Biomedical subjects
J Strauss
Publications and source records attributed to J Strauss.
Postnatal adjustment in renal function.
Renal function was studied serially in 17 healthy term infants during the hours immediately following birth. Of 14 infants delivered vaginally eight received placental blood transfusion and six did not. The remaining three infants were delivered by cesarean section and received placental blood transfusion. Results indicate that the general pattern of change in urine output (V), clearance of inulin (CIN), and p-aminohippuric acid (CPAH), was similar in all infants despite a wide range in each of the functions measured. The pattern showed an initial increase in V, CIN, and CPAH followed by a decline to low values in all infants by 3 hours of age. Urine osmolality and output generally changed in opposite directions. During the first hour the values for V ranged from 0.02 to 0.47 ml/min; for CIN, from 0.5 to 9.1 ml/min; for CPAH, from 1.4 to 21.8 ml/min; and for osmolality, from 98 to 457 mOsm/kg. By 4 hours of age the values for V ranged from 0.01 to 0.15 ml/min; for CIN, from 0.8 to 3.7 ml/min; for CPAH, from 0.8 to 7.5 ml/min; and for osmolality, from 240 to 520 mOsm/kg. The initial values of V, CIN, and CPAH, as well as the changes, were greatest in those infants who received a placental transfusion; however, there were no statistical differences among the means of the various groups. By 4 hours of age, the range of values observed in the initial measurement was much less pronounced. This probably reflects the achievement of stability of renal circulation following adaptation to a variety of stresses during the intrapartum period.
Response to rapid volume expansion during the postnatal period.
This study was designed to test the hypothesis that the postnatal diuresis observed in healthy neonates during the second hour of life is due to an expansion of their extracellular volume as a result of a purposeful or spontaneous placental blood transfusion. Seven healthy infants were given infusions of a 5% glucose solution, 0.3 to 2.5 ml/kg/min, over a period of 14 to 70 minutes during the third or fourth hour of life. Plasma and urine were analyzed for osmolality, inulin, and p-aminohippuric acid in order to estimate osmolal and free water clearances as well as glomerular filtration rate and renal plasma flow. Despite individual variation in initial values and in response, glucose infusion caused a prompt two- to fourfold increase in urine output with a similar increase in glomerular filtration rate and renal plasma flow but no consistent change in urine osmolality. The response was of short duration, subsiding within less than 30 minutes following the end of infusion. The fraction of exogenous fluid load excreted was less than 5% in five of seven infants. This study indicates that during the first few hours of postnatal life, the kidney of the newborn infant is capable of responding to a water load in a fashion similar to the kidney of the neonate aged a few days. It can also be concluded that the transient postnatal diuresis observed in these infants could, in part, be due to the expansion of extracellular volume by placental blood transfusion.
[Tuberculous trochanteritis : radiological diagnosis (author's transl)].
Based on four typical cases of tuberculous trochanteritis, the authors describe the clinical symptoms and signs, and radiological findings in this osteitis. An unusual feature of this affection is the usually slow progression of the anatomical changes, especially in vaccinated adults. Another peculiarity arises from the fact that this para-articular osteitis (which menaces the hip) is probably secondary to a bursitis of the gluteus medius. A history of tuberculosis infection facilitates the diagnosis, which must be confirmed by bacteriological or histological examinations before instituting medical treatment.
Development and food consumption patterns in rural Sierra Leone.
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[Intramedullary localization of sarcoidosis(?)].
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[Hypercalcemia, lumbosciatica and mammary tumefactions disclosing acute lymphoblastic leukemia].
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Acute effects of albumin infusion on blood volume and renal function in premature infants with respiratory distress syndrome.
The purpose of this study was to determine the acute effects of albumin infusion on blood volume and renal function in preterm infants with RDS and low total serum protein values. Ten infants (gestational age 28 to 36 weeks, body weight 0.88 to 2.46 kg) were given albumin 1 gm/kg (as 25% iv solution) over a ten-minute period. Within ten minutes after infusion was completed, total serum protein concentration, colloid osmotic pressure, and blood volume rose significantly while hematocrit fell from their preinfusion levels (P < 0.0005). Mean arterial blood pressure showed a smaller and less clear-cut increase (P < 0.05). Creatinine clearance rose significantly with infusion; even though preinfusion clearances correlated poorly with gestational age (r = 0.43), postinfusion clearances correlated well (r = 0.92). No significant rises in urinary flow rate Uosm/Posm, or free-water clearance were observed. These results indicate that albumin infusion acutely increases both blood volume and glomerular filtration in premature infants with RDS.
