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Biomedical subjects

Y Amitai

Publications and source records attributed to Y Amitai.

At least 73 records · Page 4Linked to original sources
PubMed1987

Hazards of 'deleading' homes of children with lead poisoning.

"Deleading" the homes of children with lead poisoning is a necessary step to terminate the child's exposure to lead. Lead poisoning as a result of lead exposure during the process of deleading has occurred in deleading workers but has not been well documented among children whose homes are deleaded. We treated four children with classes I through III lead poisoning (range of blood lead [Pb-B] level, 1.6 to 2.75 mumol/L [33 to 57 micrograms/dL]) who had significant elevation of their Pb-B levels (range, peak 4.34 to 6.27 mumol/L [90 to 130 micrograms/dL]) following deleading of their homes. The methods used for deleading included scraping, sanding, and burning of the paint. Symptoms included irritability (n = 3) and vomiting (n = 1). The elevation of the Pb-B levels was detected early, allowing prompt chelation therapy. Because exacerbation of lead poisoning may occur in children following deleading of their homes, safer approaches of deleading should be determined.

Chelating Agents↗
PubMed1987

Characteristics of vomiting associated with acute sustained release theophylline poisoning: implications for management with oral activated charcoal.

Vomiting in acute theophylline toxicity has assumed increased clinical importance since the introduction of multiple dose activated charcoal therapy. We performed a prospective study of 26 patients with acute overdose of sustained release theophylline to characterize vomiting, and its possible interference with the acceptance of activated charcoal. Twenty five of 26 patients vomited. The duration of vomiting correlated with both peak serum theophylline concentrations (p less than 0.001) and the duration of theophylline toxicity (p less than 0.001). Vomiting extended over 63% of the drug's absorptive phase (the time interval between ingestion and the peak level) and 49% of the elimination phase (the time interval between the peak level and decrease of theophylline level to less than 20 mcg/ml). Patients with peak serum theophylline concentrations less than 70 mcg/ml were able to accept larger amounts of activated charcoal than patients with serum theophylline concentrations greater than 70 mcg/ml (113 +/- 15 gms vs. 57 +/- 24 gms, p less than 0.05). Vomiting in acute sustained release theophylline toxicity is protracted, and limits the use of activated charcoal especially in patients with severe acute theophylline poisoning.

Adult↗
PubMed1987

Ipecac-induced emesis and reduction of plasma concentrations of drugs following accidental overdose in children.

Syrup of ipecac is widely used following accidental drug overdosage in children. Proof of its efficacy, however, in reducing the risk of poisoning is limited. We prospectively studied the effect of early v late induction of emesis by ipecac in 50 children younger than 5 years of age with accidental acetaminophen poisoning. The mean estimated ingested dose was 165 mg/kg, and all patients vomited within 15 to 255 (mean 78) minutes postingestion. Although the predicted four-hour plasma acetaminophen concentration was 97 +/- 4 micrograms/mL (mean +/- SEM, calculated on the basis of the estimated ingested dose), the measured four-hour plasma acetaminophen concentration was 34 +/- 5 micrograms/mL (P less than .01). To assess the efficacy of early v late ipecac-induced emesis, we used the ratio of measured to predicted four-hour acetaminophen plasma concentration. The ratio of the measured to predicted four-hour level increased as the delay in time to vomiting increased (r = .60, P less than .001). Ipecac syrup was administered more promptly when available in the home than when obtained from a pharmacy or a medical facility (26 +/- 8 v 83 +/- 13 minutes postingestion, respectively; P less than .001) and vomiting occurred earlier (49 +/- 9 v 103 +/- 12 minutes postingestion; P less than .01). Although the mean estimated doses ingested were greater in patients who received ipecac syrup at home, their four-hour plasma acetaminophen concentrations were lower. These data suggest that prompt administration of ipecac syrup results in a greater reduction in plasma acetaminophen concentrations in potentially toxic overdosages in children.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents, Home↗
PubMed1987

Multiple dose activated charcoal for theophylline poisoning in young infants.

Five cases are presented in which multiple doses of activated charcoal were given to infants 6 months of age or less, as treatment of theophylline overdose. This therapy was tolerated in all cases with apparent enhancement of theophylline elimination. Use of multiple dose activated charcoal appears to be a viable option in the treatment of young infants with theophylline poisoning.

Aminophylline↗
PubMed1986

Calcification of intervertebral disks in I-cell disease.

I-cell disease (ICD) is associated with skeletal dysplasia. However, changes of the intervertebral disks had not been previously reported. We describe a child with clinical and laboratory evidence of ICD who had multiple intervertebral disk calcifications. Since an excessive degeneration of the cartilage had previously been found in ICD, we propose that this process may give rise to calcification of the intervertebral disks in patients with ICD.

Calcinosis↗
PubMed1986

Thrombocytopenic purpura during the incubation period of rubella.

A child with idiopathic thrombocytopenic purpura (ITP) which started eight days before the appearance of rubella rash is described. All previous reports described ITP after or occasionally simultaneous with the onset of rubella rash. The onset of purpura in this patient was during the incubation of rubella before the initiation of immune response, suggesting that in some patients the mechanism of platelet damage in ITP associated with rubella is through a direct effect of the virus, rather than by circulating antibodies.

Child↗
PubMed1985

Tea drinking and microcytic anemia in infants.

