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Masarweh K, Felszer-Fisch C, Shinwell E, Hasanein J, Peniakov M, Weiner SA, Lurye-Marcu B, Miron D. The Yield of Targeted Examination for the Detection of Symptomatic Congenital Cytomegalovirus Infection. Isr Med Assoc J 2021; 23:318-322. [PMID: 34024050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND The incidence of congenital cytomegalovirus (CMV) infection in Israel is 0.7%. Only 10-15% are symptomatic. Valganciclovir has been shown to improve hearing and neurodevelopmental outcomes in neonates with symptomatic congenital CMV infection. Targeted examination of infants who fail routine neonatal hearing screening or have clinical or laboratory findings suggestive of symptomatic congenital CMV infection may be a cost-effective approach. OBJECTIVES To assess the possibility of targeted examination for the detection of newborns with symptomatic congenital CMV infection. METHODS A prospective observational study was conducted in 2014-2015 at two medical centers in northern Israel. Included were all newborns who were tested in the first 3 days of life by polymerase chain reaction (PCR) for urine CMV DNA (n=692), either for failure the hearing screening (n=539, 78%), clinical or laboratory findings suggestive of symptomatic congenital CMV infection, or primary CMV infection during pregnancy (n=153, 22%). RESULTS During the study period 15,433 newborns were born. The predicted rate of infection was 10-15% (symptomatic) of 0.7% of newborns, namely 0.07-0.105% or 10-15 infants. In fact, 15 infants (0.11%, 95% confidence interval 0.066-0.175) were diagnosed with symptomatic congenital CMV infection, 2/539 (0.37%) in the failed hearing group and 13/153 (8%) in the clinical/laboratory findings group. The incidence of symptomatic congenital CMV infection was within the predicted range. CONCLUSIONS Targeted examination of only 4.5% (n=692) of newborns detected the predicted number of infants with symptomatic congenital CMV infection in whom valganciclovir therapy is recommended.
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Affiliation(s)
- Kamal Masarweh
- Department of Pediatrics A, Emek Medical Center, Afula, Israel
| | | | - Eric Shinwell
- Department of Neonatology, Ziv Medical Center, Safed, Israel
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Jamal Hasanein
- Department of Neonatology, Emek Medical Center, Afula, Israel
| | - Marina Peniakov
- Department of Neonatology, Emek Medical Center, Afula, Israel
| | - Scott A Weiner
- Department of Neonatology, Emek Medical Center, Afula, Israel
| | | | - Dan Miron
- Department of Pediatrics A, Emek Medical Center, Afula, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Kuint J, Lerner-Geva L, Chodick G, Boyko V, Shalev V, Reichman B, Zangen S, Zangen S, Smolkin T, Mimouni F, Bader D, Rothschild A, Strauss Z, Felszer C, Jeryes J, Tov-Friedman SE, Bar-Oz B, Feldman M, Saad N, Flidel-Rimon O, Weisbrod M, Lubin D, Litmanovitz I, Kugelman A, Shinwell E, Klinger G, Nijim Y, Mimouni F, Golan A, Mandel D, Fleisher-Sheffer V, Kohelet D, Bakhrakh L, Lerner-Geva L. Rehospitalization Through Childhood and Adolescence: Association with Neonatal Morbidities in Infants of Very Low Birth Weight. J Pediatr 2017; 188:135-141.e2. [PMID: 28662947 DOI: 10.1016/j.jpeds.2017.05.078] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 04/19/2017] [Accepted: 05/30/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To evaluate the impact of major neonatal morbidities on the risks for rehospitalization in children and adolescents born of very low birth weight. STUDY DESIGN An observational study was performed on data of the Israel Neonatal Network linked together with the Maccabi Healthcare Services medical records. After discharge from the neonatal intensive care unit, 6385 infants of very low birth weight born from 1995 to 2012 were registered with Maccabi Healthcare Services and formed the study cohort. Multivariable negative binomial regression models were calculated to estimate the adjusted relative risk (aRR) and 95% CI for hospitalization. RESULTS Up to 18 years following discharge, 3956 infants were hospitalized at least once. The median age of follow-up was 10.7 years with total of follow-up of 67 454 patient years and 10 895 hospitalizations. The risks for rehospitalization were increased significantly for each of the neonatal morbidities: surgical necrotizing enterocolitis (NEC), aRR 2.71 (95% CI 2.08-3.53), intraventricular hemorrhage grades 3-4, 2.13 (1.85-2.46), periventricular leukomalacia (PVL), 1.83 (1.58-2.13), bronchopulmonary dysplasia, 1.94 (1.72-2.17), and