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Biomedical subjects

E Balzar

Publications and source records attributed to E Balzar.

At least 19 recordsLinked to original sources
PubMed1992

Renal transplant hemodynamics in children: prospective analysis of colour coded versus pulsed Doppler sonography.

In 30 children with renal allografts the diagnostic validity of pulsed Doppler (PD) versus colour coded Doppler (CD) sonography was assessed prospectively. 46 PD examinations were performed calculating the resistive index (RI) in the segmental arteries in comparison to 46 CD scans, where renal blood flow throughout the grey-scale image was displayed. In addition, point-spectral analysis with calculation of the RI was also performed on the CD scans. The time for examination ranged from five to ten minutes for the PD and from three to five minutes for the CD study. Concordant findings for the PD and CD technique were generally obtained (normal blood flow pattern on PD-excellent visualization of renal blood flow on CD, reduced or reversed diastolic flow on PD-poor visualization of renal blood flow on CD). There was close correlation of the RI values obtained by the PD and CD scans. CD sonography facilitated point-spectral analysis in shortening the time for examination. The ability to visualize focal hemodynamic alterations provided a higher diagnostic accuracy in comparison to PD sonography.

Adolescent↗
PubMed1991

[Importance of early diagnosis of urinary tract infections in childhood. Results of a retrospective study of children with vesico-uretero-renal reflux].

Urinary tract infections (UTI) in children are common. In the case of high grade vesico-ureteric-renal reflux (VUR) or urinary tract obstruction the abnormality may lead to end-stage renal failure. An early evaluation and adequate therapy after UTI are mandatory. Between 1980 and 1987 we evaluated 63 children with VUR. The symptoms of UTI are variable and age-dependent. Only in 13% of the children the urinary tract was evaluated after their first UTI. In 70% of the cases there were more than 1, mostly multiple UTI. The remaining 17% were admitted for other reasons. The relation boys to girls was 1:2. In boys the diagnosis of VUR was made earlier than in girls: 57% of boys and 17% of girls in their first year of life. In 24% of the boys and in 36% of the girls VUR was found between the 5th and 15th year of life. In the case of high grade reflux (IV-V) the kidneys showed heavy damage, loss of function and hypertension at the time of diagnosis. The aim must be early diagnosis and adequate therapy to prevent avoidable damages.

Adolescent↗
PubMed1989

[L-carnitine therapy and myocardial function in children treated with chronic hemodialysis].

Six out of 14 chronically hemodialysed children with significantly decreased serum carnitine levels were substituted with L-carnitine (15-30 mg/kg/day-Biocarn) up to normal and above normal carnitine levels. None of these patients were digitalised. During the time of investigation plasma carnitine levels were investigated monthly and, simultaneously, three echocardiographic parameters in M-mode were quantitatively und qualitatively determined: shortening fraction (SF-%), ratio of left ventricular pre-ejection/ejection time (LVPT/LVET) and velocity of circumferential fibre shortening (Vcf). Carnitine substitution produced measurable changes in echocardiographic parameters, and a significant quantitative improvement in left ventricular function and performance: after 6 months of carnitine substitution a 24% improvement was seen, after 18 months a 44% mean improvement. No side effects of carnitine were observed; the compatibility was good. Beside these positive effects all patients reported decreased dialysis-associated spasms and polyneuropathic symptoms and increased somatic ability.

Administration, Oral↗
PubMed1988

[First aid for severe burns and scalds in childhood].

A marked increase in the rate of admission of children with burns and scalding has been observed since 1977 at the Paediatric Hospital of Vienna University. The average age of 94 patients admitted between 1982 and 1986 was 2.2 +/- 2.1 years. An analysis of the age group 1 to 2 years revealed that burns with an extent of up to 10% of the body surface were seen in 18% of patients, up to a body surface of 20% in 18%, and more than 30% of the body surface in 5.3%. Among the entire group of 94 patients 32.9% had burns of up to 10% of the body surface, 41.4% of up to 20%. Written information as to primary care at the place of injury or in the nearest hospital was obtainable in only 35 out of 94 patients (38%). 21.1% of all patients had a raised temperature on the day of admission to this hospital as a consequence of a negative fluid balance. However, only 4 patients (4.2%) out of the 94 were transferred because of fever and/or septicaemia. Guidelines are proposed as to primary care at the site of trauma and during transport to hospital on the basis of a survey of the literature.

Burns↗
PubMed1988

Acute renal transplant rejection in children: assessment by Duplex Doppler sonography.

Over a two year period 74 consecutive Duplex Doppler scans were performed in 23 children with renal allografts and were compared to the Doppler sonographic findings in orthotopic kidneys of 25 age matched healthy controls. The Doppler waveforms of renal arterial flow were analyzed qualitatively assessing systolic and diastolic flow amplitudes, for quantitation the Pourcelot index (PI) was used. There was no variation between the Doppler waveforms in recipients with normal allograft function and healthy controls. In 12 patients with biopsy proven acute rejection a decrease or absence of the diastolic flow amplitude was noted, resulting in increased pulsatility of the Doppler waveform. The mean PI in acute rejection differed significantly from the mean PI in normal allograft function. Duplex Doppler sonography is a useful imaging modality in the differentiation between acute rejection and normal allograft function and should therefore be integrated in the screening of children after renal transplantation.

