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Garty B, Hoffer V, Marcus N, Schoerman O, Levy Y, Finkelstein Y, Danon Y. Anaphylaxis in Children in Central Israel. J Allergy Clin Immunol 2006. [DOI: 10.1016/j.jaci.2005.12.514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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152
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Finkelstein Y, Nurmohamed L, Avner M, Benson LN, Koren G. Clopidogrel use in children. J Pediatr 2005; 147:657-61. [PMID: 16291359 DOI: 10.1016/j.jpeds.2005.05.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2004] [Revised: 03/17/2005] [Accepted: 05/04/2005] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To review a pediatric experience with the antiplatelet agent clopidogrel and suggest a dosage regimen. STUDY DESIGN A retrospective chart review of all infants and children treated with clopidogrel at The Hospital for Sick Children, Toronto between January 2001 and April 2004. Clopidogrel dosages, duration of therapy, complications, and adverse effects in a pediatric population were explored. RESULTS Fifteen infants and children with congenital and acquired heart disease were treated with clopidogrel (median age, 3.5 years; range, 6 weeks to 16 years). Dosages ranged from 1 to 6 mg/kg/day for periods between 1 month and 6 months. Although no thrombotic events were reported, 1 child had a bleeding complication (gastrointestinal) while on triple antithrombotic therapy. Other complications reported in adults, including rash and clinical thrombocytopenia, were not noted in this pediatric series. CONCLUSIONS Clopidogrel was well tolerated. We suggest a starting dose of 1 mg/kg/day for children.
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153
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Finkelstein Y, Chitayat D, Schechter T, Keating S, Toi A, Koren G. Motherisk rounds. Warfarin embryopathy following low-dose maternal exposure. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2005; 27:702-6. [PMID: 16100627 DOI: 10.1016/s1701-2163(16)30550-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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154
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Finkelstein Y, Schechter T, Rokach B, Koren G. Smoke screen: increase in movie stars' smoking on the big screen and its effect on teen smoking. Ther Drug Monit 2005; 27:547-8. [PMID: 16175123 DOI: 10.1097/01.ftd.0000170364.85236.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Several recent studies show an increase in movie stars' smoking on the big screen, leading to an increased rate of teen smoking.
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155
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Tetelbaum M, Finkelstein Y, Nava-Ocampo AA, Koren G. Back to basics: understanding drugs in children: pharmacokinetic maturation. Pediatr Rev 2005; 26:321-8. [PMID: 16140874 DOI: 10.1542/pir.26-9-321] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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156
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Schechter T, Finkelstein Y, Doyle J, Koren G. Pregnancy after stem cell transplantation. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2005; 51:817-8. [PMID: 15986934 PMCID: PMC1479532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
QUESTION A married woman under my care underwent successful bone marrow transplantation as part of treatment for a malignancy. She wishes to start a family. What are her chances? Are there risks? ANSWER Success in becoming pregnant after stem cell transplantation depends on such factors as cumulative doses of chemotherapy and radiation and mother's age at time of transplant. There is increased risk of prematurity, low birth weight, and spontaneous abortion. Pregnancy should be managed as high risk.
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157
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Schechter T, Finkelstein Y, Koren G. Pregnant "DES daughters" and their offspring. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2005; 51:493-4. [PMID: 15856964 PMCID: PMC1472948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
QUESTION I am a 34-year-old woman in my second trimester of pregnancy. My mother took diethylstilbestrol when she was pregnant with me. Could my expected child be affected by this? ANSWER Animal studies suggest the child could be affected, but little data on humans strongly support this. You could plan to have your child monitored for a potential, though unlikely, effect.
