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Biomedical subjects

R Suskind

Publications and source records attributed to R Suskind.

At least 19 recordsLinked to original sources
PubMed1994

Cardiac function in malnourished children.

The cardiovascular status of severely malnourished children was characterized before, during, and after nutritional rehabilitation. In most children with third-degree malnutrition, cardiac mass was decreased on admission to the hospital and recovered subsequent to nutritional therapy. All children had echocardiographic and Doppler measurements indicative of impaired ventricular function which significantly improved during the course of hospitalization, as evidenced in part by the change in fractional shortening (P = 0.015), mean velocity of circumferential fiber shortening (P = 0.038), and systolic time interval (P = 0.030). We conclude that children with primary third-degree malnutrition not only have cardiac muscle wasting, but also have inherent ventricular dysfunction as the result of severe malnutrition that responds to nutritional therapy. Particular care with fluid administration is imperative in the first week of therapy, when heart function is the most compromised.

Child, Preschool↗
PubMed1993

Health status of pesticide applicators: postural stability assessments.

Postural sway testing was performed on 37 pesticide-exposed workers and 35 nonexposed subjects. All subjects were asymptomatic. When ratios of sway measurements in different test conditions were investigated, total length of sway was significantly different between groups (P = .0001). Weight/height (P = .0006), exposure to pesticides (P = .0215), recent organophosphate exposure (P = .0391), and plasma cholinesterase level (P = .1537) were associated with increased body sway. The pattern of sway performance suggested a proprioceptive impairment, well compensated by visual cues, potentially attributable to pesticide exposure. This finding is of unclear clinical significance because results of neurologic examinations and nerve conduction studies that were reported separately did not show evidence of neuropathy. Postural sway testing is a simple, sensitive, noninvasive, and reproducible technique to evaluate subtle neurologic dysfunction. These findings are preliminary. Further studies are required to validate the findings and, if confirmed, to explore their functional or clinical significance.

Adult↗
PubMed1993

Gastrointestinal blood loss in older infants: impact of cow milk versus formula.

Concerns that consumption of whole cow milk (WCM) by older infants may result in excessive gastrointestinal blood loss and subsequent iron deficiency led us to perform a prospective, randomized study in 104 infants. Infants were assigned to receive WCM beginning at 6 months or one of three formulas beginning at 4-6 months of age and followed until 12 months of age. Gastrointestinal blood loss was similar for all groups, as determined by both qualitative (Hemoccult II) and quantitative testing (HemoQuant). There was no association between concentration of fecal hemoglobin and volume of WCM consumed or iron status by 12 months of age. Of eight infants (seven WCM, one formula) who became iron-depleted, none had excessive fecal hemoglobin excretion. When pooled and analyzed regardless of feeding group, fecal hemoglobin increased with age and was greater at 11 and 12 months than at younger ages. We conclude that although infants fed WCM are at increased risk of developing iron depletion, the iron insufficiency is not due to gastrointestinal blood loss. We further conclude, based on our sample of normal infants age 4-12 months, that fecal hemoglobin concentrations of 0.5-0.8 mg/g stool correspond to the upper limits of normal, values much lower than in adults.

Analysis of Variance↗
PubMed1979

Risk of nutritional rickets among vegetarian children.

Records of the dietary intake of 52 preschool vegetarian children seen from 1974 to 1976 revealed that macrobiotic vegetarian diets provided amounts of vitamin D, calcium, and phosphorus that were marginal as well as less than the amounts provided by other vegetarian diets. Vitamin D supplements were rarely given. Two subjects had roentgenographic evidence of rickets. The medical histories of 32 children on macrobiotic diets who were examined in 1977 more frequently included prior physical and roentgenographic findings indicative of rickets, whereas those of 17 other vegetarian children did not. Children in the former group were more likely to have elevated levels of serum alkaline phosphatase. Two additional cases of rickets in children consuming a macrobiotic diet confirmed by roentgenograms were brought to our attention during the study.

