PubMed Health⌕ Search

Biomedical subjects

R Litt

Publications and source records attributed to R Litt.

At least 19 recordsLinked to original sources
PubMed2000

Single photon emission computed tomographic evaluation of brainstem release phenomenon and seizure in neonates.

We report the ictal brain single photon emission computed tomographic (SPECT) findings in two neonates. One neonate had hypoxic-ischemic encephalopathy, a disorganized discontinuous electroencephalogram (EEG) background, lethargy, seizures, and brainstem release phenomena. A brain SPECT was performed during a brainstem release phenomenon characterized by a 34-second sustained tonic posture of the right arm and chewing. It did not reveal focal cerebral hemisphere hyperfusion. The second neonate had hemimegalencephaly, low-voltage irregular EEG background, and seizures. A brain SPECT was performed during a seizure characterized by a 32-second sustained tonic posture of the right arm. It revealed focal hyperperfusion in the posterior region of the left hemisphere. The brain SPECT findings in these patients indicate that despite clinically similar events, brainstem release phenomena and seizures have different perfusion characteristics, and refute the theory that brainstem release phenomena are due to epileptic foci in the cerebral hemispheres undetectable by EEG.

Brain↗
PubMed2000

Evaluation of the approach of primary care physicians to the management of streptococcal pharyngotonsillitis. IPROS Network.

BACKGROUND: Streptococcal pharyngotonsillitis remains a common illness in children and can lead to serious complications if left untreated. OBJECTIVE: To evaluate the diagnostic and management approach of a sample of primary care physicians in the largest sick fund in Israel to streptococcal pharyngotonsillitis in children. METHODS: A questionnaire was mailed to all physicians who treat children and are employed by the General Health Services (Kupat Holim Klalit) in the Jerusalem District. The questionnaire included data on demographics, practice type and size, and availability of throat culture and rapid strep test; as well as a description of three hypothetical cases followed by questions relating to their diagnosis and treatment. RESULTS: Of the 188 eligible physicians, 118 (62.5%) responded, including 65 of 89 pediatricians (73%) and 53 of 99 family and general practitioners (53.5%). Fifty-six physicians (47.4%) had more than 18 years experience, and 82 (70%) completed specialization in Israel. Mean practice size was 950 patients. Fifty-three physicians (43%) worked in Kupat Holim community clinics, 25 (21%) worked independently in private clinics, and 40 (34%) did both. A total of 91 (77%) had access to laboratory facilities for daily throat culture. The time it took for the results to arrive was 48 to 72 hours. For the three clinical scenarios, 90% of the physicians accurately evaluated case A, a 1-year-old with viral pharyngotonsillitis, and 100 (85%) correctly diagnosed case C, a 7-year-old with streptococcal infection. As expected, opinions were divided on case B, a 3-year-old child with uncertain diagnosis. Accordingly, 75 (65.3%) physicians did not recommend treatment for case A, compared to 109 (92.5%) for case C. For case B, 22 (19%) said they would always treat, 43 (36%) would sometimes treat, and 35 (30%) would await the result of the throat culture. For 104 (88%) physicians the antibiotic of choice for case C was penicillin, while only 9 (7.5%) chose amoxicillin. However, the recommended dosage regimens varied from 250 to 500 mg per dose, and from two to four doses daily. For case C, 110 physicians (93%) chose a 10 day duration of treatment. CONCLUSIONS: The primary care physicians in the sample (pediatricians, general practitioners and family physicians) accurately diagnosed viral and streptococcal pharyngotonsillitis. However, there was a lack of uniformity regarding its management in general, and the dosage regimen for penicillin in particular.

Child↗
PubMed1998

Similar brain SPECT findings in subclinical and clinical seizures in two neonates with hemimegalencephaly.

Brain single-photon emission computed tomography (SPECT) findings during clinical and subclinical seizures were compared in two neonates with hemimegalencephaly. Interictal and ictal brain SPECT were performed in two neonates. The ictal studies were performed during a clinical seizure in one neonate and during a subclinical seizure in another neonate. They revealed similar focal hemispheric hyperperfusion at the electroencephalographic seizure foci in both cases. The similar perfusion patterns imply that clinical and subclinical seizures place similar metabolic demands on the cerebral tissue involved in the generation of electroencephalographic seizures in neonates with cerebral dysgenesis and suggest that clinical and subclinical seizures should be treated similarly in this population.

Brain↗
PubMed1995

The Ypt1 GTPase is essential for the first two steps of the yeast secretory pathway.