retinopathy of prematurity stages 3-4, 1.59 (1.36-1.85). During the first 4 years, children with surgically treated NEC, intraventricular hemorrhage, PVL, or bronchopulmonary dysplasia had 1.5- to 2.5-fold greater risks for hospitalization compared with those without the specific morbidity. In the 11th-14th and 15th-18th years, respectively, surgically treated NEC was associated with a 3.05 (1.32-7.04) and 3.26 (0.99-10.7) aRR for hospitalization, and PVL was associated with a 2.67 (1.79-3.97) and 3.47 (2.03-5.92) aRR for hospitalization. CONCLUSIONS Specific major neonatal morbidities as well as the number of morbidities were associated with excess risks of rehospitalization through childhood and adolescence.
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Affiliation(s)
- Jacob Kuint
- Maccabitech, Maccabi Healthcare Services, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Liat Lerner-Geva
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Women and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel
| | - Gabriel Chodick
- Maccabitech, Maccabi Healthcare Services, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Valentina Boyko
- Women and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel
| | - Varda Shalev
- Maccabitech, Maccabi Healthcare Services, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Brian Reichman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Women and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel
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Cucuy M, Juster-Reicher A, Flidel O, Shinwell E. Correlation between transcutaneous and serum bilirubin in preterm infants before, during, and after phototherapy. J Matern Fetal Neonatal Med 2017; 31:1323-1326. [DOI: 10.1080/14767058.2017.1315662] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Mor Cucuy
- Department of Neonatology, Kaplan Medical Center, Rehovot, Israel
- Hebrew University, Jerusalem, Israel
| | - Ada Juster-Reicher
- Department of Neonatology, Kaplan Medical Center, Rehovot, Israel
- Hebrew University, Jerusalem, Israel
| | - Orna Flidel
- Department of Neonatology, Kaplan Medical Center, Rehovot, Israel
- Hebrew University, Jerusalem, Israel
| | - Eric Shinwell
- Department of Neonatology, Ziv Medical Center, Tsfat, Israel
- Faculty of Medicine in the Galil, Bar-Ilan Universit, Tsfat, Israel
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Di Renzo GC, Melin P, Berardi A, Blennow M, Carbonell-Estrany X, Donzelli GP, Hakansson S, Hod M, Hughes R, Kurtzer M, Poyart C, Shinwell E, Stray-Pedersen B, Wielgos M, El Helali N. Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference. J Matern Fetal Neonatal Med 2014; 28:766-82. [PMID: 25162923 DOI: 10.3109/14767058.2014.934804] [Citation(s) in RCA: 114] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Group B streptococcus (GBS) remains worldwide a leading cause of severe neonatal disease. Since the end of the 1990s, various strategies for prevention of the early onset neonatal disease have been implemented and have evolved. When a universal antenatal GBS screening-based strategy is used to identify women who are given an intrapartum antimicrobial prophylaxis, a substantial reduction of incidence up to 80% has been reported in the USA as in other countries including European countries. However recommendations are still a matter of debate due to challenges and controversies on how best to identify candidates for prophylaxis and to drawbacks of intrapartum administration of antibiotics. In Europe, some countries recommend either antenatal GBS screening or risk-based strategies, or any combination, and others do not have national or any other kind of guidelines for prevention of GBS perinatal disease. Furthermore, accurate population-based data of incidence of GBS neonatal disease are not available in some countries and hamper good effectiveness evaluation of prevention strategies. To facilitate a consensus towards European guidelines for the management of pregnant women in labor and during pregnancy for the prevention of GBS perinatal disease, a conference was organized in 2013 with a group of experts in neonatology, gynecology-obstetrics and clinical microbiology coming from European representative countries. The group reviewed available data, identified areas where results were suboptimal, where revised procedures and new technologies could improve current practices for prevention of perinatal GBS disease. The key decision issued after the conference is to recommend intrapartum antimicrobial prophylaxis based on a universal intrapartum GBS screening strategy using a rapid real time testing.
