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Biomedical subjects

Y Rotem

Publications and source records attributed to Y Rotem.

At least 37 records · Page 2Linked to original sources

The chest radiograph in the diagnosis of atypical nephritis due to infectious mononucleosis.

A four-year-old boy developed oliguria, proteinuria and hypocomplementemia, without hematuria, in the course of proven infectious mononucleosis. A chest radiograph revealed a mild cardiomegaly, prominent pulmonary vasculature and pleural fluid. These abnormalities were compatible with acute glomerulonephritis and were in support of this clinical diagnosis in spite of the absence of hematuria.

Acute Disease

The chemically abused child.

The case of an 18-month-old child poisoned by her mother with chlorpromazine is described. Fifteen other cases of child poisoning have been previously reported. In all of these cases the assailant was the mother (who in 11 cases was described as mentally disturbed); in 14 cases the presenting sign was a change in the level of the child's consciousness; and in ten cases the agent was a psychotropic drug. These poisonings were always well planned and manipulative, usually of long duration (1 1/2 to 48 months), and often continued during hospitalization, but lacked homicidal intent. Three children died. It is suggested that this subgroup of child abuse be more rigidly defined and possibly be named "the chemically abused child." A higher degree of suspicion and alertness to this problem would increase the number of cases identified and the number of children who receive professional care.

Child Abuse

Familial cholestatic cirrhosis associated with Kayser-Fleischer rings.

A brother and sister who suffered from pruritus since infancy developed hepatic cirrhosis early in life. Although this clinical picture has never been seen in Wilson's disease, Kayser-Fleischer rings in the boy made further studies necessary. Oral radiocopper loading tests administered to both children and to their parents served to exclude Wilson's disease conclusively. Determinations of the concentrations and patterns of bile acids in the serum indicated that the abnormalities observed in these children are not related to errors in bile acid synthesis. Although a defect in bile acid transport is present, it appears to have occurred as a consequence of the liver disease.

Child

Quantitation of renal antigen excretion in the urine of normal children and of children with various renal diseases. I. Quantitation of renal antigens in random urine samples.

This study reports a serologic method for the measurement of kidney-derived antigens in the urine of healthy children and of children with renal diseases. Two hundred twenty patients were studied. Four groups were recognized: group A, patients with no evidence of renal disease; group B, patients with past history of active urinary tract infection; group C, patients with active urinary tract infection; group D, patients with other renal diseases. Urinary renal antigen concentration was tested by the complement fixation method, in which titers of antigens in the urine were compared with a standard human renal antigen extract. The distribution of renal antigen concentrations in group C differed significantly (P(X2Y less than 0.001) from the other three groups. About 85% of patients in groups A, B, and D had levels below 0.6 mg/ml, whereas in group C only 53% of patients had similar concentrations. After factoring the results by the urinary concentration of creatinine, 85% of patients in group C had antigen levels above 0.6 mg/ml as opposed to 24%, 44%, and 27% in groups A, B, and D, respectively. The results of the study are consistent with the assumption that the rate of discharge of renal antigenic material in the urine is accelerated in certain renal diseases.

Antigens

Salt conservation in familial dysautonomia (Riley-Day syndrome).

In some patients with familial dysautonimia, plasma renin activity shows a paradoxical response to postural stimuli, i.e., levels of plasma renin activity are high when the patient is in the supine position and fall significantly during subsequent ambulation. Furthermore, there is no coordinated release of plasma renin activity and aldosterone. The aim of the present study was to determine whether these findings are accompanied by a disturbance of salt conservation. Six patients were studied in a summer camp while on normal and low-salt diets. Plasma and urinary aldosterone levels rose sharply and appropriately when four of the patients were placed on a low-sodium diet. In these subjects, urinary sodium output fell sharply although three of them failed to attain sodium equilibrium by the third day of the low-sodium regimen. Elevation of early morning plasma renin activity appeared to correlate with an inversion in the normal day-night rhythm in urinary volume.

Adolescent

The association of HL-A-B8 and childhood celiac disease in an Israeli population.

The frequency of histocompatibility antigens (HL-A) was studied in 33 children with celiac disease. HL-A-B8 phenotype was detected in 27.3% of the celiac patients and 7.5% of 395 carefully matched control subjects (X2 for heterogeneity=14.23; P less than 10(-4)). HL-A typing, especially in children, is advocated both as a diagnostic and a prognostic measure. The importance of ethnically matched control subjects is discussed together with a proposal for the construction of such control groups.

Adolescent