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Biomedical subjects

B Wolach

Publications and source records attributed to B Wolach.

At least 55 records · Page 3Linked to original sources
PubMed1998

Aspects of leukocyte function and the complement system following aerobic exercise in young female gymnasts.

Recent studies have reported reduced immunity in trained athletes. Scant information exists on changes in the immune function among trained children. The purpose of this study was to assess the effect of aerobic exercise on the phagocytic process of neutrophils and the complement system in young athletes. Subjects included prepubertal elite female gymnasts (n = 7) and untrained girls (n = 6) aged 10-12 years. Venous blood was withdrawn before, immediately post and 24 h following a 20-min run at a heart rate of 170-180 beats.min-1. Neutrophil random migration, chemotactic activity, bactericidal function and PMA/FMLP-stimulated superoxide anion release as well as various complement components were assessed. Net chemotaxis was found reduced (P < 0.05) 24 h following exercise (58 +/- 11 vs. 36 +/- 11 cells/field in gymnasts and 47 +/- 7 vs. 42 +/- 8 cells/field in untrained girls pre- and 24 h post-exercise, respectively). The basal values, as well as post-exercise values of bactericidal activity were lower (P < 0.05) in gymnasts as compared with the control group (0.8 +/- 0.3, 0.8 +/- 0.2 and 0.8 +/- 0.1 log decrease of colonies in gymnasts at pre-, immediately post-, and 24 h post-exercise, respectively and 1.1 +/- 0.1, 1.1 +/- 0.1 and 1.0 +/- 0.2 log decrease of colonies in controls, respectively). No significant effect on the bactericidal activity was observed in either group following exercise. The addition of homologous sera did not correct the bactericidal activity. PMA-stimulated superoxide anion release decreased (P < 0.05) among gymnasts immediately following exercise (5.7 +/- 0.4 vs. 4.4 +/- 1.0 mmol O2/10(6) PMN.min) and remained low 24 h later. The same trend was observed in FMLP-stimulated neutrophils but the data were not significant. Significantly decreased levels (P < 0.05) of the early complement components (C1Q, C1R) were also found following exercise (1.34 +/- 0.64 vs. 1.27 +/- 0.28 and 1.09 +/- 0.07 vs. 1.02 +/- 0.06 pre- and post-exercise in gymnasts and untrained, respectively). Furthermore, consistently lower C2 and C3 were observed in gymnasts compared with controls. Neutrophil dysfunction as well as impairment of the complement system seem to occur following exercise.

Analysis of Variance↗
PubMed1998

Is greater than normal nocturnal heart rate in children with renal scars a predictor of reflux nephropathy?

BACKGROUND: The existence of renal scars constitutes the major etiologic factor for the development of hypertension during childhood. Elevated blood pressure in this setting can be considered a secondary form of hypertension. Certain forms of secondary hypertension have been associated with a lower than normal nocturnal fall in blood pressure. Resting heart rate per se has recently been reported to be an independent predictor of risk for cardiovascular mortality irrespective of age and the presence or lack of hypertension. OBJECTIVE: To ascertain the responses of heart rate and blood pressure in normotensive children with renal scars without, however, proteinuria and renal failure. METHODS: Ten children with renal scars documented by a 99Tc dimercaptosuccinic acid (DMSA) scan were subjected to ambulatory blood pressure monitoring. Ten age-matched and sex-matched healthy children served as the control group. Serum urea and creatinine levels, calculated rate of clearance of creatinine, microalbuminuria, plasma renin activity, and levels of aldosterone and catecholamines were determined for each subject. RESULTS: Average daytime and night-time systolic and diastolic blood pressures for the two groups did not differ. Subjects in both groups demonstrated the physiologic decrease in blood pressure during sleep (normal 'dipper' response), which was of equal magnitude for these two groups. Mean daytime heart rates were 92+/- 13 beats/min in children with renal scars versus 80+/-11 beats/min in controls (NS). Mean and minimal heart rates during night-time in children with renal scars were found to be significantly greater [79+/-6 versus 65+/-5 beats/min (mean) and 61+/-10 versus 56+/-7 beats/min (minimal), P < 0.01]. Parameters of renal function, plasma renin activity, and levels of aldosterone and catecholamines were similar for these two groups. CONCLUSION: Despite their having an equivalent physiologic dip in blood pressure during night-time, normotensive children with renal scars have a significantly greater nocturnal heart rate than do control subjects.

Child↗
PubMed1997

[High dose oral prednisone for hemangiomas in infants].

