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Biomedical subjects

N Sadan

Publications and source records attributed to N Sadan.

At least 19 recordsLinked to original sources

[High dose oral prednisone for hemangiomas in infants].

Over a 24-year period, 62 infants (47 girls) with hemangiomas were treated with an initial dose of either 3 or 5 mg/kg/day of oral prednisone for 2 weeks, after which the dose was gradually tapered off during 6-8 weeks. Few patients required longer treatment. Results were judged to be excellent in 68% of infants and good in 25%. Treatment was considered a failure in only 7%. The initial dose of 5 mg/kg/day was more effective than the smaller dose (p < 0.001). Of the 62 patients, 49 received 1 course of treatment, 8 required 2 courses and 5 required 3 courses. Retreatment was given whenever significant regrowth occurred. Side-effects were not serious, and resolved when treatment was discontinued. Treatment was indicated when the location of the lesions caused interference with important functions or when the lesions were likely to damage anatomic structures. Special attention was paid to early treatment of eye and subglottic hemangiomas. In all 22 children with hemangiomas of the eye (most with an orbital component), shrinkage of the lesion was observed within 24 hours of initiating treatment. In 19 of the 22 there was no residual of the hemangioma 1-18 years later. Such lesions deserve early treatment, not just as cosmetic emergencies, but to prevent secondary amblyopia. Early treatment of subglottic hemangiomas is also mandatory because they are potentially life-threatening. We conclude that oral prednisone is very effective in the treatment of hemangiomas of infants when given at a high dose for an adequate period of time.

Administration, Oral↗

Treatment of hemangiomas of infants with high doses of prednisone.

OBJECTIVE: We reviewed our experience with the use of oral corticosteroid therapy in treating hemangiomas of infants to determine the optimal effective dose. STUDY DESIGN: During a 24-year period, 60 infants with hemangiomas were treated with an initial dose of either 3 or 5 mg/kg per day of orally administered prednisone for a period ranging from 6 to 12 weeks. Involution of the hemangioma and re-growth. were monitored. RESULTS: Overall, excellent and rapid results were achieved in 68% of infants and good results occurred in 25%. In 7% treatment was deemed to have failed. Forty-seven of 60 patients received one course of therapy, 8 received 2 courses, and 5 required 3 courses. An initial dose of 5 mg/kg per day oral prednisone therapy was more effective than 3 mg/kg per day. Side effects were not serious and resolved after discontinuation of therapy. CONCLUSIONS: High oral doses of corticosteroids (5 mg/kg per day prednisone) provide an effective, rapid, and safe modality of treatment of hemangiomas of infants. We recommend that treatment continue for 6 to 8 weeks, and in more severe cases for as long as 12 weeks.

Administration, Oral↗

Impact of community educational programmes on foreign body aspiration in Israel.

The study objectives were to determine the impact of a nationwide educational campaign on the incidence of foreign body aspiration (FBA) in Israeli children. Impressed by the alarming number of FBAs, we conducted an educational campaign through the media during 1982-1983. The campaign included television and radio broadcasts, newspaper articles and interviews, and medical educational programmes in community paediatric care centres. Questionnaires were sent to all Departments of Paediatrics in Israel. Results showed a reduction in the incidence of FBA by 35% in 1983 as compared to 1981. Re-evaluation studies conducted in 1992 showed no further reduction of FBA. CONCLUSION. Continuous and extensive educational programmes should be undertaken by the health authorities if FBA is to be prevented. Furthermore, it is important to legislate mandatory labelling of seed and nut containers with the warning that the intake of seeds is dangerous to children under 5 years of age.

Adolescent↗

Aspirated foreign bodies in the respiratory tract of children: eleven years experience with 127 patients.

