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Biomedical subjects

P Robitaille

Publications and source records attributed to P Robitaille.

At least 37 records · Page 2Linked to original sources
PubMed1989

Hemolytic-uremic syndrome: intrarenal arterial Doppler patterns as a useful guide to therapy.

Seventeen children with acute renal failure due to the hemolytic-uremic syndrome were examined with duplex Doppler ultrasound. Serial measurements of intrarenal arterial pulsatility were obtained by means of the Pourcelot index. These were compared with daily urine volume, both during the phase of renal failure (during which most of the children were undergoing peritoneal dialysis) and during recovery of renal function. During oliguria or anuria there was either no intrarenal arterial flow (ie, absent Doppler shifts), or absent, reversed, or markedly reduced diastolic flow. Within 24-48 hours after diastolic Doppler shifts returned to normal, diuresis occurred. The Doppler examination enabled prediction of recovery and allowed dialysis treatment to be abbreviated or, in some cases, canceled.

Acute Kidney Injury↗
PubMed1988

Nephrocalcinosis in Bartter's syndrome.

Nephrocalcinosis was demonstrated by computerized tomography (CT) in all five children with Bartter's syndrome followed at our institution. In three of these five patients, nephrocalcinosis was also noted on ultrasound examination. Hypercalciuria was present in only one case. The mechanism leading to renal calcification remains unclear in this disease. It is noteworthy, however, that Bartter's syndrome is associated with such a high incidence of nephrocalcinosis.

Adolescent↗
PubMed1986

Urinary tract dilatation in utero: classification and clinical applications.

A morphologic classification of in utero urinary tract dilatation is presented. Ninety-two hydronephrotic fetal kidneys diagnosed with ultrasound were graded according to the proposed classification. The findings suggest that grade I dilatation (anteroposterior diameter of the renal pelvis less than 10 mm) should be considered normal. Grades II and III constitute an intermediate hydronephrosis, requiring postnatal urologic surgery in nearly half the cases. Grade IV (moderate dilatation of the calyces, with easily identified residual renal cortex) and grade V (severe dilatation of the calyces with atrophic cortex) are clearly pathologic and require neonatal corrective surgery. It is hoped that use of this simple and practical classification will facilitate communication and comparison of results in the literature.

Dilatation, Pathologic↗
PubMed1986

Ureteropelvic junction stenosis: antenatal ultrasonographic diagnosis, postnatal investigation, and follow-up.

Between January 1981 and October 1984, the diagnosis of ureteropelvic junction (UPJ) stenosis was suspected in 39 fetuses after routine obstetrical ultrasound (US) examination. Postnatal investigation revealed that the initial diagnosis had been accurate in 30 cases (77%). There were 35 UPJ stenoses in 30 patients. The degree of dilatation of the renal pelvis (grades III, IV, or V) observed postnatally with sonography as well as the obstructive excretory pattern noted by renal isotope scanning were used as criteria to determine the need for early postnatal pyeloplasty (performed in 25 patients), which relieved the obstruction and, in the majority of patients, improved renal structure and function.

Diuresis↗
PubMed1986

Renal calcium deposition in children: sonographic demonstration of the Anderson-Carr progression.

The Anderson-Carr theory of renal-stone formation, based on cadaver studies, postulates the aggregation of calcium at the tips and margins of the renal pyramid. Progressive calcium deposition is followed by the formation of calcium plaques, which may perforate the calyx and form a nidus for further stone growth. This theory has not been demonstrated in vivo. We studied 50 children with conditions leading to nephrocalcinosis with renal sonography. Seven of these had high-resolution CT. Twenty-four positive sonographic examinations were used to study patterns of calcium deposition in the kidney. Nephrocalcinosis was confined to the medulla and was found at the margins of the pyramid, at the fornix, or throughout the entire pyramid. Five children showed calcium plaques in or near the calyx. The sonographic pattern identified appears to provide an in vivo demonstration of the Anderson-Carr progression of renal-stone formation.

Adolescent↗
PubMed1985

Long-term follow-up of patients who underwent unilateral nephrectomy in childhood.

The long-term damaging potential of remnant nephron hyperperfusion was investigated in patients who had undergone unilateral nephrectomy in childhood. 27 such patients were examined after a mean of 23.3 years postnephrectomy. The average creatinine clearance was 83.9 +/- 16.5 ml/min/1.73 m2 or 74.3% of that in healthy controls with two kidneys; it was a value similar to that reported 3 to 6 months postnephrectomy in kidney donors. Age at the time of nephrectomy, duration of follow-up, or sex had no influence on the residual creatinine clearance. None of these patients had clinically important hypertension or proteinuria. Since so little evidence of kidney damage could be documented after such a long observation period, hyperperfusion would seem to be seldom of clinical importance in man unless other factors were present.

Adaptation, Physiological↗
PubMed1984

Renal osteodystrophy in children treated with 1,25-dihydroxy-cholecalciferol [1,25-(OH)2D3]. Histologic bone studies.