Adolescent↗
PubMed1988

[Diffuse xanthogranulomatous pyelonephritis in childhood].

Xanthogranulomatous pyelonephritis is a rare disease and rare cause of suppurative proliferative pseudotumor in children. An accurate diagnosis is difficult because of its clinical, radiological, sonographical and pathologic-anatomical similarities to renal tuberculosis. After removing the diseased kidney the prognosis is excellent. A 6-year old boy with xanthogranulomatous pyelonephritis is reported.

Child↗
PubMed1987

[Primary lymphedema in the nephrotic syndrome: case report].

The aim of this case report is to discuss possible connections between the development of a hypoproteinaemic oedema due to the nephrotic syndrome and the occurrence of lymphoedema. Two patients (a three year-old girl and a seven year-old boy) developed lymphoedema of one leg one year after the onset of the nephrotic syndrome. The case of the six year-old girl is presented. Malignancy was excluded by clinical investigation. Direct lymphography failed to show any peripheral lymph-vessels; indirect lymphography (i.c. infusion of a newly-developed contrast medium) revealed hypoplasia of the peripheral lymph-collectors. The development of lymphoedema 12-18 months after the appearance of the nephrotic syndrome supports the hypothesis that the increase in extravascular fluid, which is caused by a reduced oncotic pressure in the plasma, may trigger off the development of lymphoedema if there is a primary defect of the lymphatic system.

Child↗
PubMed1987

[Ocular findings in hemodialysis and following kidney transplantation in childhood and adolescence].

Between August 1980 and January 1987, 23 patients undergoing treatment for chronic renal failure underwent eye examinations. Hemodialysis and subsequent kidney transplants were performed in 18 patients; in two patients a kidney transplant was performed alone, and in three others hemodialysis without transplant. The interval between dialysis and transplantation averaged 23.1 months, the mean follow-up after transplantation 20 months. Patients who underwent hemodialysis alone were followed up for periods of two, three and 85 months. The patients' ages when hemodialysis treatment was first instituted ranged from six to 17 years (average 11.8 years). The mean age at the time kidney transplants were performed was 13.6 years (ranging from one to 17 years). Seventeen patients had conjunctival and corneal infiltrations in the area of the palpebral fissure. In two cases infiltrations were confined to the conjunctiva. Four patients had no pathologic changes, in either the cornea or the conjunctiva. Slitlamp examination revealed subcapsular losses of lens transparency in eight patients; these losses were manifested by delicate punctiform and patchy configurations. In nine cases fundus ophthalmoscopy revealed constricted retinal arteries. Within the period of observation all but one of the patients had unchanged vision. The one exception (cystinosis) had reduced visual acuity due to an accumulation of crystalline inclusions in the cornea.

Adolescent↗
PubMed1987

Acute renal failure in children. An ultrasonographic-clinical study.

Acute renal failure (ARF) may be due to obstructive uropathy or renal parenchymal disease. Twenty-five children with acute renal failure secondary to renal parenchymal disease underwent ultrasonographic examination of the kidneys. Changes of renal size and cortical echogenicity were correlated with renal function. All patients presented with bilaterally enlarged kidneys with the exception of those in the neonatal age group (12%). Improvement in renal function resulted in normalization of renal size. With regard to cortical echogenicity two groups were formed. Group A comprised 11 patients whose kidneys had the same echogenicity as the liver, while in group B the kidneys were more echogenic (14 patients). Cortical echogenicity was always increased. Determination of creatinine levels showed a statistically significant difference between group A (3.32 mg% +/- 1.40 S.D.) and group B (5.95 mg% +/- 1.96 S.D.), p less than 0.001. Changes in renal function were paralleled by rapid changes in renal size and cortical echogenicity.

Acute Kidney Injury↗
PubMed1987

[Urolithiasis in pediatrics: analysis of 34 patients].

The increasing incidence of urolithiasis makes it important to report about 34 children with urolithiasis seen between 1976 and 1986 at the Department of Pediatrics, University Medical School Vienna. At the time of the first diagnosis 59 percent of the patients were less than 7 years of age; 62 percent of our patients were males. Recurrent chronic urinary tract infection in 32 percent, metabolic disorder (secondary hyperoxaluria 5, idiopathic hypercalciuria 3, cystinuria 2, hyperuricuria 2) in 27 percent were evaluated; in 13 patients the origin of calculi was idiopathic. Most infectious stones contained magnesium ammonium phosphate, most idiopathic stones calcium oxalate. In 21 patients (62%) surgical treatment, in one patient extracorporal shock wave lithotripsie was realized. Adequate metaphylaxis (general, dietetic, medicementous) can lower the rate of occurrence of stone formation.

Adolescent↗
PubMed1986

[Familial juvenile nephronophthisis--a cause of chronic renal failure in childhood].

