PubMed Health⌕ Search

Biomedical subjects

A Tal

Publications and source records attributed to A Tal.

At least 55 records · Page 3Linked to original sources

Lipoprotein profile of children with asthma receiving long-term theophylline therapy: a preliminary study.

Lipid profiles were determined in three groups of children: children with asthma receiving long-term therapy with slow-releasing theophylline, children with asthma not treated with theophylline, and a control group of children without asthma. Total cholesterol, high-density lipoprotein cholesterol, and apolipoprotein A levels and the high-density lipoprotein/low-density lipoprotein ratio were significantly higher among theophylline-treated children. The observed changes do not seem to increase the risks of atherosclerotic coronary artery disease.

Apolipoproteins↗

Association of a nonsense mutation (W1282X), the most common mutation in the Ashkenazi Jewish cystic fibrosis patients in Israel, with presentation of severe disease.

Only about 30% of the cystic fibrosis chromosomes in the Israeli cystic fibrosis patient populations carry the major CF mutation (delta F508). Since different Jewish ethnic groups tended to live as closed isolates until recent times, high frequencies of specific mutations are expected among the remainder cystic fibrosis chromosomes of these ethnic groups. Genetic factors appear to influence the severity of the disease. It is therefore expected that different mutations will be associated with either severe or mild phenotype. Direct genomic sequencing of exons included in the two nucleotide-binding folds of the putative CFTR protein was performed on 119 Israeli cystic fibrosis patients from 97 families. One sequence alteration which is expected to create a termination at residue 1282 (W1282X) was found in 63 chromosomes. Of 95 chromosomes, 57 (60%) are of Ashkenazi origin. Together with the delta F508 (23% in this group), G542X, N1303K, and 1717-1G----A mutations, the identification of 92% of cystic fibrosis chromosomes of Ashkenazi origin becomes possible. Patients homozygous for the W1282X mutation (n = 16) and patients heterozygous for the delta F508 and W1282X mutations (n = 22) had similarly severe disease, reflected by pancreatic insufficiency, high incidence of meconium ileus (37% and 27%, respectively), early age at diagnosis, poor nutritional status, and variable pulmonary function. In conclusion, the W1282X mutation is the most common cystic fibrosis mutation in the Ashkenazi Jewish patient population in Israel. This nonsense mutation is associated with presentation of severe disease.

Cystic Fibrosis↗

Respirosonography in infants with acute bronchiolitis.

Respirosonography was used to analyze lung sounds and breathing patterns in 16 infants with acute bronchiolitis who were treated with nebulized salbutamol (albuterol). Wheezing was measured as a proportion of respiratory time (time spent wheezing [Tw]/total time [Ttot]). A decrease of 10% or greater in Tw/Ttot or a reduction in Tw/Ttot to less than 2% was considered a positive response to salbutamol. Seven infants responded to the salbutamol, and nine did not. In responders, Tw/Ttot decreased from 47% +/- 26% to 20% +/- 25% (mean +/- SD), and the respiratory rate decreased from 65 +/- 8 to 57 +/- 7 breaths per minute. In nonresponders, mean Tw/Ttot either did not change or increased, and there was no significant change in respiratory rate (53 +/- 10 breaths per minute before salbutamol inhalation and 56 +/- 9 breaths per minute after salbutamol inhalation). Complex repetitive waveforms, different from the sinusoidal waveforms of typical wheezing, were observed in 14 of 16 infants. Our findings add supportive evidence to the clinical impression that some infants with bronchiolitis respond to salbutamol. Respirosonography provides a noninvasive method for objective clinical assessment of young, wheezy children.

Acoustics↗

Ascorbic acid prevents the dose-dependent inhibitory effects of polyphenols and phytates on nonheme-iron absorption.

The effects of maize-bran phytate and of a polyphenol (tannic acid) on iron absorption from a white-bread meal were tested in 199 subjects. The phytate content was varied by adding different concentrations of phytate-free and ordinary maize bran. Iron absorption decreased progressively when maize bran containing increasing amounts of phytate phosphorous (phytate P) (from 10 to 58 mg) was given. The inhibitory effect was overcome by 30 mg ascorbic acid. The inhibitory effects of tannic acid (from 12 to 55 mg) were also dose dependent. Studies suggested that greater than or equal to 50 mg ascorbic acid would be required to overcome the inhibitory effects on iron absorption of any meal containing greater than 100 mg tannic acid. Our findings indicate that it may be possible to predict the bioavailability of iron in a diet if due account is taken of the relative content in the diet of the major promoters and inhibitors of iron absorption.