Over a 24-year period, 62 infants (47 girls) with hemangiomas were treated with an initial dose of either 3 or 5 mg/kg/day of oral prednisone for 2 weeks, after which the dose was gradually tapered off during 6-8 weeks. Few patients required longer treatment. Results were judged to be excellent in 68% of infants and good in 25%. Treatment was considered a failure in only 7%. The initial dose of 5 mg/kg/day was more effective than the smaller dose (p < 0.001). Of the 62 patients, 49 received 1 course of treatment, 8 required 2 courses and 5 required 3 courses. Retreatment was given whenever significant regrowth occurred. Side-effects were not serious, and resolved when treatment was discontinued. Treatment was indicated when the location of the lesions caused interference with important functions or when the lesions were likely to damage anatomic structures. Special attention was paid to early treatment of eye and subglottic hemangiomas. In all 22 children with hemangiomas of the eye (most with an orbital component), shrinkage of the lesion was observed within 24 hours of initiating treatment. In 19 of the 22 there was no residual of the hemangioma 1-18 years later. Such lesions deserve early treatment, not just as cosmetic emergencies, but to prevent secondary amblyopia. Early treatment of subglottic hemangiomas is also mandatory because they are potentially life-threatening. We conclude that oral prednisone is very effective in the treatment of hemangiomas of infants when given at a high dose for an adequate period of time.

Administration, Oral↗
PubMed1997

Pernicious anemia and adenocarcinoma of the stomach in an adolescent: clinical presentation and histopathology.

Primary gastric-carcinoma accounts for only 0.05% of pediatric gastrointestinal malignancies. Although elderly patients who have pernicious anemia are at greater risk of the development of atrophic gastritis and gastric carcinoma, pernicious anemia caused by vitamin B12 deficiency is extremely rare in otherwise healthy adolescents. The authors present a 14.5-year-old boy who had dimorphic anemia caused by vitamin B12 and iron deficiencies in whom atrophic gastritis and gastric carcinoma developed. To the best of our knowledge, this association has not been previously reported in children or adolescents.

Adenocarcinoma↗
PubMed1997

Neonatal sepsis: pathogenesis and supportive therapy.

Bacterial infections remain an important cause of neonatal mortality and morbidity. Pathogenesis of the neonate's predilection to infection are multifactorial. Factors directly attributable to the infant include humoral, phagocytic, and cellular deficiencies. Septic neonates may have reduced neutrophil storage pools that cause profound neutropenia. Both correlate with poor prognosis. Antibiotic administration is mandatory in neonatal sepsis. Supplementary treatments may be useful. Granulocyte transfusions, when available, provide neutrophils, improving the neonate's neutrophil count and neutrophil function. The efficacy of intravenous immunoglobulin (i.v.IG) is questionable because the prophylactic and therapeutic administration of i.v.IG fails to reduce the incidence of bacterial infections or affect the overall survival rate. Hyperimmune preparations seem to be more effective. The administration of granulocyte colony-stimulating factor induces myeloid progenitor proliferation, enhances the neutrophil storage pool, produces neutrophilia, and improves neutrophil function. More extensive, well-designed, and carefully control trials are needed to determine the benefit of supportive therapies for neonatal sepsis.

Antibody Formation↗
PubMed1997

Cellular and humoral immune response to exercise among gymnasts and untrained girls.

Recent studies reported reduced immunity in athletes following exercise. Physical activity affects both cellular and humoral immune functions. Scant information exists on exercise-induced changes in the immune system among children. The purpose of the present study was to investigate the effect of aerobic exercise on several aspects of cellular and humoral functions among 10-12 year-old highly trained female gymnasts (n = 7) and untrained girls (n = 6). All girls were pre-pubertal. Venous blood samples were drawn before, immediately after and 24 h following 20 min of treadmill running (heart rate 170-180 beats.min-1). White blood cells' number rose significantly following exercise and remained elevated for 24 h. The increase in leukocyte number was due to an increase in granulocytes as well as an increase in lymphocytes and monocytes. While neutrophil count returned to basal values after 24 h, lymphocytes and monocytes number remained elevated 24 h following exercise. Exercise resulted in a significant elevation of T cell lymphocytes, T helpers, T suppressors and natural killer cells. All values returned to normal after 24 h. There were no changes in B cell lymphocytes following exercise. Exercise had no effect on serum IgA, IgM, IgE, IgG and sub-types of IgG (IgG1, IgG2, IgG3 and IgG4). No differences were observed between gymnasts and untrained girls. In summary, the exercise-induced changes in cellular and humoral immune functions among the girls were generally similar to those described in adults. Whether the transitory effects of exercise on the immune system are related to increased susceptibility to illness is still questionable.

Child↗
PubMed1997

The development of the complement system after 28 weeks' gestation.

OBJECTIVE: To assess the levels and development of the various complement components in preterm infants, particularly among those born before 34 weeks' gestation. SUBJECTS AND METHODS: We measured the complement system's activities (CH50 and AP50) as well as its various components (C1q,r,s, C2-C9, Factor B, and properdin) in 25 preterm infants [gestational age (GA) 28-33 weeks], 35 preterm infants (GA 34-36 weeks), 50 full-term newborn infants (GA 37-42 weeks), and 49 healthy adults as control subjects. RESULTS AND CONCLUSIONS: The results of these studies are: (i) complement levels and activity were significantly reduced in preterm and full-term neonates when compared with adult levels, with the exception of C7 which was within the normal range in most infants. C8 and C9 were the most markedly reduced at all gestational ages. (ii) Complement levels correlated significantly with gestational age, but not with birth-weight, type of delivery, or gender. (iii) Between 28 and 33 weeks' gestation, there appeared to be almost no development of the complement system.

