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Biomedical subjects

L G McLain

Publications and source records attributed to L G McLain.

11 recordsLinked to original sources

The use of anabolic steroids in high school students.

The use of anabolic steroids by athletes has been a frequent topic in many recent reports. While much has been written in the lay literature, there is little in the scientific literature documenting the actual use of steroids, particularly in adolescents. We describe the results of a survey of 2113 high school students. The survey was designed to elicit information about students' general knowledge about anabolic steroids, awareness of the risks and side effects, and the incidence of use of anabolic steroids. Ninety-four (4.4%) of 2113 students admitted using anabolic steroids. Broken down by sex, 67 (6.5%) of 1028 males and 27 (2.5%) of 1085 females were users of steroids. Athletes had a higher use of steroids (79 [5.5%] of 1436 subjects) than nonathletes (15 [2.4%] of 636 subjects). These data suggest that we have another serious, as yet unappreciated drug problem in our adolescents.

Adolescent

Sports injuries in a high school.

A 1-year study was undertaken investigating all sports injuries at a large high school. A total of 1283 student athletes participated in sports and suffered 280 injuries for an overall injury rate of 22%. The largest injury rate was in football (61%) followed by girls and boys gymnastics, wrestling, and boys basketball. Five sports had no injuries--boys' tennis, golf, boys' and girls' swimming, and girls' water polo. Severity of injury was measured by number of days lost per injury. Girls' track had the greatest number of days lost per injury (320) followed by girls' basketball, girls' cross country, boys' track, and boys' wrestling. Sprains and strains accounted for 57% of all injuries. Of the injured athletes, 87 were seen by a physician and only 5 athletes required surgery. The small number of serious injuries requiring surgery suggests that a motivated and competent pediatrician can play an integral role as a team physician.

Adolescent

Croup syndrome.

Spasmodic croup has a sudden onset, almost always at night, and usually responds well to humidification. Laryngotracheobronchitis is the most common form of the croup syndrome; children with this disease generally do well, although some require hospitalization and intubation. Bacterial tracheitis may mimic severe laryngotracheobronchitis; diagnosis is usually established during visualization of the airway. Epiglottitis is rare but is often life-threatening.

Anti-Bacterial Agents

Childhood enuresis.

Enuresis is not a disease, but rather a benign clinical disorder that is very common in young children. In considering the many facets of enuresis, physicians caring for children with this disorder should always remember the dictum "Primum non nocere". Most children with enuresis will be found to have primary enuresis, that is, no organic disease or psychopathology will be found. Physicians should proceed cautiously and should avoid costly, harmful and unnecessary workups. Treatment of few disorders is more dependent on the art and skill of clinical medicine than that of childhood enuresis. All of the physician's talents and compassionate nature enter into the proper evaluation of and therapy for this disorder. Physicians must keep in mind the high spontaneous cure rate. This factor alone should encourage them to be extremely optimistic about the outcome of enuresis in their pateints.

Adolescent

Effect of beta adrenergic blockade on renin response to renal nerve stimulation.

The ability of d,l-propranolol to block renin secretion in response to various extrarenal stimuli, such as hemorrhage and hypoglycemia, has been interpreted to indicate the presence of an intrarenal beta receptor regulating renin release. However, two problems complicate this interpretation: (a) the stimuli have effects outside the kidney, and (b) d,l-propranolol has a local anesthetic, as well as a beta adrenergic blocking, action. In the present study, the effects of a purely intrarenal stimulus, in the form of renal nerve stimulation (RNS), on renin secretion was examined. The effects of d,l-propranolol (anesthetic and beta-blocking activity), l-propranolol (beta-blocking activity only), and d-propranolol (local anesthetic activity only) on the renin response to RNS were examined. In a control group of animals, two sequential RNS increased mean renin secretion from 401 to 1,255 U/min (P less than 0.25) and from 220 to 2,179 U/min (P less than 0.01). In a second group the first RNS increased renin secretion from 201 to 1,181 U/min (P less than 0.01), but after d,l-propranolol was given RNS did not significantly alter renin secretion (33 to 55 U/min). In a third group the initial RNS increased renin secretion from 378 to 1,802 U/min (P less than 0.025), but after l-propranolol was given RNS had no significant effect on renin secretion (84 to 51 U/min). A fourth group of dogs showed a rise in renin secretion from 205 to 880 U/min (P less than 0.001) in response to the first RNS, while the second RNS, given after an infusion of d-propranolol, caused a rise in renin secretion from 80 to 482 (P less than 0.005). The nature of the electrical stimulus was consistent in all groups and caused no detectable changes in renal or systemic hemodynamics or in urinary electrolyte excretion. The results, therefore, indicate that renin secretion can be stimulated through intrarenal beta receptors independent of changes in systemic or renal hemodynamics or in tubular sodium reabsorption. Hence the effect of beta stimulation on renin secretion would appear to result from a direct action on the renin-secreting cells of the juxtaglomerular apparatus.

Adrenergic beta-Antagonists