PubMed Health⌕ Search

Biomedical subjects

L Lazar

Publications and source records attributed to L Lazar.

At least 55 records · Page 3Linked to original sources
PubMed1993

Phototherapy for neonatal nonhemolytic hyperbilirubinemia. Analysis of rebound and indications for discontinuing therapy.

Phototherapy, an effective treatment for neonatal indirect hyperbilirubinemia, has guidelines for its initiation but none for its discontinuation. In our study, phototherapy was begun at a mean age of 90 hours in 28 full-term and 30 preterm infants with indirect nonhemolytic hyperbilirubinemia. After three days, phototherapy was halted at a mean bilirubin concentration of 13.0 +/- 0.7 mg/dL in term and 10.7 +/- 1.2 mg/dL in preterm infants, levels higher than those used by other investigators. Bilirubin rebound then occurred at a mean of 12.5 hours to a level of 0.86 +/- 1.0 mg/dL in term and at a mean of 14.1 hours to a level of 0.83 +/- 0.56 mg/dL in preterm infants. No complications were observed nor was there a need for reinstitution of phototherapy. Based on these data, discontinuation of phototherapy at higher bilirubin concentrations and earlier home discharge than previously described appear harmless for both term and preterm neonates.

Bilirubin↗
PubMed1993

The value of ultrasound in the diagnosis of congenital hypertrophic pyloric stenosis.

The charts of 103 children with a clinically and surgically confirmed diagnosis of congenital hypertrophic pyloric stenosis were retrospectively reviewed. We found a significant correlation between sonographic and surgical measurements of the muscular thickness of the pylorus (r = .987, P < .001). In 73.7% (76 cases), the clinical picture of gastric outlet obstruction was present when the thickness of the enlarged pyloric muscle was 3.0 mm or more. In 26.3% (27 cases), the pyloric muscle was less than 3.0 mm wide. For 10 patients in whom the muscle width was less than 2.5 mm by sonography, a barium meal was necessary to confirm the diagnosis. The width of the pyloric muscle is the most important factor in the sonographic diagnosis of pyloric stenosis, and even a width of less than 3.0 mm may be associated with clinically significant obstruction.

Female↗
PubMed1992

[Retrorectal cystic hamartoma].

The pathogenesis of retrorectal cystic hamartomas in the presacrococcygeal space, while known to be related to embryological remnants of the caudal region, is controversial. These lesions are rarely found in children; in the early stages of their development they may be symptomless. Diagnosis is usually made when the tumor is large enough to cause pain or intestinal obstruction, or when it becomes infected. A 2-month-old girl with a retrorectal cystic hamartoma initially treated as a perianal abscess is presented.

Cysts↗
PubMed1991

[Vascular injuries in children].

Vascular trauma in children differs in some respects from that in adults. In infants and children the total blood volume is smaller, and despite effective compensatory mechanisms, critical blood loss is also smaller. Gentle and meticulous technical skill is needed to correct injuries of minute vessels and allow adequate blood flow. The use of synthetic tubes and materials is not recommended, as they do not lengthen as the child grows. Ischemia is a major factor influencing limb growth and function. 3 different types of vascular injuries operated on in the past year are presented.

Blood Vessels↗
PubMed1991

[Conservative treatment of splenic and liver injuries in children].

Operative and conservative management of 44 children with injuries of the abdomen are reviewed retrospectively. Conservative treatment is well accepted for splenic injury. 12/26 children were thus treated during the period 1984-1988, and in the same 5 years, 9/18 children with hepatic injury were also treated conservatively. Indications for operation in splenic and liver injuries are: hemodynamic instability, evidence of associated severe intra-abdominal injuries, and blood transfusion of over 40 ml/kg during the resuscitation period. There was no mortality nor morbidity related to nonoperative management.

Child↗
PubMed1990

Neonatal ABO incompatibility. Complicated by hemoglobinuria and acute renal failure.

The authors present two infants with isoimmune hemolytic disease due to ABO incompatibility complicated by massive hemoglobinuria and secondary acute renal failure. This represents an incidence of 0.36% of all neonates with ABO hemolytic disease in the author's newborn population. Only two patients have been reported previously to have similar complications. Analysis of data of these four infants revealed the clinical characteristics of this complication of ABO incompatibility: 1) very low frequency; 2) early onset of hemoglobinuria (first voided urine) and of acute renal failure (first 2 days of life); 3) lack of correlation between the clinical presentation of hemolytic disease and appearance and severity of renal failure; 4) complete recovery of renal functions following intravenous fluid administration; and 5) normal renal radiologic investigations.

ABO Blood-Group System↗
PubMed1989

Serum growth hormone binding protein activity in healthy neonates, children and young adults: correlation with age, height and weight.

Serum growth hormone binding protein (GHBP) activity was estimated in healthy neonates (n = 6), children and adolescents (n = 97) and young adults (n = 19). GHBP activity was measured by incubating 125I-hGH (human growth hormone) (approximately 25,000 c.p.m.) with serum (100 microliters) in the presence and in the absence of excess unlabelled hGH, followed by separation of specifically bound 125I-hGHBP complexes from free 125I-hGH by gel filtration on Ultrogel AcA44 minicolumns. The results are expressed as the percentage specific binding relative to an adult reference serum (%RSB), after correction for endogenous hGH of the unknown serum. The between-assay coefficients of variation for two sera of %RSB activity of 51.2 and 115.4% were 6.0 and 7.0% respectively. In neonates, low values of serum GHBP were found (%RSB = 27.1 +/- 5.0 SEM) followed by a major rise during the first 6 years of life to a mean value (%RSB = 68.3 +/- 4.1 SEM) which more than doubled that of neonates. Thereafter, values rose progressively throughout childhood and puberty to reach maximum values in young adults (%RSB = 95.0 +/- 3.1 SEM). A novel observation was that serum GHBP activity correlated significantly with height standard deviation score (SDS) (males: r = 0.77, P less than 0.001; females: r = 0.56, P = 0.01) and weight SDS (P less than 0.001) for both sexes before puberty. During puberty GHBP correlated only with weight SDS in males (r = 0.60, P less than 0.01). In all age groups studied, no correlation could be found between serum GHBP and height velocity.