Adult↗
PubMed1997

Relapsing Henoch-Schönlein purpura associated with a tubo-ovarian abscess due to Morganella morganii.

Henoch-Schönlein purpura is the most common vasculitis in children. It is frequently preceded by either viral or bacterial infections of the upper respiratory tract. We present a 15-year-old female who developed recurrent episodes of Henoch-Schönlein purpura. Eventual investigation of the patient's abdominal pain, initially attributed to vasculitis involving the gastrointestinal tract, revealed a left tubo-ovarian abscess caused by Morganella morganii. Salpingo-oophorectomy resulted in complete remission of the disease process.

Abscess↗
PubMed1996

[A case of Job's syndrome].

An 8-year-old boy had been followed in our clinic for recurrent abscesses of his thigh and buttocks. Serum levels of IgE greater than 2000 IU/ml and impaired leukocyte chemotactic response led to the diagnosis of Job's syndrome (hyperimmunoglobulin E syndrome), which is characterized by markedly elevated serum IgE, impaired neutrophil chemotaxis, chronic dermatitis, and recurrent pyogenic infections. Children with this syndrome are much more likely to develop opportunistic infections. An accurate etiological diagnosis and treatment of this specific infection in these children is mandatory. We report the first successful treatment of this syndrome with cyclosporin A. We therefore suggest that to diagnose this syndrome, quantitative IgE levels be routinely performed in children with recurrent skin or other suppurative infections.

Child↗
PubMed1996

Treatment of hemangiomas of infants with high doses of prednisone.

OBJECTIVE: We reviewed our experience with the use of oral corticosteroid therapy in treating hemangiomas of infants to determine the optimal effective dose. STUDY DESIGN: During a 24-year period, 60 infants with hemangiomas were treated with an initial dose of either 3 or 5 mg/kg per day of orally administered prednisone for a period ranging from 6 to 12 weeks. Involution of the hemangioma and re-growth. were monitored. RESULTS: Overall, excellent and rapid results were achieved in 68% of infants and good results occurred in 25%. In 7% treatment was deemed to have failed. Forty-seven of 60 patients received one course of therapy, 8 received 2 courses, and 5 required 3 courses. An initial dose of 5 mg/kg per day oral prednisone therapy was more effective than 3 mg/kg per day. Side effects were not serious and resolved after discontinuation of therapy. CONCLUSIONS: High oral doses of corticosteroids (5 mg/kg per day prednisone) provide an effective, rapid, and safe modality of treatment of hemangiomas of infants. We recommend that treatment continue for 6 to 8 weeks, and in more severe cases for as long as 12 weeks.

Administration, Oral↗
PubMed1996

Childhood brucellosis in Israel.

BACKGROUND: Brucellosis has become a major medical problem in Israel particularly in the Muslim Arab population. METHODS: Eighty-eight children with acute brucellosis are described. Sixty-seven were studied retrospectively during 1987 through 1988, and 21 children were studied prospectively during 1989 through 1992. Epidemiologic, clinical and laboratory features were evaluated, and the outcome of 4 antimicrobial regimens are compared. RESULTS: Although the clinical manifestation varied, the classical triad of fever (91%), arthralgia or arthritis (83%) and hepato- and/or splenomegaly (63%) characterized most patients. Sixty-one percent of the children had elevated liver enzymes. Brucella melitensis was isolated from 61% of blood cultures. The relapse rate in patients who were treated with monotherapy (doxycycline) was 43% compared with 14% with regimens of combined therapy with rifampin and doxycycline, streptomycin and doxycycline or rifampin and trimethoprim-sulfamethoxazole (P < 0.049). Eleven children (33%) who were treated for 3 weeks had relapse compared with 1 patient (3.5%) treated for 4 weeks or longer. The total relapse or reinfection rate was 20%. All patients with relapse recovered after a second course of antibiotic therapy. During the 2 years of follow-up one child progressed to chronic osteomyelitis. CONCLUSIONS: Combination therapy and extending treatment for 4 weeks or longer gave significantly better results than monotherapy or shorter courses of therapy and resulted in fewer relapses.

Adolescent↗
PubMed1996

Eosinophilic pustular folliculitis (Ofuji disease) in a child.

Eosinophilic pustular folliculitis (EPF) has been described mostly in adults from Japan. From the few reports of children with EPF it is clear that the disease displays the characteristic features, with some clinical differences compared to EPF in adults. We describe the case of an 8-year-old boy with multiple vesicles, pustules, and erythema multiforme-like lesions on the trunk and lower extremities. Results of histopathologic examination revealed subcorneal and intraepidermal pustules, and an inflammatory infiltrate consisting of lymphocytes and eosinophils mainly with a perifollicular distribution. The patient also had impaired chemotaxis, IgG3 subclass deficiency, and elevated IgE levels.

Age of Onset↗