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Biomedical subjects

U Alon

Publications and source records attributed to U Alon.

120 records · Page 7Linked to original sources
PubMed1981

Henoch-Schönlein syndrome--paucity of renal disease. Review of 71 children.

Different rates of renal involvement in the Henoch-Schönlein syndrome have been reported in the literature. We assessed renal involvement during the initial attack of this disease in 71 children in northern Israel, and reevaluated 69 of them after an interval of one to eight years. The mean age at onset was higher than in other reports, and there was a clustering of cases in the late summer and early autumn. During the acute phase of the illness, involvement of the kidney was apparent in only seven patients (9.8%), and only one of these (1.4% of those followed up) showed evidence of continuing renal damage. Patients without initial renal involvement did not subsequently develop renal disease. The remarkably low rate of acute and continuing renal damage in our study as compared with other reports may stem from local variations in causative factors. In our experience, long-term follow-up beyond one year seems warranted only in those patients who had renal involvement during the initial attack.

Acute Disease↗
PubMed1979

Neurological sequelae of septic meningitis. A follow-up study of 65 children.

Seventy-two children who survived septic meningitis were reevaluated after 3 to 11 years. Thirty-four (52%) of 65 children were found to have neurological sequelae. Of the 34, 15 had major sequelae and 19 showed evidence of only minimal brain dysfunction--namely, hyperkinetic behavior, organic learning disturbances and minor motor disabilities. Acute-phase findings that were significantly associated with the rate of neurological sequelae were age, time between onset and admission, seizures, spinal fluid glucose level and the number of polymorphonuclear cells. In view of the high frequency of late neurological sequelae, it is advisable that children who survive septic meningitis have long-term follow-up in order to detect evidence of minimal brain dysfunction. An early diagnosis will help in proper management.

Adolescent↗
PubMed1976

Hyperbaric oxygen in acute ischaemia due to allergic vasculitis.

A case of a child with allergic vasculitis to penicillin is presented. The patient received successful treatment with hyperbaric oxygen (HBO) therapy. The pathophysiological mechanism of acute peripheral anoxia and the infleunce of HBO treatment on it is described.

Acute Disease↗
PubMedDate not supplied

Effect of infusion of bile salts into the mesenteric artery in situ on jejunal mucosal transport function in dogs.

We studied the effects of increased circulating levels of bile salts on jejunal mucosal function in dogs. In situ luminal perfusion of a 30-cm proximal jejunal segment was performed while deoxycholate, cholate, taurodeoxycholate, or taurocholate solutions were directly added to the mesenteric arterial supply, reaching the intestinal wall at successive concentrations of 5, 8, 12, and 22 mumol/L. The transport rates of water, sodium, glucose, fructose, glycine, and lysine were measured. The mucosa of the experimental loop was assayed for ATPase activity, and examined by light and electron microscopy. Deoxycholate at 8 microM in the blood supply of the perfused jejunal segment was associated with a significant (p less than 0.02) reduction in the absorption rates of water, sodium, glucose, and glycine, and inhibition of mucosal Na+, K+-ATPase. The absorption of fructose and lysine, and brush border enzyme activities, were not affected. Cholate had a similar effect at 12 microM. There were no obvious histological alterations, but electron microscopy showed swelling of mitochondria in the enterocytes. The reduction in mucosal transport, the inhibition of mucosal Na+, K+-ATPase, and the mitochondrial swelling were reversed after discontinuation of the bile salt infusion. The taurine conjugates at 22 microM depressed transport of water and sodium only, and did not inhibit Na+, K+-ATPase. Our study indicates that increased circulating concentrations of unconjugated bile salts, particularly deoxycholate, may impair Na+, K+-ATPase-related jejunal mucosal function.

Animals↗
PubMedDate not supplied

False uroradiologic pathology in children with urinary tract infection and fecal impaction.

Intravenous pyelography (IVP) in 5 children with urinary tract infection detected various uroradiologic abnormalities. Despite the lack of history of constipation, a common denominator to all 5 patients was the finding of fecal impaction in the rectosigmoid. In the first 3 patients, repeated complete IVP series done several weeks later and after preparatory bowel enema were normal. In the last 2 patients, the radiologic investigation was interrupted when the first exposure disclosed uroradiologic abnormalities and fecal impaction. Following immediate bowel enema, the studies were completed on the same settings to be found normal. It is concluded that in the face of fecal impaction, pathologic uroradiologic findings should be interpreted with great caution. Moreover, in such cases, intraprocedure cleansing enema is feasible and recommended.

