Biomedical subjects
W L Robson
Publications and source records attributed to W L Robson.
The toddler who does not eat.
The majority of children between two and five years of age who are brought in by their parents for refusing to eat are healthy and have an appetite that is appropriate for their age and growth rate. Unrealistic parental expectations may result in unnecessary concern, and inappropriate threats or punishments may aggravate the refusal to eat. A detailed history and general physical examination are necessary to rule out acute and chronic illnesses. A food diary and assessment of parental expectations of eating behavior should be completed. When the child's "refusal to eat" is found to be related to unrealistic parental expectations, the parents should be reassured and counseled about the normal growth and development of children at this age.
The hemolytic-uremic syndrome and Escherichia coli O157:H7 infection.
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Hyponatraemia following desmopressin.
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Incidence and associations of single umbilical artery.
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Down's syndrome and renal abnormalities.
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Labial fusion and asymptomatic bacteriuria.
Thirty-three female children with labial fusion were screened for bacteriuria which was defined as the growth of a single micro-organism with < or = 100,000 colony-forming units/ml (> or = 100 x 10(6) colonies/l) in a properly collected urine specimen. Six girls were found to have bacteriuria. In contrast, none of the 33 girls in a control group had bacteriuria. We recommend that a urine culture be performed in girls with labial fusion and that all girls with bacteriuria should be checked for labial fusion.
Xanthine calculi presenting at 1 month of age.
Xanthinuria is a rare cause of nephrolithiasis and is usually due to an inherited abnormality in purine metabolism. A 5-year 6-month-old boy was assessed for a history of recurrent episodes of renal colic. The child first presented with symptoms due to xanthine calculi at 1 month of age, the youngest presentation we were able to identify. Xanthine calculi, although rare, should be considered in the differential diagnosis of nephrolithiasis and ureterovesical junction obstruction in children. Xanthine calculi should also be considered when symptoms suggestive of urinary tract infection are present but the urine culture is negative, and when an orange-brown sediment is noted in the urine or similar coloured stains are found in the nappy.
Pseudohyperkalaemia in Kawasaki disease.
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Hemolytic-uremic syndrome.
HUS is one of the most common causes of acute renal failure in childhood. D+ HUS is the most common form and usually follows an episode of hemorrhagic colitis due to VTEC or S. dysenteriae type 1. The SLT elaborated by these organisms is responsible for the endothelial damage that is the initial insult in the pathogenesis of the acute renal failure. Excellent supportive care is necessary to reduce the mortality and morbidity due to HUS.
Extraordinary urinary frequency syndrome.
Thirty-one children with the extraordinary urinary frequency syndrome are presented. Several possible etiologies were identified including viral cystitis-urethritis, stress, and hypercalciuria. A case definition is provided and the literature is reviewed. The authors suggest that this problem is more common than is generally appreciated. The condition is usually self-limited, and invasive diagnostic imaging studies are unnecessary when the presentation is typical.
Parotitis in diarrhea-associated hemolytic uremic syndrome.
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Recurrent hemorrhagic colitis caused by Escherichia coli O157:H7.
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The incidence of labial fusion in children.
A retrospective study of 9070 female infants born at the Foothills Provincial Hospital was conducted to determine the incidence of labial fusion at birth. A prospective study was also conducted on 1970 female patients assessed through a paediatric outpatient clinic to determine the incidence of labial fusion in this population. None of the newborn infants had labial fusion. Thirty-five children (1.8%) assessed at the paediatric outpatient clinic were found to have labial fusion with a peak incidence at 13-23 months of age (3.3%).
Accessory nipples and urinary tract malformation.
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Relationship of the recovery in the glomerular filtration rate to the duration of anuria in diarrhea-associated hemolytic uremic syndrome.
The relationship of the duration of anuria to the recovery in glomerular filtration rate (GFR) was studied in 71 children with diarrhea-associated hemolytic uremic syndrome. A significant relationship was found, and regression analysis revealed that y = 114.61 - 5.68 x, where y is predicted GFR (ml/min/1.73 m2) and x is the square root of the duration of anuria in days. The presence of hypertension or proteinuria on follow-up was significantly related to the duration of anuria (p = 0.005 and p = 0.002, respectively).