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158
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Artom G, Koren-Morag N, Spodick DH, Brucato A, Guindo J, Bayes-de-Luna A, Brambilla G, Finkelstein Y, Granel B, Bayes-Genis A, Schwammenthal E, Adler Y. Pretreatment with corticosteroids attenuates the efficacy of colchicine in preventing recurrent pericarditis: a multi-centre all-case analysis. Eur Heart J 2005; 26:723-7. [PMID: 15755753 DOI: 10.1093/eurheartj/ehi197] [Citation(s) in RCA: 112] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS Effective prevention of recurrent pericarditis remains an important yet elusive goal. Corticosteroid therapy often needs to be continued for a prolonged period and causes severe side effects. We performed a multi-centre all-case analysis to investigate the efficacy of colchicine in preventing subsequent relapses of pericarditis, and addressed the hypothesis that pretreatment with corticosteroids may attenuate the beneficial effect of colchicine. METHODS AND RESULTS One hundred and forty published and unpublished cases of patients treated with colchicine after at least two relapses of pericarditis were aggregated from European centres. Of those, 119 were included in the study group. Only 18% of the patients had relapses under colchicine therapy, and 30% after its discontinuation. There were significantly more relapses among male patients after colchicine treatment (36 vs. 17%, P=0.046), and those with previous corticosteroid treatment (43 vs. 13%, P=0.02). Multivariate logistic regression analysis identified previous corticosteroid therapy (OR 6.68, 95% CI: 1.65-27.02) and male gender (OR 4.20, 95% CI: 1.16-15.21) as independent risk factors for recurrence following colchicine therapy. CONCLUSION Treatment with colchicine is highly effective in preventing recurrent pericarditis, while pretreatment with corticosteroids exacerbates and extends the course of recurrent pericarditis.
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159
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Klein T, Yaniv I, Stein J, Narinsky R, Finkelstein Y, Garty BZ. Extended family studies for the identification of allogeneic stem cell transplant donors in Jewish and Arabic patients in Israel. Pediatr Transplant 2005; 9:52-5. [PMID: 15667612 DOI: 10.1111/j.1399-3046.2004.00222.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
HLA-identified donors are the best source of allogeneic hematopoietic stem cell transplants, and are available in approximately 40% of cases. If no HLA-identical core family member is found, an extended family search may be performed. The aim of the study was to summarize the 10-year (1990-1999) experience of our tertiary care center with extended family donor search. During this period, 356 patients and 2659 of their family members were tissue-typed; 239 patients were Jewish (67%) and 117 were Arabic (33%). An HLA-identical core-family donor was identified for 168 patients (47%): 95 Jewish (40%) and 73 Arabic (62%) (p < 0.0001); 49 patients (14%) had more than one potential donor. An extended family search (grandmother/grandfather, aunts, uncles, etc.) was performed in 38 of the remaining families, which were found to be consanguineous: five Jewish and 33 Arabic. One HLA match was found in the Jewish families (20%) and 21 in the Arabic families (64%). The odds ratio for an Arabic patient to find a donor in the extended family search was 8.75, as opposed to a Jewish patient. Overall, HLA-matched donors were found by core and extended family search for 53% of the patients. The rate for Arabic patients was 80% and for Jewish patients, 40% (p < 0.001). This difference may be explained by the greater number of siblings and higher rate of consanguinity in the Arabic population. In conclusion, an extended family search for potential HLA-matched donors is worthwhile, especially in distinct ethnic populations with high consanguinity, such as Israeli Arabs.
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160
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Finkelstein Y, Elenberg H, Chodick G, Hoffer V, Shalit I, Garty BZ. Survey of Tuberculin Skin Test Positivity Among Israeli Pediatric Hospital Workers. Infect Control Hosp Epidemiol 2004; 25:788-91. [PMID: 15484808 DOI: 10.1086/502480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AbstractTuberculin skin test (TST) was performed in 374 healthcare workers. TST results of induration of 10 mm or more and 20 mm or more were noted in 44.9% and 10.4%, respectively. Positive TST (> 10 mm) was found to be significantly associated with age, country of origin, and duration of employment.
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161
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Abstract
The health of heads of states is not always handled in the same way as an incapacitating disability in ordinary professionals. Instead of suspension of responsibilities, the health status of political leaders is concealed, especially when the illness is perceived as stigmatizing, such as organic mental impairment or sexual disorder. The objective of the present paper is to analyse the malady of Lenin (1870-1924) in the light of relevant and new medical information. It is hoped that this will accentuate the need for transparency when the health of a statesman is concerned.
