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 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fourty-four children with Henoch-Schoenlein nephritis were studied at the onset of the nephropathy and during a follow-up from 6 to 110 months. The extra-renal manifestations were purpura (100%), abdominal pain (63.5)% or melena (27%), arthlagias (61.5%), neurological symptoms with convulsions (4.5%) and retinal involvement (4.5%). The clinical presentation of the nephropathy consisted in haematuria and proteinuria (41%), isolated haematuria (30%), acute renal failure (ARF) (23%), nephrotic syndrome (4%) or isolated proteinuria (2%). Hypertension was present in 17 patients. Renal biopsy was performed in 18 patients and the glomerular changes were graded according to the classification of ISKDC; the renal histopathology ranged from minimal lesions to severe crescentic glomerulonephritis and was found to correlate with clinical state. Twenty-four patients, who showed severe clinical presentation and/or diffuse mesangial proliferation with high proportion of crescents, received a corticosteroid therapy. Most of our patients followed a relatively benign course: all but one of patients with ARF have normal renal function at the end of follow-up and no patients with less severe renal presentation got a bad outcome. Only 2 patients showed relapse of nephropathy and purpura at the 6th and 8th year of follow-up, respectively. After 24 months of follow-up the clinical outcome of a group of 19 patients receiving corticosteroid therapy was not very different from that of 11 untreated patients.
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PMID:[Clinical aspects of the nephropathy in Schoenlein-Henoch syndrome]. 378 92

Scorpion sting in children is a hazardous and potentially lethal condition. Fifty-one infants and children were admitted to the Pediatric Departments at the Hadassah-Hebrew University Hospitals in Jerusalem, during a 5-year period, following scorpion sting. Fifteen (29.4%) had severe systemic signs of envenomation and two (3.9%) died. Analysis of our data showed that patients with severe toxicity were brought to the hospital after a significantly longer time lapse than were the patients with mild-to-moderate symptoms. The current management of children with scorpion envenomation consists of administration of specific antivenom and close surveillance in an intensive care unit, where vital signs and continuous cardiac monitoring enable early initiation of therapy for life-threatening complications, such as cardiac and respiratory failure, convulsions, or hypertension.
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PMID:Scorpion sting in children. A review of 51 cases. 397 39

Sixty-five patients with eclampsia were longitudinally evaluated regarding neurological abnormalities and maternal outcome (6 to 42 months) after eclampsia. Electroencephalograms were obtained on all patients during the subsequent 6 months. Computerized axial tomographic scans (n = 20) and cerebral arteriograms (n = 3) were obtained on patients with neurological deficits and/or those with an atypical clinical course. The electroencephalogram was abnormal in 49 patients (75%) at initial assessment but gradually returned to normal in all observed patients within 6 months. Cerebral arteriograms and computerized axial tomographic scans were normal in each patient studied. None of the patients had neurological deficits or subsequent convulsions on follow-up examination. Thirty-eight patients had one or more subsequent pregnancies without recurrent eclampsia, but 14 (37%) had pregnancy-induced hypertension. The findings suggest that neurological events of eclampsia are acute and transient and that long-term neurological deficit is rare in the properly managed patient. Computerized axial tomography and electroencephalography are rarely indicated in the management of such patients.
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PMID:Eclampsia. IV. Neurological findings and future outcome. 400 67

34 eclamptic patients treated at Harare Maternity Hospital during 1982 were managed by the use of diazepam to control convulsions, Nepresol to control the hypertension and prompt delivery. The average dose of diazepam given prior to delivery was 45.8 mgs. 80% of Greater Harare Unit patients were delivered by emergency caesarean section. The maternal mortality rate was 4% and the perinatal mortality rate 12% for patients within the Greater Harare Unit. The major factor contributing to maternal mortality in the cases reviewed was lack of antenatal care, or lack of acceptance of antenatal advice. All pregnant patients must be encouraged to book for antenatal care. The perinatal mortality is higher for unbooked patients, and in those patients witha long 1st fit-delivery interval. Perinatal mortality is also related to gestational age at delivery, mortality being greater in those patients delivered before 34 weeks gestation. A reduction in perinatal mortality could be achieved by all patients booking for antenatal care, aiming for a short 1st fit-delivery interval, and providing expert neonatal care for the pre-term infant.
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PMID:Management and pregnancy outcome in eclampsia at Harare Maternity Hospital. 404 45

