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Biomedical subjects

D Balsam

Publications and source records attributed to D Balsam.

At least 19 recordsLinked to original sources

Abnormally small adenoids in HIV-infected children.

A number of diverse head and neck manifestations of HIV infection have been described, including adenoidal hypertrophy. We report a series of HIV-infected children in which 9 of 18 had abnormally small or radiographically absent adenoidal tissue. This finding did not, however, seem to correlate with several parameters for the severity or stage of illness.

Adenoids↗

Candida epiglottitis presenting as stridor in a child with HIV infection.

Invasive laryngeal candidiasis is an uncommon cause of epiglottitis, seen most often in immunocompromised or antibiotic-treated patients. We present the clinical and radiographic findings in an HIV-infected infant who developed significant stridor due to candidal epiglottitis. Stridor or hoarseness of unknown cause in an immunocompromised patient should lead to prompt evaluation for opportunistic laryngeal infection.

Acquired Immunodeficiency Syndrome↗

Two smooth muscle tumors in the airway of an HIV-infected child.

Tumors of smooth muscle origin are rare in childhood. We report a case of multiple bronchial leiomyomata in a seven year old girl with clinical HIV infection who presented with new onset of wheezing. Clinical details of this case have been published elsewhere, but without imaging studies [1].

Acquired Immunodeficiency Syndrome↗

The sonographic appearance of the hemorrhagic ovarian cyst in adolescents.

Pelvic sonography was performed on ten teenaged girls who were proven by surgery to have hemorrhagic ovarian cysts. Pathologically, four were follicular ovarian cysts, while three were corpus luteal cysts, and the exact nature of three was undetermined. At sonography, these masses had variable appearances, ranging from anechoic to moderately echoic with septa and thick walls. All these features are nonspecific and can be encountered in other adnexal masses. The changing sonographic appearance of the hemorrhagic ovarian cyst due to clot lysis is helpful in establishing the diagnosis, and was demonstrated in two cases. These ten cases are discussed, the varied sonographic appearances are described and a review of pertinent literature is included.

Adolescent↗

Scrotal migration of ventriculoperitoneal shunts.

Ventriculoperitoneal diversion of cerebrospinal fluid in infants and children with hydrocephalus has become the procedure of choice over the last 15 years. It has replaced ventriculoatrial shunts, resulting in a marked decrease in the complication rate after such procedures. Four cases of migration of the shunt tip through patent processus vaginalis resulting in scrotal hydrocele are presented.

Cerebrospinal Fluid Shunts↗

Atypical measles syndrome: pathologic and serologic findings.

The clinical course of measles occurring in 17 adolescents who had previously received killed measles vaccine is described. All adolescents had a peripheral dermatitis. Fifteen had characteristic pulmonary infiltrates. Serologic study in six adolescents using immunoprecipitation of 35S-methionine-labeled measles virus antigens revealed that 5/6 acute sera lacked antibody to the hemolysin antigen whereas 5/6 sera contained antibody to hemagglutinin antigen. Skin biopsies, obtained from three patients, demonstrate a combination of an Arthus reaction and delayed hypersensitivity. The typical measles histologic complex was absent. Measles virions were seen in the deep dermal blood vessels. The serologic and histopathologic presentation of this disease indicates that killed vaccine does not adequately induce antibody to the hemolysin (F) which is necessary to prevent cell-to-cell spread of paramyxoviruses. Killed vaccine does, however, produce hemagglutinin antibody and simultaneously incites later hypersensitivity to wild virus infection, producing the unusual dermatopathologic reaction seen.

Adolescent↗

Amniography in prenatal diagnosis.

The increasing use of prenatal diagnostic methods, including sonography and amniotic fluid analysis, has made it possible to suspect certain fetal defects at an early gestational age. In selected cases, accurate diagnosis of the specific malformation may have an effect on fetal and neonatal prognosis, and on prenatal counseling of the parents. As part of a large regional screening program for neural tube defects, we performed 28 midtrimester amniograms. We found 14 neural tube defects (nine spina bifida, four anencephaly, one Meckel syndrome), four abdominal wall defects, two tumors, and eight normal examinations. Radiographic examples of these malformations are presented, including previously undescribed findings in meningomyeloceles. The place of amniography in prenatal diagnosis is discussed.

Abdominal Muscles↗

Bone scintigraphy for neonatal osteomyelitis: simulation by extravasation of intravenous calcium.

Intravenously administered calcium gluconate has become increasingly popular in the treatment of neonatal tetany. Occasionally, extravasation results in cellulitis, leading to a clinical diagnosis of superimposed osteomyelitis. Osseous scintigraphy, as the accepted modality in the early detection of osteomyelitis, would tend to be used in this circumstance. This case illustrates a false-positive result, probably due to soft-tissue calcification.

Bone and Bones↗

Haemophilus influenzae sepsis leading to pericarditis despite antimicrobial therapy.

Acute purulent pericarditis is a well-recognized, though infrequently seen, manifestation of systemic Haemophilus influenzae type b disease. We recently studied two pediatric patients who developed signs of this septic complication during appropriate antibiotic treatment for bacteremia. These case reports should alert physicians to the possibility that pericarditis may become clinically evident in patients with systemic H. influenzae infections many days after initiation of appropriate therapy. The pathophysiology, diagnostic modalities and therapy are briefly reviewed.

Ampicillin↗

Early prenatal diagnosis of soft-tissue malformations.

This study presents 3 cases of severe soft-tissue malformations of the fetus. Prenatal diagnosis was established early in the second trimester, and the accuracy of the diagnosis was confirmed by pathological examination in each instance. A clinically oriented work-up plan for early prenatal diagnosis is proposed.

Adult↗