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162
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Finkelstein Y, Yaniv I, Berant M, Zilber R, Garty BZ, Epstein O, Lahav J, Tamary H. Central venous line thrombosis in children and young adults with thalassemia major. Pediatr Hematol Oncol 2004; 21:375-81. [PMID: 15205080 DOI: 10.1080/08880010490457042] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
High doses of intravenous deferoxamine via central venous line (CVL) has recently been shown to improve survival in patients with noncompliant thalassemia major (TM). The aim of this retrospective study was to evaluate the extent of CVL-related thrombosis and to determine the presence of prothrombotic factors in children and young patients with TM on such a regimen. Twenty-three patients (median age 13, range 5-25 years) with TM in whom a tunneled CVL was inserted for intensification of iron chelation were evaluated for signs and symptoms of thrombosis and for inherited and acquired risk factors of thrombosis. Mean duration of CVL placement was 37 +/- 31 months (range 6-98 months). Eight patients (35%) had CVL-related thrombosis diagnosed clinically or by echocardiography. Nine patients (39%) had prothrombotic factors, but the thrombosis subgroup did not differ from the other group in age, platelet counts, duration of CVL placement, or the presence of predisposing prothrombotic factors. Based on the high rate of CVL-related thrombosis, routine monitoring is suggested for CVL thrombosis in this population.
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Abstract
Recurrent parotitis is an uncommon condition in children. In most cases the etiology is unknown, although the disease is occasionally associated with viral infections, autoimmune disorders and immunodeficiency. We describe, for the first time, a child with recurrent parotitis and isolated immunoglobulin A (IgA) deficiency, without autoimmune disease. As IgA is the main immunoglobulin secreted into the mucosal surfaces, including that of the respiratory and gastrointestinal tracts, and into the saliva, the lack of IgA may be involved in the pathogenesis of recurrent parotitis. We recommend that IgA and other immunoglobulins be tested in all cases of recurrent parotitis.
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164
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Peled N, Nakar C, Huberman H, Scherf E, Samra Z, Finkelstein Y, Hoffer V, Garty BZ. Adenovirus infection in hospitalized immunocompetent children. Clin Pediatr (Phila) 2004; 43:223-9. [PMID: 15094946 DOI: 10.1177/000992280404300303] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study investigated the clinical features of immunocompetent children with adenovirus infection requiring hospitalization. The files of 78 children (mean age 17 +/- 10 months) with community-acquired adenovirus infection admitted over a 2-year period were reviewed. The children were referred after 5.7 +/- 3.4 days of illness, all with fever (mean peak 39.8 +/- 0.8 degrees C). Temperature normalized after 3.5 +/- 2 days. Duration of hospitalization (mean, 7.0 +/- 3.9 days) correlated with lethargy, lung crackles, cracked lips, hypoxia, impaired liver tests, and high serum lactic dehydrogenase (LDH) concentration at admission. Serum LDH concentrations and hypoxemia predicted 70% of the variance in hospital stay. All patients recovered. Adenovirus infection may cause considerable morbidity, even in immunocompetent children. Disease severity, defined by duration of hospitalization, correlates with serum LDH concentrations and oxygen saturation at admission.
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165
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Gazit R, Garty BZ, Monselise Y, Hoffer V, Finkelstein Y, Markel G, Katz G, Hanna J, Achdout H, Gruda R, Gonen-Gross T, Mandelboim O. Expression of KIR2DL1 on the entire NK cell population: a possible novel immunodeficiency syndrome. Blood 2004; 103:1965-6. [PMID: 14976061 DOI: 10.1182/blood-2003-11-3796] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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166
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Hoffer V, Finkelstein Y, Balter J, Feinmesser M, Garty BZ. Ganciclovir treatment in Ménétrier's disease. Acta Paediatr 2003; 92:983-5. [PMID: 12948079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
UNLABELLED A 2-y-old girl with severe edema, oliguria and hypoalbuminemia caused by protein-losing gastritis was diagnosed with cytomegalovirus-associated Ménétrier's disease. After almost two weeks, during which the patient required repeated albumin transfusions, she was treated with intravenous ganciclovir. Within five days her condition had improved, and no additional albumin replacement was needed. Complete recovery was observed after several weeks. CONCLUSION In patients with severe Ménétrier's disease, a course of ganciclovir treatment may be of benefit and should be considered.
