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Biomedical subjects

N Hallman

Publications and source records attributed to N Hallman.

At least 19 recordsLinked to original sources
PubMed1982

Long-term outcome of primary nephrotic syndrome.

One hundred and fourteen children with primary nephrotic syndrome were followed up prospectively for periods of between 5 and 14 years. Urine samples from 94 of them became protein-free during the initial 8-week course of prednisone, and the outcome for these children was good: 74 of them have been free of symptoms for at least 3 years, 18 have had relapses during the last 3 years, and only one child still has proteinuria. All these children have normal renal function and blood pressure. One child died accidentally. Twenty children did not respond to the initial prednisone treatment. Thirteen of them had remissions later, of whom 2 have had relapses during the last 3 years. Seven were totally resistant to prednisone 4 of whom died in renal failure, the remaining 3 have persistent proteinuria with normal levels of creatinine; one has high blood pressure too. Remission during the initial treatment indicated a good prognosis, but two-thirds of the initial non-responders also fared well.

Adolescent↗
PubMed1980

[Screening for kidney diseases in childhood (author's transl)].

In the light of present knowledge, the routine screening for renal disease in the pediatric age group is not generally indicated. Asymptomatic proteinuria and microscopic hematuria are common but generally harmless, and only in exceptional cases do they indicate a latent progressive renal disease that could be influenced by early treatment. The finding of asymptomatic bacteriuria in the school age is associated with vesicoureteral reflux and pyelonephritic scars in one-third of the cases. Medical treatment of all cases with bacteriuria in this age group does not, however, seem justified. Screening for urinary tract infection would thus appear sensible only during the first years of life. However, with the presently available methods they are technically difficult and expensive. Examination of the urine is, of course, indicated in all children with suspected infectious disease or failure to thrive, and repeated studies are often advisable.

Bacteriuria↗
PubMed1980

Renal pathology in congenital nephrotic syndrome of Finnish type: a quantitative light microscopic study on 50 patients.

The quantitative histopathological analysis was performed on 68 renal specimens of 50 children with congenital nephrotic syndrome of Finnish type (CNF). Thirty five of samples were biopsies and 33 were taken at autopsy. The kidneys of the CNF children were 2-3 times larger by weight than those of normal children. The renal histological picture varied greatly from one patient to another. The glomeruli of the CNF patients showed more often fibrotic lesions and mesangial hypercellularity than those of the normal infants, while immature glomeruli were seen more frequently in the controls than in CNF children. Tubular atrophy and tubular dilatations were also common histological feature in the CNF children. Glomerular fibrosis and tubulo-interstitial changes showed significant progression during the course of the disease while mesangial cell proliferation did not increase with age. The decreased tubular cell mass was replaced by interstitial tissue in the kidneys of older CNF infants. The proportion of the total glomerular volume to the volume of the whole kidney was about the same in CNF as in normal children. Because of the greater kidney size in CNF the absolute volume of the total glomerular mass is increased in this disease.

Biopsy↗
PubMed1979

Microscopic hematuria in school children: epidemiology and clinicopathologic evaluation.

An unselected population of 8,954 children, age 8 to 15 years, was screened for hematuria. Four urine specimens from each were examined; microscopic hematuria was found in one or more specimens in 4.1%, and in two or more specimens in 1.1% of the children. The prevalence was not age or sex dependent. Those with two or more positive samples were re-examined twice during a half-year period: 33 had hematuria of 6 or more RBC/0.9 mm3, or more than 100,000 RBC/hour, on both occasions; renal biopsy performed on 28 of them revealed two cases of IgA-IgG nephropathy, one of focal segmental sclerosis, one of extracapillary glomerulonephritis, and one of possible hereditary nephritis. In 12 patients the biopsy was entirely normal; the rest showed equivocal changes. Co-existing proteinuria and the degree of hematuria correlated well with the severity of the morphologic alterations. Pathologic findings in microscopic hematuria seem to be less frequent than in hematuria in general; in most such patients, renal biopsy is probably not indicated. In some children the low-grade hematuria may merely represent the upper end of physiologic variation.

Adolescent↗
PubMed1978

Nutrition survey of Finnish rural children. IV. Serum cholesterol values in relation to dietary variables.