Boston↗
PubMed1978

Plasma somatomedin and growth hormone values in children with protein-calorie malnutrition.

This study was undertaken to define the interrelationships of somatomedin, growth hormone, and an inhibitor of SM in protein-calorie malnutrition. Twenty-seven patients, eight to 60 months of age, were studied. Twenty-one well-nourished children acted as controls. SM was significantly depressed at Days 2 and 8 (p less than 0.01) but was not different from controls at Day 29 and 50. In ten out of 27 Day 2 samples and six out of 27 Day 8 samples an inhibitor was identified. When SM values were compared to simultaneous hGH levels, there was an inverse relationship. The low SM levels in the face of markedly elevated hGH levels suggests a functional block in the synthesis and/or release of SM.

Child, Preschool↗
PubMed1977

Defective local leukocyte mobilization in children with kwashiorkor.

The Rebuck window technique was used to determine the functional integrity of the inflammatory response in nine children with kwashiorkor. The total numbers of leukocytes mobilized into skin abrasions were similar between kwashiorkor and control patients. However, children with kwashiorkor showed significantly delayed and decreased macrophage migration and increased polymorphonuclear leukocyte migration. These defects of leukocyte mobilization were corrected with nutritional repair.

Anti-Bacterial Agents↗
PubMed1976

Complement activity in children with protein-calorie malnutrition.

Using the hemolytic complement (CH50) assay, we evaluated the complement system of 28 children with severe protein calorie malnutrition (PCM) during their hospital admission and recovery. The mean CH50 activity in children with kwashiorkor was significantly less on hospital days 1 and 4 than in 17 healthy control subjects. On day 8 it rose to normal, and by day 50 it was significantly higher than the controls. The mean CH50 titer of 16 well-nourished febrile children was, in contrast to that of untreated PCM, significantly greater than the healthy controls. Of the children with PCM, 11 (40%) evidenced anticomplementary (AC) activity in their serum on either day or 1 or 4, but only two (7%) had detectable serum AC activity during later convalescence. Significantly, the CH50 titer in a PCM serum correlated inversely to the amount of AC activity in that serum (P less than 0.01). These results indicate that, in children with PCM, the complement system is compromised functionally, and that its repair coincides with intake of adequate diet. The presence of AC activity provides a possible mechanism for depressed complement activity in some untreated PCM children.

Child, Preschool↗
PubMed1976

Immunoglobulins and antibody response in children with protein-calorie malnutrition.

The immunoglobulin levels (IgG, IgA, IgM, IgD, and IgE) were studied in 28 Northern Thai children with protein-calorie malnutrition (PCM). Of these 14 had marasmus, 7 had marasmus-kwashiorkor, and 7 had kwashiorkor. The immunoglobulin levels were measured on admission and serially during 12 weeks of treatment leading to recovery. All immunoglobulin fractions either equalled or exceeded levels seen in well-nourished urban and rural Thai children, with or without infection. There was no difference in levels of IgG, IgM, IgA, or IgD in children with marasmus when compared with those who had marasmus-kwashiokor or kwashiorkor. IgA levels were higher in malnourished than control children and returned to normal with treatment. Eighty percent of the children with PCM had detectable IgD levels while 64% had detectable IgE levels as compared to none in the control groups. Ten additional children admitted with PCM and 10 who had recovered from PCM were immunized with intradermal typhoid antigen. Within 8 days a significant increase in typhoid H antibody appeared in the recovered group, while the malnourished group demonstrated no significant increase in H antibody titer.

Antibodies, Bacterial↗
PubMed1976

The iduronidase-deficient mucopolysaccharidoses: clinical and roentgenorgraphic features.