[Severe hypercalcemia from bone metastasis following transformation of a mixed parotid tumor (author's transl)].
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[Pulmonary arteriovenous malformation (report on 11 cases, 1970-1979) (author's transl)].
The clinical features and the diagnostic difficulties in 11 cases of pulmonary arteriovenous (av) malformation, diagnosed in the last 10 years, are discussed. It is possible to get the correct diagnosis with the help of the typical thorax-X-screen, inclusive tomography in combination with the clinical signs of the right to left shunt. Pulmonary angiography is indicated (first) before any kind of therapy in order to exclude av malformations in other localisations, (second) in all pulmonary lesions, where av malformations are part of the differential diagnosis, and (third) in patients suffering from symptoms of a right to left shunt after exclusion of a cyanotic vitium cordis.
Chronic renal failure in children: analysis of main causes and deterioration rate in 81 children.
Cause of chronic renal failure (CRF), age at clinical onset, and deterioration rate were studied in 81 unselected children 2 months to 18 years old who were referred to UM-JMH during a six-year period. Obstructive uropathies caused 42%, glomerulopathies 27%, renal hypoplasias 15%, and hereditary and vascular nephropathies 8%. Age at clinical onset of CRF was significantly lower in patients with obstructive uropathies (2.8 years) and renal hypoplasias (2.4 years) than in glomerulopathies (10.7 years). Deterioration rate correlated with cause of CRF; it was more rapid in primary glomerulopathies (4.1 years) and renal hypoplasias (4.2 years) than in obstructive uropathies (6.7 years). Within the six-year period, half the patients studied reached end-stage renal disease (ESRD). Final outcome did not seem to be modified significantly by corrective procedures. These findings suggest that major efforts should be directed toward identification of the etiopathogenesis of congenital nephropathies to prevent occurrence of CRF.
[Results of surgery of the rheumatoid forefoot. Apropos of 64 cases].
The authors analyze the outcome of 64 operations of different types of rheumatoid conditions in the foot. Of all the techniques used, plantar re-alignment, according to the technique of Lelièvre was the most often used, regularly providing satisfactory results.
Use of sodium nitroprusside during kidney biopsy in a 9-year-old boy.
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[Rubella prophylactic immunization problems in the Czechoslovak SSR: experiences with Ra 2713 and Cendehill rubella vaccines].
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Benign primary hematuria. Clinicopathologic study of 65 patients.
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Clinical aspects of continuous neonatal oxygen monitoring.
Twenty newborn infants (gestational age 30--40 weeks, weight 980--3400 g) were studied in two groups to compare two commercially available systems for continuous in vivo oxygen monitoring: the So2 catheter and the transcutaneous Po2 (TcPo2) electrode, and their respective electronic systems. Measurements from these systems were correlated with determinations made from samples intermittently drawn and measured by conventional So2 and Pao2 in vitro methods , respectively. Information about these two in vivo oxygen monitoring systems was then related to our previous experience with the bare-wire earlobe O2a electrode. Measurements from the two in vivo monitoring techniques studied showed good correlations with their respective in vitro oxygen measurements: So2 catheter, y = x - 3.08, r = 0.98 (range studied 74% to 100%) and transcutaneous electrode, y = 0.98x + 0.57, r = 0.89 (range studied 34 to 92 mm Hg). It was concluded that all three systems give a good reflection of central arterial oxygen (either Sao2 or Pao2)). The system to be used in specific clinical situations should depend on condition of the baby and stage of treatment, need for an umbilical line to measure other variables, equipment available, and training of personnel.
[Bone necrosis during osteomalacias].
On the basis of 3 personal cases, the authors study the characteristics of osteonecroses during osteomalacias. They compare their findings to those in the literature. Clinically, the location at the femoral head is predominant, with absence of pain and functional tolerance often noted. On the radiological level, the demineralization of the skeleton is not constant, and there are few Looser-Milkman striae. In the lower limbs the necrosis is always located in the supporting areas, showing a restricted surface with little or no perinecrotic condensation and an absence of bone sequestrum. The cartilage remains intact for long periods. A pathogenic interpretation is proposed: the increasingly fragile state of the bones causes a subchondral fatigue fracture. The malacia bone thus adapts itself to the mechanical constraints thus imposed on it.
Tissue oxygenation problems in different pathological situations. Introduction.
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