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Biomedical subjects

M Phillip

Publications and source records attributed to M Phillip.

At least 91 records · Page 5Linked to original sources
PubMed1989

Virus-specific IgA in serum, saliva, and tears of children with measles.

Measles-specific IgA antibody titres were determined by radioimmunoassay (RIA) for serial serum, saliva and tear samples obtained from 21 children with measles infection, from onset of rash until up to 14 months later. Serum IgA titres rose rapidly after onset of illness and remained detectable throughout the follow-up period. Virus-specific salivary IgA titres peaked at 4 to 7 days after onset of rash and decreased thereafter. Measles-specific lacrimal fluid IgA antibodies remained elevated for long periods of time; however, secretory component-bearing measles-specific antibodies in tears became for the most part undetectable by 1 month after onset of rash. These data raise anew the question of whether some form of viral latency is associated with the presence of virus-specific IgA antibody, or whether such antibody is simply a reflection of immune memory.

Adolescent↗
PubMed1988

Ambulatory care of febrile infants younger than 2 months of age classified as being at low risk for having serious bacterial infections.

We prospectively examined whether febrile infants younger than 2 months of age who were defined as being at low risk for having bacterial infection could be observed as outpatients without the usual complete evaluation for sepsis and without antibiotic treatment. A total of 237 previously healthy febrile infants were seen at the Pediatric Emergency Room over 17 1/2 months. One hundred forty-eight infants (63%) fulfilled the criteria for being at low risk: no physical findings consisting of soft tissue or skeletal infections, no purulent otitis media, normal urinalysis, less than 25 white blood cells per high-power field on microsopic stool examination, peripheral leukocyte count 5000 to 15,000/mm3 with less than 1500 band cells/mm3. One infant appeared too ill to be included, and had sepsis and meningitis. None of the 148 infants at low risk had bacterial infections, versus 21 of 88 (24%) of those at high risk (P less than 0.0001); eight of 88 (9%) had bacteremia. Of the 148 infants classified as being at low risk for having bacterial infection, 62 (42%) were discharged to home, and 72 (49%) were initially observed for less than or equal to 24 hours and then discharged. Seventeen infants (11%) were hospitalized: in six, low risk became high risk; six had indications other than fever; and five because the study physicians could not be found. The 137 nontreated infants were closely observed as outpatients. The duration of fever was less than 48 hours in 42%, and less than 96 hours in 91%. All infants were observed for at least 10 days after the last examination. The fever resolved spontaneously in all infants but two, with otitis media, who were treated as outpatients. Our data suggest that management of fever in selected young infants as outpatients is feasible if meticulous follow-up is provided.

Ambulatory Care↗
PubMed1987

Cellular immunity and T-lymphocyte subsets in young children with acute measles.

The changes occurring in the T-cell subsets during acute symptomatic measles were examined in ten malnourished and 18 well nourished hospitalized children younger than 5 years of age (median age 14 months). A significant decrease in total lymphocyte count was observed, which was due mainly to a decrease in helper/inducer T lymphocytes, whereas the suppressor/cytotoxic T-lymphocyte subset remained unchanged. Consequently, helper/suppressor ratio decreased significantly during the acute phase of the disease. A reduced response to mitogens (PHA, Con A, PWM) was also observed. Malnourished infants showed a trend toward a deeper depression in both helper and suppressor T cells during the acute phase than well nourished children, whereas the helper/suppressor ratio remained similar in the two groups.

Acute Disease↗
PubMed1987

An algorithmic approach to diagnosis of hypoglycemia.

An algorithm has been devised to facilitate the diagnostic approach to the causes of hypoglycemia. This systematic approach enables the physician to reach the final diagnosis in a logical way without subjecting the child to unnecessary and possibly hazardous investigations. The algorithm is based on the following measurements as required by each patient: concentrations of blood glucose, lactate, ketone bodies, and glucose-regulating hormones. These measurements are performed with the patient in the fasting state and after loading tests (glycerol and galactose) as needed. If indicated, an enzymatic test is performed to establish the final diagnosis. Eighteen children aged 1 month to 7 years who had persistent or recurrent hypoglycemia have been examined according to this algorithm. The correct diagnosis was arrived at in 17 patients. The diagnosis was not reached in one neonate who had glucose-6-phosphatase deficiency and initially did not have lactic acidosis; once lactic acidosis developed, his illness fitted perfectly into the algorithm.

Algorithms↗
PubMed1987

Outpatient treatment of serious community-acquired pediatric infections using once daily intramuscular ceftriaxone.

