摘要:

ABSTRACT.Glomerular filtration rate (GFR) was measured by two methods in 9 children with diabetic ketoacidosis (DKA), directly by true creatinine clearance and indirectly by means of serum beta‐2‐microglobulin levels. We found significantly reduced GFR in the first hours of DKA. The rapid improvement in GFR after fluid and electrolyte replacement indicates that volume depletion is the major cause of low filtration rate. In spite of the reduced GFR we observed pronounced albuminuria and low molecular weight (LMW) proteinuria. We conclude that the pathological albuminuria and microalbuminuria in DKA are caused not by glomerular hyperfiltration but by tubular dysfunc

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11491.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT.Total splenectomy has been found to accelerate disease progression in Type III Gaucher disease, therefore partial splenic resection was performed in a 28 month old girl with rapidly progressive (non‐Norrbottnian) Type III disease to alleviate the effects of hypersplenism. Surgery failed to arrest the disease process and splenomegaly recurred within three months. The erythrocyte glucosylceramide level increased post‐operatively. Post‐mortem studies revealed dense accumulation of Gaucher cells in spleen, liver, lungs, bone marrow and within the central nervous system. The glucosylceramide content of brain and liver was elevated to the range previously noted in splenectomised Norrbottnian patients. Thus, in rapidly progressive Type III Gaucher disease, neither total nor partial splenectomy alone provides a favourable ou

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11492.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT.Causes of absence were recorded at two day care centres during a seven‐month period in 1979/80 and a corresponding period in 1987/88, for 82 and 87 children, respectively. During the eight‐year interval absence due to disease decreased from 8.2 % to 5.7 % of total day‐care days. A decrease in epidemic diseases during the eight years was evident. There were no cases of morbilli, parotitis or rubella in 1987/88, following an immunisation programme for these diseases initiated in 1982. An out‐break of varicellae occurred in 1979/80, as compared with only few cases in 1987/88. Respiratory tract infection was the most common type of illness both in 1979/80 and in 1987/88. The mean number of illness episodes of respiratory tract infections per child, aged 5‐6, was significantly higher in the earlier than in the later period, whereas no corresponding difference was evident for the younger age groups. Although, in the meantime parent benefits for home care of sick children had become more generous, attendance at the two day care centres rose from 62 % in 1979/80 to 79 % in 1987/88 of total day‐care days, suggesting a truly decreased morbidity. The carriage rates of pneumococci, Haemophilus influenzae and Branhamella catarrholis decreased with increasing age of the children, and that of beta‐haemolytic streptococci increased; however, the carriage rates during the two periods did not differ significantly. The overall isolation frequencies of these bacteria were 72 %, 43 % and 38 %, respectively, for children aged 1‐2, 3‐4, and 5‐6 years, and

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11493.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT.We studied 13 children subjected to elective tonsillectomy, 6 of whom (study patients) received supplemental intravenous isotonic saline during and after operation, and 7 of whom (controls) did not. Clinical and biochemical evidence of hypovolaemia was present in the control but not in the study patients. Plasma antidiuretic hormone (ADH) and urine osmolality were higher in controls (p<0.005 and p<0.05 respectively). Plasma sodium concentration and osmolality were similar in the two groups. We conclude that hypovolaemia is the principal stimulus to ADH release following surgery and that, in addition to replacement of observed losses of blood and other fluids by fluids of appropriate composition, hypovolaemia should be prevented by the administration of maintenance quantities of isotonic fluid, rather than exacerbated by fluid restriction, in patients in whom oral fluid intake is interrupted for more than a brief period. Hypotonic and sodium free fluids should be avoided because of the risk of hyponatraemia.

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11494.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11495.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11496.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11497.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11498.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11499.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT.Recurrent respiratory infections after the first years of life are not easily related to vascular rings as the cause of these infections. Therefore six cases of older children are presented in whom a vascular ring was the cause of their respiratory problems. None of them ever had stridor or swallowing problems in early infancy, and recurrent respiratory infections occurred later in life as a symptom of a vascular ring. Unfamil iarity with this association caused a delay in diagnosis and treatment in two patients and persistent lung damage in one child. Five of the 6 children recovered well after operation. The diagnosis can be made at an early stage if close inspection of the outline of the trachea on the chest radiograph shows an impression from the right side.

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11500.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY