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Biomedical subjects

G Alpert

Publications and source records attributed to G Alpert.

At least 37 records · Page 2Linked to original sources
PubMed1986

A practical guide to the diagnosis of congenital infections in the newborn infant.

Every attempt should be made to identify an etiologic agent in infants with suspected congenital infection. Some of the infections are treatable, such as herpes simplex, syphilis, and toxoplasmosis. For other infectious agents (i.e., CMV and rubella), close follow-up will enable early detection of hearing impairment and permit early educational intervention. In addition, appropriate isolation measures will reduce the risk of nosocomial infections due to herpes simplex, rubella, hepatitis B, and CMV. Rational use of the available diagnostic tools will enable detection of most symptomatic congenitally infected neonates at a reasonable cost.

Antibodies↗
PubMed1986

Direct measurement of TP/GFR: a simple and reliable parameter of renal phosphate handling.

As the Walton-Bijvoet nomogram for estimating renal phosphate (P) threshold (TmP/GFR) is not applicable to children of all ages, we sought an alternative method for measuring renal handling of P. Recognizing that the nomogram represents an indirect correlation between TmP/GFR and TP/GFR under fasting conditions, we examined this directly in 26 children. An excellent correlation was found, expressed as TmP/GFR = (fasting TP/GFR X 1.1) -0.3 (r = 0.95). The regression line in adults, expressed as TmP/GFR = (fasting TP/GFR X 1.4) -0.9 (calculated from published studies) is markedly different at the higher values typical for children. Since no advantage could be seen in the use of a mathematically derived TmP, we investigated the direct use of measured TP/GFR (tubular P reabsorption per 100 ml glomerular filtrate) as a measure of renal P handling in clinical practice. No differences were found between morning fasting and nonfasting values. Measurements in 151 healthy subjects aged 3 days to 53 years established normal values in relation to age. The use of this parameter in patients is shown to accurately reflect defects and changes in renal P handling. We believe it to be the preferred parameter because it represents a directly measured physiologic function applicable to all age-groups.

Adolescent↗
PubMed1986

Outbreak of cryptosporidiosis in a day-care center.

An outbreak of diarrhea due to infection with Cryptosporidium occurred in a day-care center. During a period of 2 months, 23 of 53 (43%) children attending the day-care center and 15 of 104 (14%) household contacts had diarrhea. Cryptosporidium oocysts were identified in 13 of 20 (65%) symptomatic children tested compared with three of 27 (11%) asymptomatic children (chi 2 = 12.56, P less than .001). Enteropathogenic bacteria, enteroviruses, rotavirus, and other protozoan parasites were ruled out as the cause of the diarrhea. A history of diarrhea in household contacts was associated with excretion of Cryptosporidium oocysts by the children. Human-to-human transmission of the infection was suggested by the epidemiology.

Child Day Care Centers↗
PubMed1985

Imipenem/cilastatin for the treatment of infections in hospitalized children.

Imipenem is the first of a new class of beta-lactam antimicrobial agents with potent in vitro activity against most bacterial pathogens that cause infections in children. We studied, prospectively, the clinical efficacy and toxicity of imipenem/cilastatin in 40 children with proved or suspected bacterial infection. A dose of 100 mg/kg/day of imipenem was given to children younger than 3 years of age, while children older than 3 years of age received 60 mg/kg/day. Twenty-nine organisms were isolated from 26 patients. Infections treated included cellulitis, osteomyelitis, septic arthritis, lymphadenitis, renal infections, wound infections, and pneumonia. Bacteria isolated included Staphylococcus aureus, Streptococcus pyogenes, Haemophilus influenzae, and Pseudomonas aeruginosa. All patients responded favorably to treatment, with defervescence and improvement of symptoms. All of the infecting bacteria were susceptible to imipenem. Imipenem/cilastatin was well tolerated, with no serious side effects, and appeared to be an effective and safe antimicrobial agent in the treatment of the population studied.

Arthritis, Infectious↗
PubMed1985

Routine quantitative blood cultures in children with Haemophilus influenzae or Streptococcus pneumoniae bacteremia.

The potential clinical value of quantitative blood cultures determined by a commercially available lysis-direct plating method was studied in 50 children with either Haemophilus influenzae or Streptococcus pneumoniae bacteremia. The magnitude of bacteremia correlated with the severity of the infection; patients with greater than or equal to 100 colony-forming units per milliliter were significantly more likely to have meningitis (P less than .01, chi 2 = 7.5). On the other hand, all patients with S. pneumoniae bacteremia with colony counts lower than 15 colony-forming units per milliliter had "occult bacteremia" with no focus of infection. The data suggest that patients with higher levels of bacteremia have more severe disease. Quantitative blood culture results may be helpful in identifying which children are at risk for invasive disease.

Colony-Forming Units Assay↗
PubMed1984

Vancomycin dosage in pediatrics reconsidered.

Vancomycin hydrochloride levels were studied in 44 children (age range, 10 days to 10 years). These children received doses of vancomycin within current recommendations. Major variations in vancomycin levels were demonstrated in similar age groups and dosage regimens. For patients in the first month of life, second month of life, and older ages, respectively, 70%, 39%, and 30% of the peak determinations and 53%, 50%, and 23% of the trough determinations were greater than the desired level. Potentially toxic levels were found in eight patients.

Age Factors↗
PubMed1984

Osmotic fragility of erythrocytes in newborn infants treated by phototherapy.

In order to determine the in vivo effect of phototherapy on the erythrocytes' osmotic fragility, we have tested 10 preterm infants treated by continuous phototherapy, for jaundice of prematurity. Heparinized blood was obtained daily, starting before the initiation of phototherapy and ending 24 h after stopping the treatment. The osmotic fragility was tested in duplicate immediately, after 1 h incubation at 40 degrees C and after 24 h incubation at 4 degrees C in darkness. The erythrocytes of the preterm infant during and at the end of phototherapy showed a normal osmotic fragility pattern. Comparing the consecutive curves in each infant did not show any population of osmotically differing erythrocytes. Heating or cooling the erythrocytes did not alter these results. It is concluded that phototherapy does not increase the in vivo osmotic fragility of erythrocytes in newborn.

Female↗
PubMed1984

Characteristics of urinary tract infection caused by coagulase-negative Staphylococcus in a group of young women.

Of 147 young women, aged 17 to 34 years, with signs, symptoms and bacteriological evidence of urinary tract infection (UTI), 23 (15.6%) had an infection caused by coagulase-negative Staphylococcus (coag- neg Staph). All patients with coag- neg Staph UTI were sexually active, in contrast to 84.7% of those with UTI of other causes (one-tailed P = 0.03). The former had a higher rate of vaginal discharge (60.9 vs. 25.8% in the latter group, P = 0.003), but fewer of them used tampons as menstrual protection or oral contraceptives. A high percentage of women with coag- neg Staph UTI had commenced sexual activity recently, as compared with the rest of the group (P = 0.03). In a stepwise logistic regression analysis, the only variables that were significantly associated with coag- neg Staph UTI were vaginal discharge and recent onset of sexual activity.

Adolescent↗