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Biomedical subjects

J C Chan

Publications and source records attributed to J C Chan.

At least 505 records · Page 28Linked to original sources
PubMedDate not supplied

A Chinese family with non-insulin-dependent diabetes of early onset and severe diabetic complications.

Non-insulin-dependent diabetes mellitus of early onset has recently been described in Caucasians as a distinct syndrome with a characteristic pedigree suggestive of inheritance of genetic determinants from both parents. It is characterized by absence of islet cell antibodies and the severity of its clinical course. We report a Chinese family pedigree of three generations in which this form of diabetes has affected the third generation. Some members of this pedigree had severe complications at presentation in their twenties.

Adolescent↗
PubMedDate not supplied

A case of Stevens-Johnson syndrome, cholestatic hepatitis and haemolytic anaemia associated with use of mefenamic acid.

A woman with a history of drug allergy, renal impairment and carcinoma of the breast with pulmonary micrometastases developed haemolytic anaemia and Stevens-Johnson syndrome following the use of mefenamic acid, paracetamol (acetaminophen) and furosemide (frusemide). In addition there was severe cholestatic hepatitis in the absence of clinical evidence of sepsis, biliary obstruction or recurrent metastases. The rash resolved on steroid therapy but the patient eventually died from both renal and liver failure. Acute tubular necrosis with a background of chronic tubulointerstitial nephritis was also found at autopsy. Although in the presence of multiple drug therapy the causative agent cannot be identified with absolute certainty, the association of these severe idiosyncratic hepatic and dermatological reactions with haemolytic anaemia strongly suggests mefenamic acid as the most likely culprit.

Acetaminophen↗
PubMedDate not supplied

Adverse reactions to drugs as a cause of admissions to a general teaching hospital in Hong Kong.

To determine the pattern of and the risk factors for adverse drug reactions (ADRs) in Hong Kong, a prospective study of acute admissions to 2 general medical wards at the Prince of Wales Hospital was undertaken. Of the 1701 admissions included in this study, 74 (4.4%) were attributed to ADRs. Sulphonylureas, nonsteroidal anti-inflammatories (NSAIDs) and insulin accounted for 61% of cases. The most frequent ADRs were hypoglycaemia (43%) and gastrointestinal haemorrhage (29.7%). Both old age and impaired renal function appear to be important risk factors for ADRs. In such situations, careful dose adjustments, use of an alternative drug or total avoidance may be necessary. Particular attention should be given to oral hypoglycaemic drugs and NSAIDs.

Drug-Related Side Effects and Adverse Reactions↗
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Ampicillin/sulbactam versus cefazolin or cefoxitin in the treatment of skin and skin-structure infections of bacterial etiology.

This randomized, double-blind study compared 1 g of ampicillin plus 0.5 g of sulbactam with 0.5 g of cefazolin in the treatment of cellulitis and with 1 g of cefoxitin in other skin and skin-structure infections. Study drugs were administered intravenously every 6 hours to 58 hospitalized patients. Each indication was evaluated separately. In cellulitis, ampicillin/sulbactam and cefazolin produced clinical cure or improvement in 100% and 91.7% of patients, respectively; duration of hospitalization was 7.7 and 7.2 days. In other skin and skin-structure infections, results for ampicillin/sulbactam and cefoxitin, respectively, were clinical cure or improvement, 80% and 64.7%; treatment failures, 0% and 11.8%; bacterial eradication, 40% and 53%; and duration of hospitalization, 7.7 and 9.4 days. No unusual or unexpected adverse experiences related to any study drug occurred. One patient treated with ampicillin/sulbactam died of a pulmonary embolism, and 1 patient treated with cefoxitin was discontinued from the study following amputation of an infected foot. These events were not considered drug-related. The treatment groups showed no statistically significant differences in efficacy or safety.

Adolescent↗
PubMedDate not supplied

Asymptomatic gross hematuria followed by persistent microhematuria.

A case of a previously healthy, 13-year-old male with IgA nephropathy is presented in order to illustrate clinical onset and differential diagnosis of this rather common clinical entity. The laboratory and histopathological diagnosis is illustrated and discussed, as well, together with a brief discussion of possible pathogenesis. In this disorder, in which approximately 11% of affected patients experience spontaneous remission, future development of molecular probes to determine prognosis is of great importance.

Adolescent↗
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Urinary tract infections in children.

This article will review the clinical and laboratory characteristics of urinary tract infection in children. The diagnostic workup, the current recommended treatment and the long-term prognosis will also be reviewed.

Child↗
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Recognition and management of aluminum intoxication in children.

