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Biomedical subjects

H Boichis

Publications and source records attributed to H Boichis.

At least 73 records · Page 4Linked to original sources

Enhanced renal tubular calcium reabsorption independent of parathormone activity, in children on long term anticonvulsant therapy.

A significant reduction in the urinary calcium-creatinine ratio, was found in thirty-four ambulatory epileptic children on long term anticonvulsant therapy, studied during wintertime. No significant difference in the urinary excretion of cyclic AMP, phosphate or amino-acids was observed when the study-group was compared to an age-matched control group. Serum calcium and phosphate values were normal, but a significant increment in alkaline phosphatase was noted. Since there was no evidence of hyperactivity of the parathormone, it is suggested that the enhanced renal tubular calcium reabsorption in children on long term anticonvulsant therapy is a nonparathormone mediated phenomenon, possibly compensating for reduced calcium absorption in the gastrointestinal tract.

Absorption↗

Minoxidil in the treatment of refractory hypertension.

Minoxidil, a powerful vasodilator, is a very effective antihypertensive drug. It was used to treat 22 patients, most of whom were refractory to conventional antihypertensive medication. There was a swift and definite drop of blood pressure in all cases. In 7 patients with renal disease, renal function did not deteriorate during the administration of Minoxidil, and it improved dramatically in the eighth patient. Side effects of the drug were hirsutism, fluid retention, and in 1 patients a pruritic bullous eruption which disappeared when the drug was discontinued.

Adolescent↗

Minoxidil in the treatment of refractory hypertension.

Minoxidil, a powerful vasodilator, is a very effective antihypertensive drug. Twenty-two patients, who were mostly refractory to conventional anti-hypertensive medication, were treated with this drug. There was a swift and definite drop of blood pressure in all cases. In 7 patients with renal disease, renal function did not deteriorate during the administration of minoxidil, and it improved dramatically in the eighth patient. Side effects of the drug were hirsutism, fluid retention, and in 1 patient a pruritic bullous erruption which disappeared when the drug was discontinued.

Adolescent↗

The conservative management of vesicoureteric reflux: a review of 121 children.

A group of 121 children with vesicoureteric reflux (VUR) grades 1 to 3 managed conservatively were followed-up for a period of six to ten years. In the majority of patients VUR grades 1 and 2 disappeared spontaneously. Prognosis was less favorable in those who were seen initially with grade 3 VUR. A statistically significant higher incidence of reflux disappearance was observed in children who were seen before 4 years of age. In the majority of patients with paraureteric-vesicle diverticulum, reflux persisted. Reflux was more likely to disappear in children with lower incidence of urinary tract infection than in those with multiple infections.

Adolescent↗

Radiological findings of the urinary tract in hypospadias: a report of 110 cases.

One hundred and ten patients with hypospadias underwent excretory urography and micturating cysto-urethrography before surgical correction. Urographic studies revealed abnormalities in 50 patients (45%), mainly anomalies of ascent and rotation of the kidneys. None of these patients required corrective surgery. Voiding cysto-urethrography disclosed disease of the urinary tract in 65 of 110 patients (59%). Meatal stenosis was found in 38 patients and a rudimentary vagina or a prostatic utricle was revealed in 11 others. Vesico-ureteral reflux was present in 14 patients, seven of whom had meatal stenosis as well. Cystitis was found in eight and a stricture of the membraneous urethra in one patient. The voiding cysto-urethrogram is able to demonstrate functionally significant meatal stenosis, genital abnormalities and vesico-ureteral reflux. It can also serve as a useful baseline for comparison with postoperative studies. We therefore consider that it should be included in the preoperative work-up of every patient with hypospadias. Excretory urography, however, is perhaps indicated only in those with urinary tract infection, or in patients otherwise symptomatic.

Adolescent↗

Anuria in childhood due to bilateral urolithiasis. A report of four cases.

Four children with anuria due to occlusion of both ureters by calculi are presented. A plain film of the abdomen revealed faintly radiopaque urinary calculi bilaterally in three patients. In the fourth case, one calculus was visualized in the right ureter, but further contralateral exploration showed an obstructing ureteral calculus in the left ureter as well. It is concluded that in children with acute anuria, the possibility of bilateral ureteral obstruction due to calculi should be the physician's first consideration.

Acute Disease↗

Steady state serum concentrations and renal clearance of digoxin in neonates, infants and children.