Familial juvenile nephronophthisis (FJN) represents an important cause of chronic renal insufficiency in the first two decades of life. Its frequency is reported to vary between 7 and 20% of all cases of terminal renal failure in childhood. Usually the onset is insidious, with polyuria, polydipsia and anaemia being the main clinical features. The diagnosis is based on clinical, laboratory and pathological findings. The purpose of our report is to emphasize the importance of this pathological entity with respect to the clinical symptoms and signs and diagnostic approach on the basis of the case reports of four patients.

Adolescent↗
PubMed1986

Identification of a major sialoprotein in the glycocalyx of human visceral glomerular epithelial cells.

Glomerular visceral epithelial cells are endowed with a sialic acid-rich surface coat (the "glomerular epithelial polyanion"), which in rat tissue contains the sialoprotein podocalyxin. We have identified a major membrane sialoprotein in human glomeruli that is similar to rat podocalyxin in its sialic acid-dependent binding of wheat germ agglutinin and in its localization on the surface of glomerular epithelial and endothelial cells, as shown by immunoelectron microscopy, using the monoclonal antibody PHM5. Differences in the sialoproteins of the two species are indicated by the discrepancy of their apparent molecular weights in sodium dodecyl sulfate gels, by the lack of cross reactivity of their specific antibodies, and by the lack of homology of their proteolytic peptide maps. It is therefore possible that the human glomerular sialoprotein and rat podocalyxin are evolutionarily distinct, but have similar functions.

Animals↗
PubMed1986

[Spinal lipoma with a dural closure defect as a cause of neurogenic bladder and chronic renal failure].

It is reported on a 6-year-old boy, in whom 3 years after the appearance of a neurogenic disturbance of the urinary bladder a lipoma in the spinal canal of the inferior thoracic region was diagnosed myelographically. The operative removal of the growing and displacing fatty tissue which by a (congenital?) dural gap continued in epidural direction indeed resulted in a far-reaching regression of the paresis of the lower extremities, not, however, in an improvement of the urological picture of the disease. The renal insufficiency caused by the hydronephrosis was no more reversible, which emphasizes the importance of the early diagnosis of this relatively infrequent malformation.

Child↗
PubMed1986

Quantitative EEG: investigation in children with end stage renal disease before and after haemodialysis.

Changes in brain function of 9 children (6 males and 3 females) ages 7 to 14 years (mean 12 years) with end stage renal disease (ESRD) were investigated before and after haemodialysis treatment, utilizing computer assisted spectral analysis of the scalp-recorded EEG. A control group of age-matched healthy children was studied as well. Statistical analyses demonstrated that ESRD children exhibited more Delta and Theta activity, less Beta activity, a slower dominant frequency of the Alpha activity as well as a slower centroid of the total activity before treatment than the controls. These findings suggest a deterioration of vigilance as characterized by Head. Haemodialysis decreased slow activity and increased Alpha and Beta activity, thereby inducing an improvement of brain function.

Adolescent↗
PubMed1985

High levels of plasma protein C in nephrotic syndrome.

In patients with severe nephrotic syndrome determinations of plasma protein C: Ag levels (8 patients: 5 adults, 3 children) and protein C activity (3 out of 8 patients) revealed significantly elevated plasma protein C concentrations. Furthermore we observed a significant inverse correlation of protein C: Ag to AT III: Ag levels. No protein C: Ag could be detected in the urine of two patients studied. We conclude from our data, that changes of plasma protein C do not contribute to the high thrombotic tendency in nephrotic syndrome.

Adolescent↗
PubMed1978

Urinary excretion of glomerular basement membrane antigens in Alport's syndrome. A new diagnostic approach.

Alport's syndrome is defined by the combination of hereditary nephropathy and neurosensory deafness, and is diagnosed from the family history combined with renal electron microscopy. Immunoelectrophoresis of the urine of 8 of 12 children suspected of Alport's syndrome showed a precipitation line moving into the beta-zone, applying an antiglomerular basement membrane antibody derived from an immunised rabbit. All patients who showed the typical pattern of Alport's syndrome on renal electron microscopy were among the 8 cases whose urine gave this immunoelectrophoresis pattern. Additionally, 5 of the mothers of the 8 children excreted the same antigen in their urine. The urine of 30 healthy children and of 10 patients with the idiopathic nephrotic syndrome did not show the presence of this antigen. This characteristic sign of Alport's syndrome may therefore be useful for its detection.

Adolescent↗
PubMed1978

Acquired antithrombin III deficiency in patients with glomerular proteinuria.

Antithrombin III (AT II/III) was determined immunologically and by means of a heparin cofactor assay in plasma samples and 24-hour urine of 15 patients with various degrees of proteinuria, being predominantly of glomerular origin. In urine the AT II/III concentrations were significantly correlated to the concentrations of albumin, plasminogen and IgG. One third of the patients had AT II/III plasma levels below the normal range. The plasma levels showed a significant inverse correlation to the AT II/III and albumin clearance rates. Similarily, the plasminogen concentrations in plasma were decreased in two thirds of the patients, being inversely correlated to the renal plasminogen clearance values. It is proposed that AT II/III deficiency in the nephrotic syndrome is an important pathogenetic factor in venous thrombosis.

Adolescent↗