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Biomedical subjects

J Strauss

Publications and source records attributed to J Strauss.

At least 127 records · Page 7Linked to original sources
PubMed1986

Renal bicarbonate handling in low birth weight infants during metabolic acidosis.

We studied the fractional excretion of bicarbonate (FE HCO-3) in 10 low birth weight infants aged 1-6 days during metabolic acidosis (base excess greater than or equal to -5 mEq/l) and during subsequent sodium HCO-3 infusion. The mean birth weight was 1,095 g; the mean gestational age was 29 weeks. The ability to decrease urine pH to less than 5.5 and FE HCO-3 to less than 1% during metabolic acidosis was not limited by low gestational age or birth weight. After HCO-3 therapy, all infants corrected their negative base excess, and plasma HCO-3 increased significantly. All infants with blood pH less than or equal to 7.22 or PaCO2 greater than or equal to 50 mm Hg had minimal or absent FE HCO-3. Infants with elevated PaCO2 and mild or absent acidosis also had complete HCO-3 tubular reabsorption. These results suggest that the HCO-3 tubular reabsorption is adequate during metabolic and/or respiratory acidosis in low birth weight infants.

Acidosis↗
PubMed1986

[Periarticular ossification. Complication of total hip prosthesis].

The authors analyse peri-prosthetic ossification, a complication which can occur in the presence of certain risk factors. Grades I and II calcifications are frequent and do not interfere with the final post-operative result. On the other hand, grades II and IV result in a progressive stiffening of the coxo-femoral joint within one year after the operation. They may be bilateral and can sometimes be responsible for serious handicap. These cases should be re-operated in order to restore joint mobility, but surgical treatment should be completed by radiotherapy according to a defined protocol. Non-steroidal anti-inflammatory agents and diphosphonates also have a preventative action. Subjects at risk (ankylosing vertebral hyperostosis, spondyloarthritis, alcoholism, patients with a history of ossification of the first side) require effective prophylactic treatment. In the authors' own series, 49 cases of ossification were observed in a retrospective analysis of 100 patients, including 6 cases of grades III and IV ossification. They analyse their results in relation to the initial hip pathology treated by prosthesis, but their series is too small to allow an statistically valid conclusions. Complementary studies are required.

Anti-Inflammatory Agents↗
PubMed1985

Infant formula as a cause of aluminium toxicity in neonatal uraemia.

Aluminium toxicity occurred in two infants with congenital uraemia who had never received phosphate binders or other aluminium-containing agents or intravenous fluids. One patient was treated by peritoneal dialysis from the age of two weeks and died at three months after the sudden onset of neurological symptoms; the other died after one month of conservative management without dialysis. Brain aluminium concentration was high in both infants (6.4 and 47 micrograms/g, respectively) whereas bone aluminium content was normal and there were no histological changes or stainable aluminium on bone biopsy specimens. Both infants were fed with 'Similac PM 60/40'. To investigate possible sources of aluminium, powdered milk formula, sterilised water used for preparation of the feed, and dialysate concentrate (first patient) were analysed. Aluminium concentration was high (232 +/- 60 ng/ml) in powdered milk but negligible in sterilised water and dialysate concentrate (4 ng/ml and 3.4 +/- 2.4 ng/ml, respectively). These findings indicate that proprietary infant milk formula is another source of aluminium. Aluminium-free milk should contribute to the prevention of aluminium toxicity in infants with renal failure.

Aluminum↗
PubMed1985

Simultaneous ectopic pregnancy with intrauterine twin gestations after in vitro fertilization and embryo transfer.

A simultaneous ectopic tubal pregnancy with viable intrauterine twin gestations after IVF-ET of five fertilized eggs is presented. Pelvic ultrasound and serial quantitative hCG levels were not helpful in the diagnosis of the tubal pregnancy. The risk of multiple pregnancies and of concomitant intrauterine and extrauterine gestations increases with transfer of a greater number of embryos. Karyotype of the tubal pregnancy was normal (46,XX).

Adult↗
PubMed1985

Tc-99m glucoheptonate scintigraphy in a case of renal vein thrombosis.

Tc-99m glucoheptonate flow and static studies with computer-assisted analysis provided specific diagnostic information in unilateral renal vein thrombosis complicating a case of nephrotic syndrome. Decreased flow with congestion, a large kidney with parenchymal thickening, pelvocalyceal thinning, good function, and no obstruction in the proper clinical settings indicated the diagnosis of a chronic form of renal vein thrombosis with compensating collateralization. The differential diagnosis is discussed.

Adolescent↗
PubMed1985

Minerals and bone-modulating hormones in children on continuous ambulatory peritoneal dialysis.

Peritoneal fluxes of minerals and bone-modulating hormones and their impact on corresponding serum levels and bone mineralization in 7 children on continuous ambulatory peritoneal dialysis (CAPD) were studied. Most mass transfer studies revealed modest losses of calcium into peritoneal effluents. Peritoneal losses of phosphorus and magnesium, although substantial, were not sufficient to normalize hyperphosphatemia and hypermagnesemia in most patients. Parathormone and vitamin D metabolites (25-hydroxyvitamin D and 1,25-dihydroxyvitamin D) were readily detectable in peritoneal effluents. Improved bone mineral content, by sequential densitometries, was associated with amelioration of hyperparathyroidism. These data suggest that CAPD in children induces an overall improvement of disturbed mineral metabolism; nevertheless, peritoneal losses of calcium and vitamin D metabolites must be considered and replenished appropriately.

