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Biomedical subjects

E S Lightner

Publications and source records attributed to E S Lightner.

26 records · Page 2Linked to original sources

Theophylline poisoning.

Three cases of theophylline poisoning in young children, two of which occurred after erroneous administration of commonly prescribed pediatric drugs, are presented. The possible association of hyperglycemia and ketoacidosis with severe theophylline toxicity is discussed. Serial serum theophylline levels and half-life determinations for two patients suggest that, although serum half-lives (8.5 hours and 9.0 hours) may be slightly longer than average, drug disappearance followed first order kinetics even at extremely high erum theophylline levels.

Female↗

Low-dose intravenous insulin infusion in patients with diabetic ketoacidosis: biochemical effects in children.

Twenty-five episodes of diabetic ketoacidosis in 20 children were treated with continuous low-dose intravenous insulin infusion. Stable serum immunoreactive insulin concentrations were produced, along with prompt falls in glucose, beta-hydroxybutyrate, and glucagon levels, and a steadily increasing bicarbonate level. Neither hypokalemia nor hypophosphatemia developed. Elevated serum alanine concentrations were found during ketoacidosis in contrast to the lowered concentrations found in adults, and were correlated inversely with plasma glucagon concentrations. The treatment regimen described is safe, easy to use, efficacious, and resulted in prompt correction of the observed biochemical alterations in children with diabetic ketoacidosis.

Adolescent↗

Low-dose intravenous insulin: treatment of diabetic ketoacidosis in children (suitability for use in community hospitals).

A regimen is described to simplify current methods of ketoacidosis therapy by using only standard intravenous equipment and without requiring albumin administration. After an initial intravenous insulin bolus of 2 units, a dose of up to 3 units per hour was sufficient to bring patients out of ketoacidosis. No hypoglycemia, significant hypokalemia, or rapid fall in serum osmolality was detected. Patients showed steady increases in endogenous bicarbonate and were out of metabolic acidosis in 8.4 hours. This modified regimen appears to be a safe and easy method of treating diabetic ketoacidosis in children and is suited for use in community hospitals. Since the method is described for children over the age of three or those not in severe coma, consultation should be sought for any infant and for any child in severe coma or with a significant complication, such as severe infection.

Child↗

Congenital hypothyroidism: clues to an early clinical diagnosis.

Congenital hypothyroidism is clinically difficult to diagnose early in life. A review of the common signs and symptoms of this treatable disease is presented, and a case diagnosed on the third day of life is discussed. Until neonatal thyroid screening is generally available it behooves all physicians caring for newborns and young infants to have a high index of suspicion for this disease.

Congenital Hypothyroidism↗

X-short arm deletion gonadal dysgenesis in two siblings due to unique translocation (Xp-;16p+).

A family demonstrating short arm deletion of the X chromosome as a consequence of X-16 balanced translocation in the mother is reported. The two Xp- sisters exhibit clinical signs of gonadal dysgenesis, while the balanced carriers are phenotypically normal. To our knowledge this represents the only example of both the balanced carrier state for an X translocation and its genetic consequence occurring in the offspring, as well as the involvement of X-16 interchange. Literature data of 37 additional cases of verified X translocations are discussed.

Adolescent↗

Growth hormone excess and sexual precocity in polyostotic fibrous dysplasia (McCune-Albright syndrome): evidence for abnormal hypothalamic function.

A 5-5/12-year-old boy with gigantism and precocious puberty associated with the McCune-Albright syndrome is presented. Serum concentrations of growth hormone were extremely elevated (128-163 ng/ml) and were not suppressed by hyperglycemia or chlorpromazine. Serum LH (7.4 +/- 1.0 SD mIU/ml) and FSH (5.3 +/- 0.3 SD mIU/ml) concentrations were in the range observed in midpuberty. The secretion pattern of LH was episodic. The administration of estradiol suppressed the secretion of FSH and had an apparent positive feedback effect on release of LH. These findings are compatible with abnormal hypothalamic function as the mechanism for the endocrinopathies associated with the McCune-Albright syndrome.

Blood Glucose↗