Absorption↗

Effect of traditional oriental soy products on iron absorption.

The effect of a variety of traditional oriental unfermented and fermented soy products on iron absorption was evaluated in 242 Indian women. When compared with a soy-flour meal containing an equal amount of protein, iron absorption was found to be significantly improved with silken tofu, natto, tempeh, rice miso, barley miso, and soybean miso. This improvement could not be adequately explained except with reference to changes in the protein composition of the products. The protein fraction profiles of the soy products were obtained by size-exclusion high-performance liquid chromatography. An inverse relationship between food iron absorption and the high-molecular-weight fraction of the soy products was demonstrated (r = 0.66, p = 0.01). However, anomalous results obtained with three products (sufu, tempeh, and fully hydrolyzed isolated soy protein) did not make it possible to reach firm conclusions concerning the effect of the protein fraction of soy on iron bioavailability.

Biological Availability↗

Perceived temperamental characteristics and regulation of physiological stress: a study of wheezy babies.

Explored prospectively were the temperamental dimensions involved in the modulation of wheeziness in infancy. Subjects were 69 infants, 4 to 8 months old, referred to the emergency room because of wheeziness, and a control group of 30 infants, 4 to 8 months old, referred to the emergency room because of an acute illness other than wheeziness. Infant respiratory clinical score for wheeziness was registered and the Revised Infant Temperament Questionnaire and a demographic questionnaire were completed. Fourteen months later the recurrence of wheeziness attacks--that is, asthma--was investigated. Maternal reports of infant's rhythmicity significantly improved the prediction of asthma among wheezy babies; wheezy babies were perceived as significantly less active than nonwheezy babies.

Arousal↗

Methylprednisolone therapy for acute asthma in infants and toddlers: a controlled clinical trial.

A controlled double-blind trial was carried out to assess the effect of the early introduction of combined corticosteroid and beta-adrenergic drugs for the treatment of acute asthma in infants and toddlers. Seventy-four emergency room patients (aged 7 to 54 months) who were treated for acute asthma were studied. Treatment included, in addition to salbutamol inhalations, a single dose of intramuscular methylprednisolone (4 mg/kg) or normal saline as placebo. The patients were reevaluated 3 hours after initiation of treatment. At that time, patients were either admitted or discharged based on a clinical decision. Only 8 (20%) of 39 patients treated with steroids were admitted, compared with 15 (43%) of 35 in the placebo group (P less than .05). Sequential analysis of 33 pairs, matched by age and severity of symptoms, revealed statistically significant reduced admission rates in patients treated with steroids. In the younger patients (6 to 24 months), admission rate was significantly lower for those treated with steroids (18%) as compared with those treated without steroids (50%) (P less than .05). In the older group (24 to 54 months), the trend was similar but not statistically significant: 23% vs 31% in the steroid and placebo groups, respectively. These data indicate that corticosteroid treatment combined with an adrenergic agent, given early during an acute asthmatic episode, significantly reduces the hospital admission rate of infants and toddlers.

Acute Disease↗

Variations in theophylline concentrations detected by 24-hour saliva concentration profiles in ambulatory children with asthma.

Sustained-release theophylline (SRT) therapy was monitored in ambulatory children with asthma by measuring theophylline in citric acid-stimulated saliva. Ninety-six around-the-clock saliva theophylline profiles were performed in 59 children (median age, 8.3 years) under routine life conditions. Five to seven stimulated saliva samples were collected by parents at home during a 24-hour period. Highest (Cmax) and lowest (Cmin) saliva theophylline concentrations (Sal-TC) were not consistently found after or before medication, respectively. Cmax occurred during morning hours (before or after medication) in 82% of patients. Cmax was found immediately before morning or evening dose in as many as 25% of patients. Cmin occurred in 70% of children during evening hours. Cmin was found 4 hours after morning or evening dose in 19% of patients. Excessive fluctuation in Sal-TC between pre- and post-SRT doses during both day and night hours occurred in six patients (286% +/- 87% (mean +/- SD)). Marked circadian variation in Sal-TC was disclosed in 23% of children. The first profile performed was therapeutically satisfactory in only 39% of patients; satisfactory profiles were achieved in other children after changing daily SRT dose or dosing interval. Determination of theophylline concentration in stimulated saliva specimens obtained frequently during a 24-hour period and under routine life conditions is practical and extremely valuable for close monitoring and individualization of theophylline therapy in ambulatory children with asthma.