Small GTPases of the rab family are involved in the regulation of vesicular transport. The restricted distribution of each of these proteins in mammalian cells has led to the suggestion that different rab proteins act at different steps of transport (Pryer, N. K., L. J. Wuestehube, and R. Sheckman. 1992. Annu Rev. Biochem. 61:471-516; Zerial, M., and H. Stenmark. 1993. Curr. Opin. Cell Biol. 5:613-620). However, in this report we show that the Ypt1-GTPase, a member of the rab family, is essential for more than one step of the yeast secretory pathway. We determined the secretory defect conferred by a novel ypt1 mutation by comparing the processing of several transported glycoproteins in wild-type and mutant cells. The ypt1-A136D mutant has a change in an amino acid that is conserved among rab GTPases. This mutation leads to a rapid and tight secretory block upon a shift to the restrictive temperature, and allows for the identification of the specific steps in the secretory pathway that directly require Ypt1 protein (Ypt1p). The ypt1-A136D mutant exhibits tight blocks in two secretory steps, ER to cis-Golgi and cis- to medial-Golgi, but later steps are unaffected. Thus, it is unlikely that Ypt1p functions as the sole determinant of fusion specificity. Our results are more consistent with a role for Ypt1/rab proteins in determining the directionality or fidelity of protein sorting.

Base Sequence↗
PubMed1995

Six year neurodevelopmental follow-up of very low birthweight children.

Twenty-four children born preterm with very low birthweight (VLBW) in 1985 at Bikur Holim Hospital were followed until age 6 years. Their neurological status and developmental and cognitive abilities were examined at 1, 2 and 6 years of age respectively and were compared with a control group at age 6 years. Of the 24 VLBW children, 4 had major disabilities. Of those without major disabilities, mean total IQ (WPPSI) at six years was 101.5 +/- 11.3, not significantly different from their mean Mental Development Index (Bayley) at age 2 years which was 96.1 +/- 19.6, or from the mean total IQ of a control group of 6-year-old children which was 109.8 +/- 14.7. However, the mean verbal IQ of the VLBW children (95.3 +/- 11.7) was significantly lower than that of the control group (106.2 +/- 14.3) (P = 0.02). Minor neurological deficit was found in seven of the VLBW children and in only one of the controls (P = 0.05). These findings point to possible future learning difficulties and should alert both pediatricians and educationalists to the importance of long-term follow-up of VLBW children in order to identify and address their specific educational needs.

Case-Control Studies↗
PubMed1995

[Hemi-arthroplasty of the shoulder: radiological, functional and dynamic studies].

From September 1973 to October 1992, forty-three shoulder arthroplasties were performed in forty-one patients with complicated fractures or degenerative disease. Radiological and functional assessment with a mean follow-up time of forty-five months permitted us to review twenty patients with fifteen Neer II prosthesis, three isoelastic prosthesis and two total shoulder replacements. Of these, eleven presented with traumatic injuries and four with degenerative disease. The mean age at operative time was 61 years. Radiological evaluation showed that all cases had a retroversion of about 30 degrees. Normal humeral length and lateral shifting were not achieved in most patients; in fact only one had a restored length and lateral shifting. The mean scapulothoracic range of motion was found to be half that of a normal gliding shoulder (angle 30 degrees instead of 60 degrees). The subacromial space was diminished by one third in all cases. Relief of shoulder pain was the most significant finding. Mobility was restored to a level of about 75% of normal according to Constant's Scale. Dynamometric measures showed an important loss of force (47% of normal) despite a normal external rotation force. Recent improvements in implant conception (modular prosthesis) and a better understanding of physiological shoulder mechanisms should improve the functional results of this arthroplasty in the future.

Adult↗
PubMed1993

The effect of mode of delivery on long-term outcome of very low birthweight infants.

A prospective 2-year neurodevelopmental follow-up was carried out on 69 very low birthweight (VLBW) infants (< 1501 g), born in the years 1985-87. The aim of the study was to determine whether there was a long-term advantage to cesarean section in these infants. The incidence of major disability and cognitive ability at 2 years of age were assessed, comparing modes of delivery. Cesarean section was performed in 38 out of 69 (55.1%) of the infants. Major disability was diagnosed in 11/69 (15.9%) of the children, of whom 7/38 (18.4%) were delivered by cesarean section, compared with 4/31 (12.9%) delivered vaginally. The difference, accounting for presentation and multiple birth was not statistically significant. Cognitive ability at 2 years of age was tested using the Mental Development Index (MDI) of the Bayley Scales, and was compared, according to mode of delivery, in 55 of 58 infants without major disability. There was no statistically significant difference between mean +/- S.E. in the MDI of 28 infants delivered by cesarean section (99.7 +/- 7.3) and that of 27 infants delivered vaginally (95.6 +/- 4). In summary, at 2 years of age, no clinically relevant benefit was found for VLBW infants who had been delivered by cesarean section.

