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Biomedical subjects

J R Salcedo

Publications and source records attributed to J R Salcedo.

At least 19 recordsLinked to original sources
PubMed1990

Intravenous immunoglobulin in minimal change nephrotic syndrome: a crossover trial.

To determine whether intravenous immunoglobulin (IVGG) would be an efficacious adjunct in the treatment of childhood minimal change nephrotic syndrome (MCNS), we enrolled ten patients with frequently relapsing or steroid-dependent MCNS in a double-blind crossover clinical trial. At the time of relapse of the nephrotic syndrome, patients were assigned to treatment with a single outpatient infusion of IVGG (800 mg/kg) or intravenous albumin as a control. The relapse was treated concurrently with standard doses of oral prednisone. At the time of the next relapse, patients who had first received IVGG were treated with albumin, and vice versa. There were no significant differences in the length of remission between the IVGG and albumin treatments. The study had a power of 0.72 to detect a true difference of 45 days between the two therapies. We conclude that in the dose of drug used in this trial, administered at the time of relapse in conjunction with prednisone therapy to children with frequently relapsing or steroid-dependent MCNS, IVGG does not lead to a clinically important extension of the period of remission.

Adolescent↗
PubMed1989

Calcium-activated potassium channels in human platelets.

The cationic fluorescent probe, DiSC3(5) was used to measure the membrane potential in human platelets. Hyperpolarization was induced by the addition of Ca2+ to the medium and also by the addition of the Ca2+ ionophore, A23187. In the absence of extracellular Ca2+ ([Ca2+]o) there was no response to A23187. The threshold concentration for [Ca2+]o was 20 microM and for A23187 was 12 nM. The increase polarity induced by [Ca2+]o was not affected by various K+ channel blockers. However, the effect of A23187 was inhibited by quinine and charybdotoxin, while apamin, tetraethylammonium, and the calmodulin inhibitors trifluoperazine and compound R24571 were ineffective. The resting membrane potential was -66 +/- 0.9 mV and was decreased by quinine. There are three conclusions from this study: (i) Ca2+-activated K+ channels exist in human platelets; (ii) they are the type that are apamin insensitive, charybdotoxin sensitive; and (iii) they may contribute to the resting membrane potential.

Adult↗
PubMed1988

Renal histology of mucocutaneous lymph node syndrome (Kawasaki disease).

Renal involvement is well described in patients with mucocutaneous lymph node syndrome (MCLNS), or Kawasaki disease and is manifested by mild azotemia, hematuria, pyuria or cylinduria, and more often, proteinuria. Renal morphology during the acute stages of the illness has never been reported. In this paper we describe the renal histopathologic changes in a child with MCLNS. The glomerular histopathologic findings suggest immune complex damage to the kidney as a possible mechanism of nephrotoxicity in MCLNS. Presence of kidney lesions, which speak in favor of the injurious role of immune complexes in MLCNS may be relevant to the understanding of the pathogenesis of the vascular lesions that are characteristic of this disease.

Antigen-Antibody Complex↗
PubMed1986

Urinothorax: report of 4 cases and review of the literature.

Urinothorax should be considered when pleural effusion occurs in patients with urinary tract obstruction accompanied by retroperitoneal urinoma. This recommendation is based on our experience with 4 cases and a review of the literature. In 2 patients urinary obstruction was owing to retroperitoneal fibrosis secondary to malignancy, including one who had a neuroectodermal undifferentiated small round cell tumor and the other who had a metastatic epithelial neoplasm. In the 2 other patients urinary obstruction resulted from a failed ureteroneocystotomy following renal allograft transplantation. All 4 patients had a urinoma, which may be a predisposing factor to urinothorax.

Adolescent↗
PubMed1985

Accelerated recovery from immune-mediated thrombocytopenia with plasmapheresis.

Autoimmune thrombocytopenia unresponsive to corticosteroid therapy developed in a 16-year-old female with long-standing Sjögren's syndrome. Serial plasma exchange caused a linear decrease in platelet antibody titer associated with a concomitant rise in platelet count. Statistical analysis of sequential platelet counts revealed an increase with plasmapheresis and immunosuppression that was significantly greater than that achieved with immunosuppression alone (p less than 0.005).

Adolescent↗
PubMed1985

Hematuria after renal allograft biopsy: treatment with aminocaproic acid.

Aminocaproic acid (EACA) was used in 2 patients with cadaveric renal allografts because gross hematuria developed after percutaneous renal biopsies. Marked improvement was noted within twelve hours with no recurrence after discontinuation of EACA. EACA was effective in moderate renal failure.

Adolescent↗
PubMed1985

Vancomycin prevents polytetrafluoroethylene graft infections in pediatric patients receiving chronic hemodialysis.

Polytetrafluoroethylene (PTFE) grafts have been a useful addition to the pediatric hemodialysis vascular access armamentarium. In this study, 17 pediatric patients underwent 331 total months of hemodialysis via PTFE grafts. There was a statistically significant (P less than .025) decrease in the incidence of graft infections in 12 patients (235 patient-months) while receiving prophylactic parenteral vancomycin compared with 9 patients (96 patient-months) while receiving no vancomycin (0% v 44%). Vancomycin side effects were uncommon and mild. Vancomycin is a safe and effective agent for the prevention of PTFE graft infections in pediatric patients receiving chronic hemodialysis.