To evaluate the effect of tea drinking on the occurrence of microcytic anemia in infants, we studied 122 healthy infants who underwent routine blood counts at the age of 6-12 months. An overall high frequency of anemia (Hb less than 11 gm/dl-48.4%), microcytosis (MCV less than 70 Mm3-21.3%) and microcytic anemia (19%) was found in the whole group. The percentage of tea drinking infants with microcytic anemia (32.6%) was significantly higher than that of the non-tea drinkers (3.5%). The daily amount of tea drinking was 50-750 ml (median 250 ml). The tea drinkers had significantly lower mean levels of hemoglobin than that of the non-tea drinkers (10.5 +/- 1.2 gm/dl vs 11.2 +/- 0.8 gm/dl, respectively) and significantly lower mean levels of mean corpuscular volume than that of the non-tea drinkers (71.5 +/- 7.1 micron 3 vs 76.1 +/- 4.6 micron 3). There were no significant differences between the two groups in their sex distribution and in the duration of breast feeding. The two groups differed with regard to their ages and social class but a multivariate analysis had excluded the possible confounding effect of these differences on the hematological results. Based on our finding we do not recommend giving tea to infants whose main source of iron is from milk, grains, vegetables or medicinal sources.

Anemia↗
PubMed1985

Scorpion sting in children. A review of 51 cases.

Scorpion sting in children is a hazardous and potentially lethal condition. Fifty-one infants and children were admitted to the Pediatric Departments at the Hadassah-Hebrew University Hospitals in Jerusalem, during a 5-year period, following scorpion sting. Fifteen (29.4%) had severe systemic signs of envenomation and two (3.9%) died. Analysis of our data showed that patients with severe toxicity were brought to the hospital after a significantly longer time lapse than were the patients with mild-to-moderate symptoms. The current management of children with scorpion envenomation consists of administration of specific antivenom and close surveillance in an intensive care unit, where vital signs and continuous cardiac monitoring enable early initiation of therapy for life-threatening complications, such as cardiac and respiratory failure, convulsions, or hypertension.

Antivenins↗
PubMed1985

Increasing frequency of penicillin-resistant pneumococci: epidemiological aspects and case-control study.

At the Hadassah University Hospital, Mt. Scopus, Jerusalem, the frequency of patients with relatively penicillin-resistant pneumococci (RPRP) isolates has increased from 0.9 to 10.8% during the years 1979-82. Infants and children were particularly involved. Significantly more RPRP isolates were found in those less than 14 years old than in those who were older (P less than 0.005). The determination of susceptibility or relative resistance to penicillin was based on the disk sensitivity method, which remained unchanged throughout the study period. The minimal inhibitory concentration (MIC) to penicillin G was also determined for 20 RPRP isolates and was found to be in the range of relative resistance to penicillin (0.25 to 0.50 micrograms/ml) in all 20 isolates. A case-control study of 16 index patients examined antibiotic usage during the 60 days preceding pneumococcal isolation. Total antibiotic usage was high in both groups (18.8 vs. 8.8 days, P = 0.2); beta-lactam antibiotic usage was significantly higher in the RPRP group than in the control group (13.3 vs. 4.2 days, 0.01 less than P less than 0.02). General prescribing practices, even in nonisolated areas where there is no need for public health programs to dispense prophylactic antibiotics, may produce sufficiently high antibiotic exposures to aid the emergence of RPRP strains.

Age Factors↗
PubMed1984

Effect of positive ionisation of inspired air on the response of asthmatic children to exercise.

To evaluate the effect of positive ionisation of inspired air on bronchial reactivity, 12 asthmatic children were twice challenged by exercise in random order. During one test positively ionised air (5-10 X 10(5) ions/cm) was breathed. All challenges were matched in terms of basal lung function and exercise tests were matched in terms of ventilation and respiratory heat loss. Exercise induced asthma was significantly aggravated by exposure to positively ionised air, the postexercise fall in FEV1 (delta FEV1) being 24.7% (SEM and 5.3%) and 35.3% (5%) after the control and ionised air tests respectively (p less than 0.04). It is concluded that positive ionisation aggravates the bronchial response to exercise.

Adolescent↗
PubMed1984

Cerebrovascular accidents in infants and children with congenital cyanotic heart disease.

The red blood cell (RBC) counts and indices of 12 patients with congenital cyanotic heart diseases (CCHD) who had had cerebrovascular accidents (CVA) (study group) were compared with those of 41 infants and children with CCHD who had not had CVA (control group); the groups were matched for age and type of CCHD. The patients in the study group were found to have nonsignificantly lower hemoglobin levels and similar hematocrit levels, in comparison with the control group. On the other hand, significantly lower RBC indices were found among the patients of the study group in comparison with the control group. The arterial oxyhemoglobin concentration, studied in six patients of the study group, was not found to be significantly lower than that of the patients in the control group. Thus, we conclude that relative anemia with microcytosis is associated with the occurrence of CVA in children with CCHD.

Cerebrovascular Disorders↗
PubMedDate not supplied

Treatment of phenobarbital poisoning with multiple dose activated charcoal in an infant.

A 28-day-old infant developed lethargy, hypotonia, and hypothermia following a phenobarbital overdose secondary to a pharmacist's error. He was treated with multiple dose activated charcoal (MDAC) and alkalinization of the urine, which resulted in prompt recovery with rapid elimination of the drug (t1/2-11.2 hours, expected 45 to 118 hours). The use of MDAC in this newborn was safe and effective. We suggest that age should not pose a barrier to the use of MDAC, when indicated.

Charcoal↗