[Acute dehydration: physiopathology and therapeutic attitudes].
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Biomedical subjects
Publications and source records attributed to E Gautier.
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Five different methods of assessment of glomerular filtration rate (GFR) were compared in 500 children older than one year of age. Results of each method were compared with standard inulin clearance values: 1. An evaluation of glomerular function may be inferred from plasma creatinine levels; the validity of this inference is, however, limited because of the wide range of normal values; 2. creatinine clearance values calculated over 3 hours significantly overestimate inulin clearance values; 3. clearance values derived from plasma creatinine concentration ahd height show a poor correlation with traditionally calculated inulin clearances; 4. clearance values calculated as the sum of twice the creatinine clearance and once the urea clearance, divided by three, better predict inulin clearance than either C-creatinine or C-urea alone; 5 inulin clearance values calculated by dividing the quantity of inulin perfused by its plasma concentration, once it has become stable, differ significantly from the values obtained by the standard inulin clearance.--Of all the methods studied, none was found to be an ideal alternative to the traditional inulin clearance when a precise assessment of GFR is warranted. It is concluded that in most clinical conditions derived clearance values do not have significant advantages over the simple determination of plasma creatinine, a valuable but not infallible index of glomerular function.
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A boy of 3 2/12 years of age with Richner-Hanhart syndrome (plantar and palmar keratosis and chronic keratitis) was found to have hypertyrosinemia and to excrete the hydroxyacids derived from tyrosine. A diet poor in phenylalanine and tyrosine cured the skin and corneal lesions. Clinical and biochemical observations are reported.
This study based on hospital records is an analysis of 7433 deliveries in Adjamé Maternity Hospital, Abidjan, Ivory Coast. The incidence of low birthweight babies is 14.1%. Mean birthweight and height were shown to increase significantly from parity 1 to 9. Lowest mean birthweight and highest incidence of low birthweight babies were observed in primiparae. Incidence of stillbirths and abortions according to parity are described and an estimate of infant mortality rate has been attempted.
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The effect on heart rate (HR) and blood pressure (BP) of metoprolol, propranolol and terbutaline, applied alone or in combinations was studied in spontaneously hypertensive rats. Terbutaline had little effect on BP and HR. Propranolol combined with terbutaline had no effect while metoprolol combined with terbutaline decreased BP by 48 mm Hg without affecting HR. Thus the beta2-mediated increase in peripheral vascular resistance after terbutaline was revealed by a drop in BP after beta1-blockade by metoprolol, but not when both beta1-and beta2-receptors were blocked by propranolol.
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Renal function wa assessed in 20 newborn infants with idiopathic respiratory distress syndrome and compared to that of 10 neonates without respiratory distress or renal disease. Inulin and PAH clearances were markedly depressed in neonates with RDS as compared to controls (5.9 +/- 0.6 vs 9.3 +/- 0.8 ml/min/m2 (p less than 0.01) and 13.5 +/- 2.0 vs 23.2 +/- 1.2 ml/min/m2 ( p less than 0.01), respectively). The impairment of inulin and PAH clearances correlated with the severity of the pulmonary disease. Improvement of the respiratory distress was followed by a progressive rise of inulin and PAH clearances toward normal values. Intravenous administration of hypertonic mannitol in three patients resulted in an immediate increase in urine flow and inulin and PAH clearances. It is concluded that a state of acute, reversible, renal insufficiency can occur in the acute phase of idiopathic respiratory distress syndrome.
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Clearances of inulin and para-aminohippuric acid were performed in 22 newborn infants without renal disease. Ages varied from 12 hours to 25 days. The mean values of inulin and PAH clearances during the first four days of life were 10.8 +/- 1.0 ml/min/m2 and 30.8 +/- ml/min/m2, respectively. A twofold increase in glomerular filtration rate was observed during the first 14 days of life. A similar increase in PAH clearance occurred during this period. No correlation was found between gestational age (range: 32 to 39 weeks) and GFR in ten neonates studied during the first four days after birth.
In a family with a metachromatic leukodystrophy patient, two further pregnancies at risk were monitored by amnion cell culture. In one case, a normal baby was predicted and born. In the other case, a prenatal deficiency of arylsulfatase A was found. The diagnosis of metachromatic leukodystrophy was confirmed biochemically in various organs of the fetus by the deficiency of arylsulfatase A. The residual enzyme activity was shown to have an abnormal pH optimum and an increased heat stability. Ultrastructural studies revealed lipid storage in the myelinating nervous system and in the liver. For the interpretation of morphological results, it was indispensable to analyze an age-matched control fetus.
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