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Affiliation(s)
- G C Di Renzo
- Department of Ob/Gyn and Centre for Perinatal and Reproductive Medicine, Santa Maria della Misericordia University Hospital , Perugia , Italy
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Fanaroff JM, Hascoët JM, Hansen TWR, Levene M, Norman M, Papageorgiou A, Shinwell E, van de Bor M, Stevenson DK. The ethics and practice of neonatal resuscitation at the limits of viability: an international perspective. Acta Paediatr 2014; 103:701-8. [PMID: 24635758 DOI: 10.1111/apa.12633] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 03/01/2014] [Accepted: 03/12/2014] [Indexed: 11/30/2022]
Abstract
UNLABELLED Premature infants at the limits of viability raise difficult ethical, legal, social and economic questions. Neonatologists attending an international Collegium were surveyed about delivery room behaviour, and the approach taken by selected countries practicing 'modern' medicine was explored. CONCLUSION There were strong preferences for comfort care at 22 weeks and full resuscitation at 24 weeks. Resuscitation was a grey area at 23 weeks. Cultural, social and legal factors also had a considerable impact on decision-making.
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Affiliation(s)
- Jonathan M. Fanaroff
- Department of Pediatrics and the Rainbow Center for Pediatric Ethics; Case Western Reserve University School of Medicine; Cleveland OH USA
| | - Jean-Michel Hascoët
- Department of Neonatology; Maternité Régionale; Université de Lorraine; Nancy France
| | - Thor Willy Ruud Hansen
- Women's and Children's Division; Department of Neonatology; Oslo University Hospital; Oslo Norway
- Institute of Clinical Medicine; Faculty of Medicine; University of Oslo; Oslo Norway
| | - Malcolm Levene
- Division of Pediatrics and Child Health; University of Leeds; Leeds UK
| | - Mikael Norman
- Department of Neonatal Medicine; Karolinska Institutet & University Hospital; Stockholm Sweden
| | - Apostolos Papageorgiou
- Department of Pediatrics; Jewish General Hospital; McGill University; Montreal QC Canada
| | - Eric Shinwell
- Department of Neonatology; Ziv Medical Center; Bar-Ilan University; Tsfat Israel
| | - Margot van de Bor
- Department of Health and Life Sciences; VU University; Amsterdam The Netherlands
| | - David K. Stevenson
- Division of Neonatal and Developmental Medicine; Stanford University School of Medicine; Palo Alto CA USA
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Ginsberg GM, Eidelman AI, Shinwell E, Anis E, Peyser R, Lotan Y. Should Israel screen all mothers-to-be to prevent early-onset of neonatal group B streptococcal disease? A cost-utility analysis. Isr J Health Policy Res 2013; 2:6. [PMID: 23425020 PMCID: PMC3585784 DOI: 10.1186/2045-4015-2-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 12/24/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Israel, an average of 37 children are born each year with sepsis and another four with meningitis as a result of Group B Streptococcal (GBS) disease. Israel currently only screens mothers with defined risk factors (around 15% of all pregnancies) in order to identify candidates for Intrapartum Antiobiotic Prophyhlaxis (IAP) of GBS. This paper presents a cost-utility analysis of implementing an alternative strategy, which would expand the current protocol to one aiming to screen all pregnant women at 35-37 weeks gestation based on taking a vaginal culture for GBS. METHODS A spreadsheet model was built incorporating technical, epidemiological, health service costs, demographic and economic data based primarily on Israeli sources. RESULTS The intervention of universal screening (compared with the current scenario) would increase screening costs from 580,000 NIS to 3,278,000 million NIS. In addition, the intervention would also increase penicillin costs from 39,000 NIS to 221,000 NIS. Current culture screening of approximately 15% of mothers-to-be with high risk factors resulted in 42 GBS births in 2008-9 (0.253/1000 births). Expanding culture screening to 85% of mothers-to-be, will decrease the number of GBS births to 17.3 (0.104/1000 births). The initial 2.9 million NIS incremental intervention costs are offset by decreased treatment costs