Biomedical subjects
Publications and source records attributed to J Amir.
During a mumps outbreak between 1987 and 1988, six children presented with symptoms of acute cerebellar involvement as the sole neurologic complication. The neurologic symptoms followed parotitis and lasted for up to 3 weeks. Serologic evidence was suggestive of recent mumps infection. Symptoms spontaneously resolved in all patients without any residual signs or symptoms during 2- to 2.5-year follow-up.
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A 52-year-old man who presented symptoms compatible with paraneoplastic limbic encephalopathy (PLE) was found to have small cell lung cancer. Antineoplastic therapy resulted in complete remission. Because the neuropsychiatric symptoms are potentially reversible, it is important to recognize these symptoms as a manifestation of malignancy so that treatment can be instituted.
The possible association of urinary tract infection (UTI) with ritual circumcision on the eighth day of life was studied by analyzing the epidemiology of urinary tract infections during the first year of life in 169 children with UTI (56 males and 113 females) born in Israel from 1979 to 1984. Forty-eight percent of the episodes of UTI occurring in males appeared during the 12 days following circumcision, and the increased incidence during that period was highly significant. The median age of the males at the time of the UTI was 16 days, compared with seven months in females. Ritual Jewish circumcision as practiced in Israel may be a predisposing factor for UTI during the 12-day period following that procedure.
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The prevalence of asthma in 2,160 schoolchildren from Arab and Jewish rural and urban communities in central Israel, was determined by means of questionnaire. For the purposes of the study, asthmatic children were defined as those suffering from two or more asthmatic episodes which had been diagnosed by their physicians and had necessitated anti-asthmatic therapy. Doubtful cases were classified after personal interviewing and physical examination. The overall prevalence of asthma was 6.38%. In the Arab rural sample, it was 2.86%, significantly lower than the other groups studied: Arab urban 6.63% (P < 0.001), Jewish urban 9.2% and Jewish rural 8.66% (P < 0.001). The relatively low prevalence in the Arab rural sample is in accordance with the rarity of asthma reported from less advanced societies in other countries. The reasoning for the low asthmatic morbidity found in this group is not clear.
Jaundice associated with breast feeding is a frequent problem facing the paediatrician. Despite numerous reports on this subject, the natural history, familial occurrence and late neurodevelopment of children with breast milk jaundice remain unclear. The follow up of 60 infants with breast milk jaundice showed that there are two bilirubin peaks, on the 4th and 5th day and on the 14th-15th day of life. In the infants with uninterrupted breast feeding, the hyperbilirubinaemia disappeared slowly and could still be detected 12 weeks after birth. The familial incidence of 13.9%, indicating that in some cases a unique genetic factor is expressed. Late neurodevelopment or hearing defects were not observed, thus enabling the paediatrician to encourage continuation of breast feeding in most cases of healthy infants with breast milk jaundice.
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Disk inflammation in children is believed to result from infection, and Staphylococcus aureus is reported to be the organism most commonly isolated from cases of intervertebral disk infection. A case of disk inflammation caused by the unusual pathogen Kingella kingae is described. The antibiotic susceptibility of other K. kingae isolates and the clinical features of 11 other previously reported cases of disk infection caused by this microorganism are reviewed.
Complement-mediated bactericidal and opsonic activity of IgG1 and IgG2 antibodies to Haemophilus influenzae type b polysaccharide (polyribosyl ribitol phosphate [PRP]) were investigated. The antibody sources were IgG1 or IgG2 subclass polyclonal antibody fractions prepared by immunoabsorption of sera from adults immunized with PRP or PRP-diphtheria toxoid conjugate vaccine or clonally purified anti-PRP antibodies from eight adults immunized with PRP vaccine. In bactericidal assays using an inoculum of 3 x 10(3) colony-forming units (cfu)/ml, twofold lower concentrations of IgG1 compared with IgG2 antibody were required for 50% killing. With approximately 10(6) cfu/ml, IgG1 antibody killed 3 logs more of bacteria than were killed by comparable concentrations of IgG2 antibody. The IgG1 antibody also required lower concentrations of complement than did the IgG2 antibody for comparable bacteriolytic activity. Clonally purified IgG1 and IgG2 anti-PRP antibodies from most individuals showed similar relative differences in bactericidal activity. IgG1 anti-PRP antibody was also more efficient than IgG2 anti-PRP antibody in enhancing the uptake of radiolabeled type b H. influenzae by human polymorphonuclear leukocytes in the presence of complement and in protecting infant rats from developing bacteremia. However, the differences in opsonic or protective activity of the two subclasses were smaller than the differences in bactericidal activity. Thus, IgG1 anti-PRP antibody is functionally more effective than IgG2 antibody, but it is likely that both subclasses can confer protection against disease.
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Sera from 3 of 30 adults vaccinated with Haemophilus influenzae type b polysaccharide vaccine (Hib PS) had poor complement-mediated bacterial activity despite the presence of anti-Hib PS antibody concentrations of 8.6 to 20.5 micrograms/mL. These "nonkiller" antibodies killed less than 0.4 log cfu/mL compared to greater than 3 logs with all but one of the other sera. To investigate the basis of this poor functional activity, we characterized in detail the IgG antibodies to Hib PS present in two of the nonkiller sera, and compared the results with two of the "killer" sera. The latter were selected based on comparable levels of total antibody to Hib PS. No consistent differences were found between the relative proportions of IgG or IgA antibody to total anti-Hib PS antibody, or the respective ratios of IgG1 to IgG2 antibody in the nonkiller and killer sera. IgG fractions, and IgG affinity purified antibody to Hib PS were prepared. When tested at 2 micrograms/mL of antibody, the IgG fractions from the two nonkiller sera had much lower bactericidal activity than the corresponding fractions from the killer sera (3 logs less killing), and the former also had lower complement-mediated opsonic activity (20 and 13% uptake by human PMN compared to 62 and 93%). These data show the striking variability in the functional activity of vaccine-induced antibody to Hib PS. Antibody functional activity is likely to be affected by a number of factors but one important variable appears to be avidity since the IgG anti-Hib PS antibody from the two nonkiller sera had 2- to 5-fold lower avidity than the IgG antibody from the two killer sera.(ABSTRACT TRUNCATED AT 250 WORDS)
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Hypocalcemia (HC) is a frequent complication of neonatal polycythemia (NP): 9.93% in the present study. Its pathogenesis is not clear. We suggest that one of the main pathogenetic explanation of HC in NP is the high level of phosphate significantly different (P less than 0.01) than serum phosphate of normal normocalcemic non-polycythemic newborns. The intense postnatal erythrocyte breakdown will increase the serum level of phosphate. This hyperphosphatemia will decrease calcium ion concentration by their combination and bone deposition, a process allowed by inadequate postnatal parathyroid gland response.
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