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Biomedical subjects

J U Leititis

Publications and source records attributed to J U Leititis.

At least 37 records · Page 2Linked to original sources
PubMed1993

[Preventive and therapeutic use of intravenous administration of immunoglobulins in intensive care patients in pediatrics].

The intravenous infusion of immunoglobulin preparations (ivIg) still is no established mode of therapy for neonatal septicemia or for the prevention of nosocomial infections in premature infants. Some recent studies show a decrease in nosocomial infections by ivIg infusions. However, a significant reduction in infections by any specific pathogen has not been demonstrated; the specific antibody content of the ivIg preparations in relation to these pathogens has not been examined. No statistical differences were found regarding duration of hospitalization, morbidity, or mortality of premature infants. ivIg seem to have positive effects on neonatal isoimmune thrombocytopenia or on thrombocytopenia caused by maternal immunothrombocytopenic purpura. There is also evidence that ivIg could have a positive effect on the course of Guillain-Barré syndrome, although this has not been proven for children.

Autoantibodies↗
PubMed1992

Critical care in uraemic children.

The special problems posed by renal disease have to be considered when a uraemic child requires intensive care. This report gives an overview on the problems of dialysis treatment, circulatory support, infectious complications, coagulation disorders and increased intracranial pressure.

Anti-Bacterial Agents↗
PubMed1991

RARE-MR-urography in the diagnosis of upper urinary tract abnormalities in children.

RARE-MR-urography (Rapid Acquisition with Relaxation Enhancement) is a fast MR imaging technique (6.4 s/acquisition) that selectively depicts fluid by heavy T2-weighting. From 9/1989 to 11/1990, RARE-MR urograms were prospectively evaluated in the diagnosis of upper urinary tract abnormalities in 55 children. The method is performed in several planes and combined with a coronal, T1-weighted spin-echo sequence. Forty out of 42 kidneys with dilated renal pelvis, and 21 out of 24 dilated ureters were identified, only the mildly dilated ones were missed. Even in non-functioning kidneys the urinary tract was clearly depicted by RARE-MR-urography. However, no differentiation could be made with this technique between vesicoureteral reflux and non-refluxing dilatation of ureter and/or renal pelvis. All 19 pelviureteric obstructions and all eight renal duplications with a dilated segment were identified. RARE-MR-urography is a new tool for diagnosing urinary tract abnormalities in children without having to employ ionizing radiation, contrast media, or general anesthesia. A dilated urinary tract can be shown in one image displaying the entire urinary system, similar to excretory urography. The technique is presently not able to provide the information of voiding cystourethrography or renal scintigraphy, nor is it as easy to perform as ultrasound. However, in certain cases it may replace excretory urography.

Adolescent↗
PubMed1991

[RARE-MR urography: a rapid MR tomographic imaging procedure for the diagnosis of urinary tract malformations in childhood].

RARE-MR urography (so called "water-pictures") is a fast MR imaging technique that selectively depicts fluid without contrast application. Acquisition time is 6.4 s per slice with 1 excitation, or 23 s per slice with 2 averages respectively. From Sept. 1989 to April 1990 24 children with anomalies of the urinary tract have been examined each by RARE MR urography and one T1-weighted spin-echo sequence. Independent of excretory function, the technique can show dilated calices and renal pelvis, pelviureteric obstruction, renal duplication, and megaureter. However, it cannot distinguish between vesicoureteric reflux and obstructive megaureter. Our first results suggest that RARE MR urography combined with ultrasound, reflux cystography and isotope nephrography, can replace excretory urography in certain circumstances--or at least postpone it to the preoperative phase.

Adolescent↗
PubMed1991

Evaluation of local renal function in newborn infants under tobramycin therapy.

Aminoglycosides (AG) provided for less than 5 days to newborn infants do not produce a marked disturbance of glomerular filtration rate (creatinine clearance) or tubular sodium handling (fractional sodium excretion). However, transient disturbances of proximal tubular cell functions can be noted: the excretion of N-acetylglucosaminidase, a lysosomal enzyme, is elevated, and mature not premature infants show a decreased tubular reabsorption of low-molecular-weight proteins during AG treatment. Preliminary investigations show an increased excretion of villin, a structural protein of proximal tubular cells, and a decreased secretion of Tamm-Horsfall protein by the cells of ascending limb of Henle and early distal tubule.

Aminoglycosides↗
PubMed1990

Cyclosporine inhibits renal uric acid transport in renal transplants not in children treated for nephrotic syndrome.

Children with various grades of renal insufficiency (CON group) maintained uric acid excretion over a range of glomerular filtration rate (GFR) from 27 to 160 ml/min*1.73m2 despite a decreased filtered load which was paralleled by glomerular filtration of uric acid. This was achieved by a compensatory decrease of net uric acid reabsorption (TUA) and an increasing fractional excretion of uric acid (FEUA) with decreasing GFR. Although there was a decreased GFR in the group of children after transplantation (NTx group) there was no difference in TUA and FEUA between the NTx group and the CON group. Uric acid transport was not affected in children treated with Cyclosporine (CyA) for nephrotic syndrome (NEPH group) compared to the CON group. Decreased fractional phosphate reabsorption in the NTx group suggests proximal tubule damage associated with disturbed uric acid handling. Under conditions of water diuresis hyperuricemia seen in NTx may result from an indirect effect of renal ischemic damage due to the transplantation procedure causing disturbance of proximal tubular uric acid (active) secretion/reabsorption.

Adolescent↗
PubMed1989

[Treatment of renal anemia with recombinant human erythropoietin].