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167
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Abstract
A 14-month-old female with familial dysautonomia was referred to the pediatric department with high fever (41.6 degrees C), watery diarrhea, and vomiting. A few hours later, signs of encephalopathy appeared. Laboratory tests revealed elevated levels of lactate dehydrogenase (3500 U/L), aspartate aminotransferase (640 U/L), alanine aminotransferase (320 U/L), and creatine kinase (28,420 U/L). The diagnosis was heat stroke. Impaired autonomic nervous system function may be another risk factor for the development of heat stroke in young children.
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168
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Nussinovitch M, Avitzur Y, Finkelstein Y, Amir J, Harel D, Volovitz B. Lactic dehydrogenase isoenzyme in cerebrospinal fluid of children with febrile convulsions. Acta Paediatr 2003; 92:186-9. [PMID: 12710644 DOI: 10.1111/j.1651-2227.2003.tb00524.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To study the lactic dehydrogenase isoenzyme values in children with simple and complex febrile convulsions. METHODS Cerebrospinal fluid samples were collected from 115 children, 57 with simple febrile convulsions, 27 with complex febrile convulsions and 31 with no neurological or intracranial pathology (controls). Lactic dehydrogenase activity and isoenzyme levels were measured on a Hitachi analyser. RESULTS Mean total lactic dehydrogenase activity was similar in the three groups. In the control group, lactic dehydrogenase-1 was the main fraction, followed by lactic dehydrogenase-2 and lactic dehydrogenase-3; only small percentages of lactic dehydrogenase-4 and lactic dehydrogenase-5 were detected. In the febrile convulsion group, the lactic dehydrogenase-1 fraction percentage was lower and lactic dehydrogenase-2, lactic dehydrogenase-3 percentages were higher than those in the control group; and the differences were statistically significant between the control and study groups (p < 0.01). Values of lactic dehydrogenase-4 and lactic dehydrogenase-5 were similar in all three groups. CONCLUSION This is the first report on the lactic dehydrogenase isoenzyme pattern in the cerebrospinal fluid of patients with simple and complex febrile convulsions. The important finding that focal and general febrile convulsions are not associated with cell damage and changes in aerobic and anaerobic metabolism as lactic dehydrogenase remained unchanged. Analysis of cerebrospinal fluid lactic dehydrogenase isoenzyme levels can assist clinicians in differentiating febrile convulsions from clinical situations that might mimic them.
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169
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Finkelstein Y, Marcus N, Mosseri R, Bar-Sever Z, Garty BZ. Streptococcus acidominimus infection in a child causing Gradenigo syndrome. Int J Pediatr Otorhinolaryngol 2003; 67:815-7. [PMID: 12791460 DOI: 10.1016/s0165-5876(03)00088-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
UNLABELLED Gradenigo syndrome is a rare presentation of acute petrositis. The clinical triad of Gradenigo syndrome consists of acute suppurative otitis media, severe unilateral headache and abducens nerve palsy. We report the first case of Gradenigo syndrome caused by Streptococcus acidominimus, a Gram-positive coccus of the Streptococcus viridans group, which rarely causes deep-seated infection in humans. CONCLUSION Gradenigo syndrome may complicate acute otitis media and should be suspected in case of unilateral headache and abducens nerve palsy. Conservative medical treatment without surgery may be considered in some patients.
