). In one of them the generalized skin disorder was manifested by slipping off of the epidermis and mucous membranes with the slightest trauma. This sib also had pyloric atresia and other congenital malformations. Two hypotheses are presented to explain the discordance between the siblings for the abnormalities other than the ACC. One hypothesis assumes varying degrees of severity of the same autosomal recessive disease. The second suggests linkage between the gene for ACC and the gene for an epidermolysis bullosa (EB)-like disorder and pyloric atresia. a recombination event involving the EB-pyloric atresia gene in one carrier parent would then lead to an offspring with only ACC. Prenatal diagnosis is suggested by monitoring alpha-fetoprotein levels in aminotic fluid.

Abnormalities, Multiple↗