In connection with a survey of child nutrition in Finland a study was carried out on the serum cholesterol concentration in childhood and its relationship to dietary and other variables. The material consisted of 1496 children ages 5, 9, and 13 years from 14 local districts in Finland. Total cholesterol was determined from nonfasted venous serum samples by a modification of the p-toluenesulfonic acid reaction. Food consumption was investigated by the 24-hr recall method and nutrient intakes determined from these results using food composition tables. For analysis, children in each age group were classified into low, medium, and high cholesterol groups. The serum cholesterol concentrations of the 5, 9, and 13 year olds were 6.03 +/- 1.03, 6.16 +/- 1.04, and 6.08 +/- 1.01 mmole/liter (233 +/- 40, 238 +/- 40, and 235 +/- 39 mg/100 ml), respectively. Of the children 10% had serum cholesterol concentrations of 7.4 mmole/liter (286 mg/100 ml) or more. Serum cholesterol concentration was not correlated with sex, relative body weight, or systolic or diastolic blood pressure. High cholesterol concentrations appeared to be associated with traditional dietary habits and especially with a high proportion of saturated fats in the diet.

Adolescent↗
PubMed1977

Association of postmedication hypocortisolism with early first relapse of idiopathic nephrotic syndrome.

A 2-hour adrenocorticotrophic-hormone (A.C.T.H.) test was given to 23 children in their first attack of idiopathic nephrotic syndrome, after treatment with prednisone according to the schedule of the International Study of Kidney Disease in Children. The length of the first remission was correlated with the response to the postmedication A.C.T.H. test. In 11 children this response was subnormal, and 10 of them had the first relapse within a year. Of the 7 children who stayed in remission for more than a year, 6 had normal responses. The treatment scheme should be adjusted to prevent postmedication adrenocortical suppression.

Adolescent↗
PubMed1977

Congenital chloride diarrhoea. Clinical analysis of 21 Finnish patients.

Clinical findings in 21 Finnish children with congenital chloride diarrhoea are reported. Inheritance of this disease by the autosomal recessive mode is established. All children were born 1-8 weeks prematurely. Hydramnios was present in every case and no meconium was observed; intrauterine onset of diarrhoea is thus apparent. In most cases the diarrhoea or passing of large volumes of "urine" was noted on the first day of life and the abdomen was usually large and distended. The neonatla weight loss was abnormally large, and was associated with hypochloraemia and hyponatraemia. Some infants survived the neonatal period without adequate therapy. They presented later with failure to thrive and usually had hypochloraemia, hypokalaemia, and metabolic alkalosis associated with hyperaldosteronism. However, these features may be absent and the diagnosis is based on a history of hydramnios and diarrhoea, and a faecal Cl- concentration which always exceeds 90 mmol/l when fluid and electrolyte deficits have been corrected. Lower faecal Cl- concentrations were seen only in chronic hypochloraemia, which is also associated with achloriduria. Adequate treatment consists of full continuous replacement of the faecal losses of water, NaCl, and KCl. This should be given intravenously in the early neonatal period; later a solution can be taken orally with meals. The dose has to be adjusted to maintain normal serum electrolyte concentrations, normal blood pH, and some chloriduria. This therapy prevents the renal lesions and the retarded growth and psychomotor development which were seen in the children who were diagnosed late and in those who received inadequate replacement therapy. The watery diarrhoea persists and increases slightly with age, though patients learn to live with their disease and to make an adequate social adjustment.

Abdomen↗
PubMed1976

Glomerular basement membrane antigens in congenital and acquired nephrotic syndrome in childhood.

Urinary and serum glomerular basement membrane (GBM) antigens were detected by immunodiffusion in patients with nephrotic syndrome and in healthy subjects. The excretion of urinary GBM antigens was greatest in patients with congenital nephrotic syndrome of Finnish type (CNF) and in patients with acquired, therapy-resistant nephrotic syndrome who had a variety of histologically identified glomerular lesions. One GBM antigen, indistinguishable from the urinary one, was also detected in the serum of four of these patients. Excretion of urinary GBM antigens was within normal limits, in patients with steroid-sensitive nephrotic syndrome with minimal changes in renal histology and in the parents (heterozygotes) of CNF patients.

Antigens↗