During 10 years, 127 children were admitted to the pediatric ward because of aspiration of foreign bodies (0.56% of all admissions). Eighty-one percent of the children were under 3 years of age. One hundred and one children (80%) had a positive history of foreign body aspiration. Vegetable substances, particularly peanuts and grains, were the commonest type of foreign body removed. Clinical signs and radiological studies were, in most children, pathognomonic, but sometimes not conclusive. Chest X-rays were normal in 18%; fluoroscopy was diagnostic in 92%. Rigid bronchoscopy and subsequent removal of the foreign body was the treatment instituted. Pneumonia (the commonest complication) developed before and after bronchoscopy in 28% of the children. Pneumomediastinum and subcutaneous emphysema were present on admission in 2 children. Cardiac arrhythmias, bronchospasm, and cardiac arrest were recorded during bronchoscopy. Bronchiectasis developed in one, and persistent intractable pneumonia, requiring lobectomy, developed in another patient. One death occurred.

Bronchi↗

Thrombocytosis after pneumonia with empyema and other bacterial infections in children.

Thrombocytosis is seen in association with many conditions, including infectious diseases. We studied thrombocytosis after severe bacterial infections, particularly pneumonia with empyema in children. A systematic survey of the phenomenon was conducted. Twenty-seven children admitted for pneumonia with empyema were studied. Thrombocytosis (platelet counts greater than 500 x 10(3)/microliters) was present in 92.5%. Platelet counts reached their maximum at 15.1 +/- 3.7 days (range, 7 to 25) and declined to normal after 3 weeks of illness. Compared with a healthy control group, significant thrombocytosis, but of lower incidence, was also noted in children with lobar pneumonia without pleural effusion, bacterial meningitis and osteomyelitis. Platelet functions were examined in seven of the children but no abnormalities were observed. Bone marrow aspiration of three children with pneumonia and empyema showed megakaryocytic hyperplasia. We found no correlation between thrombocytosis, neutrophilia, fever, the clinical course, complications, prognosis or treatment. Neither thromboembolic nor hemorrhagic phenomena were observed.

Bacterial Infections↗

Clinical and laboratory findings of spotted fever in Israeli children.

In a prospective study of 70 Israeli children with spotted fever the major clinical features were fever (100%), skin rash (98.5%), myalgia (54%) and vomiting (40%). Thrombocytopenia (75%) and hyponatremia (62.5%) were common, but were not associated with increased mortality. Antibodies to Rickettsia conorii were detected by the indirect immunofluorescent antibody assay. In one patient Rickettsia was grown from blood. Contacts with dogs were reported in 17 of 40 patients questioned, and in only 2 was a canine tick bite obvious. Hospitalization was required in 11 (16%) patients. There was 1 fatality. The rickettsia responsible for spotted fever in Israel appears to be an antigenic variant of R. conorii. Early recognition and treatment of this disease permits rapid eradication of the rickettsiae and facilitates complete recovery.

Antibodies, Bacterial↗

Late neuropsychologic status after childhood head trauma.

A neurologic and neuropsychologic test battery was administered to a sample of 35 children drawn from all those in a defined geographic area who had been hospitalized for head trauma before age 7 during the years 1970-1976. Examination was performed 3 1/2 to 10 years after injury, at age 6-15. Twelve subjects had been diagnosed at the time of injury as suffering moderate insult and had been referred to the metropolitan neurosurgical center, while twenty-three with only mild injury had been retained for observation in a local pediatric ward. The twelve with more severe insult were significantly inferior to the other subjects on the Block Design and Coding subtests of the revised Wechsler Intelligence Scale for Children. The Koppitz score of the Bender Test, the WISC-R scatter, the Benton Visual Retention Test, the GATB Motor Speed Test and the Bourdon-Wiersma Vigilance Test showed less diagnostic power and failed to distinguish between the group with more severe injury and that with less. A detailed and carefully scored neurologic examination also failed to distinguish between the two groups. The findings suggest that relatively common traumatic injury may be associated with detectable late cognitive deficit, and that some WISC-R subtests may be among the best measures for detecting such deficit.

