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Biomedical subjects

M Lison

Publications and source records attributed to M Lison.

13 recordsLinked to original sources

Atopy, bronchial hyperresponsiveness, and peak flow variability in children with mild occasional wheezing.

BACKGROUND: Children who suffer from recurrent wheezy episodes are often promptly classified as asthmatic. The aim of this study was to evaluate a population of mild wheezy children with repeatedly normal spirometric tests at rest for atopy, bronchial hyperresponsiveness, and peak expiratory flow variability. METHODS: Thirty nine children aged 6-16 years with 1-12 wheezy attacks during the previous year were recruited from a community paediatric primary health care clinic serving an urban Israeli population. The conditions for inclusion were a physician-diagnosed wheeze on auscultation and normal spirometric tests at rest on at least three occasions. Evaluation included skin prick tests for atopy and a physician-completed questionnaire. In addition, two tests of bronchial hyperresponsiveness (BHR) were performed--namely, exercise-induced bronchospasm and inhaled methacholine hyperresponsiveness--as well as diurnal variability of peak expiratory flow (PV). RESULTS: One or more tests of BHR/PV were positive in 27 (69%) but repeatedly negative in 12 (31%). In terms of frequency of wheezing attacks, atopy, and questionnaire responses, there were no differences between BHR/PV and non-BHR/PV children, with the exception of a history of chest radiography proven pneumonia (only noted in the BHR/PV group). Overall, evidence of atopy (mainly indoor allergens) was noted in 21 (56%) of those tested and parental smoking in 29 (74%) of households. Thirty-two (82%) of the children complained of an exercise-related wheeze, yet exercise-induced bronchospasm was only demonstrated in nine (23%). CONCLUSIONS: This selected group of wheezy children appears to be intermediate between a normal and clearly asthmatic population and, despite the recurrent wheezy attacks, some should probably not be classified as asthmatic by conventional criteria. Important aetiological factors in the symptomatology of these children may include parental smoking and atopy as well as other elements such as viral infections.

Adolescent↗

Shigella lipopolysaccharide antibodies in pediatric populations.

Shigellosis is the most common cause of bacterial dysentery. To study the specific immunity to the two major groups causing shigellosis, we assayed antibodies to lipopolysaccharide (LPS) by enzyme-linked immunoadsorbent assay to both Shigella sonnei and Shigella flexneri 2a serotypes in the following populations: (1) women immediately after delivery and their infants to assess the transfer of passive immunity by placenta and the presence of secretory antibodies in breast milk; (2) children of different ages; and (3) the kinetics of antibody production in pediatric patients, who had culture-proved shigellosis. The sera of these women showed variable concentrations of antibodies of all three isotypes to LPS of S. sonnei and S. flexneri 2a. These serotype-specific antibodies were not cross-reactive. Transfer of IgG anti-LPS across the placenta was significantly correlated with concentration of the specific antibody in the mother (S. sonnei, r = 0.96; S. flexneri, r = 0.84). Varying concentrations of anti-LPS IgA were present in colostrum, which was correlated with serum anti-LPS IgA titers in the case of S. sonnei (r = 0.44; P < 0.05) but not S. flexneri (r = 0.17). Healthy children between the ages of 6 months and 4 years in our population had undetectable or relatively low titers of anti-S. sonnei IgG. More children had detectable antibody titers to S. flexneri 2a than to S. sonnei. The relatively high concentrations of these natural antibodies are particularly noteworthy because there is a far lower incidence (< 10% of patients) with S. flexneri than with S. sonnei disease in this population.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Health profile of children without medical insurance].

Lack of medical insurance is a health risk factor. Underutilization or postponement of medical services, as well as lack of planning for long-term care are common among the uninsured, project was implemented within the framework of the Or Yehuda Intervention Program to assess the health status of children from birth to 17 years of age in 72 families without health insurance. Information on medical status and service utilization was summarized for 169 of the 217 children in these families. These families constituted a substantial burden on the health system, both in the form of hospitalization debt (636 hospital-days owed to a nearby hospital) and as uncompensated primary care clinic visits. Half of the visits were made by 12% of the children, while a quarter of the study children had not visited the clinic at all during the preceding year. Among families uninsured for over 2 years, the trend of underutilization was even more pronounced. Significant morbidity and signs of neglect were found among the study children, nearly 60% of whom suffered from health problems and a similar proportion had been hospitalized. The most common diagnoses were infections, congenital anomalies, and musculoskeletal and hematological problems; a third of the children had 2 or more conditions. Over 40% of the study children were referred for specialist consultation or treatment--about half of them to the pediatric subspecialties and the other half to surgical clinics. Signs of medical neglect were noted in 42.6% of study children and among 60.4% of those with 2 or more medical problems.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Injuries in primary care practices.

A study of injuries among 0-15 year old children attending primary care clinics in a low social class and a middle class neighbourhood was carried out during a period of one year. Data were collected in a structured form by the physicians while the patient was in the clinic. The rate of injuries was 121.3/1000 children per year in the clinic from the lower social class neighbourhood and 70.7/1000 children per year in the clinic from the middle class neighbourhood. Injuries in playgrounds, and on pavements and streets occurred in higher proportions in the low social class than in the middle class neighbourhood clinics. The most frequent causes of injuries were falls and being struck and injured by cutting/piercing instruments; these caused mostly contusions and lacerations. The clinic was the first place of treatment in 65% of the cases in the middle class area and in 45% in the lower social class area; 28% and 10% respectively were referred to the hospital for additional treatment. Data from primary care clinics should be considered when estimating the incidence of injuries in the community, in planning intervention programmes, and future research.

Adolescent↗

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↗

A polymorphism of the ability to smell urinary metabolites of asparagus.

The urinary excretion of (an) odorous substance(s) after eating asparagus is not an inborn error of metabolism as has been supposed. The detection of the odour constitutes a specific smell hypersensitivity. Those who could smell the odour in their own urine could all smell it in the urine of anyone who had eaten asparagus, whether or not that person was able to smell it himself. Thresholds for detecting the odour appeared to be bimodal in distribution, with 10% of 307 subjects tested able to smell it at high dilutions, suggesting a genetically determined specific hypersensitivity.

Adolescent↗