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170
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Saig A, Danon A, Finkelstein Y, Koresh JE. Selective and reversible entrapment of He and Ne in NaA zeolite at atmospheric pressure. J Chem Phys 2003. [DOI: 10.1063/1.1540612] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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171
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Finkelstein Y, Shemesh J, Mahlab K, Abramov D, Bar-El Y, Sagie A, Sharoni E, Sahar G, Smolinsky AK, Schechter T, Vidne BA, Adler Y. Colchicine for the prevention of postpericardiotomy syndrome. Herz 2002; 27:791-4. [PMID: 12574898 DOI: 10.1007/s00059-002-2376-5] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Postpericardiotomy syndrome (PPS) is a troublesome complication of cardiac surgery, occurring in 10-45% of cases. Accepted modalities of treatment include nonsteroidal anti-inflammatory drugs, corticosteroids, and pericardiectomy in severe cases. The optimal method for prevention of PPS has not been established. Recent trial data have shown that colchicine is efficient in the secondary prevention of recurrent episodes of pericarditis. The aim of the present study was to evaluate the possible benefit of colchicine for the primary prevention of PPS in patients after cardiac surgery. To the best of our knowledge, this is the first study addressing this issue. PATIENTS AND METHODS A prospective, randomized, double-blind design was used. The initial study group included 163 patients who underwent cardiac surgery in two centers in Israel between October 1997 and September 1998. On the 3rd postoperative day, the patients were randomly assigned to receive colchicine (1.5 mg/day) or placebo for 1 month. All were evaluated monthly for the first 3 postoperative months for development of PPS. RESULTS 52 of the 163 patients were excluded because of postoperative complications, noncompliance, or gastrointestinal side effects of treatment. Of the 111 patients who completed the study, 47 (42.3%) received colchicine and 64 (57.7%) placebo. There was no statistically significant difference between the groups in clinical or surgical characteristics. PPS was diagnosed in 19 patients (17.1%), 5/47 cases (10.6%) in the colchicine group and 14/64 (21.9%) in the placebo group. The difference showed a trend toward statistical significance (p < 0.135). CONCLUSIONS Colchicine may be efficacious for the prevention of PPS in patients after cardiac surgery. Further evaluations in larger clinical trials are warranted.
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172
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Nussinovitch M, Prais D, Finkelstein Y, Harel D, Amir J, Volovitz B. Lactic dehydrogenase isoenzymes in cerebrospinal fluid of children with Guillain-Barré syndrome. Arch Dis Child 2002; 87:255-6. [PMID: 12193446 PMCID: PMC1719249 DOI: 10.1136/adc.87.3.255] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Increased levels of lactic dehydrogenase (LDH) in the cerebrospinal fluid (CSF) have been reported in association with several intracranial pathologies. No studies have been performed on patients with Guillain-Barré syndrome (GBS). AIMS To study LDH isoenzymes in CSF of children with GBS. METHODS CSF samples collected from nine patients with GBS were analysed for total LDH isoenzymes activity, and compared to samples from 15 patients with normal results. RESULTS Mean total LDH activity was 33.33 (6.63) U/l. All patients had significantly increased LDH-3 isoenzyme compared to controls. LDH-3 was the predominant fraction, accounting for more than 50% of total LDH activity and present in more than twice the percentage of LDH-1 or LDH-2. By contrast, in the control group, there were high percentages of mainly LDH-1 and LDH-2. CONCLUSIONS GBS is apparently associated with a distinct LDH isoenzyme pattern in the CSF. More studies are needed to confirm the rise in LDH-3, as serial CSF analyses are unavailable, and to determine the optimum time of analysis when this finding first becomes detectable.
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173
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Finkelstein Y, Moran O, Avitzur Y, Nussinovitch M, Harel L, Volovitz B, Amir J. Clinical dysentery in hospitalized children. Infection 2002; 30:132-5. [PMID: 12120936 DOI: 10.1007/s15010-002-2166-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Clinical dysentery is a severe presentation of an enteric infection. The aim of the study was to evaluate the impact of a serious bacterial etiology in clinical dysentery in hospitalized children and determine if children at high risk can be identified on the basis of clinical or laboratory parameters. PATIENTS AND METHODS A prospective study design was used. The study population included 60 children admitted to our department with clinical dysentery over a 16-month period. Fresh stool specimens were collected on days 1, 2 and 3. The clinical and laboratory data of the children were analyzed. RESULTS Clinical dysentery accounted for 1.7% of all pediatric hospitalizations during this period. Stool cultures were positive for Shigella spp. in 18 children (30%), and Salmonella spp. in 15 children (25%), Campylobacter jejuni was identified in one patient (2%). There were no significant differences in clinical characteristics or laboratory parameters between children with positive and negative stool cultures. CONCLUSION 40% of the children hospitalized for clinical dysentery were eligible for antibiotic treatment. Early administration of empiric antibiotic treatment is justified in children hospitalized for clinical dysentery in Israel. Clinical or laboratory parameters were unable to differentiate those with clinical dysentery at risk of serous bacterial pathogens in stool.
