Search PubMed⌕ Search

Biomedical subjects

J Strauss

Publications and source records attributed to J Strauss.

At least 91 records · Page 5Linked to original sources
PubMed1990

Quantitation of proteinuria with urinary protein/creatinine ratios and random testing with dipsticks in nephrotic children.

We examined the relative feasibility of using random urinary dipstick testing and urinary protein/creatinine ratios in the quantitation of proteinuria. Sixty-four children with relapsing nephrotic syndrome, ranging in age from 1 1/2 to 16 years, contributed 145 timed urine collections and 150 random specimens, which were analyzed by urinary protein dipstick, quantitation of protein and creatinine, or both. Total protein excretion was expressed as grams per surface area per day and the urinary protein/creatinine ratio as milligrams of protein per milligram of creatinine. Degrees of proteinuria were designated as physiologic (less than 0.1 gm/m2/day), intermediate (greater than 0.1 and less than 1.0 gm/m2/day), or nephrotic (greater than 1.0 gm/m2/day). The log regression analysis of the 24-hour urinary protein/creatinine ratio (y) and total protein excretion (x) was highly significant (r = 0.97; p less than 0.001). The upper and lower confidence limits of the urinary protein/creatinine ratio (1.0 and 0.1, respectively) closely approximated the designations for nephrotic and physiologic proteinuria, respectively. These values were therefore used to classify degrees of proteinuria by the urine protein/creatinine ratio. The validity of these tests was assessed by sensitivity, specificity, and predictive value, and compared with that of random testing by urinary dipstick. The urinary protein/creatinine ratio offered good reliability as a test for classifying degrees of proteinuria and accurately predicting nephrotic and physiologic proteinuria. The random dipstick testing was reliable only when results were distinctly positive and when sensitivity and specificity were low. The error in the total protein excretion value that was imposed by collection errors with high and low variations in the creatinine value (57% of samples) was largely corrected by normalization of the data by log transformation. When controlled for creatinine excretion, linear regression analysis allowed calculation of total protein excretion (TP) from the urinary protein/creatinine ratio (U P/Cr) by the following equation: TP (gm/m2/day) = 0.63 (U P/Cr) at all levels of proteinuria. The random urinary protein/creatinine ratio appeared to offer the most sensitive test for classification of proteinuria in children with nephrosis, with the advantages of ease and expediency not afforded by the 24-hour urine quantitation.

Adolescent↗
PubMed1990

Effects of methylphenidate on processing negativities in patients with attention-deficit hyperactivity disorder.

This study compared the impact of methylphenidate on patients with Attention-deficit Hyperactivity Disorder (ADHD) with and without aggressive/noncompliant features in an oddball test consisting of a randomly ordered series of loud (frequent) tones, soft (rare) tones, bright (frequent) lights, and dim (rare) lights. In alternate conditions, subjects were required to respond to either the rare tones or the rare lights. These tasks were administered in a drug-free baseline session and after a counterbalanced treatment of 14 days each of methylphenidate (0.3 mg/Kg b.i.d.) and placebo (lactose b.i.d.). In comparison with placebo, methylphenidate resulted in greater accuracy and speed of reactions to targets of both modalities. The amplitude of N1 to auditory nontargets was larger when the target was a rare tone as opposed to a rare light, and this attention-related effect was increased by methylphenidate. The same differential amplitude enhancement by stimulant treatment was found for an early area measure of difference ERPs. In contrast, for N1 to visual nontargets the effect of selective attention (larger amplitude when the target was a rare light vs. a rare tone) was not significant and was not affected by stimulant medication. All these findings were comparable for the three ADHD subgroups, a result attesting to the generality of stimulant effects on information processing.

Arousal↗
PubMed1989

Renal disease in children with the acquired immunodeficiency syndrome.

Of 155 children with the acquired immunodeficiency syndrome (AIDS) whom we evaluated during a 6 1/2-year period, 12 were found to have proteinuria. Histologic studies of tissue from these 12 patients revealed a wide spectrum of renal disease: focal glomerulosclerosis in 5, mesangial hyperplasia in 5, segmental necrotizing glomerulonephritis in 1, and minimal change disease in 1. In addition, 6 had tubulointerstitial infiltrates, and 10 had glomerular dense deposits. All 10 renal specimens studied by electron microscopy contained endothelial tubuloreticular inclusions. The mean age (+/- SD) of the five patients with focal glomerulosclerosis when this condition was identified was 27 +/- 19 months. All five had severe renal failure within a year and died of other causes during the following year. The mean age of the five patients with mesangial hyperplasia was 38 +/- 31 months. Although none of them went on to have renal failure, four died within 8 +/- 7 months. Ten of the 12 patients with proteinuria died during the study period. Of the two surviving, one had mesangial hyperplasia and the other had minimal change disease. We conclude that children who acquire human immunodeficiency virus (HIV) infection during the perinatal period may have renal disease, most often focal glomerulosclerosis, as is the case in adults, or mesangial hyperplasia. Although 5 of the 12 children we studied had renal failure during the study period, none died of it. Further studies are needed to determine the correlations between clinical and pathological features and the pathophysiology of AIDS nephropathy in children.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Serological evidence of persistent elimination of measles in Czechoslovakia].

