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Biomedical subjects

M Ziai

Publications and source records attributed to M Ziai.

At least 19 recordsLinked to original sources
PubMed2000

Acute mastoiditis in children: an increase in frequency in Northern Virginia.

BACKGROUND: Acute mastoiditis is reported to occur 2 or 3 times annually in the largest children's hospitals. We encountered an average of 1 case annually at our hospital from 1986 to 1991. During an 8-year period ending October 31, 1999, 22 patients were diagnosed and treated at our hospital. Of these, 17 presented during the last 34 months. METHODS: Retrospective chart review from office and hospital records of children from infancy to age 12 years with a discharge diagnosis of acute mastoiditis who were treated from 1992 through 1999. RESULTS: All children were referred to one of the two pediatric otolaryngologists in our community because of forward protrusion of the auricle and retroauricular cellulitis. Eleven (50%) were <14 months old. Ninety-five percent had a concomitant ipsilateral, inflamed, bulging, immobile eardrum. Computerized tomographic imaging, performed on all patients, revealed universal cortical destruction, subperiosteal abscess or bone destruction in four and dural venous thrombosis in two. Mastoidectomy was necessary for eight children (36%) because of complications of mastoiditis (n = 4) or for failure to improve with antibiotics and myringotomy drainage (n = 4). Streptococcus pneumoniae or Streptococcus pyogenes was recovered from 10 of 17 children (59%) from whom cultures were obtained. CONCLUSION: Cases of acute mastoiditis have markedly increased in our suburban children's hospital. The disease was most common during infancy. Serious complications of mastoiditis occurred in four (18%) of the children in this series.

Anti-Bacterial Agents↗
PubMed1997

Antimicrobial prescribing for acute purulent rhinitis in children: a survey of pediatricians and family practitioners.

BACKGROUND: The tenet that children with acute purulent rhinitis need not be treated with antibiotics unless drainage persists for 7 to 10 days is taught to medical students and residents in primary care specialties but may not be adhered to in actual clinical practice. Because of the global increase in bacterial resistance stemming largely from the overuse of antibiotics, we sought to determine how acute purulent rhinitis is managed in the primary care setting. METHODS: We surveyed all 450 pediatricians (PD) and family practitioners (FP) in northern Virginia who were in active practice in 1994. The survey instrument was a questionnaire containing two clinical vignettes followed by a series of multiple choice or fill-in-the-blanks questions. Initial nonresponders received up to three additional mailings of the same questionnaire. RESULTS: There were 346 (77%) evaluable responses. Seventy-one percent of FP and 53% of PD (P = 0.001) immediately prescribed antibiotics for infants with scant, green nasal mucopurulent secretions of 1 day duration; fewer treated an older child immediately (50% FP vs. 24% PD, P < 0.00001). Only 15% of FP vs. 23% of PD (P = 0.07) waited for 7 to 10 days of persistent purulent nasal drainage in infants before prescribing antibiotics. Ninety-four percent of FP and 95% of PD (P = 0.8) indicated that they would prescribe antibiotics immediately for infants with acute purulent rhinitis who attended day care. For otitis-prone children who were not in day care, 86% of FP and 78% of PD (P = 0.02) would also treat without delay. The reasons given for prompt antibiotic therapy were (1) the belief that many untreated patients would develop persistent purulent nasal drainage, (2) concern that acute otitis media would develop, (3) pressure from mothers to prescribe an antibiotic and/or (4) the desire to allow employed parents to return to work earlier. Amoxicillin was the initial choice for 89% of FP vs. 76% of PD (P = 0.003). Most FP (89%) and PD (97%) were concerned about the increase in bacterial resistance rates arising from unnecessary antibiotic prescribing (P = 0.01). CONCLUSIONS: Most infants and children with acute purulent rhinitis of short duration were treated with antibiotics despite professed concerns over the spread of bacterial resistance; the practice was more prevalent among FP.

Acute Disease↗
PubMed1986

Zinc status of infants with fetal alcohol syndrome.

Plasma and urinary zinc levels were examined in 6 infants with fetal alcohol syndrome to determine whether zinc deficiency, if present in fetal alcohol syndrome patients, is secondary to an increased urinary zinc excretion. Six infants born to nonalcoholic mothers served as controls. There was no significant difference in creatinine clearance, urine flow rate, or plasma albumin concentrations between the two groups. Plasma concentrations of zinc were significantly lower in fetal alcohol syndrome patients (62.5 +/- 2.8 micrograms/dl) in comparison to controls (71 +/- 1.8 microgram/dl), (p = 0.0001). Urinary excretion of zinc in fetal alcohol syndrome patients averaged 646 +/- 125 micrograms/24 h, significantly higher than in control subjects (76.6 +/- 22 micrograms/24 h), (p = 0.0001). Thus (1) lower plasma zinc levels are present in infants with fetal alcohol syndrome and (2) increased urinary zinc excretion appears to be responsible for decreased plasma zinc concentrations.

