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Neonatal herpes simplex virus (NHSV) infection, although rare, is related to high rates of morbidity and mortality, both can be reduced by prompt acyclovir treatment. In contrast, enterovirus is a common cause of neonatal meningitis, with relatively negligible incidence of serious illness or long‐term sequelae, and its clinical course is not affected by acyclovir treatment. Acyclovir is associated predominantly with renal adverse effects, and its widespread application in the context of neonatal fever is not always justified. To further characterized the Israeli NHSV infection epidemiology and to evaluate the distinct clinical characteristics of NHSV and neonatal enteroviral meningitis (NEM), Israeli NHSV patients, hospitalized between January 2015 and April 2022 in 22 medical centers were assessed, together with NEM patients, hospitalized at Sheba Medical Center during the same period. NHSV demographic and clinical characteristics were documented and compared to those of NEM. Eighty‐five NHSV (73% males) and 130 NEM (62% males) patients were included. The incidence of NHSV was 5.9/100 000 live births, the common phenotype and HSV type were SEM (53%) and HSV1 (91%), respectively. Horizontal transmission was suspected in 50% cases (of which 67% underwent a Jewish ritual circumcision with direct wound sucking, 33% had relatives with highly suspicious herpetic lesions). Compared with NEM, NHSV tends to present with rash (14% vs. 60%, p < 0.01) and seizures (0% vs. 6%, p = 0.02), while fever, irritability and poor feeding appear more frequently in NEM (94% vs. 18%, p < 0.01; 37% vs. 1%, p < 0.01; 25% vs. 1%, p < 0.01, respectively). Of NEM patients, 28% were treated with acyclovir. Our results mark a decrease in the incidence rate of NHSV in Israel and a prominent mode of horizontal infection acquisition. We underscore the unique localized phenotype of NHSV, in contrast to enterovirus, which tends to cause a systemic disease with constitutional symptoms. These findings should be considered when evaluating the need for comprehensive empirical treatment for HSV in the context of neonatal fever, or according to a certain clinical presentation. [ABSTRACT FROM AUTHOR]

Energy drink (ED) consumption among Israeli-Arab adolescents is widespread. This study aimed to investigate the acute glycemic and insulin effects of EDs in healthy adolescents. Seventy-one Israeli-Arab adolescents (56% girls, average age 16.04 ± 1.03 years) participated in a non-randomized, case-controlled, open-label study. Participants consumed ED (n = 36) or a volume- and carbohydrate-matched non-caffeinated soft drink (SD, n = 35), followed by a 2 h glucose tolerance test. Blood glucose was measured at baseline and 15, 30, 60, and 120 min post-consumption (T0, T15, T30, T60 and T120, respectively). Serum insulin concentration and caffeine relative intensity were determined 45 min post-consumption (T45). Blood glucose levels peaked significantly at T15 and remained significantly higher at T30 in the ED group compared to the SD group (p = 0.005, p = 0.017, respectively). Insulin concentrations were substantially higher at T45 in the ED group (t [64] = 2.794, p = 0.001). This pattern was especially prominent in heavy ED consumers. A positive correlation emerged between the amount of caffeine consumed (mg/kg), blood glucose levels at T15 and T30, and insulin concentration at T45. This study is the first to demonstrate the glycemic and insulin responses to ED consumption in adolescents, suggesting that regulatory measures limiting ED sales to adolescents could improve their health. [ABSTRACT FROM AUTHOR]

Introduction: In cases of recurrent pneumonia that involved both lungs, foreign body aspiration (FBA) requires a high index of suspicion., Background: A previously healthy one-year old boy, was admitted to our department, because of right lower lobe pneumonia with a moderate amount of pleural effusion. He was treated with IV Cefuroxime resulting in a good clinical response. Three weeks later, he was referred again due to left lower lobe pneumonia with a mild amount of pleural effusion. Due to two episodes of pneumonia involving two different lungs within a five week period, a suspicion of an underlying immunodeficiency or other systemic disease was raised and a broad investigation revealed no underlying disease. Despite the lack of a history of FBA and the inappropriate clinical presentation (recurrent pneumonia not in the same side), FBA was still highly considered as a potential diagnosis, mainly due to the fact that these two episodes of pneumonia occurred within a short period of time. A flexible bronchoscopy was performed which revealed a FB lodged at the entrance of the left main bronchus, the FB was extracted by rigid bronchoscopy. Since then the child is asymptomatic with no further signs of pneumonia., Conclusions: FBA should be highly considered in recurrent pneumonia that involves two lungs especially when the episodes of pneumonia occur within a short period of time., Discussion: In cases of recurrent pneumonia that involve both lungs, FBA requires a high index of suspicion. Our assumption in this unusual case was that the FB was stuck in the carina, tilting and obstructing the entry of the right main bronchus leading to right side pneumonia; and in the second episode, later on, tilting to the left side and obstruction to the left main bronchus resulting in left sided pneumonia.