Pediatric patients with serious infections are usually hospitalized for parenteral antibiotic treatment. We studied prospectively 74 pediatric patients with community-acquired serious infections and used once daily intramuscular ceftriaxone. Seventeen patients (23%) were initially hospitalized and 57 (77%) patients were treated entirely as outpatients. An initial intramuscular dose of 75 mg/kg was followed by daily doses of 50 mg/kg (maximum, 1.5 g). Infections treated included periorbital/buccal cellulitis, other cellulitis, urinary tract infections, pneumonia, osteomyelitis, mastoiditis, suppurative arthritis and orbital cellulitis. Organisms were recovered from cultures of 37 (50%) patients and 6 (8%) patients were bacteremic. Bacteria included Gram-positive (mostly Staphylococcus aureus) and Gram-negative (mostly enteric bacilli and Haemophilus influenzae organisms). No serious side effects were observed. Of 74 patients 72 (97%) were cured and improvement was usually observed within 24 hours. Two patients did not improve: one with chronic Pseudomonas mastoiditis; and one with lung abscess. Based on previous experience it is estimated that 376 hospitalization days were saved. All 72 successfully treated patients and their parents resumed normal activity within 72 hours of starting therapy. Our data suggest that ceftriaxone can be used for outpatient treatment of some infectious diseases.

Adolescent↗
PubMed1984

Antigenicity of sperm cells after freezing and thawing.

Freezing and thawing is thought to result in removal of spermatozoal membrane antigens. We investigated the presence of sperm antigens before and after freezing and thawing by means of the immunoperoxidase assay (IPAMA), sperm immobilization test (SIT), and separation of proteins by gel electrophoresis. The results of the IPAMA and SIT assays showed no difference in the membrane antigens before and after freezing and thawing. Analysis of surface proteins by gel electrophoresis demonstrated that freezing and thawing did not remove any particular group of proteins from the surface membrane of spermatozoa. According to the evidence of the three tests performed, there is no meaningful removal of antigens from the sperm cell surface membrane by the process of freezing, preservation, and thawing when carried out by the specific methods used. This work does not support the suggestion that in cases of immunologic incompatibility between spermatozoa and cervical mucus it would be possible to overcome the couple's infertility by employing the process of freezing, preservation, and thawing.

Antigens, Surface↗
PubMed1983

Comparison of post-thaw sperm motility after freezing in liquid nitrogen with protective media of either glycerol or glycerol-egg-yolk-citrate.

Thirty semen samples with a mean prefreezing motility of 70.4% were frozen for 1 month in liquid nitrogen by means of a modified Barkay's method and with either glycerol or glycerol-egg-yolk-citrate (GEYC) as protective media. The post-thaw motility was found to be 37.9% and 30.7% and cryosurvival rate (CSR) was 54.6% and 44.4%, respectively--the difference being significant (P less than 0.05). When samples achieving at least 40% of post-thaw-motility (PTM) in either medium were selected, the mean prefreezing motility increased to a 71.6%, and the PTM and the average CSR were 44.1% and 62.2% and 35.5% and 50%, respectively, when either glycerol or GEYC was used. It appears that glycerol alone is superior to a mixture of GEYC for cryo-preservation of sperm if the technique mentioned above is used and PTM is a criterion for sperm quality.

Citrates↗
PubMed1977

The consequences of early overnutrition for fat cell size and number: the pig as an experimental model for human obesity.

(1) The objectives of these studies were: (a) to determine the period during which fat cells were being formed in different fat depots in the pig; (b) to discover whether total fat cell number could be affected by overfeeding from weaning or later in life, and (c) to examine the domestic pig as a model for human obesity studies especially as to the influence of the energy intake at different stages in life on fat cell size and number. (2) Pigs were weaned at six weeks of age and allocated to one of four diets. Group H was fed to appetite on a high carbohydrate diet and became extremely obese. Group L was fed at half the energy intake of group H; these animals grew steadily but deposited little adipose tissue. Group L-H was fed as group L for 40 weeks and then as group H for the rest of the experiment, while group H-L was fed as group H for 40 weeks and then placed on a very restricted ("slimming") diet for the remainder of the experiment. (3) The volume of fat cells in group H was about four-fold greater than in group L at the end of the experiment. Cell volume increased rapidly when group L was fattened after 40 weeks and could be reduced significantly, albeit slowly, when group H was "slimmed". (4) There was a significant increase in the apparent number of fat cells in the depots of overfed pigs that did not diminish when the animals were "slimmed". However, in restricted pigs subsequently fattened, there was an apparent steady increase in fat cell number that eventually reached the same figure as in pigs overfed from weaning. (5) The standard methodology is inadequate to make broad generalizations about the influence of diet on cellularity. First, the development of fat cell size and number follows different time scales in different depots. It is essential to monitor several sites before attempting to estimate cell number. Secondly, since cells with diameters less than about 15 micrometer are not detected, "empty" cells, containing no fat, may be present from birth: subsequently they may be filled when energy intake is appropriate so that later they become visible, and are recorded as fat cells. In these cases there will be an "apparent" but not a real increase in cell number.

