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Biomedical subjects

B Z Morgenstern

Publications and source records attributed to B Z Morgenstern.

27 records · Page 2Linked to original sources
PubMed1991

Angiotensin converting enzyme inhibitors for reduction of proteinuria in children with steroid-resistant nephrotic syndrome.

The effects of angiotensin converting enzyme inhibitors (ACEI) on proteinuria, renal function, and serum proteins were evaluated in six children with steroid-resistant nephrotic syndrome and proteinuria of 3-15 g/24 h (277 +/- 47 mg/m2 per hour). Following ACEI, proteinuria decreased from 7,408 +/- 2,385 (mean +/- SEM) to 3,746 +/- 1,395 mg/24 h (P less than 0.05). Creatinine clearance was 87.8 +/- 22.6 before and 96.4 +/- 23.6 ml/min per 1.73 m2 after ACEI. In two patients, inulin and para-aminohippuric acid clearances were normal before and after ACEI, together with parallel reductions of urine protein of 50% and 46%. Clearance of total protein was reduced by 56% following ACEI, compared with reduction in the clearance of gamma globulin by 58% and albumin by 39.5%. No significant change was seen in blood pressure, serum albumin, or total protein following ACEI. After ACEI, diuretic doses were able to be reduced or eliminated in three patients. Reduction of proteinuria was sustained during a followup period of 11-20 months in three patients. ACEI may be of benefit in the clinical management of children with steroid-resistant nephrotic syndromes, allowing reduction in diuretic requirements.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1989

Hypophosphataemic rickets: final height and clinical symptoms in adults.

The heights and symptoms of 52 patients, aged at least 18 years, with X-linked hypophosphataemic rickets were analysed retrospectively; 47 had been seen as children and 5 were adult at their first examination. 2 patients were lost to follow-up. 3 patients had died but their adult heights were known. There was no evidence that any form of treatment (ie, vitamin D in high doses, vitamin D plus phosphate supplements, or calcitriol plus phosphate) had any effect on adult height, symptoms, or alkaline phosphatase levels. There was a negative relation between adult height and the number of osteotomies undergone. The complications of treatment, such as renal failure, which occurred secondary to vitamin D intoxication in 3 patients in their twenties, may outweight any possible benefits. Until a treatment is established as effective in controlled trials, it may be better that these patients remain untreated.

Adolescent↗
PubMed1986

The utility of renin profiling in childhood hypertension.

Criteria to categorize children as having hypertension associated with high, low or normal PRA as determined by the technique of renin sodium indexing; or with PRA responsiveness which was normal, suppressed or excessive after acute volume depletion induced by a loop diuretic were established in 30 normotensive adolescents. Four hour upright PRA corrected for daily sodium excretion was elevated in 16% of 43 and 84% of 25 children with essential and renal related hypertension. Low PRA was found in 5 of 43 and 0 of 25 children. In 36 children with essential hypertension evaluated after acute volume depletion, 4 and 5 had hyper- and hypo- responsive PRA compared to the 30 normotensive children. The application of these two approaches enables the renin angiotensin system to be systematically categorized in hypertensive children.

Adolescent↗
PubMed1984

Development of pneumatosis cystoides intestinalis following transperitoneal renal transplantation in a child.

A 9 1/2-year-old female developed pneumatosis cystoides intestinalis (PCI) which was detected radiographically 4 1/2 months after transperitoneal cadaveric renal transplantation, during a period characterized by recurrent episodes of acute rejection. Radiographic evaluation was prompted by the development of cramping abdominal pain, distention, and tenderness localized to the region of the allograft, which occurred during one such episode. Pneumatosis was localized primarily to an area of colon that lay in direct contact with the allograft. Evaluation of the available clinical and roentgenographic evidence suggested that pneumatosis may have resulted from the development of a sympathetic inflammatory reaction within the bowel wall adjacent to the acutely inflamed allograft. Subsequent stabilization of renal function was associated with resolution of the pneumatosis over the ensuing 8 months without surgical intervention or additional medical therapy.

Child↗
PubMed1983

Transperitoneal solute movement in children.

The transperitoneal movement of solute in children was examined by means of a theoretical consideration of the peritoneal clearance formula and by the performance of peritoneal solute diffusion curves and measurement of peritoneal clearances of multiple solutes. Theoretical considerations led to the conclusion that when dialysis mechanics are held constant, peritoneal clearances scaled for weight are similar in individuals of widely varying weight when the volume of infused dialysate is also scaled for weight if peritoneal permeability and surface area are constant. In one group of studies, solute diffusion curves and weight-scaled peritoneal clearances of urea, phosphate, creatinine, and urate were similar in 3 children ages 4 to 18 months compared to 4 children ages 2.5 to 18.5 years. In a second group of studies, weight-scaled peritoneal clearances of inulin but not urea were shown to be marginally lower in 4 children who had been dialyzed longer than 6 months compared with 4 children dialyzed less than 1 month. Hypertonic glucose dialysis in these children was shown to enhance urea clearance but not that of inulin. It is concluded that comparative studies of peritoneal clearances can characterize the transperitoneal movement of solute in children of widely varying body size. Such studies are of greatest value when systematically performed and similar ratios of dialysate volumes to body pools of solute are used.

Adolescent↗
PubMedDate not supplied

Hypertensive retinopathy mimicking neuroretinitis in a twelve-year-old girl.

Bilateral disk swelling and marked peripapillary and macular exudates were found on routine ophthalmologic examination in a 12 1/2-year-old girl. Eleven months later, with persistent findings, her blood pressure was found to be extremely elevated. She had an Ask-Upmark kidney, a rare form of segmental renal hypoplasia. The Ask-Upmark kidney abnormality occurs primarily in young women and is associated with hypertension. The disk edema and retinopathy resolved after the hypertension was controlled. Hypertensive retinopathy can sometimes resemble neuroretinitis.

Child↗