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Biomedical subjects

I G Verber

Publications and source records attributed to I G Verber.

7 recordsLinked to original sources
PubMed1990

Glucose polymer regimens and hypernatraemia.

A 3 year old boy who had glutaric aciduria diagnosed at 22 months of age was admitted with a history of lethargy, vomiting, and fever. He had been receiving glucose polymers as part of his dietary management. He was severely hypernatraemic, but after resuscitation and rehydration made a good recovery. The possible aetiology of his hypernatraemia is discussed.

Amino Acid Metabolism, Inborn Errors↗
PubMed1989

Serial 99mTc dimercaptosuccinic acid (DMSA) scans after urinary infections presenting before the age of 5 years.

Forty five children presenting with a first proven urinary tract infection under the age of 5 years were studied by sequential 99mTc dimercaptosuccinic acid (DMSA) scans. Forty nine kidneys in 40 children had definite defects at presentation, and 39 (80%) of these defects were still present when the DMSA scan was repeated. Changes in the appearance of defects were independent of the presence or degree of reflux at presentation and of symptomatic recurrence of infection, though the combination of new infection and grade 3 reflux (reflux reaching the renal calices with distension) was associated with deterioration. No kidney with a relative DMSA uptake of less than 35% showed any improvement in its cortical defects. Only two kidneys that were initially without defects, in a single patient who had bilateral grade 3 reflux and breakthrough infections, developed defects on subsequent scans. The outcome after urinary tract infection is dependent on the effect of the first infection on the kidney. Occasionally children with grade 3 reflux develop damage during subsequent infections. More widespread use of DMSA scans should improve our understanding of the factors that determine the development of renal damage.

Child, Preschool↗
PubMed1989

Prolonged rupture of the fetal membranes and neonatal outcome.

In order to establish the incidence of neonatal infection following prolonged (greater than 24 hours) rupture of the fetal membranes (PROM) and assess outcome of two year retrospective study was undertaken. The names of all babies born following PROM were obtained from the computerised obstetric record and the bacteriological results and outcome reviewed. Of 208 babies born following PROM only three had blood cultures containing pathogens--all of whom were of less than 1500 g birthweight and all of whom died. This represents a fivefold increased frequency of infection for premature babies but no increased risk for full term babies. The overall incidence of infection was much lower than in previous series and this may be due to performing amniocentesis as soon as possible following rupture and inducing labour where there was evidence of incipient chorioamnionitis. Meningitis was not associated with prolonged rupture of the membranes. The mortality for these babies was higher than those of babies without PROM in the 28-31 week gestation group. This was strongly associated with early onset of membrane rupture and none of the babies born following membrane rupture prior to 20 weeks gestation survived. Non-infective pulmonary disease was the main cause of increased mortality.

Bacterial Infections↗
PubMed1988

99mTc dimercaptosuccinic acid (DMSA) scan as first investigation of urinary tract infection.

A total of 115 children under 5 years who presented with a first symptomatic urinary tract infection and who had a 99mTc dimercaptosuccinic acid (DMSA) scan were studied to assess its value and compare the findings with those of other imaging techniques. Renal cortical defects were detected in 65 kidneys by DMSA scan, intravenous urogram, and ultrasound scan combined; 62 (95%) being seen on DMSA scan. The finding of reflux on micturating cystourethrography showed a highly significant correlation with renal defects seen on DMSA scanning, a less close but still significant correlation with abnormalities on intravenous urography, but none with ultrasound scan findings. The sensitivity of the DMSA scan in screening for all grades of reflux is estimated as 0.66, which is higher than that previously reported for the intravenous urogram or ultrasound scan. DMSA scans were less likely to miss grade 3 reflux than the other two methods. DMSA scans are more useful than other upper renal tract imaging techniques in detecting renal defects. Consideration should be given to their use as a first investigation in place of routine intravenous urograms. Ultrasound scans alone will overlook potentially serious urinary tract abnormalities.

Child, Preschool↗