Adipose Tissue↗
PubMedDate not supplied

Lack of birth defects among offspring conceived during or after paternal exposure to dibromochloropropane (DBCP).

The present study describes birth defects and health status of offspring of men with dibromochloropropane (DBCP) induced testicular dysfunction. One case with a major anomaly (urinary bladder extrophy and epispadias) and 2 cases of minor birth defects were observed among the 34 children evaluated. This rate was similar and not significantly different (p = 0.80) from that observed in a control group of 51 children conceived during pre-exposure in the same families. The health status of all the children was unremarkable. It is concluded that paternal exposure to DBCP, severe enough to cause azoospermia or oligozoospermia, did not increase the rate of congenital malformations or of impaired health status of offspring conceived during or after exposure.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

Thyrotropin secreting pituitary adenoma associated with hypopituitarism and diabetes insipidus in an adolescent boy.

A 13 year-old boy was referred to our hospital because of several months of school performance deterioration, behavioral changes and secondary enuresis. Hyperthyroidism, diabetes insipidus and hypopituitarism due to thyrotropin secreting pituitary macroadenoma were found. Six weeks of therapy with octreotide failed to reduce the serum TSH levels and the tumor size. Transsphenoidal pituitary surgery had a transient effect on serum TSH levels as the patient redeveloped hyperthyroidism with elevated serum TSH levels. Several months had elapsed from the time the patient first presented with the symptoms to the time the diagnosis was made. Thyrotropin secreting pituitary adenoma is a rare cause of hyperthyroidism. Recognizing the signs of the disease might lead to early diagnosis and might improve the prognosis.

Adenoma↗
PubMedDate not supplied

An early rise in urine N-telopeptide predicts the growth response of normal prepubertal short children to growth hormone therapy.

The effects of growth hormone (GH) therapy on biochemical markers of bone turnover were investigated in 11 short prepubertal children without GH deficiency by measuring serum osteocalcin, a marker for bone formation, and urinary concentrations of pyridinium cross-linked amino acids of collagen (PCL), and the peptide-bound pyridinoline residue N-telopeptide (NT), which are specific markers for bone resorption. GH treatment for three months increased bone turnover in this group of children: urinary PCL concentrations increased from 69 +/- 6.2 to 114 +/- 9.3 nmol/mmol Cr (p < 0.01), and urinary NT levels increased from 512 +/- 65 to 766 +/- 74 pmol BCE/mumol Cr (p = 0.058). Serum osteocalcin concentrations increased from 13.64 +/- 2.57 ng/ml to 26.45 +/- 1.39 ng/ml (p < 0.01). The increment in 12-hour urinary concentrations of PCL was highly correlated with the increment in 12-hour urinary NT levels (r = 0.92, p < 0.01). Stepwise multiple regression analysis revealed that the urinary concentrations of NT after 3 months of GH therapy were the best predictor of growth after 12 months of treatment (r = 0.78, F = 7.9, p = 0.037).

Body Height↗
PubMedDate not supplied

Subnormal cortisol response to adrenocorticotropin in isolated partial 17,20-lyase deficiency.

We describe three male children from a Bedouin clan, two of whom are siblings, who have various degrees of incomplete virilization due to isolated 17,20-lyase deficiency. The patients have low (basal and post ACTH or hCG stimulation) plasma testosterone and androstenedione levels. An abnormally high plasma 17-hydroxyprogesterone concentration was detected. A favorable response following local testosterone administration was seen in two patients. Surprisingly, an unexplained flat cortisol response to ACTH test was also noted. Although no biochemical model can yet adequately explain the impairment in cortisol response to ACTH in these patients, it seems prudent to take this lack of cortisol response into consideration. We therefore recommend hydrocortisone supplement during moderate to severe stress.

17-alpha-Hydroxyprogesterone↗