of 1.9 million NIS and work productivity gains of 811,000 NIS as a result of a decrease in neurological sequelae from GBS caused meningitis. Thus the resultant net cost of the intervention is only around 134,000 NIS. Culture based screening will reduce the burden of disease by 12.6 discounted Quality Adjusted Life Years (QALYS), giving a very cost effective baseline incremental cost per QALY (cf. risk factor screening) of 10,641 NIS per QALY. The data was very sensitive to rates of anaphylactic shock and changes in the percentage of meningitis cases that had associated long term-sequelae. CONCLUSION It is recommended that Israel adopt universal culture-based GBS screening.
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Affiliation(s)
- Gary M Ginsberg
- Medical Technology Assessment Sector, Ministry of Health, Jerusalem, Israel.
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Abstract
AIM To conduct a single-centre "look-back" study of the prevalence of hepatitis C in teenagers who had received blood products as newborns, prior to hepatitis C virus (HCV) blood donor screening. METHODS Using blood bank records, we identified 732 surviving teenagers aged 14-18 years who had received blood products as neonates during 1986-1990. Letters recommending HCV antibody testing were sent to 732 surviving teenagers; 581 recipients were contacted and invited to undergo testing, and, of these, 429 consented (59% of the survivors). HCV antibody testing was performed on all and HCV-RNA was tested on those who were antibody positive. RESULTS Three teenagers (0.7%, 95% CI 0.54-0.86) tested positive for HCV antibodies and all three were HCV-RNA positive. There were no cases in which antibodies were detected and polymerase chain reaction (PCR) was negative. Two of the three had mildly elevated liver enzymes and all three had mild inflammatory activity and low fibrosis scores on liver biopsy. CONCLUSIONS The look-back process, even in a single centre with a stable urban population, is relatively inefficient in screening at-risk populations. Although the prevalence of hepatitis C in this sample was relatively low, paediatricians should offer screening to teenagers and young adults who received blood products in the neonatal period.
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Affiliation(s)
- Michal Kori
- Division of Pediatrics, Kaplan Medical Center, Rehovot, Israel.
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Juster-Reicher A, Flidel-Rimon O, Amitay M, Even-Tov S, Shinwell E, Leibovitz E. High-Dose Liposomal Amphotericin B in the Therapy of Systemic Candidiasis in Neonates. Eur J Clin Microbiol Infect Dis 2003; 22:603-7. [PMID: 13680398 DOI: 10.1007/s10096-003-0993-4] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
High-dose (5-7 mg/kg/day) liposomal amphotericin B was evaluated prospectively during the period 1995-2001 in 41 episodes of systemic candidiasis occurring in 37 neonates (36 of the 37 were premature infants with very low birth weights). Median age at the onset of systemic candidiasis was 17 days. Candida spp. were isolated from blood in all patients and from urine, skin abscesses and peritoneal fluid in 6, 5 and 1 neonates, respectively. Candidiasis was due to Candida parapsilosis in 17 cases, Candida albicans in 15 cases, Candida tropicalis in 5 cases, Candida guilliermondii in 2 cases, Candida glabrata in 2 cases and an unidentified Candida sp. in 1 case. Twenty-eight, five and eight infants received 7, 6-6.5 and 5 mg/kg/day, respectively. Median duration of therapy was 18 days; median cumulative dose was 94 mg/kg. Fungal eradication was achieved in 39 of 41 (95%) episodes; median duration of therapy until fungal eradication was 8.7+/-4.5 days. Fungal eradication was achieved after 10.9+/-4.8 days in patients who had received previous antifungal therapy compared to 8.2+/-4.3 days in those treated with liposomal amphotericin B as first-line therapy. One patient died due to systemic candidiasis on day 12 of therapy. High-dose liposomal amphotericin B was effective and safe in the treatment of neonatal candidiasis. Fungal eradication was more rapid in patients treated early with high doses and in patients who received high-dose liposomal amphotericin B as first-line therapy.