Adolescent↗
PubMed1984

Muscle changes in venous insufficiency.

The diagnosis of venous insufficiency and hypertension was established in 53 patients using standard diagnostic methods including ascending and descending venography, venous pressure measurements, and photoplethysmography. Autogenous vein valve transplant, which is gaining acceptance as a treatment for this condition, was employed in this group of patients to relieve venous valvular insufficiency. Biopsy specimens of the gastrocnemius muscle were obtained before surgery in all 53 patients and studied pathologically. Three types of morphologic injury were encountered, suggesting that disuse, denervation, and ischemia may each be partially responsible for damage in skeletal muscle subjected to venous insufficiency and hypertension. Skeletal muscle injury probably explains the preoperative elevations of serum creatine kinase levels in many of our patients and may account for the failure of venous pressures to return to normal levels following surgery.

Biopsy↗
PubMed1983

Viral pollution of some artificial reservoirs in Romania.

Five reservoirs were investigated for the presence of enteroviruses by using simultaneously two methods for concentration (PE60 and yeast cells) and two techniques for isolation (inoculation into suckling mice and into cell cultures). The average rate of virus positive samples was lower in reservoir water than in the water of the adjoined rivers. The paper discusses the possibilities of viral self-purification in reservoir water and the advantages of its use for drinking purposes after adequate treatment.

Animals↗
PubMed1982

Status of vein valve transplant after 12 months.

Sequelae of the postphlebitic syndrome can now be treated by direct valve surgery. However, present surgical treatment of stasis ulcer, including removal of the incompetent communicating veins, ulcer excision, and skin grafting, remains essential to patient care. When done alone, perforator interruption and ulcer care are effective but allow a high rate of ulcer recurrence. Experimental studies to restore venous valve function have included autogenous vein valve transplantation, and synthetic valve procedures also have been tried. Clearly, the patency rate of an autogenous vein graft is better than any other procedure. Operations were done in 11 patients using an autogenous vein valve from the upper extremity to restore a normal-functioning venous valve in the lower extremity. Data on preoperative and postoperative measurements and ascending and descending venography indicate hemodynamic improvement of venous function in these extremities.

Adult↗
PubMed1982

Surgical treatment of post-phlebitic syndrome.

The post-phlebitic syndrome which succeeds deep vein thrombophlebitis may be treated by various surgical interventions. Removal of incompetent perforating veins and excision of any concomitant skin ulcer with grafting is a usual course of therapy. However, if the skin ulceration and symptoms are actually due to deep venous incompetence then a more direct approach should be attempted. Numerous procedures have been advocated, such as valvoplasty, homologous vein transplant, synthetic valve procedures and autogenous vein valve transplant. It has been demonstrated that autogenous vein valve transplant yields a satisfactory haemodynamically stable result with high valve competency rates. The authors have operated on 10 patients utilizing an autogenous vein valve with good results. Pre- and postoperative data including ascending and descending venography indicate that valvular competence is restored and ulcers heal.

Adult↗
PubMed1982

Surgical treatment of postphlebitic syndrome with vein valve transplant.

Sequelae of the postphlebitic syndrome can new be treated by direct valve surgery. The present surgical treatment of stasis ulcer, including removal of the incompetent perforators, ulcer excision, and skin grafting, remains essential. Excision of perforators and ulcer care are effective but are associated with a high rate of ulcer recurrence. Experimental studies to restore venous valve function include autogenous or homologous vein valve transplantation, valvuloplasty, and valve transposition. In 23 cases of vein valve transplantation and two transpositions, a normal autogenous vein valve from the arm was used to restore a normal functioning venous valve in the leg. Pre- and postoperative noninvasive and invasive testing indicates hemodynamic improvement of venous function in these legs. Follow-up direct venous pressure measurements did not show normalization and may indicate that more than one competent valve is necessary. Changes in muscle structure may play a role in the maintenance of venous pressure.

Adult↗
PubMed1982

Vein valve transplant.

The sequelae of deep vein thrombophlebitis, such as postphlebitic syndrome with or without ulcer, can be treated by direct surgery on the valve. The present surgical treatment of stasis ulcer includes removal of the incompetent communicating veins with excision of the ulcer and skin graft. If this operation is performed on patients who actually have deep venous incompetence, then a high incidence of reulceration and skin graft slough may be expected if there is no concommitant correction of deep venous incompetence. Experimental studies to restore venous valve function such as autogenous vein valve transplant, valvoplasty, homologous vein transplant, and synthetic valve procedures have been tried. It has been shown that with autogenous vein graft there are a lower incidence of thrombosis and a more effective restoration of valve competency than with other procedures. We operated on six patients utilizing an autogenous vein valve from the upper extremity to achieve hemodynamically functioning venous system of the lower extremity. Data on pre- and postoperative noninvasive evaluations and ascending and descending venography with the results of surgery will be discussed.

Adult↗