Brain Injuries↗

Tx polyagglutination in three members of one family.

A case of acute haemolytic anaemia is described in a child. Tx polyagglutination of his red cells was observed, but no direct association with the anaemia could be proved. Polyagglutination was suspected because of irregularities in the AB0 blood grouping. Confirmation of the cryptantigen Tx was made when the patient's red cells were tested with lectins including Arachis hypogaea, Glycine soja, and Vicia cretica. Examination of family members showed Tx polyagglutination on the red cells of 2 siblings. The Tx polyagglutination was a transient phenomenon lasting 4-5.5 months, and could have been caused as the result of some unidentified bacterial or viral infection. Guidelines for transfusion therapy are suggested in patients in whom polyagglutination is recognised.

Adolescent↗

Hypertension in a neonate with 11 beta-hydroxylase deficiency.

A female newborn infant with ambiguous genitalia was found to have hypertension (121/82 mm Hg) immediately after birth. The plasma testosterone (T) (0.73 nmol/l), delta 4-androstenedione (delta 4-A) (5.9 nmol/l), dehydroepiandrosterone (DHEA) (8.9 nmol/l), as well as 17 OH-hydroxyprogesterone (17 OHP) (152 nmol/l) were elevated. The diagnosis of 11 beta-hydroxylase deficiency was finally established on the basis of elevated plasma eleven-deoxycortisol (compound S) (greater than 0.6 mumol/l) and confirmed by the normalisation of the blood pressure during hydrocortisone therapy. Our case is probably the youngest patient with 11 beta-hydroxylase deficiency in whom the hypertension was found at birth.

Adrenal Hyperplasia, Congenital↗

Childhood head injuries in Israel: epidemiology and outcome.

Results are reported of a regional survey of hospitalized head injuries in Israeli children aged 0-7 years during the period 1970-1976. There were 370 such cases surveyed. Incidence of head injury requiring hospitalization was 1.71/1000 per year. Follow-up examination 4-10 years after injury was achieved in 50 per cent of the cases. Late seizures and focal neurological deficit were rare, while school failure and various neuropsychiatric symptoms were common. Prevalence of seizures and new nervous habits was significantly related to severity of injury, while the prevalence of fears, nightmares, dizziness and school failure was not.

Achievement↗

The treatment of subglottic hemangiomas of infants with prednisone.

Because of their spontaneous regression, capillary and cavernous hemangiomas of infants usually do not require treatment. However, when they interfere because of their location with important functions of the body or even threaten life, treatment becomes mandatory. This is the case in most patients with congenital subglottic hemangiomas. In the past various methods of treatment have been used. All of them have disadvantages, and some are hazardous. Most cases (74.2%) required protracted tracheostomy. Mortality rate is still high (23.8%). We report herewith 5 infants with subglottic hemangiomas successfully treated with prednisone. No remarkable side-effects were observed, besides transient moonfacing. Similar good results were previously reported in 9 cases by several authors. Prednisone therapy if instituted early may reduce the need of tracheostomy and bring about complete recovery in this sometimes severe condition. Proper dosage and sufficient length of treatment are absolutely essential for such successful outcome.

Female↗

Circulating immune complexes in children with acute poststreptococcal glomerulonephritis.

Sera from 22 children with acute poststreptococcal glomerulonephritis were examined for circulating immune complexes (CIC) during the acute phase of the disease and six to eight months following its onset. CIC were found in 10 of 22 (45%) children during the acute phase and in 4 of 19 (21%) during follow-up. No correlation was found between the presence of CIC during the acute phase and disease severity as measured by several clinical and laboratory parameters. There was, however, a positive correlation between the presence of CIC in serum and the duration of proteinuria following disease onset. The possible role of CIC in the induction of chronic glomerulonephritis following acute poststreptococcal glomerulonephritis is discussed.

Acute Disease↗

[Celiac disease].

Explore the source record for details and available documents.

Celiac Disease↗