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Biomedical subjects

N J Shaw

Publications and source records attributed to N J Shaw.

At least 145 records · Page 8Linked to original sources

Hemophagocytosis and acute monoblastic leukemia.

A 16-month-old girl presented with hepatosplenomegaly and pancytopenia. Bone marrow aspiration showed a florid increase in macrophages with marked hemophagocytosis. She subsequently improved spontaneously with no therapeutic intervention, but 2 months later presented with frank acute monoblastic leukemia. This case illustrates the difficulties in classifying malignancies of the monocyte-macrophage lineage and how hemophagocytosis can be the presenting feature of a range of diseases.

Female↗

Epilepsy precipitated by bathing.

A case of epilepsy precipitated by bathing is described and previously reported cases are reviewed. The prognosis for this rare form of reflex epilepsy seems to be good, in that the seizures resolve with age and neurodevelopment remains normal.

Baths↗

Captopril in heart failure secondary to a left to right shunt.

Captopril was used in 20 infants aged less than 1 year with heart failure secondary to defects with predominantly a left to right shunt that was poorly controlled with digoxin and diuretics. Total daily dose of captopril ranged from 0.88 to 2.5 mg/kg (mean 1.3 mg/kg) in three divided doses. Improvement in the control of heart failure was seen mainly as an increase in the rate of weight gain from a mean of 48 g/week before treatment to 102 g/week on treatment and a decrease in the mean respiratory rate from 68 breaths/minute to 60 breaths/minute. Side effects were seen in four patients--two with asymptomatic mild hypotension, one with renal insufficiency which improved with a reduction in dose, and one with severe oliguria progressing to renal failure. Significant changes in plasma electrolyte concentration did not occur except in the infant who developed acute renal failure.

Captopril↗

Liver failure and Epstein-Barr virus infection.

A 5 year old boy developed liver failure secondary to infection with Epstein-Barr virus. He was subsequently shown to have a partial C4 complement deficiency. The importance of considering Epstein-Barr virus as a cause of fulminant hepatic failure and the need to assess immune state in such an event is emphasised.

Child, Preschool↗

Sublingual nifedipine in acute severe hypertension.

Sublingual nifedipine was used for the treatment of acute severe hypertension in 12 children with renal disease. An average dose of 0.24 mg/kg was safe and proved effective on most occasions within 30 minutes with a median duration of action of three hours. There were no major adverse effects.

Acute Disease↗

Misdiagnosis of cystic fibrosis.

On reassessment of 179 children who had previously been diagnosed as having cystic fibrosis seven (4%) were found not to have the disease. The importance of an accurate sweat test is emphasised as is the necessity to prove malabsorption or pancreatic abnormality to support the diagnosis of cystic fibrosis.

Child↗

Inhaled beclomethasone and oral candidiasis.

Two hundred and twenty nine children aged 6 to 15 years attending the asthma clinic at the Royal Hospital for Sick Children, Edinburgh, had throat swabs taken to determine the incidence of candida colonisation of the oropharynx. One hundred children (group A), who were not receiving steroids, were compared with 91 children (group B) receiving less than 500 micrograms of inhaled beclomethasone a day and 38 children (group C) receiving 500 micrograms or more of inhaled beclomethasone a day. Sore throat and hoarse voice were not related to the presence of candida or to treatment with inhaled steroids. The incidence of candida was greater in the groups given treatment with steroids but did not increase at a higher dosage, nor was it related to the type of inhaler used. There was only one case of clinical thrush in all the children studied.

Adolescent↗

Persistent acquired lobar overinflation complicating bronchopulmonary dysplasia.

UNLABELLED: Persistent acquired lobar overinflation (PALO) may complicate bronchopulmonary dysplasia (BPD). From infants admitted to the regional neonatal intensive care unit or who had been followed up at the chronic lung disease clinic in Liverpool over a 6.5-year period, 11 children with BPD and PALO were identified and details of their neonatal and subsequent outcome obtained. Their median gestational age was 29 weeks (range 24-33) and median birth weight was 1317 g (range 676-1968 g). All had received ventilatory support for severe neonatal respiratory distress syndrome for a median of 26 days (range 5-86). The median age the acquired lobar overinflation was detected was 82 days (range 45424 days). Nine patients required continued neonatal or paediatric intensive care re-admission for deteriorating respiratory function. Six children have subsequently died at a median age of 9.5 months (range 6.5-20). Five patients underwent bronchoscopy, four suggesting the presence of bronchomalacia. Three patients had ventilation-perfusion scans all showing that the overinflated lobe had no mismatch defect unlike other areas of the lung. CONCLUSION: The place of specific therapies for persistent acquired lobar overinflation is unclear. Surgery to remove the overinflated lobe in such cases may be inappropriate and the outcome of this complication of bronchopulmonary dysplasia appears to be poor.

Bronchopulmonary Dysplasia↗

Pulmonary function in survivors of Wilms' tumor.

The respiratory status of 47 patients surviving childhood Wilms' tumor was studied. The group that had received flank irradiation (which impinges on the lower lung) (n = 17) had a significantly lower mean percent predicted for forced expiratory volume in one second, residual volume, and total lung capacity when compared to those who had received no irradiation (n = 23). Those patients who had received whole-lung irradiation (n = 3) had significantly lower transfer factor for carbon monoxide and gas transfer per unit lung volume when compared to the nonirradiated group (n = 23). There was no significant difference in the prevalence of respiratory symptoms between the three groups. Patients receiving any form of radiotherapy for Wilms' tumor may have abnormalities of pulmonary function and should have pulmonary function tests performed as part of their long-term follow-up.

Adolescent↗