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Biomedical subjects

A B Gruskin

Publications and source records attributed to A B Gruskin.

At least 37 records · Page 2Linked to original sources
PubMed1984

Single-dose treatment of uncomplicated urinary tract infections in children.

Thirty-six girls, aged two to 17 years, with culture-proven, acute, uncomplicated lower urinary tract infections and without signs or symptoms of upper urinary tract infection, were randomized to receive either single-dose amoxicillin or conventional therapy for ten days. Twenty-six patients completed the study, ten in the single-dose group and 16 in the conventional therapy group. The patients treated with single-dose therapy had cure rates (70% vs 75%), relapse rates (30% vs 25%), and reinfection rates (0% vs 12%) comparable to those of conventionally treated patients. A significant difference in the induction of resistant organisms was seen between treatment groups (P less than .05). All single-dose relapses were due to failure to clear a sensitive organism from the urinary tract. All relapses on conventional therapy resulted from an initially sensitive organism becoming resistant to amoxicillin during treatment. Single-dose antibiotic therapy of uncomplicated urinary tract infections in children is effective in patients with culture-proven infections selected by clinical criteria, and appears to be safe when combined with conscientious long-term follow up and radiographic evaluation. Single-dose therapy offers the advantage of selecting significantly fewer resistant organisms from the gut flora than do conventional antibiotic regimens.

Adolescent↗
PubMed1984

Development of pneumatosis cystoides intestinalis following transperitoneal renal transplantation in a child.

A 9 1/2-year-old female developed pneumatosis cystoides intestinalis (PCI) which was detected radiographically 4 1/2 months after transperitoneal cadaveric renal transplantation, during a period characterized by recurrent episodes of acute rejection. Radiographic evaluation was prompted by the development of cramping abdominal pain, distention, and tenderness localized to the region of the allograft, which occurred during one such episode. Pneumatosis was localized primarily to an area of colon that lay in direct contact with the allograft. Evaluation of the available clinical and roentgenographic evidence suggested that pneumatosis may have resulted from the development of a sympathetic inflammatory reaction within the bowel wall adjacent to the acutely inflamed allograft. Subsequent stabilization of renal function was associated with resolution of the pneumatosis over the ensuing 8 months without surgical intervention or additional medical therapy.

Child↗
PubMed1984

Resting blood pressure and pulse rate distributions in black adolescents: The Philadelphia Blood Pressure Project.

Reference percentile distributions for blood pressure in black adolescents are not generally available. The most recently published BP percentile grids for children and adolescents were derived almost exclusively from information on white populations, and few data are available on the distribution of pulse rate for black adolescents. Reference percentiles for black adolescents for resting BP and 60-second pulse rate are presented. Given the tendency for high BP levels to track, these reference percentiles may be of value in determining the extent to which black adolescents are at risk for hypertensive disorders in adulthood. The percentiles were derived from a 3-year longitudinal study of black, urban Philadelphia adolescents, aged 12 to 17 years. Confirming results from studies of other populations in adolescence, a trend was found toward increased mean systolic BP for boys (P less than .001), and that boys have significantly higher (P less than .001) systolic BP than girls after chronologic age 15 years. Diastolic BP phase IV (muffling) exhibits no age or sex trends from ages 12 to 17 years, but adolescent girls overall have significantly higher (P less than .001) phase V diastolic (disappearance) than boys. Sixty-second pulse rate declines for both boys and girls in adolescence, although at every age 60-second pulse rate means are significantly faster in girls than boys (P less than .02). For girls older than 12 to 17 years, there is a significant, positive correlation between pulse rate and systolic BP (r = .16, P less than .01) and between pulse rate and phase IV diastolic (r = .23, P less than .01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

Blood pressure response to dynamic exercise in adolescents before and after percutaneous transluminal renal artery angioplasty.