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Affiliation(s)
- A Juster-Reicher
- Department of Neonatology, Kaplan Medical Center, 76100 Rehovot, Israel
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Shani M, Shinwell E. [Breastfeeding characteristics and reasons to stop breastfeeding]. Harefuah 2003; 142:426-8, 486. [PMID: 12858826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
INTRODUCTION Decision making concerning breastfeeding is a complicated process with many variables influencing the decision to breastfeed or not. OBJECTIVE To study breastfeeding patterns among Israeli women and to understand why and when women stop breastfeeding. METHODS Questionnaires were distributed to the mothers in the Maternity Department at Kaplan Medical Center, Rehovot. The questionnaires included demographic data and questions relating to their current desire to breastfeed and their previous breastfeeding experience. The women were contacted by phone after 4-6 months and the actual breastfeeding history was noted. Women who were still breastfeeding at that time were contacted again 12-15 months after delivery. RESULTS During the study period, there were 733 births in the hospital. Approximately 600 questionnaires were distributed and 515 (86%) women responded. Four hundred and seventy (91%) of the mothers were contacted by phone 4-6 months after delivery. The results showed that 87% of the women started breastfeeding, while 51% breastfed their babies for at least 3 months, 25% for at least 6 months and 8% breastfed their babies for one year. Women born in Ethiopia breastfed their babies for significantly longer periods than women of any other origin. Women who defined themselves as ultra orthodox, breastfed their babies significantly longer then women who defined themselves as religious, traditional or secular. The study revealed that 70% of the women did not receive any assistance with breastfeeding outside the hospital and 42% of the women stop breastfeeding because of "insufficient milk". CONCLUSIONS The rate of initiation of breastfeeding is high among Israeli women in our survey. Breastfeeding duration is higher today than in previous reports for Israeli women in the 1970's and 1980's. Women who were born in Ethiopia breastfed their child for a longer duration than women who were born elsewhere. Women who defined themselves as ultra orthodox breastfed longer then women who defined themselves in any other way. The most common reason to stop breastfeeding is "insufficient milk", which in most cases is a reversible condition.
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Perlman S, Goldman RD, Maatuk H, Ron E, Shinwell E, Blickstein I. Is the sampling site along the umbilical artery significant? Gynecol Obstet Invest 2003; 54:172-5. [PMID: 12571441 DOI: 10.1159/000067887] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2001] [Indexed: 11/19/2022]
Abstract
The purpose of umbilical blood sampling is to obtain accurate reflection of fetal acid-base status at birth. The site along the umbilical artery from which blood should be sampled postpartum was not specified. We evaluated if blood gases and pH values from three sampling sites along the umbilical artery are different. After defining the range of intraobserver (method) variability, blood pO(2), pCO(2), and pH were directly determined. The data showed consistent and significant increases in arterial pH and pCO(2) values and decreases in pO(2) values from near the fetal cord insertion to the placenta. The largest difference was noted between the fetal site and the placental plate and the smallest between the site near the placental cord insertion and the placental plate. We conclude that the site of cord blood sampling should be standardized and the umbilical artery should be sampled at a site nearest to the neonate.