Adolescent↗

Carbamate and organophosphate poisoning in early childhood.

Twenty-five infants and young children intoxicated by carbamate and organophosphorus compounds are described. Presenting signs and symptoms in children differed from those described in adults and were mainly related to severe CNS depression, coma and stupor, dyspnea, and flaccidity. Other clinical signs such as miosis, excessive salivation and tearing, sweaty, cold skin, and gastrointestinal symptoms were less frequent, while fasciculations and bradycardia were quite uncommon on arrival. Only two patients presented with all typical signs of organophosphate poisoning as described in adults. Signs of carbamate poisoning were indistinguishable from those of organophosphate poisoning and included signs of myoneural and CNS cholinergic receptor involvement, in addition to parasympathetic muscarinic dysfunction. Atropine sulfate was found to have a clear beneficial CNS effect in addition to its known peripheral antimuscarinic effect. Our data suggest that the clinical presentation of carbamate and organophosphate poisoning in early childhood and its response to therapy are quite different from those of adults and older children.

Atropine↗

Ventricular dysfunction in children with obstructive sleep apnea: radionuclide assessment.

Ventricular function was evaluated using radionuclide ventriculography in 27 children with oropharyngeal obstruction and clinical features of obstructive sleep apnea. Their mean age was 3.5 years (9 months to 7.5 years). Conventional clinical assessment did not detect cardiac involvement in 25 of 27 children; however, reduced right ventricular ejection fraction (less than 35%) was found in 10 (37%) patients (mean: 19.5 +/- 2.3% SE, range: 8-28%). In 18 patients wall motion abnormality was detected. In 11 children in whom radionuclide ventriculography was performed before and after adenotonsillectomy, right ventricular ejection fraction rose from 24.4 +/- 3.6% to 46.7 +/- 3.4% (P less than 0.005), and in all cases wall motion showed a definite improvement. In five children, left ventricular ejection fraction rose greater than 10% after removal of oropharyngeal obstruction. It is concluded that right ventricular function may be compromised in children with obstructive sleep apnea secondary to adenotonsillar hypertrophy, even before clinical signs of cardiac involvement are present.

Adenoids↗

Obstructive sleep apnea in young infants.

Obstructive sleep apnea (OSA) was diagnosed in 14 infants less than 18 months of age. Snoring, apnea, failure to thrive, developmental delay and recurrent respiratory infections were the main presenting symptoms. The diagnosis was made by polysomnographic studies or overnight monitoring. Adenotonsillectomy resulted in the relief of symptoms and signs in 13 children. In one infant prolonged nasopharyngeal intubation was needed. An increased awareness of OSA in young infants may prevent the delay in diagnosis, will allow early treatment and thus prevent the development of sequela or complications associated with this syndrome.

Adenoidectomy↗

Cor pulmonale due to adenoidal or tonsillar hypertrophy or both in children. Noninvasive diagnosis and follow-up.

Four children, aged 1 to 3 1/2, were first seen with cor pulmonale, pulmonary edema and severe respiratory distress due to chronic upper airway obstruction secondary to adenoidal or tonsillar hypertrophy or both. Arterial blood gas values, electrocardiograms and chest x-ray films were compatible with cor pulmonale. Echocardiography (four cases) and radionuclide angiography (two cases) showed severe right ventricular and right atrial dilation with reduced right ventricular ejection fraction. Following surgery, all four children improved; their echocardiographic and radionuclide findings returned to normal. Cardiac catheterization, traditionally performed in such cases, was unnecessary. The diagnosis and follow-up of this syndrome are adequately performed noninvasively.

Adenoids↗