Creatinine↗
PubMed1985

Impaired renal acidification in infants with fetal alcohol syndrome.

Urinary acidification was studied in six unrelated infants with fetal alcohol syndrome and eight healthy age-matched infants. Creatinine clearance, fractional sodium excretion, plasma renin activity, and plasma aldosterone were normal in all patients but fractional potassium excretion was lower in the patients than in the controls (p = 0.0001). After ammonium chloride loading, minimum urine pH was significantly higher in FAS patients than in control subjects (5.5 +/- 0.1 and 4.7 +/- 0.1, respectively, p = 0.00005). Net acid excretion was also lower in the patients (24.5 +/- 1.7 Eq/min) than in the controls (27.8 +/- 2.1 Eq/min, p = 0.008). Following sodium bicarbonate loading, fractional bicarbonate excretion was significantly higher (p = 0.00005) and fractional potassium excretion significantly lower (p = 0.002) in the patients than in the controls with comparable blood pH and bicarbonate levels. Treatment with chlorothiazide lowered plasma potassium and raised plasma bicarbonate to normal levels (p = 0.05). Concomitantly, fractional sodium excretion, fractional potassium excretion, and urinary net acid excretion increased significantly (p = 0.01). We conclude that patients with fetal alcohol syndrome have a defect in distal acidification and potassium excretion which cannot be attributed to abnormal aldosterone secretion.

Acidosis, Renal Tubular↗
PubMed1983

Incidence of acute rheumatic fever. A suburban community hospital experience during the 1970s.

The incidence of acute rheumatic fever has declined remarkably in the past three decades, but the disease has not been eradicated, as some physicians believe. This study documents the diagnosis of the disease in 23 middle-class children from Fairfax County, Virginia, during the 11-year-period from 1970 through 1980. This county has one of the highest median family incomes in the United States. The annual age-adjusted incidence rate of initial attacks of acute rheumatic fever per 100,000 Fairfax County children declined from 3.0 in 1970 to 0.5 in 1980. In six of the 23 children, carditis accompanied by monarticular arthritis or arthralgia was present. Another seven children had carditis plus polyarthritis. Two patients had Sydenham's chorea. None of the children had erythema marginatum or rheumatoid nodules. In two children, symptoms of acute rheumatic fever developed two weeks after they finished a 10-day course of penicillin for Group A streptococcal pharyngitis. The remaining 21 children had not been considered ill enough to be brought to medical care prior to development of symptoms of acute rheumatic fever.

Acute Disease↗
PubMed1978

[Campomelic syndrome (author's transl)].

A female premature infant with dwarfism, peculiar facial features, cleft palate and bone anomalies including bowing of the lower extremities with pretibial skin dimpling, the so called "campomelic syndrome" is presented. Other symptoms were hypotonia and respiratory distress. The radiological and autopsy findings in this child are described. The lack of known teratogenic factors during the pregnancy and the available data about the familial occurance of this malformation syndrome suggest the possibility of an autosomal recessive mode of inheritance in this patient. This is the first case of campomelic syndrome reported from Iran.

Abnormalities, Multiple↗
PubMed1977

Hypertriglyceridemia in homozygous beta-thalassemia.

A case of hypertriglyceridemia in association with homozygous beta-thalassemia in an 11-month-old female infant is reported. The hypertriglyceridemia proved to be secondary, as it was indicated by clinical features as well as laboratory findings. Attention is called to a possible alteration of lipid metabolism in association with thalassemia major.

Cholesterol↗
PubMed1976

Curriculum for the new college of health sciences: A departure from the traditional medical education.

As an outgrowth of the Report of the Imperial Commission on the Study of Health and Medical Problems, The College of Health Sciences was established as the basic educational unit to provide comprehensive health care education within the framework of a team approach to Iranian national health care. The programs are to nonrestrictive, thereby demonstrating the principles of the concept and practice. Because of this, the College is a multidiscipline institution, and will expand to include programs of study in all health care specialties. The program of study for the equivalent of the baccalaureate degree in the College is based on functional analysis of the tasks to be performed by the primary care workers called behdars. The curriculum is task oriented and is made up to two sections, each of 33 months instruction. The first year concentrates on basic functional science and medicine in an academic setting, and the following two years are spent in clinical training in geographically diverse dispensaries and health care facilities. The second stage of the academic program will be available to graduate behdars who have successfully completed two or more years of work in the health care network and who display academic and professional excellence. Through a unit system approach these candidates for doctor of medicine will complete eleven months or more of comprehensive instruction in functional basic sciences, and this will be followed by two years in comprehensive hospital internship.

Allied Health Personnel↗