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Affiliation(s)
- S Perlman
- The Hadassah-Hebrew University School of Medicine, Jerusalem, Israel
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Auerbach J, Geller V, Lezer S, Shinwell E, Belmaker RH, Levine J, Ebstein R. Dopamine D4 receptor (D4DR) and serotonin transporter promoter (5-HTTLPR) polymorphisms in the determination of temperament in 2-month-old infants. Mol Psychiatry 1999; 4:369-73. [PMID: 10483054 DOI: 10.1038/sj.mp.4000531] [Citation(s) in RCA: 156] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We and others have previously shown that the dopamine D4 exon III repeat (D4DR) and the serotonin-transporter promoter region (5-HTTLPR) polymorphisms are not only associated with adult personality traits1-7 but also with temperament in 2-week-old neonates.8 We now report the results of a second study of these infants and their temperament at 2 months using Rothbart's Infant Behavior Questionnaire (IBQ).9 There were significant negative correlations between neonatal orientation and motor organization as measured by the Neonatal Behavioral Assessment Scale (NBAS)10 at 2 weeks and negative emotionality, especially distress in daily situations, at 2 months of age. There were significant main effects for negative emotionality and distress when the infants were grouped by the D4DR and the 5-HTTLPR polymorphisms. Infants with long D4DR alleles had significantly lower scores on Negative Emotionality (F[1, 72] = 8.50, P = 0.005) and Distress to Limitations (F[1,72] = 4.93, P = 0.03) than infants with short D4DR alleles. In contrast, infants with the short homozygous (s/s) 5-HTTLPR genotype had higher scores on Negative Emotionality (F[1,72] = 3.88, P = 0.053) and Distress to Limitations (F[1,72] = 4.94, P = 0.029) than infants with the I/s or I/I genotypes. The strongest effects occurred in those infants with the s/s 5-HTTLPR polymorphism who also were lacking long D4DR alleles which in some studies has been linked to adult novelty seeking.1,6 These infants showed most negative emotionality and most distress to daily situations, temperament traits that are perhaps the underpinning of adult neuroticism.
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Affiliation(s)
- J Auerbach
- Department of Behavioral Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Zvulunov A, Kachko L, Manor E, Shinwell E, Carmi R. Reticulolinear aplasia cutis congenita of the face and neck: a distinctive cutaneous manifestation in several syndromes linked to Xp22. Br J Dermatol 1998; 138:1046-52. [PMID: 9747372 DOI: 10.1046/j.1365-2133.1998.02277.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A distinct form of aplasia cutis congenita presenting as linear facial skin defects has been described under a variety of names as Xp deletion syndrome. MIDAS (microphthalmia, dermal aplasia and sclerocornea) syndrome, MLS (microphthalmia and linear skin defects) and Gazali-Temple syndrome. The syndrome is lethal in males, and its severity in females varies from a relatively mild residual facial scarring with short stature to lethal developmental organ malformations. A new case with peculiar ultrastructural findings is presented. A review of the literature suggests that these associations represent a series of contiguous-gene syndromes.
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Affiliation(s)
- A Zvulunov
- Department of Dermatology, Soroka Medical Center, Ben Gurion University, Beer Sheva, Israel.
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14
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Abstract
Hypomelanosis of Ito is an uncommon syndrome where bizarre, systematized hypopigmentation is often associated with neurological and other non-cutaneous abnormalities. We report two cases, one which was associated with laryngomalacia and sudden death (in which the parents were consanguineous), and one which was associated with episodes of loss of consciousness.
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Affiliation(s)
- E Finkelstein
- Dermatology Department, Soroka Medical Centre, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel
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Howard CB, Shinwell E, Nyska M, Meller I. Ultrasound diagnosis of neonatal fracture separation of the upper humeral epiphysis. J Bone Joint Surg Br 1992; 74:471-2. [PMID: 1587906 DOI: 10.1302/0301-620x.74b3.1587906] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- C B Howard
- Department of Orthopaedic and Traumatic Surgery, Soroka Medical Centre, Ben Gurion University of the Negev, Beer-Sheva, Israel
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