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Biomedical subjects

J P Guignard

Publications and source records attributed to J P Guignard.

18 recordsLinked to original sources
PubMed1979

Single injection clearance in the neonate.

The single injection clearance of inulin was compared to the standard clearance in neonates aged 1--20 days. In the first 3 days of life, the single injection method overestimated glomerular filtration rate by approximately 30%. From the 2nd week of life, values obtained by the two techniques were not significantly different. We conclude that caution should be paid when interpreting results obtained by the single injection technique during the very first days of life.

Age Factors↗
PubMed1979

Captopril and salt subtraction to treat "uncontrollable" hypertension in haemodialysis patients.

Eight patients on chronic haemodialysis for six months to 7 years with hypertension resistant to ultrafiltration and antihypertensive therapy, received Captopril (SQ 14, 225) an orally active inhibitor of converting enzyme. With this therapy, blood pressure was controlled in the 4 patients with the highest plasma renin activity. In the other 4, this treatment had to be supplemented with "isovolumetric salt subtraction", i.e. following conventional dialysis, 1-2 litres of ultrafiltrate were replaced by an equal volume of 5% glucose. The slight hyponatraemia induced by this procedure (plasma sodium 128mmol/L) was well tolerated. This procedure allows the removal of an excess of body sodium and seems to be effective even when conventional ultrafiltration during dialysis has failed. Administration of Captopril either alone or combined with "isovolumetric salt subtraction" induced good control of blood pressure in all 8 patients.

Adolescent↗
PubMed1979

Maturation of renal function in full-term and premature neonates.

The development of renal function was studied in neonates with gestational ages ranging from 28 to 43 weeks. The effect of gestational age on the maturation of renal function was assessed in newborn infants studied during the first 72 h of life. Postnatal maturation was examined during the first 3 weeks of life. None of these neonates presented any cardiopulmonary or renal disturbances. Inulin and PAH were used as markers of glomerular filtration rate and effective renal plasma flow, respectively. From the 28th to the 35th week of gestation, there is a progressive increase in inulin and PAH clearances (r = 0.93; p less than 0.001 and r = 0.81; p less than 0.005, respectively), which then level off up to the end of gestation. A linear increase in systemic blood pressure is observed during the last 12 weeks of gestation (r = 0.88; p less than 0.001). There is a positive significant correlation between the rise in blood pressure and inulin or PAH clearance (p less than 0.005). Postnatal maturation of renal function is similar in preterm and term neonates. In both groups birth is followed by a sharp rise in inulin and PAH clearances, a twofold increase of these parameters being observed during the first two weeks of life.

Gestational Age↗
PubMed1978

Urinary tract infection in high-risk newborn infants.

The prevalence of neonatal urinary tract infection (UTI) was studied in 1,762 high-risk neonates. Symptomatic bacteriuria was found in 1.9% and asymptomatic bacteriuria in 0.5% of these neonates. Male preponderance was 5:1. Clinical manifestations were extremely variable--vomiting, weight loss, and diarrhea being the prominent symptoms. Bacteremia was associated with UTI in six infants. The organisms identified in the urine obtained by suprapubic aspiration were Escherichia coli, Klebsiella, and Proteus. A mixed infection was found in four patients. Roentgenographic examination of the urinary tract showed abnormalities in 44% of the symptomatic patients. It is conclued that symptomatic high-risk newborn infants should be screened for bacteriuria, and that radiological investigations be preformed in those with proven infection.

Bacteriuria↗
PubMed1977

[Urinary infection and reflux nephropathy in children].

Urinary tract infection (UTI) is relatively frequent in children. The symptoms are often atypical; the more so, the younger the child. UTI is often associated with functional or malformative uropathy, such as vesico-ureteral reflux or obstruction. Radiological investigation should be carried out in every child presenting with his first UTI. The prognosis of uncomplicated UTI is good, but is less favorable when UTI is associated with urological abnormalities. Development of pyelonephritic lesions can lead to kidney scarring for which the occurrence of intrarenal reflux, associated with a specific type of papilla, is probably responsible. Short-term treatment is recommended for uncomplicated UTI. Uncomplicated UTI with frequent relapses, or UTI associated with vesio-ureteral reflux, requires prophylactic chemotherapy. Worsening of reflux and/or the development of pyelonephritic lesions while on prophylactic treatment are an indication for surgical intervention. Surgery is always indicated in the presence of a major urological malformation. Be it medical or surgical, treatment of UTI should always be followed by regular urine cultures for several years.

Child↗
PubMed1975

[Urinary infections following bladder catheterization].

The incidence and the prophylaxis of urinary tract infection following bladder catheterization have been studied in 142 patients admitted for voiding cystourethrography (VCU). 71 children received a prophylactic treatment of 2 mg/kg nitrofurantoin daily for 4 days, while 71 received no treatment following bladder catheterization. Bacteriologic examination of the urine 4-9 days after catheterization showed significant bacteriuria in 5 untreated children. The germs responsible were E. coli, Proteus, and Klebsiella. None of the treated patients presented with significant bacteriuria. It is concluded that the incidence of significant bacteriuria after a VCU is not inconsiderable, that this urinary tract infection is often asymptomatic, and that the prophylactic administration of a disinfectant is justified.

Adolescent↗
PubMedDate not supplied

Studies on compensatory adaptation of renal functions.

Changes in the excretion of water and electrolyte in one kidney after exclusion of its partner have been studied in anesthetized dogs and rabbits. Complete clamping of the contralateral kidney pedicle or ureter results in a rapid increase in the excretion of water, sodium, potassium, chloride, calcium, phosphate and bicarbonate. This response is also observed in denervated kidneys. Pretreatment with the loop inhibitor, furosemide, does not preclude adaptation which, however, is blunted by acetazolamide, an inhibitor of proximal sodium and bicarbonate reabsorption. Free-water reabsorption during hypertonic saline diuresis is normal in the remaining kidney. Compensatory adaptation, thus, appears to be located in the proximal tubule. The regulatory response to contralateral kidney exclusion is already fully developed in one-month-old rabbits. Compensatory adaptation of electrolyte excretion is not accounted for by changes in extracellular fluid volume, plasma composition, glomerular filtration rate, effective renal plasma flow, aldosterone or vasopressin.

Acetazolamide↗