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Biomedical subjects

J D Roscelli

Publications and source records attributed to J D Roscelli.

At least 19 recordsLinked to original sources
PubMed1997

Electrolyte composition of human breast milk beyond the early postpartum period.

The electrolyte composition of breast milk beyond 6 months postpartum has not been extensively examined, particularly chloride concentrations. A total of 140 samples of breast milk from 30 breast-feeding mothers were collected and analyzed. Mean mother's values +/- standard error of sodium (141 +/- 17 mg/L), potassium (480 +/- 11 mg/L), and chloride (452 +/- 32 mg/L) were found to be stable after 4 months postpartum until weaning commenced. Considerable variability was found for each constituent, equally divided between intra-individual and inter-individual for chloride and potassium, and predominantly intra-individual for sodium and lactose. In light of reported nutritional deficiency states involving electrolytes in exclusively breast-fed infants, it is possible that the variability of breast milk electrolyte concentrations may adversely affect infant nutrition in selected cases of older exclusively breast-fed infants.

Chlorides↗
PubMed1994

Management of salt poisoning in an extremely low birth weight infant.

We present the first reported case of severe salt poisoning in an extremely low birth weight neonate. The salt poisoning was managed with the careful use of intravenous fluids, insulin to manage the severe hyperglycemia, and furosemide to induce a saline diuresis. The hypertonicity was normalized slowly over 3 days by following the corrected serum sodium (Na) (serum Na + 2.7 mEq for every 100 mg/dl of glucose over 100). No neurological damage was seen in our patient during the development of the hypertonicity or its correction. This suggests that the premature brain can develop osmoprotective molecules if hypertonicity develops slowly over 2-3 days. Slow correction is therefore recommended to avoid the development of water intoxication during correction. Despite the development of mild reversible renal failure, a large saline diuresis was induced with furosemide, thereby avoiding the need for dialysis in our patient. The only complication was the development of necrotizing enterocolitis, which has not been previously reported in association with salt poisoning.

Drug Overdose↗
PubMed1992

Establishing standards of orthostatic measurements in normovolemic adolescents.

OBJECTIVE: To determine normal orthostatic heart rate and blood pressure changes in healthy adolescents. DESIGN: Survey. SETTING: General adolescent clinic at a military teaching medical center in Honolulu, Hawaii. PARTICIPANTS: One hundred healthy normovolemic patients aged 12 to 19 years representing a cross section of individuals from a diverse military population during a 5-month study period. SELECTION PROCEDURE: Convenience sample. INTERVENTIONS: None. MEASUREMENTS/MAIN RESULTS: The mean (+/- 2 SDs) orthostatic heart rate change in beats per minute was 21.5 +/- 21.2, with a range of 50 to -3 beats per minute. The mean (+/- 2 SDs) systolic blood pressure change was -0.9 +/- 15.7 mm Hg, with a range of 19 to -17 mm Hg. Orthostatic measurements in a normal adolescent population may result in a heart rate increase of 40 to 50 beats per minute and a systolic blood pressure decrease of 15 mm Hg. There were no significant differences between individuals with respect to age, race, sex, and body habitus. CONCLUSIONS: Healthy adolescents display wide variation in orthostatic measurements that exceed previously accepted standards. Further study is required to determine if sensitivity and specificity values exist for orthostatic measurements that can identify individuals with intravascular volume depletion.

Adolescent↗
PubMed1991

Guillain-Barré syndrome and influenza vaccination in the US Army, 1980-1988.

An increased incidence of Guillain-Barré syndrome (polyradiculoneuritis) occurred in individuals who received the A/New Jersey (swine) influenza vaccine in 1976-1977. A retrospective study encompassing the years 1980-1988 was conducted to determine if the US Army's mass influenza vaccination program has been associated with an increased incidence of Guillain-Barré syndrome in active duty soldiers during the study years. No temporally related increase in Guillain-Barré syndrome was found during the study years.

Causality↗
PubMed1989

A meconium suctioning device that is safe and practical.

Immediate suctioning of meconium from the trachea of newborns is believed to be an effective method for preventing or minimizing the meconium aspiration syndrome. Recently, however, the possibility of transmitting disease from the newborn to the physician or vice versa, while using the standard technique of direct oral suction (through a surgical mask), has been stressed. This has prompted the development of alternative methods for suctioning the newborn's trachea. These methods, while eliminating the possibility of disease transmission, create other problems. We, therefore, devised a technique for tracheal suctioning using inexpensive, readily available materials that is not only safe and effective in suctioning meconium but is also practical and easy to perform.

Humans↗
PubMed1988

Pruritic rash associated with cat scratch disease.

Cat scratch disease is a benign, self-limited illness characterized by regional lymphadenopathy that usually occurs in association with a history of contact with a cat. Cases of cat scratch disease with skin manifestations that included erythema nodosum; erythema multiforme; erythema marginatum; and non-specific maculopapular, petechial, and morbilliform rashes have been reported. No case of pruritic rash associated with cat scratch disease has been previously reported. In fact, one authority specifically states that the rash of cat scratch disease is nonpruritic. We report a well-documented case of cat scratch disease in which the patient's principal symptom was a pruritic rash. It is possible that this rash was the result of an immunologic reaction to the infectious agent of cat scratch disease. We conclude that cat scratch disease should be included in the differential diagnosis of pruritic rashes in children.

Cat-Scratch Disease↗
PubMed1986

Corroborative evidence for the decreased incidence of urinary tract infections in circumcised male infants.

We report the results of a two-part study examining the incidence of urinary tract infection during the first year of life. In the first part of the investigation, we reviewed the occurrence of urinary tract infection in a cohort of 3,924 infants born at our institution during a 4-year period. Infection developed in 16 infants (0.41%). The incidence of urinary tract infection in noncircumcised males was greater than the incidence in both female (P less than .004) and circumcised male (P less than .001) infants. In the second part of the study, we explored the frequency of urinary tract infection in all infants born in US Army hospitals, worldwide, over a 10-year period. There were 422,328 infants born in army facilities during this time period. Subsequent hospitalization for urinary tract infection occurred for 1,825 (0.43%) infants during the first year of life. Overall, there was no male preponderance for infections in early infancy compared with females. After an equivalent incidence during the first month of life, female infants had significantly more infections than did male infants (P less than .001). However, noncircumcised male infants had a higher incidence of urinary tract infection than female infants (P less than .001). Additionally, noncircumcised male infants had a tenfold greater incidence of infection than circumcised male infants (P less than .001). There was a significant decrease in the circumcision frequency rate during the 10-year study period (from 85.4% to 73.9%, P less than .001). As the number of circumcisions decreased, there was a concomitant increase in the overall number of urinary tract infections in males (P less than .02).(ABSTRACT TRUNCATED AT 250 WORDS)

Circumcision, Male↗
PubMed1985

Hemorrhagic shock and encephalopathy: further description of a new syndrome.

Abrupt onset of coma, seizures, severe shock, and hyperpyrexia occurred in two previously healthy children. Their illnesses closely resembled a clinical syndrome of uncertain cause, the hemorrhagic shock and encephalopathy syndrome. Our patients had striking similarities to as well as certain differences from reported patients. Based on the similarities, we believe our two cases represent additional occurrences of the syndrome. Based on the differences, we conclude that the syndrome should be labeled "shock and encephalopathy syndrome" and that the prognosis may be improved by early aggressive treatment of shock.

Brain Diseases↗