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Biomedical subjects

I Shohet

Publications and source records attributed to I Shohet.

17 recordsLinked to original sources
PubMed1988

Cyclophosphamide in treatment of minimal change nephrotic syndrome.

Nineteen children with the minimal change form of nephrotic syndrome were divided according to their pattern of response to prednisone: steroid-dependent and frequent relapsers. All patients received cyclophosphamide for 56 days in a single daily dose of 2.5 mg/kg (total 140 mg/kg), in order to prolong the length of remission. The percentage of patients who continued in remission at the end of the 1st, 2nd and 5th years was greater in the frequent-relapser group. This retrospective analysis confirms that the pattern of response to prednisone may be an important criterion for the selection of patients who will benefit from cyclophosphamide therapy.

Adolescent↗
PubMed1987

Cardiovascular complications in the Ehlers-Danlos syndrome with minimal external findings.

Ehlers-Danlos syndrome (EDS) is clinically and genetically a heterogeneous disorder of connective tissue. Eleven different types of EDS have been documented, several of which have major cardiovascular complications as part of their clinical manifestations. The purpose of this report is to call attention to a form of EDS with minimal external features but severe internal vascular complications.

Aneurysm↗
PubMed1987

Pharmacokinetics and therapeutic efficacy of gentamicin in an experimental pleural empyema rabbit model.

The pharmacokinetics and therapeutic efficacy of gentamicin were investigated in an experimental pleural empyema rabbit model. Pleural effusion was induced by the intrapleural administration of turpentine, and empyema was induced by direct inoculation of the effusion with Klebsiella pneumoniae. Pleural empyema compared with effusion was characterized by lower pH, oxygen tension (PaO2), and glucose levels and higher leukocyte count, lactic acid concentration, and PaCO2. After a single administration, gentamicin was first detectable in the pleural fluid at 60 min, whereas peak levels in empyema were observed at 180 min. Gentamicin persisted in the empyema longer than in blood. Animals treated with gentamicin only had 60% bacterial cure on day 7; those treated with gentamicin in an oxygen chamber had 100% cure on day 5 (P = 0.004). Low oxygen tension diminished the antibacterial efficacy of gentamicin in this model. An increase in oxygen tension improved the therapeutic results without alteration of the pharmacokinetics of gentamicin.

Animals↗
PubMed1985

Analysis of thirty-seven cases of pleural empyema.

A retrospective analysis of 37 pediatric patients with pleural empyema revealed that Streptoccoccus pneumoniae was the most frequently isolated pathogen (41%), followed by Staphylococcus aureus (14%). Twenty-three patients were treated with thoracic drainage and systemic antibiotics, and the other 14 patients with antibiotics only. The case fatality ratio (11%), the complication rate (38%), the length of hospital stay, and the number of febrile days did not differ significantly between the two treatment groups. The immediate insertion of drainage tubes is probably not indicated in all children with pleural empyema but should be reserved for specific indications.

Adolescent↗
PubMed1985

Diagnosis of bacterial meningitis in previously treated children.

We reviewed the charts of 115 children with the clinical diagnosis of bacterial meningitis admitted to our hospital over a period of eight years. Of these, 47 patients had received antimicrobial agents before hospitalization and eight (17%) of them had negative cerebrospinal fluid (CSF) cultures. These eight children, however, had CSF features suggestive of bacterial meningitis. We conclude that prior antimicrobial therapy does not alter the chemical properties of CSF, the response to pharmacologic agents, or the ultimate outcome, even though previously treated children may have lower rates of positive CSF and blood cultures.

Adolescent↗
PubMed1984

Familial persistent pulmonary hypertension.

We report three siblings who presented with a clinical picture of persistent pulmonary hypertension of newborn and died between 4 and 15 days of age. Pulmonary artery pressure in all was above systemic values, with a right to left shunt via either the foramen ovale or ductus arteriosus, or both. Histology of the pulmonary vascular bed showed extension of muscle into small arteries which are normally non-muscular.

Female↗
PubMed1983

Postoperative catheterization and prophylactic antimicrobials in children with hypospadias.