Anemia is an almost invariable feature of chronic renal failure and is particularly severe in children treated by long-term hemodialysis. Recombinant human erythropoietin (rhEPO) offers entirely new aspects in the treatment of renal anemia. This report presents three patients on maintenance hemodialysis aged 10, 10/10 12, and 18 years who were treated with rhEPO. Two suffered from hemochromatosis secondary to multiple transfusions. 100 U/kg rhEPO were administered three times weekly, and venesection after dialysis was performed when a target hematocrit value of 30% was achieved. Hematocrit, reticulocyte-counts and hemoglobin rose within 3 to 6 weeks after initiation of therapy in all patients. Serumferritin levels declined significantly in the two patients with hemochromatosis. No deterioration of the metabolic status (i.e. increase of blood urea nitrogen, serum-creatinine, -phosphate or -potassium) could be detected. Therapy had to be discontinued in one patient who experienced hypertensive ceisis. This patient, however, had suffered from severe hypertension prior to rhEPO therapy. Blood pressure remained stable in the other patients. We conclude that renal anemia can be effectively treated by rhEPO in children. Increase of blood pressure may necessitate discontinuation of therapy especially in primary hypertensive patients. Extensive studies are necessary to eluciate long-term effects of rhEPO in children.

Adolescent↗
PubMed1988

Serum creatinine and creatinine clearance in healthy neonates and prematures during the first 10 days of life.

Normal serum creatinine (Scr) and creatinine clearance (Ccr) values during the first 10 days of life were obtained in 63 very premature (28-32 weeks of gestation), premature (33-37 weeks) and term infants (38-42 weeks). Scr fell, and Ccr rose less markedly in the very premature infants. Scr was 80 mumol/l on the 1st day of life both in very premature and premature infants, and 77 mumol/l in full-term neonates. After 10 days, Scr was 73, 53 and 35 mumol/l respectively. There was an exponential correlation between Ccr and gestational age, indicating rapid maturation of glomerular function.

Creatinine↗
PubMed1987

Microproteins in amniotic fluid as an index of changes in fetal renal function during development.

Protein content and protein composition were studied in amniotic fluid obtained from 171 healthy pregnant women between the 16th and 38th week of gestation, using microgradient gel electrophoresis to separate proteins according to their molecular size into albumin (68 KD), proteins of low molecular weight (LMW proteins, less than 68 KD), and proteins of high molecular weight (HMW proteins, greater than 68 KD). Additionally alpha-1-microglobulin (alpha-1-MG, 33 KD) and beta-2-microglobulin (beta-2-MG, 11,8 KD) were analysed as micromolecular marker proteins. Concentrations of LMW proteins were 0.15-0.22 g/l, of alpha-1-MG 28.4-34.5 mg/l, and of beta-2-MG 7.2-11.6 mg/l during the second trimester of gestation, and thereafter decreased progressively to 0.03 g/l, 14.1 mg/l and 2.4 mg/l respectively near term. The same developmental trends were confirmed by calculating the protein/creatinine ratios in amniotic fluid. The concentrations of LMW proteins found in the first postnatal urine of 73 healthy infants born prematurely or at term were similar to those in amniotic fluid of corresponding fetal age. Concentrations of albumin and HMW proteins in postnatal urine were about 5% and 15% respectively when compared with amniotic fluid concentrations. No strong correlation existed between gestational age and either of the analysed proteins which would allow accurate assessment of fetal maturation by protein analysis in amniotic fluid. It is concluded that fetal urinary excretion is the major determinant of the microprotein content of amniotic fluid. Microproteins seem to reflect an increasing tubular reabsorption capacity, which accelerates rapidly after the second trimester of gestation.

Adult↗
PubMed1987

Effect of a modified fluid therapy on renal function during indomethacin therapy for persistent ductus arteriosus.

A rehydration with 7 ml/kg/h for six hours prior to indomethacin administration prevented the adverse effects of this drug on renal function in prematures with persistent ductus arteriosus. During the 36 hour observation period after indomethacin administration, no significant changes in serum creatinine, sodium, and potassium concentrations, or urinary flow, creatinine clearance, or filtered sodium could be detected. The only significant finding was a reduction in fractional sodium excretion. One can assume that this beneficial effect of the fluid load is due to a suppression of some parts of the vasoconstrictor mechanisms, which are responsible for the deterioration of renal function in newborns during indomethacin therapy. Using this modified fluid regimen, no cardiovascular side effects were noticed, a closure of the duct was achieved in 7 of 10 treatment courses.

Creatinine↗
PubMed1987

[Developmental physiologic aspects of volume and sodium regulation in premature and mature newborn infants].

Concentrations of sodium and creatinine were measured in serum and time collected urine samples of 72 newborn infants in the first ten days of life. Creatinine clearances, fractional and absolute sodium excretions were calculated. For analysis the group of newborns was divided into three according to gestational age: group A: less than 33 weeks; group B: 33-37 weeks; group C: greater than 37 weeks. The GFR was correlated to the conceptional age. Renal sodium losses exceeded alimentary supplementation in premature infants during the observation period. An additional supplementation of sodium seems therefore to be indicated early in life, as sodium balance is negative from the first day on. Individual investigations are necessary to evaluate the amount of sodium needed. 3-5 mMol/kg/day seem to be well tolerated and preventive for hyponatriaemia. Fluid administration during the first days should be calculated so that a weight loss of about 10% of body weight is achieved in premature infants in order to prevent cardiovascular and gastrointestinal complications. Because of a higher insensible water loss the amount of fluids administered per body weight should be higher in prematures than in matures.

Aldosterone↗