Steady state serum concentrations of digoxin were determined repeatedly in 34 infants with congenital heart disease. Simultaneous measurements of renal clearances of digoxin, creatinine and urea were obtained in 29 of the subjects. Serum digoxin concentrations were markedly higher in children under the age of 3 months than in those over this age, despite equal weight--adjusted 24 h doses. This finding was explained by a very rapid increase in renal digoxin clearance in the first 3 months--32 +/- 7 ml/min/1.73m2 at 1 week to 65.6 +/- 30 at 3 months. The subsequent increase in digoxin clearance was much slower, e. g. to 87.7 +/- 43 ml/min/1.73m2 at 12 months. Renal clearance of digoxin was equally well correlated with creatinine clearance (r = 0.87) as with urea clearance (r = 0.83), but it exceeded that of creatinine in all age groups. The findings indicate that both glomerular and tubular function is involved in the renal elimination of digoxin in young children, and that development of renal elimination of the drug parallels that of the maturation of renal function in the early months of life. The neonate and infant with congestive heart failure display impaired ability to eliminate digoxin. The impairment lessens rapidly with the development of renal function over the first 3 months of life. Diminished doses of digoxin should be advocated in this age group if therapeutic serum concentrations of the drug are to be maintained and toxicity avoided.

Aging↗

Fused labia. Clinical and radiological findings.

The clinical and radiological findings in fused labia are described. Some of the patients were asymptomatic. The others were referred because of a suspicion of urinary infection. Micturating cystourethrography showed collection of contrast material above the labia and marked reflux into the vagina in all patients examined. These findings were not seen after separation of the labia. Although the diagnosis is usually a clinical one, it is suggested that labial fusion may first be recognized by the radiologist through these cystourethrographic findings and while catheterizing the child.

Adolescent↗

Minoxidil-induced bullous eruption.

A previously unreported side effect--serosanguineous bullae--was found in one patient receiving minoxidil. The eruption disappeared with cessation of the drug and reappeared on rechallenge. The question arises whether continuation of minoxidil treatment could have led to vasculitis.

Aged↗

Steady state serum digoxin concentration in relation to digitalis toxicity in neonates and infants.

Steady state serum digoxin concentrations were determined in 34 neonates and infants receiving standard maintenance doses of the drug. Digitalis intoxication, diagnosed by ECG criteria, occurred in four of 13 patients with a serum concentration above 2 ng/ml and not in any of 21 subjects with a serum digoxin concentration below this level. This association was found to be significant. It seems that the concept of increased tolerance to digoxin hitherto ascribed to infants is not tenable and that the monitoring of serum digoxin concentration is essential to treatment in this age group.

Digitalis Glycosides↗

The metabolic effects of excess noradrenaline secretion from a pheochromocytoma.

We report a 14-year-old boy with severe hypertension who was cured by surgical removal of a pheochromocytoma. The tumor was shown biochemically and morphologically to secrete predominantly noradrenaline. The metabolic effects noted in this patient were raised free fatty acid levels and depressed insulin levels, hyperreninemia, hypercalcemia, and hypercalciuria with normal parathyroid function. All these abnormalities returned to normal after removal of the tumor. It is suggested that these effects were mediated via beta-adrenergic stimulation of the excess noradrenaline.

Adolescent↗

Quantitation of renal antigen excretion in the urine of normal children and of children with various renal diseases. I. Quantitation of renal antigens in random urine samples.

This study reports a serologic method for the measurement of kidney-derived antigens in the urine of healthy children and of children with renal diseases. Two hundred twenty patients were studied. Four groups were recognized: group A, patients with no evidence of renal disease; group B, patients with past history of active urinary tract infection; group C, patients with active urinary tract infection; group D, patients with other renal diseases. Urinary renal antigen concentration was tested by the complement fixation method, in which titers of antigens in the urine were compared with a standard human renal antigen extract. The distribution of renal antigen concentrations in group C differed significantly (P(X2Y less than 0.001) from the other three groups. About 85% of patients in groups A, B, and D had levels below 0.6 mg/ml, whereas in group C only 53% of patients had similar concentrations. After factoring the results by the urinary concentration of creatinine, 85% of patients in group C had antigen levels above 0.6 mg/ml as opposed to 24%, 44%, and 27% in groups A, B, and D, respectively. The results of the study are consistent with the assumption that the rate of discharge of renal antigenic material in the urine is accelerated in certain renal diseases.

Antigens↗

Metabolic responses to the administration of angiotensin II, K and ACTH in two salt-wasting syndromes.

Metabolic responses to the administration of Angiotensin II, K and ACTH are described in two salt-wasting syndromes: hypoaldosteronism in Jews from Iran, which is characterized by an enzymic block in the conversion of 18-hydroxycorticosterone to aldosteron; and pseudohypoaldosteronism, a disorder in which aldosterone secretion is high in association with renal tubular unresponsiveness to mineralocorticoids. The response of plasma and urinary aldosterone to K and ACTH is qualitatively normal in hypoaldosteronism; however, infusion of Angiotensin II, in a dose that was pressor and elevated aldosterone levels threefold in control subjects, was only pressor in hypoaldosteronism. In pseudohypoaldosteronism, plasma and urinary aldosterone respond to Angiotensin II, K and ACTH, notwithstanding very high basal hormonal levels.

Adrenocorticotropic Hormone↗