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F B Stapleton

Publications and source records attributed to F B Stapleton.

122 records · Page 7Linked to original sources
PubMed1977

Therapeutic approach to pancreatic extract-induced hyperuricosuria in cystic fibrosis.

The relationship between the dosage of pancreatic extract and the excretion of uric acid was investigated in 29 patients with cystic fibrosis and exocrine pancreatic insufficiency. Urinary excretion of uric acid was normal in patients receiving small doses of pancreatic extracts and abnormally high in those receiving large amounts. In the latter group, normouricosuria was achieved by reducing the dose of pancreatic extract. Normal stool patterns and adequate weight gains were preserved by a diet modification that was well accepted by the patients. To eliminate the potential renal consequences of hyperuricosuria, it seems appropriate to control the need for increasing amounts of pancreatic enzymes by limiting the dietary intake of fat and maintaining a positive caloric and nitrogen balance with high intake of protein and carbohydrates and supplementation with medium-chain triglycerides.

Body Weight↗
PubMed1977

Effect of basement membrane and colloid osmotic pressure on renal tubule cell volume.

Renal tubule cell volume is thought to be kept constant by a cation pump. When active transport is blocked, intracellular impermeant solutes cause cells to swell. Cell size is then determined by transmembrane hydrostatic and colloid osmotic forces. We studied the importance of passive transmembrane forces in determining cell size in isolated rabbit proximal straight tubules (PST). We blocked active solute transport with ouabain and evaluated subsequent changes in cell size by measuring outer diameter of nonperfused tubules. Tubules in a ouabain and 6 g/100 ml protein bath swelled only 40% above control. However, removal of the tubule basement membrane with collagenase dissipated a transmembrane hydrostatic pressure and caused more swelling. Final cell volume was determined largely by bath protein concentration. Tubules in ouabain and collagenase swelled enormously in hyponcotic protein, moderately in isoncotic protein, and could be shrunk below control in hyperoncotic protein. Intracellular colloid osmotic pressure was estimated to exceed 38 cmH20. We conclude that hydrostatic and colloid osmotic forces are major determinants of cell size in isolated PST treated with ouabain.

Animals↗
PubMed1976

Hyperuricosuria due to high-dose pancreatic extract therapy in cystic fibrosis.

Dysuria, uric acid crystalluria and hyperuricosuria developed in a child with cystic fibrosis and normal serum uric acid. Hyperuricosuria in this patient and two other children was directly related to ingestion of large amounts of pancreatic extract. In these three children, reducing pancreatic extract dosage by 85 percent lowered their purine intake by 307, 225, and 148 mg, respectively; urinary uric acid excretion decreased by 245, 239, and 158 mg. Overmedication resulted from parents' decisions to increase enzyme dosages. In our cystic fibrosis clinic, 15 of 32 patients screened at random were taking higher than the prescribed dose of pancreatic enzymes, and 14 of these 15 children were hyperuricosuric. On the basis of this information, we suggest that the minimal effective dose of pancreatic extract should be determined and adhered to for each child with cystic fibrosis to avoid potential renal injury from hyperuricosuria.

Administration, Oral↗
PubMed1976

Hypokalemia associated with antibiotic treatment. Evidence in children with malignant neoplasms.

A patient with acute lymphocytic leukemia developed hypokalemia during two separate courses of antibiotic therapy. In a review of 33 children from our institution with various malignant neoplasms, 24 of 48 antibiotic courses were associated with hypokalemia that could not be explained by gastrointestinal fluid losses. Carbenicillin disodium, gentamicin sulfate, and methicillin sodium or nafcillin sodium combination therapy was associated with hypokalemia in 23 of 35 courses in which serum electrolytes were monitored. No correlation between hypokalemia and the stage of the basic disease or the use of antineoplastic agents was found with this antibiotic combination. Our data and a review of the literature suggest that carbenicillin produces hypokalemia through an impermeant anion effect on the renal tubule. Children receiving carbenicillin should be monitored with frequent serum potassium determinations.

Adolescent↗
PubMed1976

Telephone assessment of illness by practicing pediatricians.

Telephone assessment of illness by 40 practicing pediatricians was studied using simulated complaints of cough, vomiting, diarrhea, or rash. Of a possible 370 standardized questions based on the American Academy of Pediatrics "Guidelines for telephone communications," only 194 were used. Crucial questions such as difficulty breathing with cough, the state of hydration in diarrhea, the character of the eruption in rash, or the presence of abdominal pain with vomiting were asked less than 50% of the time. Pediatricians in practice for fewer than five years requested more information and spent more time on the telephone than did those with greater than five years' experience.

Child, Preschool↗
PubMedDate not supplied

Vagal hypotension after percutaneous biopsy: possible confusion with hypovolemic shock.

Vagal hypotension can occur after percutaneous biopsy and be misdiagnosed as hypovolemia due to hemorrhage. Inappropriate exploratory surgery and death have resulted. Increased vagal tone or massive discharge is characterized by hypotension with bradycardia or lack of tachycardia and can occur after many stimuli including contrast medium injection, anxiety, and needle insertion. Vagal reactions can be mild and self-limited, but can also progress to cardiac arrest. Atropine 0.6 to 0.8 mg intramuscularly or intravenously in increments up to 3 mg has been recommended for prompt treatment. Volume expansion is adjunctive.

Adult↗
PubMedDate not supplied

Genitourinary malformation with calcified intraluminal meconium and pulmonary hypoplasia.

Calcified intraluminal meconium is a rare finding in newborn infants that is often associated with communication between the urinary and gastrointestinal tracts. Frequently such infants die because of respiratory problems. An illustrative case is presented, and pulmonary hypoplasia is suggested as an etiology of the respiratory difficulties observed.

Calcinosis↗
PubMedDate not supplied

Cerebrovascular complications in children with nephrotic syndrome.

Although the nephrotic syndrome is known to be a hypercoagulable state, cerebral arterial thrombosis associated with the nephrotic syndrome is an uncommon yet treatable cause of stroke syndrome in children. We report 2 children, 1 with congenital nephrotic syndrome and the other with minimal change nephrotic syndrome, who developed cerebral arterial thrombosis. The complication was fatal in 1 patient.

Child↗
PubMedDate not supplied

Spectrum of glomerulocystic kidneys: a case report and review of the literature.

An 8-year-old boy developed end-stage renal disease 7 years after the in utero diagnosis of bilateral cystic kidneys. There was no history of cystic renal disease in the family. Initial ultrasonographic screening of the parents failed to reveal cysts in the kidneys. Pathological evaluation of the kidney biopsy findings was consistent with the glomerulocystic kidney disease. He had bilateral nephrectomies in preparation for a living related renal transplant at 7 years of age. At that time, a repeated renal ultrasound examination of the mother showed bilateral cystic kidneys. Pathological evaluation of the nephrectomy specimens confirmed the diagnosis of autosomal dominant polycystic kidney disease. In this report, a discussion of the differential diagnosis of glomerular cysts and the relationship of glomerulocystic kidney disease and autosomal dominant polycystic kidney disease is provided.

Child↗