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Biomedical subjects

S Reif

Publications and source records attributed to S Reif.

At least 55 records · Page 3Linked to original sources

[Complications of exchange transfusion in term and preterm newborns].

Exchange transfusion has an important role in the treatment of hyperbilirubinemia of the newborn. It is used in attempts to prevent kernicterus when bilirubin levels are high. We describe our experience in 203 exchange transfusions performed on 143 infants (81 males and 62 females) with hyperbilirubinemia during 1983-1992. In only 30% of cases was there a specific etiological diagnosis of the jaundice based on a positive Coombs test, G6PD deficiency, or the presence of sepsis or maternal diabetes; the rest were idiopathic. 57% of the neonates were premature (26-36 weeks of gestation). Premature neonates underwent more transfusions than full-term infants (1.6 vs 1.2). There was no direct death from exchange transfusion; morbidity was 6.3% (including bradycardia, apnea, thrombocytopenia, hypoglycemia and hyponatremia). Most complications occurred in preterm infants and those severely ill. All complications were treated immediately and there were no sequelae.

Exchange Transfusion, Whole Blood↗

Protein-restricted diet alters concentration of plasma membrane glycoproteins in rat liver.

Malnutrition is known to have adverse effects on the physiology and morphology of the liver. The aim of this investigation was to examine the effect of protein restriction on the content of plasma membrane proteins residing in the sinusoidal and bile canalicular domains of rat liver. Post-weanling rats maintained on low protein isocaloric diets showed marked growth retardation concomitant with reduced liver protein concentration compared to control animals. The content of leucine aminopeptidase, a bile canalicular enzyme, and asialoglycoprotein receptor, a sinusoidal receptor, in livers of protein-restricted rats was 66% and 50%, respectively, of control livers. In contrast, the relative concentrations of dipeptidyl peptidase IV and a cell adhesion molecule (GP 110), both canalicular proteins, were 160% and 121%, respectively, in rat livers upon protein restriction. After a 4-week rehabilitation period, the concentrations of all canalicular membrane proteins were similar to those in control livers, while the sinusoidal receptor was only 68% of control values. Protein restriction was found to adversely affect the concentrations of protein constituents, but not their localization in the hepatocyte plasma membrane. In general, altered concentrations of hepatocyte membrane proteins were reversed on the administration of a normal protein diet.

Animals↗

Helicobacter pylori and peptic disease in the pediatric patient.

The data accumulated on Helicobacter pylori infection in children suggests an important causative role of the organism in gastritis and peptic ulcer disease in this age group. The importance of eradication of H pylori in asymptomatic children in relation to its role in peptic disease and cancer in adults is debatable. This article describes the current data on bacteriologic features, pathologic spectrum, clinical significance, epidemiology, methods of diagnosis, and treatment of H pylori infection in children. Further studies will provide the information on the pathogenicity, mode of transfer, and optimal treatment of H pylori infection.

Adolescent↗

Immune response to hepatitis B virus vaccine in 1-year-old preterm and term infants.

The recent mass immigration to Israel from the former U.S.S.R. and Ethiopia has significantly increased the hepatitis B virus (HBV) carrier rate. Since January 1992, all newborns in Israel have been routinely immunized against HBV. The same routine of vaccination has been used for premature and term newborns. The aim of the present study was to investigate the immune status against HBV in term and preterm infants at the age of 1 year. All infants were vaccinated at day 1 and at 1 and 6 months with Engerix. Hepatitis B antigen antibody (Ab) serum titers were determined at the age of 1 year. All infants had detectable Ab titers (responders); 92.5% had protective titers (> 10 mlU/ml), out of which 26.5% were low responders (< 100 mlU/ml) and 65% were high responders (> 100 mlU/ml). There was no significant difference in immune responses between term and preterm infants.

Female↗

Increased leukocyte adhesiveness/aggregation is the single best biochemical indicator of disease activity in adolescent patients with inflammatory bowel disease.

We determined the relative utility of inflammatory markers in evaluating disease activity in adolescent patients with inflammatory bowel disease (IBD). Sixty-one adolescent patients and 50 age and sex matched volunteers who served as controls were evaluated prospectively. The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), white blood cell count (WBCC), and the leukocyte adhesiveness/aggregation (LAA) test were determined in each patient. There were 28 subjects in remission and 33 in relapse. Their percentage of aggregated white blood cells in the peripheral blood was 7 +/- 5 and 16 +/- 8, respectively, when compared with the control group (5 +/- 3) (p < 0.0001). Moreover, the LAA test was the only one which could effectively classify patients with IBD into their correct diagnostic categories of remission, mild-moderate, or moderate-severe disease activity. The LAA test is superior to other acute phase reactants used in daily practice to detect the presence of inflammation as well as for the assessment of its severity in adolescent patients with IBD. In addition, our findings may have biological relevance to the disease process and its potential manipulation by anti-adhesive agents.

Adolescent↗

Lack of association between smoking and inflammatory bowel disease in Jewish patients in Israel.

