Search PubMed⌕ Search

Biomedical subjects

L Finberg

Publications and source records attributed to L Finberg.

At least 19 recordsLinked to original sources
PubMed1991

Capillary refilling (skin turgor) in the assessment of dehydration.

This study was undertaken to evaluate the usefulness of skin turgor or capillary refilling in estimating the degree of dehydration in infants with diarrhea. After initial standardization of the technique, capillary filling time was found to be more reproducible when measured in the fingernail bed after applying just the amount of pressure necessary to blanch the nail bed. Capillary refilling time in 30 normal infants 2 to 24 months of age was 0.81 +/- 0.31 seconds. Capillary filling time was then measured in 32 infants with diarrhea admitted to the hospital and correlated to the degree of dehydration as estimated from the difference in weight from the time of hospital admission to the weight after rehydration. A turgor time of 1.5 seconds or less was found to be indicative of a less than 50-mL/kg deficit or of a normal infant; 1.5 to 3.0 seconds suggests a deficit between 50 and 100 mL/kg, and more than 3 seconds suggests a deficit of more than 100 mL/kg.

Capillaries↗
PubMed1991

Primary care in New York State: report and recommendations of the associated medical schools of New York.

Medical education in New York is unique in the country in its scope and its diversity. It is important, as we go forward, that these strengths be neither eroded nor compromised. The AMS member institutions are making a collective commitment to work together to promote changes that will improve medical education for all students by providing them with enriched experience in primary care. Our major resource is faculty. To whatever degree medical schools can influence career choice, it is essential to this aim that the best possible people are placed in the settings in which primary care is taught. The schools will intensify their efforts to recruit and retain such faculty and, in whatever way is appropriate to each institution, provide them with the stature needed to emphasize the value which the school places on primary care. The schools will also work to provide exposure to primary care early in a student's academic career given anecdotal evidence, at least, that such early experience can influence subsequent specialty choice. Finally, the medical schools will assume greater responsibility for graduate medical education. If, with state support, ambulatory teaching sites are developed, the schools will make every effort to assure that they are staffed with high-quality faculty. Residents and students must see primary care practiced with total commitment to quality. It is hoped that, with state-initiated improvements in the practice environment, the ultimate outcome will be an increase in the number of our graduates selecting primary care disciplines for their practices and locating in areas in need of physicians.2+ Corporation, and the Greater New York Hospital Association. We are ready to work with others toward our common objectives, and we call on all of those who share these concerns to participate with us.

Career Choice↗
PubMed1990

Pediatrics.

Explore the source record for details and available documents.

Neonatology↗
PubMed1990

Modified fat diets: do they apply to infancy?

Almost no data exist to permit assessment of the optimal fat content in the diet of the 6- to 12-month-old infant. Human milk contains about 50% of energy as fat, a large portion of it saturated fat. Commercial infant formulas mimic this proportion but use vegetable sources; most of them also duplicate the saturated fat fraction. At present, only linoleic acid is known to be an essential fatty acid. However, if all but 2% to 3% of energy had to come from sources other than fat, the energy density of the feed would be low, perhaps too low to permit ingestion of adequate energy. On the other hand, if fat concentration were increased at the expense of carbohydrates, ketosis would result.

Dietary Fats↗
PubMed1990

Minimizing the risk of brain herniation during treatment of diabetic ketoacidemia: a retrospective and prospective study.

We studied retrospectively, 219 episodes of diabetic ketoacidemia in 119 patients aged 13 months to 30 years, to determine the trend of the concentration of sodium in serum as glucose declined during treatment of uncomplicated episodes and of episodes with complications attributable to brain swelling. Of 20 complication, 13 were minor (headache only) and 7 major (death or near death). The concentration of sodium in serum failed to rise as that of glucose declined in 82 (54%) of 164 uncomplicated episodes and in 18 (95%) of 20 complicated episodes (p less than 0.01). Hence complications were more likely to occur among patients with a failure of the concentration of sodium to rise as glucose declined. Fifty-eight episodes of diabetic ketoacidemia in 40 patients aged 1 1/2 to 20 years were then studied prospectively on a 48-hour treatment plan to provide the volume of deficit evenly, with half the deficit of sodium in the first 42 hours. Sodium concentration in serum rose in 55 (95%) of 58 episodes as that of glucose declined. No patient had a major complication. We conclude that failure of the sodium concentration measured in serum to rise as glucose concentration declines is a marker for excessive administration of free water. An expanded repair period, with repair fluid containing an average of 125 mmol/L Na+ early in therapy, will usually protect against a downward trend in the concentration of sodium in serum and therefore against a rapid decline in effective serum osmolality. This regimen may be protective against near-death episodes and brain herniation during treatment.

Adolescent↗
PubMed1988

Familial glucocorticoid deficiency in a girl with familial hypophosphatemic rickets.

Familial glucocorticoid deficiency is a rare multisystem disorder characterized by glucocorticoid deficiency with normal mineralocorticoid activity, achalasia of the cardia, and alacrima. Familial hypophosphatemic rickets is characterized by selective renal phosphate wasting with subsequent hypophosphatemia and an inappropriately low 1,25-dihydroxyvitamin D concentration for the degree of hypophosphatemia. A 6-year-old girl with both disorders is described. A biochemical relationship between familial glucocorticoid deficiency and familial hypophosphatemic rickets could not be defined; the influence of cortisol on her serum calcium level, phosphorus level, and rickets, as well as the natural history of these two entities, is described.

Child↗
PubMed1988

Taurine and osmoregulation. II. Administration of taurine analogues affords cerebral osmoprotection during chronic hypernatremic dehydration.

We have previously shown that in the cat, taurine is an osmoprotective molecule that lessens mortality, neurological morbidity, and brain-cell dehydration during chronic hypernatremic dehydration. We examined the ability of two taurine analogues to afford cerebral osmoprotection in rats. Pretreatment with guanidinoethane sulfonate, a competitive antagonist for beta-amino acid transport, as a 1% drinking solution for ten days led to a significant reduction in brain-cell dehydration. Thus, total brain-cell water was higher in experimental vs control animals (544.3 +/- 36.8 vs 478.2 +/- 12.7 mL/100 g of fat-free dry solids [FFDS]) and the difference was almost exclusively derived from the intracellular water compartment (452.7 +/- 27.3 vs 371.4 +/- 7.7 mL/100 g of FFDS). Pretreatment with taltrimide, a lipophilic taurine derivative (intraperitoneal injection of 200 mg/kg for four days), led to similar results. Total brain-tissue water was significantly higher in experimental vs control rats (507.6 +/- 18.8 vs 363.2 +/- 9.5 mL/100 g of FFDS), with the difference primarily derived from the intracellular water space (372.8 +/- 18.1 vs 221.3 +/- 13.1 mL/100 g of FFDS). These results suggest that the cerebral response to chronic hypertonic stress includes accelerated transmembrane flux of osmoprotective solutes in addition to mobilization from sequestered intracellular storage sites in an attempt to increase the cytosolic pool of osmotically active molecules.

Animals↗