The authors report on the elimination surveillance programme initiated in 1969 with the introduction of mass vaccination. In 1982 the elimination of measles was achieved. It included serological surveillance or/and annual serological reports, which considerably contributed to the optimum effect of vaccination and re-vaccination strategies. Within the frame work of this programme, from 1971 to 1987, approximately 40,000 probands from all regions of the Czech Socialist Republic were examined. Proof was supplied as regards low vaccination and high post-vaccination seropositivity in children. Since the elimination of measles, seropositivity in children's and adult age has been in the range of approximately 95%. The paper gives an illustration of the vaccination history in children born in the Czech Socialist Republic in 1960-1986. It also analyzes the average levels of HI antibodies in non-vaccinated persons (1:54.9) with measles infection, in vaccinated and non-vaccinated newborns (1:20.4) and in persons after a single-dose vaccination (1:12.0). From 1982, when measles was eliminated, up to 1987, 126 sporadically occurring cases with measles were reported. In some of these cases, the exact diagnosis of measles was made with the aid of serological tests (HI test, CF reaction, EIA, IF IgM tests and SPIT-HI test).

Adolescent↗
PubMed1989

Long-term outcome of adolescents with anorexia nervosa.

The long-term outcome of 49 adolescent girls hospitalized for the treatment of anorexia nervosa on a pediatric service was determined by personal interview an average of 80 +/- 21 months after admission to the hospital. The mean age at follow-up was 22.7 years. Between admission to the hospital and follow-up, body weight increased, on average, from 72.1% to 96.1% of ideal. Amenorrhea occurred in all subjects, but menstruation began or resumed in 80% of patients after hospitalization, at a mean body weight 90.3% +/- 6.5% of ideal. A total of 15 pregnancies resulted in 2 elective abortions, 3 ongoing pregnancies, and 10 healthy newborns. No subject who desired to become pregnant was unable to conceive. Almost half of the subjects (22 of 45) acquired binge eating patterns after hospitalization. Overall, 86% had a satisfactory outcome. These data indicated that adolescents with anorexia nervosa can be successfully treated with a developmentally oriented, multidisciplinary approach that includes inpatient and outpatient management based in pediatrics.

Adolescent↗
PubMed1989

Long-term results of kidney transplantation at the University of Miami.

Of 631 renal allografts performed at our center between January 1, 1979 and June 30, 1989, 368 were from cadaver donors (CAD) and 263 were from living-related donors (LRD). The recipients were almost equally divided among 3 ethnic groups: Black, Hispanic, and non-Hispanic, non-Black (primarily of northern European background). Recipient ages ranged between 1 and 70 years. In the CAD group HLA matching was emphasized so that no patient received a kidney with less than a 1 DR match, and for the entire series there was a mean of 2.4 of 6 HLA antigens matched between donor and recipient. All patients (LRD and CAD) received at least 3 pretransplant blood transfusions. Overall actuarial 10-year patient and graft survival were 68% and 48% respectively, with 72% patient and 56% graft survival for LRD and 58% patient and 36% graft survival for CAD recipients. Factors adversely affecting long-term graft outcome were: a) Black race. Overall 10-year graft survival was 23% versus 55% for non-Blacks (p = 0.008); b) Type I Diabetes before transplant. Overall 10-year graft survival was 35% versus 51% for nondiabetics; and c) Compliance. This was the most significant factor influencing long-term survival, other than death due to cardiovascular disease. In a non-Black, nondiabetic category of less than 36 years of age at transplantation (n = 169), 10-year patient survival in LRD and CAD groups was 95% and 85%, respectively, and graft survival was 78% and 70%, respectively. This was markedly different from the entire series (p = 0.008). Even in this group, 4 of the 17 graft losses (including mortality) were due to documented prolonged noncompliance in teenagers. The 6 other deaths that occurred were due to hepatitis/cirrhosis (2), CMV (3), and AIDS (1). Among the factors not influencing graft survival in the CAD group was HLA matching after the minimum requirements were fulfilled, either by comparing 1 with 2 DR antigens, or total HLA (1-6) antigens matched.

Adolescent↗
PubMed1989

[Immunoglobulin specific and conventional methods in the serodiagnosis of measles].