A prospective study of 78 children who underwent 84 operations for correction of hypospadias was done. Of these, 54 had a transperineal indwelling Foley catheter for ten days after surgery and 30, a transurethral catheter. Forty-five randomly selected children received prophylactic antimicrobial therapy (sulfamethoxazole), and the remaining 39 children served as controls. Incidence of urinary tract infection was significantly higher in the control group (10 of 39) as compared with the treated group (3 of 45) in spite of the higher incidence of vesicoureteral reflux in the treated group. This suggests that prophylactic antimicrobial treatment may prevent urinary tract infection from prolonged indwelling catheterization.

Catheters, Indwelling↗
PubMed1983

Pre-excitation syndrome in infants and children. Effect of digoxin, verapamil, and amiodarone.

Clinical and electrocardiographic findings for 30 patients with the pre-excitation syndrome are described together with details of treatment. Nineteen (63%) were younger than 2 years, 14 of whom were under 2 months. Sixteen infants and 7 children (77%) presented with paroxysmal supraventricular tachycardia, 14 (61%) of whom had the electrocardiographic pattern of type A Wolff-Parkinson-White (WPW) syndrome. During paroxysmal bouts the QRS complex was normal in 21 patients and wide in two. Six (20%) patients had congenital heart disease often associated with WPW syndrome type B. Seventeen patients were treated with either digoxin or verapamil intravenously to stop tachyarrhythmias. Verapamil was more effective due to the immediate response and lack of adverse effects. The tachyarrhythmias resolved in all the patients and in some of them the WPW pattern resolved later indicating maturation of the conduction tissue with loss of the accessory pathways. Verapamil provides a rapid and safe form of treatment for conversion of tachyarrhythmias since it has no effect on the accessory pathways. Oral amiodarone prevents recurrent tachyarrhythmias resistant to other treatment.

Adolescent↗
PubMed1983

Endogenous endophthalmitis due to Salmonella typhimurium.

Endogenous endophthalmitis due to Salmonella typhimurium is reported in a 1-year-old child. Despite vigorous antibiotic therapy, the child's vision deteriorated, and loss of light perception occurred in the infected eye. Endophthalmitis is a very rare complication of salmonellosis, and it should alert physicians because of its severe damage to the eye.

Endophthalmitis↗
PubMed1983

Elevated risk of osteoarticular complications in children with acute Brucella melitensis infection.

Infection with brucella microorganisms is considered uncommon in the paediatric age group. We report nine paediatric patients between the ages of 8 to 17 years with acute Brucella melitensis infection, who presented with spiking fever, night sweats, anorexia and malaise for 5 to 60 days prior to diagnosis. Four patients developed various osteoarticular complications: migratory arthralgia, hydroarthrosis of the knees, arthritis and osteomyelitis. Therapy with tetracyclines alone or in combination with streptomycin resulted in complete recovery in eight children. This combination failed in one patient who developed severe osteoarticular disease successfully responding to rifampicin. Since infection of bone and joints leads to irreversible damage, early recognition and immediate management are crucial for recovery. Rifampicin might be of benefit in children with severe osteoarticular complications when the traditional anti-brucella regimen fails.

Adolescent↗
PubMed1982

Bacterial meningitis. A follow-up study of 115 children.

The clinical and laboratory date on 115 pediatric patients with bacterial meningitis are presented. Sixty-one were less than 12 mo of age including 13 less than 1 mo of age. Thirty-nine children were treated prior to admission with antimicrobial agents which obscured accurate bacteriologic diagnosis in eight of them. Gram-negative enteric bacteria, mainly Escherichia coli, were recorded in 9 of 13 neonates. Hemophilus influenzae type B accounted for 56 (52%) of all isolated recorded in those greater than 2 mo of age, of which 35% were resistant to chloramphenicol. Seventy-eight patients (73%) recovered completely following 10 to 14 days of antimicrobial therapy. Fifteen patients died, most of whom were less than 1 yr of age, including five neonates. Major neurologic sequelae included subdural effusions, cerebral abscesses and recurrent convulsions. This study, which documents the infrequency of Streptococcus group B and H. influenzae as etiological agents of neonatal meningitis, indicates that treatment of this disease with ampicillin and an aminoglycoside is efficacious. Chloramphenicol may be the drug of choice in the postnatal period, since H. influenzae is partly resistant to ampicillin.

Aminoglycosides↗