Over a period of 13 years, 353 cases of metastases in the brain, spinal canal or peripheral nerves were treated in 14,350 inpatients. In 79.6% of the cases, the metastases were localized intracranially, in 14.7% spinally, in 2.6% peripherally and in 3.1% in several of these sites. Solitary tumors predominated (65.7%). Of 420 intracranial metastases, 336 were located supratentorially (80%) with a slight preponderance on the left side (54.5%), 15% cerebellar, and 5% in the brainstem. Of the spinal metastases, 80% were located in the thoracic spinal cord. Almost 60% of the cases also displayed metastases outside the nervous system, mainly in the skeletal system and the lungs. The most frequent primary tumor was bronchial carcinoma (26,6%) followed by breast cancer (19.5%) and unknown primary tumor (17.6%), which was also not found on autopsy in 0.8%. Rare primary tumors were parotid and pancreatic carcinomas, testicular and bladder tumors. There are correlations between the primary tumor and the location of the metastases in the nervous system in general and in the brain in particular. The latency between diagnosis of the primary tumor and that of the metastasis was 1-3 years. In one out of three cases, the metastasis in the nervous system was the first sign of the tumor condition. In six cases, the metastasis was removed before the primary tumor and two possible kinds of primary tumors were found in seven cases. Compared to intracranial hypertension focal deficit manifestations including focal convulsions occurred twice as frequently in cerebral metastases. Spinal metastases led to CSF blockade in 20%.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Metastases to the nervous system]. 405 15

In a brief view there are described experimental results obtained from starving animals and teratogenous influences of the deficiency disease. By reference to a model group of 60 children there are depicted the complex influences of the deficiency disease and stresses of war. Two subgroups are described clinically, explaining the various pathogenesis. Children born under conditions of war and persecution or living under such conditions during childhood--41 persons. Children who after the war were born into families of previously persecuted people--19 persons. Neurotic conditions accompanied by anxiety, headache, disturbance of memory, tendency to fits, and excitability are common to both of these groups. The differences manifest themselves in the percentage of tiredness, sleeplessness, and depression, which occur much more frequently in the first group, while bodily weakness, ailments characterized by the occurrence of fits, perinatal encephalopathies with pyramidal disorders are more often observed in the second group. Lack of adaptability, especially in the first postwar years in the first group, could be remedied in the majority of cases, although it was possible here, too, to observe symptoms of premature senility. These cases showed not only hypertension (26.8 per cent), but also roentgenologically demonstrable arteriosclerotic changes. The higher percentage and statistically significant difference in the occurrence of anxiety and depression as compared with the percentage of neuroses in the average population as well as the frequent occurrence of perinatal encephalopathies and ailments characterized by fits show the serious degree to which the consequences of war still manifest themselves in children after many years.
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PMID:[Effect of hunger on the development of the child]. 500 79

Toxemia was induced in 13 of 20 pregnant ewes by the stress of a change in environment and food deprivation late in pregnancy. Of the toxemic ewes, eight developed prominent neurological findings with convulsions, motor weakness, and blindness, whereas five ewes developed azotemia without neurological signs. Proteinuria and azotemia occurred in all but one of the toxemic animals. Seven animals did not develop clinical or laboratory evidence of toxemia. Hypertension did not occur with the onset of toxemia but all toxemic animals showed glomerular changes by light and electron microscopy. These abnormalities, which were similar to those seen in human preeclampsia, included endothelial cell swelling, focal reduplication of the basement membrane, and fusion of the epithelial cell foot processes. The toxemia could not be attributed to changes in hematocrit, plasma glucose, Na, Cl, CO(2), K, Ca, fibrinogen, arterial pH, lactate, or pyruvate concentrations. Cardiac output fell only in ewes with prominent neurological signs. Plasma renin rose strikingly in animals developing toxemia, without change in substrate concentration. In contrast to human and other species, sheep uterus and amniotic fluid contained no detectable quantities of renin. Thus in response to stress the pregnant ewe develops a toxemia which in the absence of hypertension has clinical and pathological similarities to human preeclampsia.
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PMID:Toxemia of pregnancy in sheep: a clinical, physiological, and pathological study. 538 29