The blood pressure response to maximal bicycle exercise was studied using the James protocol in two adolescents with renal artery stenosis before and after percutaneous transluminal renal artery angioplasty. Prior to angioplasty, one patient (pt A) had persistent and one patient (pt B) had labile elevation of the resting blood pressure above the 95th percentile for age; both patients had elevated systolic blood pressure at maximal exercise (pt A: 215 mm Hg; James expected 170 +/- 20; pt B: 228 mm Hg; James expected 156 +/- 15). Following angioplasty, both patients had resting blood pressures below the 95th percentile for age; patient A had improved systolic pressure at maximal exercise (195 mm Hg) while patient B had persistent elevation in the exercise systolic blood pressure (215 mm Hg). Angiography confirmed the presence of residual/recurrent renal artery stenosis in patient B. We conclude that measurement of blood pressure during exercise may reveal residual abnormalities not apparent at rest and thus may be useful in assessing the result of renal artery angioplasty in children with renal artery stenosis.

Adolescent↗
PubMed1983

Transperitoneal solute movement in children.

The transperitoneal movement of solute in children was examined by means of a theoretical consideration of the peritoneal clearance formula and by the performance of peritoneal solute diffusion curves and measurement of peritoneal clearances of multiple solutes. Theoretical considerations led to the conclusion that when dialysis mechanics are held constant, peritoneal clearances scaled for weight are similar in individuals of widely varying weight when the volume of infused dialysate is also scaled for weight if peritoneal permeability and surface area are constant. In one group of studies, solute diffusion curves and weight-scaled peritoneal clearances of urea, phosphate, creatinine, and urate were similar in 3 children ages 4 to 18 months compared to 4 children ages 2.5 to 18.5 years. In a second group of studies, weight-scaled peritoneal clearances of inulin but not urea were shown to be marginally lower in 4 children who had been dialyzed longer than 6 months compared with 4 children dialyzed less than 1 month. Hypertonic glucose dialysis in these children was shown to enhance urea clearance but not that of inulin. It is concluded that comparative studies of peritoneal clearances can characterize the transperitoneal movement of solute in children of widely varying body size. Such studies are of greatest value when systematically performed and similar ratios of dialysate volumes to body pools of solute are used.

Adolescent↗
PubMed1981

Encephalopathy in infants and children with chronic renal disease.

The examination of five pediatric patients with encephalopathy secondary to chronic renal failure has indicated a stereotyped sequence of neurologic signs and symptoms including ataxia, loss of motor abilities, myoclonus, seizures, dementia, and bulbar dysfunction. Both the patients with CNS dysfunction and a control group selected for a similar degree of renal failure had increased levels of serum phosphate, alkaline phosphatase, and parathyroid hormone. Serial EEGs in the affected group revealed progressive slowing and an increase in paroxysmal features. No specific neuropathologic findings were noted in one patient.

Brain Diseases↗
PubMed1981

Uric acid in childhood essential hypertension.

Serum uric acid concentrations and the fractional excretion of uric acid were determined in 31 children from 3 1/2 to 18 years of age with essential hypertension. While on an unrestricted sodium intake, elevated serum values of uric acid were found in 13 of 31 (42%) of the children. After ingesting a low-sodium diet (200 mg/day) for three days, mean serum uric acid values increased by 0.7 mg/dl (P less than 0.001). There was a significant inverse correlation between the serum uric acid concentrations and fractional excretion of uric acid during the normal and low-sodium diet. This study indicates that the major factor leading to hyperuricemia in our hypertensive patients was a decrease in urate clearance. Insofar as hyperuricemia may represent a cardiovascular risk factor, this abnormality already exists in a significant fraction of hypertensive children and adolescents.

Adolescent↗
PubMed1981

Development aspects of peritoneal dialysis kinetics in dogs.