BACKGROUND/AIMS: An excess of smokers in patients with Crohn's disease (CD) and a paucity of smokers in patients with ulcerative colitis (UC) were reported in many studies. The aim of this study was to examine the association between smoking and inflammatory bowel disease (IBD) in Israel. METHODS: Two independent studies were performed. Patients with recent IBD in comparison with matched population and outpatient controls and patients with chronic UC and CD were studied. Altogether, 475 subjects were investigated. RESULTS: In both studies, the presence of current smokers was lower in CD (9% and 18%) than in UC (24% and 26%). The proportions of nonsmokers in both studies were similar (UC, 61% and 65%; CD, 67% and 70%) and comparable to those found in their two control groups (57% and 61%; 63% and 68%, respectively) and to the general population of Israel. All differences in smoking habits between patient groups and their controls were not statistically significant, except for the paucity of current smokers in the small group of patients with newly diagnosed CD (P < 0.05). A matched analysis produced similar results. CONCLUSIONS: The expected associations between smoking and IBD could not be confirmed. Two hypotheses are considered: (1) the association between smoking and IBD may not be universal, and (2) our findings may be related to the higher genetic predisposition to IBD in Jewish people.

Adult↗

Diurnal variation in serum bilirubin concentrations in infants with neonatal jaundice.

We investigated whether there are independent intradaily changes in bilirubin levels in neonates. Healthy term newborn infants (n = 124) with neonatal jaundice bilirubin >/t171 mmol/L (10mg/dl) were studied for at least 3 consecutive days. Starting from the second day of life, consistent intradaily changes were observed in bilirubin levels (morning levels were greater than evening levels; p < 0.001), and body weight steadily increased. This diurnal variation in bilirubin levels should be considered in the follow-up and treatment of neonatal jaundice.

Bilirubin↗

Portal vein thrombosis caused by protein C and protein S deficiency associated with cytomegalovirus infection.

A 4-month-old girl who was examined because of splenomegaly had portal vein thrombosis, which apparently resulted from a combination of cytomegalovirus infection and deficiency of both protein S and protein C. The cytomegalovirus infection, by damaging endothelial cells, may have triggered a cascade of events that was ultimately expressed as portal vein thrombosis resulting from deficiency of proteins S and C.

Blood Protein Disorders↗

Long-term follow-up and outcome of infants with non-organic failure to thrive.

Sixty-one children diagnosed as having non-organic failure to thrive during infancy were reviewed at an average of 5 years after their initial presentation, and were compared to a control group matched for age, sex, social class, and ethnic affiliation. Children with a previous history of failure to thrive were found to be shorter and, in particular, to gain less weight. Birthweight percentile and maternal height of children with failure to thrive were lower than those of matched children from the control group. They also had more learning difficulties and evidenced developmental delay. The degree of growth retardation and the duration of follow-up had no significant effect on the outcome. In contrast, birthweight, maternal height, and social status and, to a lesser extent, paternal parameters were good predictors of catching-up capabilities of these infants in terms of weight and height. Children who caught up faster had better school performances and came from families of higher socioeconomic status. Failure to thrive is a multifactorial process involving biological, nutritional, and environmental factors. All these components should be considered in long-term follow-up and management.

Anthropometry↗

[Intussusception in infants].

Intussusception, the invagination of a portion of the intestine into an adjacent segment, is the most common cause of intestinal obstruction in post neonatal children. Most cases are idiopathic, but in about 2-12% the intussusception evolves secondary to an underlying abnormality. Classically, there is sudden onset of attacks of screaming, accompanied by pallor, vomiting, and irritability in a previously health child. Some gradually become weaker and lethargic. We evaluated variations in presenting symptoms and outcome as related to age and time until admission. There were incidence peaks in the spring and autumn. 48% developed irritability, while 42% were described as apathetic. These results emphasize the importance of awareness that apathy can be a major presenting symptom. The younger the child, the greater the rate of success of reduction by hydrostatic pressure. In those admitted within 24 hours of onset, the rate of reduction was twice that in those admitted later. Awareness of atypical symptoms and early diagnosis may affect treatment and improve prognosis.

Humans↗

Urine as an alternative to urethral swabs for the diagnosis of Chlamydia trachomatis in infertile males.

Swabbing the urethrae of men has been the traditional approach for collecting specimens for detection of Chlamydia trachomatis. Recently, however, urine testing using enzyme immunoassay has yielded promising results. A total of 105 patients attending the Andrology Clinic at Ga Rankuwa Hospital, Medunsa were included in the study. These patients were asymptomatic and had no urethral discharge. Three endo-urethral swabs and first-catch urine were collected from each patient. The urethral swabs were used for enzyme immunoassay (EIA) (IDEIA III), tissue culture and direct immunofluorescent antibody (DFA) test (IMAGEN) to detect C. trachomatis. In addition about 15-30 ml of first-catch urine, or urine collected at least 2h after the previous micturition, was collected for each patient for EIA testing. Fifteen (14.3%) of 105 patients were positive on urethral swab EIA, in comparison with the DFA test in which 14 (13.3%) were positive. Eight (7.8%) were positive in tissue culture. Urine EIA was positive in 17 (16.2%) patients, of whom five (4.8%) were positive in urine EIA only. All EIA positive urines were confirmed by DFA. We recommend that first-catch urine or urine collected at least 2h after the previous micturition in infertile males may be considered a suitable alternative to urethral swab for chlamydial diagnosis because it is noninvasive and nontraumatic.