We have studied and found valuable a numerical value best designated as the "renal chlormerodrin uptake". This represents not a transient state, like the renogram, but a measurement of the biological ability of the renal tubules to firmly bind (203)Hg chlormerodrin presented to them as a very small standard dose passing through the kidney. Normal kidneys bind a remarkably fixed portion, and there is a consistent parallel between retention and tubular function.This binding, expressed for each kidney as a percentage of the normal, provides an easily measured value which allows isotopic renal measurements made from day to day and from year to year, on various individuals, to be accurately compared.These uptake values may be used to measure individual organ function or, by their addition, to evaluate the total renal function possessed by that patient. The utility of such uptake values goes beyond the conventional assessment of renal flow in hypertension, and is applicable to most forms of renal dysfunction, including trauma.Determination of the renal uptake at three to four hours fits well into a standard set of procedures which also includes the renogram, the renal scan, the local quantitation of scan areas, and the intravenous pyelogram. It requires only a few additional minutes, and no additional instrumentation or radiopharmaceuticals.
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PMID:The quantitative measurement of tubular chlormerodrin binding as an index of renal function: a study of 400 cases. 545 77

Fifty-three neonates born to 51 mothers treated with lorazepam were followed up for five days after delivery. Lorazepam had been given by mouth to 35 mothers and intravenously to 16. In general, maternal plasma concentrations of lorazepam were higher than the corresponding cord plasma concentrations. Cord plasma concentrations exceeding 45 micrograms/l were associated with three-quarters of the infants requiring ventilation at birth. Neonates conjugate lorazepam slowly to the pharmacologically inactive glucuronide, which is then excreted in the urine, where it is detectable for over seven days. Though lorazepam was detectable in breast milk, the maximum amounts that an infant could absorb would be pharmacologically insignificant. Full-term neonates whose mothers had received oral lorazepam had no complications apart from slight delay in establishing feeding, which in seven out of 29 cases was associated with relatively large doses of lorazepam. Intravenous lorazepam for severe hypertension was associated with significantly low Apgar scores, need for ventilation, hypothermia, and poor suckling. Preterm babies whose mothers had been given lorazepam by either route had a high incidence of low Apgar scores, need for ventilation, hypothermia, and poor suckling. These babies had lower Apgar scores than those whose mothers had received diazepam, but the diazepam group were heavier and more mature. Lorazepam was an effective sedative and anxiolytic by either route, and there were no eclamptic fits among the lorazepam-treated patients. The effects of lorazepam on neonates indicate that its intravenous use at any stage in pregnancy and oral use before 37 weeks should be restricted to hospitals with facilities for neonatal intensive care.
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PMID:Effect of maternal lorazepam on the neonate. 611 19

Water intoxication from intravascular absorption of non-electrolyte irrigating fluid is a well-known and often serious complication of transurethral resection of the prostate. The amount of absorbed fluid depends on the duration of the operative procedure, the number of transected open venous sinuses and the hydrostatic pressure of the irrigating fluid. Arterial hypertension, bradycardia, mental agitation, confusion, headache, nausea, dyspnoea, convulsions and pulmonary edema are the typical syndromes. In this case, severe Angina Pectoris was the first alarming symptom.
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PMID:[Angina pectoris -- an early sign of water intoxication during transurethral prostatectomy (author's transl)]. 617 35


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