Eleven uremic children with osteodystrophy aged 3 to 17 years were studied during administration of 1,25-(OH)2D3 for periods up to 21 months. Nine children presented with pure hyperparathyroidism, one with osteomalacia and one with mixed bone disease. Bone biopsies were performed before initiation of therapy and after 6 to 21 months of treatment following double tetracycline labeling. Skeletal lesions were improved but not cured in 5 of 9 children with hyperparathyroidism. In three instances lesions remained unchanged and worsened in one. No significant change was observed in the child with osteomalacia. Moderate improvement was noted in the patient with mixed bone disease. The propensity to develop hypercalcemia was the major factor associated with treatment failure since it precluded administration of adequate amounts of medication. Therapy with 1,25-(OH)2D3 was associated with a spectacular improvement in growth velocity in two of six children under age twelve.

Adolescent↗
PubMed1983

Hemolytic uremic syndrome; treatment with plasma, vitamin E and cod liver oil.

A 21 month old male child with severe hemolytic uremic syndrome was treated with peritoneal dialysis and a two blood volume exchange transfusion. As renal function had recuperated and platelet count had risen to 393,000/mm3, ,neurological deterioration occurred and complete blindness developed. A complete recovery was observed with a treatment regimen made of fresh frozen plasma, vitamin E and cod liver oil.

Blindness↗
PubMed1982

Neonatal renal vein thrombosis - long-term follow-up after conservative management.

Six patients who had neonatal renal vein thrombosis underwent re-evaluation of renal function 21 months to 12 years after initial diagnosis. Plasma creatinine clearances were normal in all patients as was urinary concentrating ability and urinalysis. Five patients had elevated systolic and diastolic blood pressures. However plasma renin activities were normal. Intravenous pyelography and renal scintigraphy revealed morphologic abnormalities in four patients. This study emphasizes that after apparent full recovery from neonatal renal vein thrombosis, arterial hypertension may persist and warrants careful long-term follow-up.

Adolescent↗
PubMed1981

Orchitis mimicking testicular torsion in Henoch-Schönlein's purpura.

Henoch-Schönlein's purpura is a systemic vasculitis involving mainly skin, joints, intestine and kidney. We report on 2 patients who presented with clinical signs and symptoms suggestive of testicular torsion. In 1 case purpuric areas after leg cast removal indicated a diagnosis of Henoch-Schölein's purpura. Surgical exploration of the other case revealed congestion of the hydatid of Morgagni, which was followed by typical systemic manifestations of Henoch-Schönlein's purpura. These and another case indicate that orchitis accompanying Henoch-Schönlein's purpura may mimic testicular torsion.

Child↗
PubMed1981

Primary nephrosis in childhood associated with focal glomerular sclerosis: is long-term prognosis that severe?

In our study, 32 nephrotic children with focal glomerular sclerosis were observed for an average period of 8 years (ranging 1-19 years of age). Of the 32, 25 children showed histological lesions of focal segmental sclerosis (FSG) and 7 of focal global glomerulosclerosis (FGG). All patients were reevaluated in 1979, creating the most recent status as follows: for children with FSG, 6 (24%) are in remission, 10 (40%) have a relatively normal renal function but exhibit either a persisting proteinuria (PP) or a recurrent nephrotic syndrome (NS), 1 (4%) is in chronic renal failure, 5 (20%) required dialysis and transplantation, and 3 (12%) died from non-renal causes. For children with FGG, 4 (57%) are in remission, 2 (29%) have a good renal function but display either PP or NS, and 1 patient (14%) is in chronic renal failure. The long-term observation of our study shows a more favorable prognosis than the one reported in researched literature. We believe that such results reflect a difference in the type of population encountered in our institution. Our population of patients represents less a highly referred population than the one of the centers who reported similar long-term studies, and we believe therefore that our study may represent a wider spectrum of the natural history of the disease. Moreover, the group of patients with PP or NS does not show a progressive decrease of glomerular filtration rate with time, which suggests that the disease may progress in a stepladder fashion.

Adolescent↗
PubMed1981

Kidney transplantation in uremic children with cystinosis.

10 children underwent cadaveric renal transplantation between the ages of 8.0 and 12.5 years for uremia secondary to infantile cystinosis. 6 children are doing well 6-62 months after-transplantation. 3 of the 4 other recipients required a second graft and eventually died of uremia or fulminant viral encephalitis, the other lost her first graft due to accelerated acute rejection and is now on maintenance hemodialysis. No further systemic complications of cystinosis have been observed in the patients with functioning grafts. Our experience confirms that kidney transplantation is the treatment of choice for uremic children with infantile cystinosis.

Cadaver↗
PubMed1980

Cystine calcium bladder calculus in a 2-year-old child.

We report on a 2-year-old child who presented with urinary tract infection and a large solitary bladder calculus. Dietary history indicated an intake of 2 gm. calcium with supplemental vitamin D daily. Urinary amino acid analysis revealed cystinuria. The high dietary intake of calcium and vitamin D may have precipitated early cystine calcium stone formation.

Calcium, Dietary↗