The serological diagnostics of suspicions of measles is of ever growing importance with adequately decreasing morbidity. The utilization of the complement binding reaction is compared with results of the haemagglutination test, the IgG enzyme immunoassay, the IgG and IgM immunofluorescence technique and the haemadsorption immunosorbent test for IgM prove of measles. The virus-specific methods of evidence prove to be favourable ones. The present possibilities of the decentralized routine diagnostics in district laboratories make the complement binding reaction a reliable method.

Adolescent↗
PubMed1989

[Rubella screening using a radial hemolysis test with whole blood].

The authors present the results of examination of 121 probands by the rubella test of radial haemolysis (RH), using capillary blood (direct test), as compared with the use of serum from venous blood in correlation with the rubella haemagglutination inhibition test. The diameter of the haemolytic zone, 7 mm, was as compared with the haemagglutination inhibition test in both modifications in 95% and the diameter 8 mm was seropositive in 100%. Haemolytic zones up to 6 mm must be considered seronegative even when some of the bloods or sera have bonder line haemagglutination inhibition titres. Seronegativity was expressed in the direct test of radial haemolysis by larger haemolytic zones. The specificity of the direct test of radial haemolysis, even when serum was used, was 87.5%, the sensitivity 88.2% and 88.4% resp. The reliability of positive diameters of haemolytic zones (7 mm+) is 99%, while that of negative ones (2-6 mm) only 35%. The less laborious direct test of RH proved equivalent to the radial haemolysis test using serum, as far as screening with the purpose of aimed immunization against rubella is concerned.

Adolescent↗
PubMed1989

Effect of dialysate composition on the lipid response to L-carnitine supplementation.

Cumulative carnitine losses through dialysis membranes may worsen hyperlipidemia during long-term hemodialysis. However, carnitine supplementation has not shown a consistent beneficial response in hyperlipidemia. We have compared in a double-blind, cross-over study the effect of dialysate buffer composition (acetate or bicarbonate) on the serum lipid response to L-carnitine supplementation during hemodialysis. We studied nine patients (mean age, 19 years; range, 14 to 23) with hyperlipidemia undergoing maintenance hemodialysis. Plasma levels of carnitines and lipids, including total and HDL cholesterol (HDL-C) and triglycerides (TG), were measured at baseline and monthly intervals after receiving 2 grams of L-carnitine or placebo added to dialysis bath for three months. One month of carnitine supplementation in acetate hemodialysis significantly reduced plasma TG (230 +/- 95 to 136 +/- 20 mg/dl; P less than 0.05) and elevated HDL-C (50 +/- 12 to 71 +/- 26 mg/dl; P less than 0.05). However, this effect was no longer observed at the end of three months of supplementation. Bicarbonate hemodialysis had lower baseline TG values, but carnitine supplementation did not modify plasma lipids (TG:144 +/- 87 to 158 +/- 115 mg/dl; HDL-C:50 +/- 23 to 50 +/- 19 mg/dl). Both groups had a significant increase in plasma carnitine levels after carnitine supplementation. These results suggest that bicarbonate hemodialysis may add a protective effect in hyperlipidemia by reducing requirements of carnitine supplementation. On the other hand, carnitine supplementation should be considered in patients with hyperlipidemia undergoing acetate hemodialysis. The observed difference in response between acetate and bicarbonate hemodialysis may be due to enhanced formation of acetyl-CoA and fatty acid synthesis during acetate hemodialysis.

Acetates↗
PubMed1989

Serological survey of measles in Yemen in 1985.

The HI assay for measles was used to evaluate the sera of 191 children of preschool age (1-6 ys) from five regions of South Yemen: highland, coastal, Vadi Hadramot, the agricultural area Abijan and the capital city Aden. The serum positivity rate was 47.5% in 1-2-year-old children, 75.5% in 3 year-old and 88.5% in 4-6 year-old children. The geometric mean of HI titres was 4.8 log2 in preschool children. An optimal strategy of vaccination against measles in Yemen is discussed.

Age Factors↗
PubMed1989

Serological survey of rubella in Yemen in 1985.

476 sera from subjects of 6 age groups were investigated using the HI test for rubella, the sera originating from 5 distinct regions of Yemen, namely highland, coastal the agricultural area Abijan, Vadi Hadramot and the capital Aden. The positivity rate among children aged 1-6 ys was 46.2%, the values obtained for girls aged 15-18, women in the 19-24 and 25-29 ys age group being 81%, 86.3% and 89.9%, respectively. When the findings of the immunological survey were evaluated with respect to the five different regions studied, the positivity rate in the highlands was found to be significantly higher among girls under 18 ys of age. The geometric means of HI titres for rubella antibodies proved to be the lowest in 1-3-year-old children (1: 59) and the highest in girls aged 15-18 ys (1: 163). The authors discuss the comparatively high risks of contracting rubella during pregnancy in four regions of Yemen.

Adolescent↗