Adolescent↗
PubMed1985

Bone modulating factors in nephrotic children with normal glomerular filtration rate.

Factors influencing bone and mineral metabolism were evaluated in 16 children with active nephrotic syndrome and normal glomerular filtration rate. All patients were proteinuric and/or hypoalbuminemic and had elevated serum triglyceride and cholesterol levels. Seven patients had never received or had discontinued glucocorticoid treatment at least 6 months before the study; six patients were receiving prednisone at the time of study. Although all patients were hypocalcemic (serum total or ionized calcium), none was hypomagnesemic. Despite the low serum calcium levels, circulating immunoreactive parathyroid hormone was elevated in only nine of 16. Plasma 25-hydroxyvitamin D was low in all 16 patients, averaging 7.6 +/- 1.2 ng/mL for the group. In contrast, levels of 1,25-dihydroxyvitamin D were normal in 12 of 14 patients. Bone mineral content measured by photon absorptiometry averaged 83% and was less than 90% of normal in six of nine patients tested. The findings were not influenced by the recent or concurrent administration of glucocorticoid. The data demonstrate abnormalities of mineral and bone modulation in nephrotic children even in the absence of impaired glomerular filtration rate and irrespective of glucocorticoid therapy. The decrease in serum ionized calcium may be related to an absolute deficiency in 25-hydroxyvitamin D and/or a relative deficiency in 1,25-dihydroxyvitamin D. Undermineralization of bone may result from the low levels of vitamin D metabolites and, in some patients, from an increase in immunoreactive parathyroid hormone. Whether treatment with vitamin D metabolites and/or calcium supplementation will prevent the abnormalities remains to be demonstrated.

Calcifediol↗
PubMed1984

Persistence of serum lipid abnormalities in children with idiopathic nephrotic syndrome.

We investigated the severity and duration of hyperlipidemia in 59 nephrotic children during relapse and remission. Serum total cholesterol and triglyceride values were greater than or equal to 95th percentile for age and sex in all patients with minimal change nephrotic syndrome in relapse and in patients with non-MCNS and persistent proteinuria. Most of these patients also had a significant elevation of low- and very-low-density lipoproteins. A significant number of children with MCNS during prolonged remission had elevated serum concentrations of total cholesterol (46%), triglycerides (42%), LDL (29%), and VLDL (40%). Persistence and severity of lipid changes correlated well with duration of disease and frequency of relapses. Significantly decreased HDL and HDL/LDL were found in patients with non-MCNS and persistent proteinuria. Our results suggest that nephrotic children may have prolonged periods of hyperlipidemia even after clinical remission. In addition, some of these children with significantly decreased HDL/LDL may be at increased risk of developing premature atherosclerosis.

Adolescent↗
PubMed1984

Improving the technique of nuclear cystography: the manometric approach.

A simple technique of manometric scintigraphic retrograde cystography was applied prospectively to 125 patients (85 per cent children) with 142 studies. 99mTechnetium sulfur colloid (0.5 to 1 mCi.) was instilled in the bladder followed by increments of normal saline under manometric control. The sensitivity of the test was increased when the filling phase was concluded at 25 cm. water pressure rather than when the patient complained of fullness (usually at 15 cm.). The studies had a voiding phase that was essential for patients in whom pressures greater than 15 cm. could not be achieved. Reflux was not detected on the voiding phase alone in 5 patients and the voiding phase could not be performed in 5 of 34 positive studies. It was not possible to predict volumes of fluid instilled to achieve satisfactory pressures. Monitoring during the entire study was necessary to diagnose reflux, which may occur at low or high pressure, or while voiding only.

Adolescent↗
PubMed1984

The clinical significance of mesangial IgM deposits and mesangial hypercellularity in minimal change nephrotic syndrome.

Some patients with minimal change nephrotic syndrome (MCNS) present on biopsy mesangial IgM deposits, which may be associated with mesangial hyperplasia. These patients have been considered as a possible subset with a different response to therapy as well as prognosis and designated as mesangial IgM nephropathy or mesangial proliferative glomerulonephritis. However, the clinical relevance of these biopsy findings has been questioned by others. We reviewed the clinical, biopsy, and follow-up data in 61 MCNS children, 33 with mesangial IgM and 28 free of immunoglobulins. There were no significant differences in response to therapy or prognosis between these two groups. The lack of IgM elution and heterologous in vitro C3 fixation in the biopsies of some MCNS cases with IgM mesangial deposits does not support the possibility that the deposited IgM plays an immunologic role.

Adolescent↗
PubMed1984

A developmental study of the relationship between handedness and eyedness as applied to disappearing visual targets.

This study investigated differences between adult and children's perception of a disappearing, lateralized stimulus. In 20 trials, 23 first graders and 22 college students viewed a luminous target of parallel lines subtending a visual angle of 11 degrees 30' and reported whether a stimulus disappeared on either side of fixation or all at once. Both groups, regardless of handedness and eye dominance, had stronger right-field stability, therefore more left-field fragmentation.

Adult↗
PubMed1984

Clinical research: a key to clinical training.

Rational clinical decision making is at the core of any medical field, including psychiatry. Although clinical decision making should be based on reasoning logically from sufficient hard data, the process is often short-circuited; hypotheses are considered fact or causality is inferred where only association exists. This report describes how clinical research protocols provide a structure that helps train clinicians to reduce these errors. A good research design forces articulation and evaluation of hypotheses and prevents premature assumption of causality. The authors present case examples which show that clinical research can serve as in-service training for staff clinicians.

Adult↗