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174
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Finkelstein Y, Shenkman B, Sirota L, Vishne TH, Dardik R, Varon D, Linder N. Whole blood platelet deposition on extracellular matrix under flow conditions in preterm neonatal sepsis. Eur J Pediatr 2002; 161:270-4. [PMID: 12012223 DOI: 10.1007/s00431-002-0938-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2001] [Revised: 01/16/2002] [Accepted: 01/22/2002] [Indexed: 11/30/2022]
Abstract
UNLABELLED Platelet function in preterm infants with sepsis was evaluated by measuring their adhesion and aggregation properties using the Cone and Plate(let) Analyser. This may lead to earlier detection of bleeding tendency in septic infants. Platelet function was investigated in 54 preterm infants, of whom 32 had proven neonatal sepsis and 22 were healthy matched controls. Citrated whole blood was subjected to shear stress (1300 s(-1)) for 2 min on tissue culture plates precoated with subendothelial extracellular matrix (ECM). The percentage of ECM surface covered with platelets and the average size of the ECM-bound platelet particles were determined with an image analyser. Assays for von Willebrand factor (vWF) antigen, ristocetin co-factor, and vWF collagen binding activity (CBA) were performed on samples from an additional 47 preterm infants: 38 healthy and 9 septic. Platelets of the preterm infants with sepsis displayed lower adhesion than those of the healthy controls. Mean surface coverage was 16.9+/-8.2% for the septic infants, 15.4+/-7.9% for the septic infants after exclusion of those with coagulase-negative staphylococci sepsis, and 20.8+/-9.6% for the healthy group ( P<0.05). Platelet aggregation, vWF antigen, ristocetin co-factor, and CBA levels were similar between the septic and healthy groups. The most significant factor influencing surface coverage was the presence of sepsis. CONCLUSION platelet adhesion to extracellular matrix is significantly lower in septic preterm infants than in healthy preterm infants. Intrinsic platelet properties, rather than the concentration or activity of plasma von Willebrand factor, may be responsible for this difference. Surface coverage obtained by the collagen binding activity test under flow conditions, which represents platelet adhesion, may be an earlier, more sensitive indicator of bleeding tendency in neonatal sepsis than decreased platelet count.
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175
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Mosseri R, Finkelstein Y, Monselize Y, Garty BZ. Large T-cell lymphoma in a 13-year-old girl with hyperimmunoglobulinemia E syndrome. Pediatr Allergy Immunol 2002; 13:143-6. [PMID: 12000489 DOI: 10.1034/j.1399-3038.2002.00088.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Large T-cell lymphoma was diagnosed in a 13-year-old girl with hyperimmunoglobulinemia E syndrome (HIES). Her past medical history included severe dermatitis, recurrent pneumonia, urinary tract infections, mucocutaneous herpetic infections, fungal skin infections, and staphylococcal sepsis. The diagnosis of HIES, based on the clinical features and a serum IgE level of >20000 IU/ml, was established when the girl was 6 years old. This is the eighth case of lymphoma in a patient with HIES reported in the English-language medical literature. HIES has not usually been considered a predisposing factor for malignancy, but in view of the rarity of HIES and the young age of the patients, this association seems to be more than coincidental. A link between lymphoma and Epstein-Barr virus (EBV) infection in patients with HIES has been proposed. Serological tests for EBV in our patient were positive 6 years prior to the development of the lymphoma; however, examination for EBV DNA in the lymph node biopsy failed to detect EBV in the tumor.
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