Adolescent↗
PubMedDate not supplied

Hypercalciuria in chronically institutionalized bedridden children: frequency, predictive factors and response to treatment with thiazides.

Calcium and creatinine concentrations were analyzed in urine samples of 42 chronically institutionalized bedridden children, with neurologic disorders. Their ages ranged from 2 to 16 (mean 8.7) years. Hypercalciuria, defined as UCa/UCr ratio greater than 0.21, was recognized in 18 children (42.8%), the mean UCa/UCr ratio of this group was 0.40 +/- 0.18. Twenty-four children were normocalciuric, with a mean UCa/UCr ratio of 0.08 +/- 0.03. There were no significant differences between the two groups with regard to age, sex, length of institutionalization, the basic neurologic disorder, diet, anticonvulsive medications, exposure to sunlight and weekly hours of physiotherapy. Age- and sex-matched percentiles for fat and muscle areas were similar in both groups. Seven limb fractures had occurred in the hypercalciuric group during the last three years, but only in one of the normocalciuric patients (p less than 0.02). The hypercalciuric children were treated with a hydrochlorothiazide-amiloride preparation for three weeks, which resulted in reduction of their mean UCa/UCr ratio by 57.7%, to 0.17 +/- 0.13 (p less than 0.005); only four children remained hypercalciuric. We conclude that resorptive hypercalciuria is common among chronically immobilized bedridden children. Hypercalciuria in such children should be specifically looked for, because of its association with deranged bone metabolism and increased frequency of limb fractures. Treatment with thiazides was found to be efficient in reducing urinary calcium excretion in our hypercalciuric patients. This therapeutic modality for the reduction of morbidity in bedridden chronically immobilized children should be further explored.

Adolescent↗
PubMedDate not supplied

Hyperchloremic metabolic acidosis as a clue to recto-urethral fistula in an infant with anal atresia.

An infant with high anal atresia and transverse colostomy, in whom initial radiologic evaluation of the urinary tract had been normal, developed hyperchloremic metabolic acidosis at 24 days of age. Gastroenteritis and renal tubular acidosis as possible causes for this metabolic disturbance were excluded, which prompted a repeat investigation of the possibility of a communication between the urinary tract and the rectum. A recto-urethral fistula was demonstrated by urethrography. Analysis of the fluid obtained from the left colon as compared to urine in the bladder and voided urine demonstrated that electrolyte exchange was taking place in the colon, resulting in hyperchloremic hypokalemic acidosis. Treatment with oral sodium bicarbonate and daily lavage of the left colon resulted in normalization of the acid-base status and catch-up growth of the baby. Hyperchloremic acidosis associated with anal atresia and recto-urinary communication appears to be uncommon. However, early diagnosis and treatment of the metabolic derangement are of importance as it may determine the infant's overall prognosis.

Acidosis↗
PubMedDate not supplied

Peritoneal dialysis in the neonatal period: outcome data.

Scant information exists on the prognosis of infants with renal failure who receive peritoneal dialysis in the first month of life. We reviewed the outcome of 23 such patients 1 year after the onset of renal failure. Diagnoses included acute tubular necrosis (11 infants), renal dysplasia (5), obstructive uropathy (4), polycystic kidney disease (1), renal vein thrombosis (1), and renal artery thrombosis (1). Seven of the eleven patients with acute tubular necrosis had had cardiac surgery. At 1 year, eight (35%) of the patients had died, six (26%) had a full recovery, seven (30%) were receiving long-term dialysis awaiting a transplant, and two (9%) had chronic renal failure. Effective dialysis, characterized by the reversal of metabolic disturbances or attainment of fluid balance, was accomplished in all patients. The mean duration of dialysis was 4.5 months (range, 0.1 to 12 months). The most common complications of dialysis were peritonitis and catheter exit site infection. Despite the provision of supplemental calories via nasogastric tube, the majority of patients receiving long-term dialysis showed impaired growth and mild developmental abnormalities. Peritoneal dialysis is an effective means of renal replacement therapy in the neonatal period; however, the morbidity and mortality rate for this population remains high.

Acute Kidney Injury↗