To determine whether solute transfer during peritoneal dialysis is age related and to identify those factors which might explain age-related differences in dialysis kinetics, the peritoneal dialysance of [14C]urea (DU), [3H]inulin (DI), and the permeability index (DR = DI/DU) were examined in six puppies and five adult dogs. Exchange volume of lactated Ringer's (40 ml/kg) and exchange times (30 min) were identical in all studies. Theoretical calculations for urea dialysance for animals of differing body size were made. Assuming the existence of a similar functional peritoneal surface area per kg and the use of similar exchange volumes per kg and dwell times, theoretical values for the urea dialysance per kg for different sized animals were identical. The experimental studies demonstrated that DI per kg and DU per kg were higher in the puppies (0.146 +/- 0.023 and 0.765 +/- 0.054 ml/min kg; X +/- S.E.) than in the adult (0.052 +/- 0.01 and 0.462 +/- 0.05 ml/min/kg) (P less than 0.01). Also, DR was higher in the puppies (0.187 +/- 0.026), than in the adults (0.11 +/- 0.015) (P less than 0.05). The greater values for DI and DU per kg and DR in the young are best explained by the young having an increased peritoneal membrane permeability as well as an increase in functional peritoneal surface area relative to body weight. This increase in solute movement is independent of the dialysis mechanics used in an exchange and reflects age-related differences in the intrinsic characteristics of the peritoneal membrane.

Age Factors↗
PubMed1980

Improved hemodialysis access in children.

Vascular access for chronic hemodialysis in children is difficult because of problems that include obtaining vessels of sufficient size, the limited life-span of external shunts, and the multiple painful punctures associated with internal fistulae. Twenty-five expanded polytetraflouroethylene (PTFE) grafts of 6-mm diameter were inserted for dialysis access over a 2-yr period in 23 children. Grafts were placed either in the upper arm or thigh. Each patient was successfully dialyzed from 60 to 370 times. Longterm patency of the PTFE grafts was 88%, with a complication rate of 36%, mostly minor. The same ease of insertion and high flow characteristics were noted in a series of 22 bovine carotid heterograft (BCH) fistulae inserted in the two years immediately preceeding this study. However, the patency rate was only 36% and the complication rate was 69%, mostly major. We consider the PTFE graft fistula to be the preferred method for long-term hemodialysis access in children.

Adolescent↗
PubMed1980

Hypochloremic alkalosis in infants associated with soy protein formula.

Thirteen infants, 2 to 10 months of age, developed hypochloremic alkalosis (serum chloride 59 to 92 mEq/l) while taking Neo-Mull-Soy (Syntex), a soy-based formula low in chloride (measured to be 0 to 2 mEq/l) but with considerable potassium citrate. Range of symptoms included lethargy, anorexia, mild spitting up, diarrhea, hematuria, and growth failure. Urine chloride excretion was less than 3 mEq/l. Plasma renin activity or aldosterone, measured in six infants, was elevated. All responded promptly to supplemental salt. One infant receiving Neo-Mull-Soy redeveloped alkalosis when supplemental salt was discontinued. Two of nine apparently normal infants receiving Neo-Mull-Soy also had hypochloremia (85, 86 mEq/l). Three of four receiving Prosobee (Mead Johnson; Cl content 7 mEq/l) had urine chloride concentration less than 20 mEq/l. The chloride content of some infant formulas is insufficient to offset salt losses following mild stress.

Alkalosis↗
PubMed1980

Cefazolin in children with renal insufficiency.

Cefazolin (7 mg/kg) were administered to 11 children with renal insufficiency and to ten children on hemodialysis. The serum half-life of the drug was progressively prolonged as glomerular filtration rate fell. The serum half-life of cefazolin was variably prolonged in those children on hemodialysis, but their serum levels of cefaxolin had dropped by 35 to 65% during dialysis. Most had no measurable level prior to the next dialysis. Dosage recommendations are made for both groups of patients.

Adolescent↗
PubMed1980

Heterophile antibodies in the serum of children with nephrotic syndrome.

Serum of children with the nephrotic syndrome contained high titers of a (19S) IgM antibody against sheep, horse, guinea pig, rat, and rabbit red blood cells but not against cow red blood cells. There was high correlation between high titers of antisheep antibodies and active nephrotic syndrome in the children with minimal change nephrotic syndrome. The antibody differed from the Paul-Bunnell antibody found in patients with infectious mononucleosis and from the anti-Forssman, Hangautziu-Deicher antibody found in patients with horse serum sickness. Rabbit red blood cells completely absorbed the antibody, but horse or guinea pig red blood cells removed only the anti-Forssman activity.

Animals↗