Adult↗

Biochemical analysis of tunica vaginalis fluid in patients with or without idiopathic hydroceles.

OBJECTIVE: To establish the differences, if any, between the biochemical composition of idiopathic hydrocele fluid and the fluid normally present in the tunica vaginalis. PATIENTS AND METHODS: Aspiration and sclerotherapy of 37 idiopathic hydroceles from patients who presented to this urology clinic were performed. The biochemical content of the fluid was compared with that of the tunica vaginalis fluid from a small group of controls (n = 8), taken from patients undergoing orchidectomy for carcinoma of the prostate. RESULTS: Differences in several measurements were recorded; in particular, there were significantly higher concentrations of calcium, albumin, total protein and creatine-kinase in the hydrocele group. The levels of potassium, aspartate transaminase, alanine transaminase and alkaline phosphatase were significantly lower in the hydrocele group. CONCLUSION: Whether these differences have a role in the causation of an idiopathic hydrocele is, at this stage, speculative. A similar study on a larger scale would probably be more conclusive.

Albumins↗

Perinatal food restriction in rats reduces the content but not concentration of liver extracellular matrix proteins.

Fibrosis of the liver has been reported to be associated with malnutrition, based on qualitative histological and histochemical approaches. The aim of this study was to quantitatively examine the effect of perinatal food-restriction on the expression of extracellular matrix components of the liver, using rats fed 50% of ad libitum intake, determined by the food consumption of the control group on the previous day. Levels of extracellular matrix proteins were measured by dot blot analysis using monospecific antibodies against collagen types I, III and IV, laminin and fibronectin. The body weights of 4, 8 and 13-wk-old malnourished groups were 25, 35 and 48% of the control group body weights, respectively, and the liver weights were 22, 32 and 60% of the controls. The total contents of the extracellular matrix components were significantly reduced to 30, 34 and 58% of the controls, but when expressed per tissue or per milligram protein there were no significant differences. Indirect immunofluorescence revealed no major changes in extracellular matrix localization. The major histological change in the food-restricted rats was fatty infiltration. Our observations suggest that the effect of perinatal food restriction is mainly liver steatosis, and that the liver of food-restricted animals during the perinatal period has the capacity to preserve its main extracellular matrix components.

Animals↗

The immunopathology of cardiac xenograft rejection in the guinea pig-to-rat model.

The mechanisms underlying rejection by rats of vascularized guinea pig xenografts have been controversial. The aim of this study was to define, using sequential immunopathologic analysis, the contributions of xenoreactive antibody, complement, and effector cells to the rejection of guinea pig cardiac xenografts by Lewis rats. In untreated recipients, hyperacute rejection of guinea pig cardiac xenografts occurred in 20 +/- 10.2 min and was characterized by focal endothelial deposition of IgM and by diffuse deposition of C3. IgG was not localized to endothelial surfaces, but was present in the same locations as albumin, suggesting that the accumulation of IgG might reflect nonspecific leakage of plasma proteins from blood vessels. No polymorphonuclear or monocytic infiltrate was observed. Depletion from rats of xenoreactive antibody to undetectable levels prolonged the survival of guinea pig cardiac xenografts, but did not prevent hyperacute rejection; the rejected xenografts contained deposits of C3 along the microvasculature but no deposits of IgM or IgG. No cellular infiltrate was observed. Depletion of complement with cobra venom factor prolonged the survival of xenografts up to 96 hr. Xenograft tissues from complement-depleted animals had diffuse deposits of IgM along the microvasculature, but no detectable deposits of C3 or IgG were noted. Graft tissues obtained at various times after transplantation into complement-depleted animals revealed cellular infiltrates consisting of granulocytes, monocytes, and lymphocytes, but few cells bearing an NK cell phenotype. Our findings are consistent with the concept that complement activation is essential for the hyperacute rejection of discordant xenografts, and that in this particular model complement activation can proceed without the involvement of antibody. However, our findings also suggest that xenoreactive antibody contributes to hyperacute rejection and, along with effector cells, contributes to the later rejection of a xenograft when hyperacute rejection has been averted. Finally, we show that when hyperacute rejection is avoided, a form of vascular rejection occurs in which certain of the pathologic features--i.e., interstitial hemorrhage, interstitial edema, and thrombosis--are very similar to those observed in hyperacute rejection. Whether this form of rejection is a delayed form of the process that leads to hyperacute rejection or a novel pathologic process of graft rejection has yet to be determined.

Animals↗