Hurler and Scheie syndromes, two of the six clinically distinct mucopolysaccharidoses, are deficient in the same lysosomal enzyme, alpha-L-iduronidase. A third group of iduronidase-deficient patients can now be identified during the pediatric years using clinical and radiographic criteria. Based on inferential evidence for allelism between the Hurler and Scheie genes, the occurrence of genetic compounds which simultaneously carry both mutant alleles may be predicted to occur. This can be considered analogous to the structural gene mutations leading to hemoglobin SC disease. Four patients with phenotypes intermediate between Hurler and Scheie syndromes are flet to represent genetic compounds of this type. Both clinical and roentgenographic features are helpful in distinguishing these patients from those with Hurler syndrome or Scheie syndrome. Fibroblast correction characteristics identical to those of Hurler syndrome and Scheie syndrome and absence of consanguinity are additional features which favor classification as genetic compounds. The possibility of a third mutant allele at the Hurler-Scheie locus or of extreme phenotype variation are not considered likely alternative explantations. Depending on the frequency of the Scheie syndrome and the Hurler syndrome, genetic compounds may occur with an intermediate frequency or may be more common than either homozygous condition.

Adolescent↗
PubMed1975

Plasma vitamin A, retinol-binding protein and prealbumin concentrations in protein-calorie malnutrition. III. Response to varying dietary treatments.

Plasma vitamin A, retinol-binding protein, and prealbumin concentrations have been studied in 38 northern Thai children with protein-calorie malnutrition (PCM). The 4-week study period consisted of 1 week of stabilization followed by 3 weeks of treatment with formula diets varying in their protein and calorie content. The stabilization period comprised 7 days of initial treatment with fluids, antibiotics, and a gradually increasing intake of protein and calories to a final level of 1 g protein and 100 kcal/kg of body weight. During this period vitamin A, retinol-binding protein and prealbumin levels all showed significant increases compared to admission values, whereas plasma albumin and total protein did not change. During the subsequent 3 weeks, the effects of four different dietary regimens, with daily calorie and protein intakes of 100 or 175 kcal/kg and 1 or 4 g/kg, respectively, were studied. Significant increases in plasma total protein concentration were seen in each of the four test groups, and increases in plasma albumin and prealbumin were also seen in three of the four test groups, and increases in plasma albumin and prealbumin were also seen in three of the four test groups (all but the 175 kcal-1 g protein group). Significant increases in plasma vitamin A levels were not seen in any of the groups. The higher protein regimens (4 g/kg per day) resulted in much greater increases in plasma albumin and total protein levels than did the lower protein regimens. No significant differences in the changes in retinol-binding protein or vitamin A levels were apparent between the test groups. Sixteen additional children with both clinical vitamin A deficiency and protein-calorie malnutrition showed significant increases in total plasma vitamin A concentrations 24 hours after the intramuscular injection of 100,000 IU water-miscible vitamin A palmitate, without a change in plasma retinol-binding protein concentrations. These studies demonstrate that plasma retinol-binding protein and prealbumin concentrations are more rapidly responsive and sensitive to dietary protein intake than is plasma albumin concentration. Furthermore, the absence of a 24-hour rise in plasma retinol-binding protein after parenteral vitamin A provides further evidence that hepatic retinol-binding protein synthesis is impaired in protein-calorie malnutrition.

Blood Proteins↗
PubMed1975

Secretory and serum IgA in children with protein-calorie malnutrition.

The local immune system of children suffering protein-calorie malnutrition (PCM) was investigated by analyzing the amount of immunoglobulins in the nasal washing on admission, repeatedly during 84 days of hospital therapy, and on follow-up, one to two years later. Although measured concentrations of total protein, IgG, and albumin in nasal washings were reduced in children with PCM, only secretory IgA concentrations were significantly lower (P less than .01) in PCM compared to normal children. Mean secretory IgA concentrations were significantly reduced on admission through hospital day 70 and returned to near normal thereafter. At one to two years after hospital discharge, mean concentrations of secretory IgA in nasal secretions were within normal limits. The concentrations of secretory IgA in nasal washings were lowest at a time when serum IgA was markedly elevated; serum IgA concentrations fell to normal values during dietary treatment. The possible role of secretory IgA deficiency in PCM and infection is discussed.

Albumins↗