Biomedical subjects
Publications and source records attributed to R D Adelman.
The hemolytic uremic syndrome (HUS) must be considered as a cause of oligo-anuria in a previously healthy young child. This syndrome consists of a viral-like prodromal illness, followed by acute renal failure, thrombocytopenia, and an abnormal blood smear with fragmented erythrocytes. Awareness of this syndrome will permit earlier diagnosis and management and will minimize unneccessary investigation in the anuric child.
To test the hypothesis that basal energy expenditure may be abnormal in azotemia, oxygen consumption was studied in partially nephrectomized, azotemic male Sprague-Dawley rats and sham operated control rats 10, 16, and 31 days after surgery. Observed decreased oxygen consumption in the azotemic group was related to their decreased body weight. There was no significant difference in oxygen consumption between groups when oxygen consumption values were related to weight.75.
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Renal failure in childhood is often associated with poor growth. Growth in uremia was studied using young growing male Sprague-Dawley rats made moderately uremic (SUN77 mg/100 ml) by partial nephrectomy. Uremic rats weighed less than control rats after 17 days of observation (P less than .01). Uremic rats supplemented by corn oil gavage had significantly better weight gain than nonsupplemented uremic rats (P less than .005). Uremic rats whose appetite was stimulated by the addition of saccharin to diet also had significantly better daily weight gain than uremic rats not having saccharin added to diet (P less than .05). Calorie intake appeared to be the limiting variable with regard to observed differences in growth. In fact, when adjusted for calorie intake/weight-75, uremic rats did not differ from control rats in weight gain/weight-75. In addition, control rats fed diets identical to those consumed by uremic rats grew equally as poorly. Improved growth in uremic rats with calorie supplementation was felt to be real growth in that body composition studies showed proportionate gains in cell mass, total body solids, liver and muscle. Catch-up growth was not observed, perhaps because insufficient supplemental calories were provided or because other unexplained factors contributed to growth retardation.
Urinary tract infections (UTI's) are common in medicine. Symptoms may include fever, chills, frequency, and dysuria. Asymptomatic UTI's are also common, with a prevalence of one percent in school girls and ten percent in pregnant women. Pyuria, dysuria, and frequency may be absent in patients with UTI's or present in patients without UTI's. Therefore, a UTI must be bacteriologically diagnosed as greater than 100,000 organisms/ml, usually of a single organism, in a properly obtained urine specimen. The dipslide is a simple, convenient, inexpensive device for the quantitative diagnosis of a UTI. Culture media are layered on both sides of the dipslide, one medium allowing growth of all organisms and the other medium favoring growth of enterobacteriae. After immersion in a clean catch urine specimen, the dipslide is incubated for 24 hours at 37 C. Each urinary organism forms a colony "dot". The density of colony "dots" can be quantitated easily by comparison with standardized graphs. The dipslide is a highly accurate and sensitive tool that can be used for the diagnosis of UTI's, assessment of antimicrobial effectiveness, follow-up for presence of recurrence or relapse, and screening of high-risk individuals.
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