Biomedical subjects
S A Ross
Publications and source records attributed to S A Ross.
Risk of transmission of human immunodeficiency virus by bite of an infected toddler.
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Cause of abnormal glucose metabolism in patients with lichen sclerosus et atrophicus.
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Transepithelial transport of immunoglobulins: a model of protein sorting and transcytosis.
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Dermatology diagnosis. Erythema chronicum migrans (ECM).
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Recommendations from the Canadian Hypertension Society Consensus Conference on Hypertension and Diabetes.
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Acquired renal insufficiency in critically ill patients.
We undertook a study to determine the frequency, predisposing factors, and outcome in 315 patients admitted to a medical-surgical ICU, of whom 47 (14.9%) subsequently acquired renal insufficiency (ARI) during their stay in the unit. Four well-recognized risk factors for ARI were present alone or in combination in all episodes: hypotension, sepsis, aminoglycoside antibiotics, and radiocontrast dye. Hypotension was the most prevalent factor, present in 42 (85.8%) episodes, and was the sole factor present in 18 (36.7%). Patients with ARI but without hypotension all survived their ICU stay, while only 13 (33%) of 40 with hypotension survived (p less than .05). Neither initial, peak nor change in BUN or creatinine predicted mortality; oliguria was marginally associated with poor prognosis. Our findings indicate that: a) ARI was a frequent and important contributing factor to mortality in our critically ill patients, b) hypotension was the most common of well-recognized risk factors, and c) conditions that predisposed to ARI also predisposed to mortality, although mortality did not appear to depend on the severity of renal insufficiency.
Assessment of pediatric pain: an overview.
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Use of Haemophilus polysaccharide vaccine in a rural clinic setting.
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Value of pre-exposure rabies human diploid cell vaccine for individuals living in areas hyperendemic for rabies.
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Within-day variation of taurine and other nitrogen substances in human milk.
Milk samples were collected from seven mothers during their 8th wk of lactation. On the day of collection one breast was completely emptied at 600, 1000, 1400, 1800, and 2200 h. Concentrations of total nitrogen, protein nitrogen, urea nitrogen, and free amino acids (taurine and glutamine plus glutamic acid) were determined. Concentrations of these nitrogen substances in the milk differed significantly among women but were relatively constant during the day. The mean concentrations of these substances per 100 ml of milk were total nitrogen, .189 g; protein nitrogen, .145 g; urea nitrogen, .020 g; taurine 34.9 mumol; glutamine plus glutamic acid, 200.0 mumol.
Salmonella enteritidis. A rare cause of pyelonephritis in children.
A previously healthy 2.5-year-old boy developed symptoms of acute pyelonephritis following an acute gastroenteritis. The patient received parenteral ampicillin and gentamicin for 72 hours and then ampicillin for an additional 11 days when the original urine and stool cultures grew Salmonella enteritidis, sensitive to ampicillin. The patient responded very well to treatment, but B-mode renal ultrasonogram revealed a left hydronephrosis and megaureter suggestive of longstanding obstruction of the ureterovesicular junction, later confirmed by other diagnostic studies and by surgical exploration and repair. Salmonella infection has been rarely documented to cause pyelonephritis in children. Obstructive uropathy appears to be a predisposing factor for this unusual complication of Salmonella enteritis.
Pain instruction with third- and fourth-grade children: a pilot study.
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Nitrogen distribution in human milk from 2 to 16 weeks postpartum.
The objective of this study was to determine how the major nitrogen components in human milk vary as total nitrogen in the milk changes. Milk samples were collected from 10 mothers at 2, 6, 12, and 16 wk postpartum. The major nitrogen components compared were total, nonprotein, urea, protein, casein, and whey nitrogens. Total nitrogen decreased from 2.18 mg/ml at 2 wk to 1.76 mg/ml at 16 wk. The percentage of nonprotein nitrogen was 19% and remained constant with time postpartum. Urea nitrogen averaged .14 mg/ml and also remained constant. Protein nitrogen decreased from 1.77 mg/ml at 2 wk to 1.42 mg/ml at 16 wk. As the total nitrogen in milk changed, the percentages of nonprotein nitrogen, whey nitrogen, and casein nitrogen remained relatively constant.
Impending hospitalization: timing of preparation for the school-aged child.
The current consensus on the optimal time for preparing children for impending hospitalization rests on clinical expertise and experimental group data. The study reported here has demonstrated marked heterogeneity of temporal preferences across age and sex of children 5 to 12 years old and, as such, questions the validity of applying general guidelines on the timing of preparation to the case of an individual child. Instead, it appears that the parents' knowledge of how the child reacts when confronted with impending events of a potentially threatening nature should be the primary basis for such decisions.
Teaching the child with leukemia to cope with teasing.
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Pancreatic autotransplantation.
Segmental pancreatic autotransplantation is successful in our hands if blood flow through the splenic artery is enhanced by either a jump graft or a distal fistula, and if these technical manoeuvres are supplemented by anticoagulation. We found the jump method of arterial anastomosis was the most successful. Perfusion of the isolated graft is not necessary, and may even be harmful. Ischemia up to 3 hours appears to be well tolerated. The intraperitoneal location of the graft does not affect outcome, but preservation of the left gastric artery reduces mortality secondary to stomach and omentum ischaemia. Animals must be supplemented with Viokase 10 tablets daily. If the remaining pancreas has been removed graft function is best assessed by monitoring blood sugars. No animal recovers which becomes diabetic under these conditions. Serum insulin, serum glucagon and glucose tolerance tests (with or without calculation of K values) are no more useful than blood glucose to recognize graft loss.
Hypersecretion of gastric inhibitory polypeptide in nondiabetic children with cystic fibrosis.
Failure of secretion of an insulinotropic enteric hormone has been postulated as a cause for the impaired insulin secretion observed following a glycemic stimulus in children with cystic fibrosis (CF). Gastric inhibitory polypeptide (GIP), a hormone located primarily in the duodenum, is the main hormonal stimulus to insulin release from the gastrointestinal tract. To determine whether hyposecretion of GIP was present in CF subjects, GIP secretion was measured in 15 control children and ten children with CF, following a standard oral glucose tolerance test. None of the subjects was diabetic but the CF children demonstrated significant insulinopenia compared to the normal control subjects. GIP secretion in the CF children was significantly greater than in the normal control subjects (normal, 38.8 +/- 4.6 ng/ml . min; CF, 54.9 +/- 6.1 ng/ml . min, P less than .01). These findings indicate that there is increased production of GIP in CF children rather than impaired secretion as had been postulated. The demonstration of hypersecretion of GIP in nondiabetic insulinopenic individuals adds further support to the hypothesis that insulin exerts feedback control on GIP secretion.