Blindness↗
PubMed1992

A 2-year prospective study of very low birthweight infants.

A prospective 2-year follow-up study was carried out on 68 of the 69 surviving very low birthweight (VLBW) infants (< 1,501 g) born in Bikur Holim Hospital in the years 1985-87. The aims were a) to determine the incidence of major disability, and b) to compare the 2-year outcome of VLBW infants without major disability with that of a control group of full-term small-for-gestational-age infants, using the Mental Development Index (MDI) of the Bayley Scales. Mean birthweight of the VLBW infants was 1,234 +/- 216 g and mean gestational age was 30.7 +/- 2.4 weeks. Their neonatal mortality during the study period was 29.8%. Major disability was diagnosed in 11/68 infants (16%). At age 2 years there was no significant difference between the mean MDI of the VLBW infants without major disability (97.7 +/- 19.5) and that of the controls (99.7 +/- 17.0). These data, representing the outcome of VLBW infants from a community-based hospital with neonatal intensive care facilities, are comparable in incidence of major disability with data of large tertiary centers. Cognitive ability of VLBW infants without major disability at age 2 years was equivalent to that of their full-term peers.

Analysis of Variance↗
PubMed1990

A human D1 dopamine receptor gene is located on chromosome 5 at q35.1 and identifies an EcoRI RFLP.

Dopaminergic neurons have been shown to affect voluntary movement, hormone secretion, and emotional tone. Mediating these activities are two receptor subtypes, D1 and D2, which are biochemically and pharmacologically distinct. The D1 subtype, the most abundant form of dopamine receptor in the central nervous system, stimulates adenylate cyclase, modulates D2 receptor activity, regulates neuron growth and differentiation, and mediates several behavioral responses. Recently we reported the cloning of a human D1 dopamine receptor gene (DRD1). High-stringency hybridization of the DRD1 clone to human genomic blots suggests that DRD1 is single copy. When used to probe a Southern blot made with DNAs from a rodent-human somatic cell hybrid panel, DRD1 hybridized to a 6.5-kb EcoRI restriction fragment which was assigned to chromosome 5. Fluorescent in situ hybridization of this gene to human metaphase chromosomes refined the location of DRD1 to 5q35.1. A search for RFLPs associated with DRD1 identified a two-allele EcoRI RFLP, allowing confirmation of DRD1's localization by linkage analysis in Centre d'Etude du Polymorphisme Humain families.

Alleles↗
PubMed1990

[Screening for congenital hip dislocation in Belgium. Results of a survey in maternity wards. Proposals].

Congenital dislocation of the hip (CDH) is probably more frequent in our country than generally appreciated. In most European countries, the incidence of CDH varies from 6 to 20 per thousand living births. The screening for the condition is organized with the help of public services. Our purpose was to survey the maternity wards to estimate the extent of the occurrence in Belgium. A volunteer orthopedic surgeon met with the pediatrician and the obstetrician in every hospital with a maternity ward to complete a questionnaire. We present a detailed analysis of the results of the survey and propose a better system for screening.

Belgium↗
PubMed1990

[Coxa vara. Isolated growth of the greater trochanter. Prevention-treatment].

Prevention of avascular complications is a primary aim. The ischemic insult to the femoral head provokes different types of morphologic deformities depending on its location. When the lateral part of the growth plate is affected, the head will be in valgus with a short neck, on the contrary, when the medial part is affected, a coxa vara occurs. The sooner the growth is stopped, the shorter the neck will be. Nevertheless, the greater trochanter will continue its growth and under certain conditions, will extend beyond the head. The Articulo-Trochanteric Distance is a measurement of the deformity which may be checked regularly. Early recognition permits prevention and adequate treatment. Treatment options include epiphysiodesis of the greater trochanter before the age of 8 to 10 years, trochanteric repositioning with osteotomy, and valgus osteotomy (Pauwels' Y-osteotomy).

Bone Diseases, Developmental↗
PubMed1990

[What becomes of the interposed capsule in Colonna's arthroplasty?].

A total hip replacement had to be performed 25 years after a Colonna arthroplasty. The acetabulum has been cut off for examination (articular cartilage and subchondral bone). The evolution of the case is detailed. Histological examination shows that the capsular tissue became articular cartilage, but not a normal one. This observation confirms that Colonna arthroplasty can give a good joint for more than 20 years but not longer.

Adult↗