The awareness of aluminum as a potential toxic risk in patients, especially infants and children with chronic renal insufficiency, is beginning to be widely appreciated. This paper will review the clinical features of aluminum intoxication, potential sources of aluminum, risk factors in pediatrics, and treatment of aluminum intoxication. It is hoped that this review provides the nephrologist with useful information concerning recognition and management of aluminum intoxication.

Aluminum↗
PubMedDate not supplied

Chronic renal failure in children.

It is important to appreciate that the recent advances in nutritional management over the past two decades (19-22) have added to the longevity and the "joie de vivre" of children with chronic renal failure. The significant advances in vitamin D therapy and new treatment of complications in long-term maintenance dialysis have provided the pediatric nephrologist with new avenues of management.

Adolescent↗
PubMedDate not supplied

Peritoneal dialysis in chronic renal failure in children: a six year study.

A six year study was conducted to evaluate the long-term use of chronic peritoneal dialysis in children with end-stage renal failure at a single center. All patients maintained satisfactory clinical status and achieved good biochemical control. No significant changes in developmental continuum as measured by weight and length/height were observed in these patients upon institution and maintenance on peritoneal dialysis. The incidence of peritonitis was one episode every 12.3 patient-months. The overall incidence of catheter replacement was one change every 15 patient-months. Our results serve to underscore the effectiveness of long-term peritoneal dialysis in children.

Adolescent↗
PubMedDate not supplied

The synergistic effect of angiotensin II and urea on systemic blood pressure.

The hypertensive synergism of A-II and urea was studied in anesthetized cats. Femoral arterial pressure was measured while test substances were infused in a femoral vein. Dose-response analysis of the A-II + urea interaction suggested that A-II pressor effects and A-II + urea potentiation involve a common mechanism. Methylurea and mannitol + A-II also induce a similar potentiation. While plasma osmolality and plasma volume indicated no systemic changes, intracellular osmotic shifts may be a factor in the synergism. Since inhibition of the potentiation by indomethacin was not replicated, prostaglandins can no longer be considered important. No effect of ganglionic blockade also eliminated CNS influences as a factor. Dual infusion suggested urea-induced A-II changes were not important for the synergism. Since a synergism of A-II with amino acids occurred, alteration of A-II receptors was indicated. Thus, the A-II + urea pressor synergism may involve either intracellular osmotic shifts or a receptor modification so A-II is more accessible.

Angiotensin II↗
PubMedDate not supplied

Nephrogenic diabetes insipidus. Radiological and clinical features.

Two brothers with nephrogenic diabetes insipidus are presented. The importance of early recognition and treatment to reverse the consequential complications are underscored. The disorder has a sex-linked recessive transmission, where all male offspring of an affected mother show the extreme thirst characteristic of the disease; in whom hyposthenuria persisted despite arginine vasopressin infusion, and in whom the serum arginine vasopressin concentrations correlate with the serum osmolality which serves to discriminate nephrogenic diabetes insipidus from the pituitary diabetes insipidus. The radiological features of "non-obstructive" hydronephrosis and hydroureters, the combined use of hydrochlorothiazide and the potassium-sparing diuretic amiloride in comparison to the prostaglandin inhibitor are discussed.

Adolescent↗
PubMedDate not supplied

Hypercholesterolemia and growth hormone in renal diseases.

The interrelationships of hypercholesterolemia, progression of renal disease to renal failure, and to risks of nephrotic syntrouse are emerging. Both hypercholesterolemia and growth hormone are progression factors, and, in the chronically nephrotic patient, these factors may help to explain the progression to renal failure. Treatment of such patients with growth hormone even though growth retarded should be approached with caution.

Animals↗
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X-linked hypophosphatemia: molecular biology and treatment controversies.

X-linked hypophosphatemia, currently one of the most prevalent varieties of familiar rickets, is attributed to renal phosphate wasting secondary to a gene defect localized to X p22 chromosomal region. The proximal tubular phosphate reabsorption defect is associated with blunted 1,25-dihydroxyvitamin D synthesis to hypophosphatemia or parathyroid hormone administration. It is characterized clinically by hypophosphatemia, growth retardation, and rickets especially in male patients. As the affected patients mature, pseudofractures, skeletal deformities, osteomalacic bone pain, progressive ankylosis, and dental caries occur, which may be alleviated and even prevented with adequate medical therapy. Long term treatment combines phosphate supplementation with calcitriol, augmented occasionally by diuretics. Hypercalcemia, hyperparathyroidism, and nephrocalcinosis are potential complications which require careful monitoring and continued investigations. The use of recombinant human growth hormone to augment renal tubular reabsorption of phosphate and to promote linear growth remains to be examined in well controlled, clinical trials.

Humans↗