Adolescent↗
PubMed1985

Urinothorax as a manifestation of nondilated obstructive uropathy following renal transplantation.

A 12-year-old patient developed prolonged nondilated urinary obstruction and pleural effusion shortly after undergoing renal transplantation. Renal sonography, angiography, and isotope renography failed to identify an obstructive process. On the 18th postoperative day, pleural effusion was noted in the right hemithorax, and by day 24, increased perinephric fluid was observed on renal scan. Following a nephrostomy, the pleural effusion resolved and renal function improved remarkably. A ureterovesical junction obstruction and renal pelvis tear that were later discovered were repaired. Whenever a ureteral obstruction is suspected the diagnosis should be pursued vigorously, despite normal radiologic findings, especially in the presence of pleural effusion. Consideration of the possibility of urinothorax in such cases may obviate the need for lung biopsy.

Child↗
PubMed1985

Nephritis associated with an infected peritoneovenous LeVeen shunt.

A patient with chronic active hepatitis and medically unmanageable ascites developed staphylococcal bacteremia after insertion of a peritoneovenous LeVeen shunt. The patient developed glomerulonephritis, manifested by moderate proteinuria, microscopic hematuria with red cell casts, azotemia, and evidence of complement activation. The protracted infection, urinary, and renal abnormalities subsided after removal of the LeVeen shunt and a 3-week course of antibiotics. The clinical course of this patient is typical of the immune-complex mediated glomerulonephritis that has been previously well described in hydrocephalic patients with chronically infected ventriculoatrial shunts.

Ascites↗
PubMed1985

The role of ambulatory blood pressure monitoring in the evaluation of adolescent hypertension.

We performed 24-hour ambulatory blood pressure monitoring in a group of adolescents with hypertension induced by dynamic exercise and a group of normotensive controls. Ambulatory blood pressure monitoring was performed using a Del-Mar Avionics PIII recorder with readings taken every 7 1/2 minutes. There was little inter-individual variation in mean hourly blood pressure and the difference between mean hourly readings was not significant in hypertensives. Mean 24-hour ambulatory blood pressure was 130.2/80.7 mmHg for hypertensives and 115.2/70.8 in normotensives. Mean 24-hour variability was 18.3/12.9 mmHg in hypertensives and 14.6/11.5 in normotensives. There was no significant change in blood pressure or variability between day-time and evening for hypertensives. Normotensives showed a significant reduction in both BP and variability compared to hypertensives. In adolescents with systolic hypertension, ambulatory blood pressure monitoring confirmed a failure to reduce blood pressure following routine activity. This technique maybe used as a predictive marker of early, adult essential hypertension.

Adolescent↗
PubMed1979

Exercise electrocardiography and myocardial perfusion imaging in the diagnosis of coronary artery disease: preliminary report.

Exercise electrocardiography and rest/exercise myocardial perfusion imaging with thallium-201 were performed in 43 patients with typical angina or atypical chest pain; the results were correlated with those of coronary arteriography. Exercise electrocardiography sensitivity was 65%, specificity was 78%, predictive value for a positive result was 73% and for a negative result was 93%. The low sensitivity of the exercise electrocardiogram was mainly due to the number (13 of 43, 30%) of inconclusive results (no ST-segment change on the electrocardiogram, but failure to attain the target rate), most of which were in the group with typical angina. The predictive value of exercise electrocardiography for both a positive and negative result was excellent in typical angina. In patients with atypical chest pain, the negative predictive value was high (90%) but the positive predictive value was very low (50%). The sensitivity of myocardial perfusion imaging was 71%, specificity was 59%, positive predictive value was 52% and negative predictive value 89%. The low specificity of this test is related to the number of false-positive results obtained, most of which occurred in the group with atypical pain. When the results of exercise electrocardiography and myocardial perfusion imaging are combined, the sensitivity is increased but specificity is unacceptably low. However, myocardial perfusion imaging in patients with an inconclusive result from exercise electrocardiography (most of them in the group with typical angina) showed a sensitivity of 80%, specificity of 88%, positive predictive value of 80% and negative predictive value of 100%.

Coronary Circulation↗
PubMed1978

Usefulness of three additional electrocardiographic chest leads (V7, V8, and V9) in the diagnosis of acute myocardial infarction.

Additional electrocardiocardiographic chest leads (V7, V8, and V9) were used in 117 persons consecutively admitted to a coronary care unit. Among the 46 (39%) with a proven acute myocardial infarction the electrocardiograms (ECGs) of 9 (20%) showed ST-segment elevation or abnormal Q-waves, or both, in the three additional leads. In six of the nine, such changes were associated with signs of anterolateral or inferior wall infarction (in three each) on the standard 12-lead ECG, but in the other three (7% of the 46) electrocardiographic changes diagnostic of acute myocardial infarction were found only on the additional chest leads; the last three had characteristic changes in serum enzyme concentrations. This study showed that additional chest leads are helpful in detecting myocardial injury of necrosis in areas of the heart not properly reflected on the standard 12-lead ECG.

Acute Disease↗