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Biomedical subjects

N J Shaw

Publications and source records attributed to N J Shaw.

At least 19 recordsLinked to original sources
PubMed1992

The tubular maximum for calcium reabsorption: a normal range in children.

OBJECTIVE: We aimed to establish a normal range for the tubular maximum rate of reabsorption of calcium corrected for glomerular filtration rate. DESIGN: A prospective survey was used. PATIENTS: One hundred and ten normal children aged 2-14 years were studied. MEASUREMENTS: Total plasma calcium, ultrafiltrable calcium and parathyroid hormone. Urinary calcium, sodium and creatinine excretion. RESULTS: The normal range was found to be 1.87-3.39 mmol/l of glomerular filtrate with a geometric mean value of 2.40 mmol/l. There was a significant inverse relationship between the tubular maximum for calcium and the urinary sodium excretion. No significant relationship was found between the tubular maximum for calcium and the level of parathyroid hormone in this group of normal children. CONCLUSIONS: The normal range seen in children is higher than that seen in adults with a higher mean value. This normal range should be useful in the assessment of renal calcium handling in children with disorders of calcium homeostasis.

Absorption↗
PubMed1992

Pneumonia and pneumonitis in childhood malignancy.

We conducted a survey over a 21-year period of the incidence and risk of occurrence of episodes of pneumonia and pneumonitis in children treated for solid tumours and leukaemia. One hundred episodes occurred amongst 219 patients, seven of which were associated with death. Focal opacification on the chest radiograph was more common than diffuse opacification. Patients with leukaemia had a significantly higher rate of occurrence of pneumonia and pneumonitis during the periods of induction and maintenance compared with the off-treatment period, and during the relapse period compared with the period of maintenance. Patients with solid tumours had a significantly higher rate of occurrence during treatment compared to the off-treatment period. The rate of occurrence on treatment was the same in patients with solid tumours and acute leukaemia. Children with malignancy have a high incidence of pneumonia and pneumonitis and death is rare if the patient does not have terminal malignant disease.

Acute Disease↗
PubMed1991

Long-term outcome for children with acute renal failure following cardiac surgery.

Acute renal failure requiring dialysis occurred in 34 children (2.9%) following cardiac surgery over a five year period. 17 children (50%) recovered renal function with 11 (32%) long-term survivors. The long-term outcome for the survivors, in terms of renal function, was studied from 1 to 5 years after their episodes of acute renal failure. Three children had significant abnormalities of renal function despite normal urinalysis. Detailed assessment of renal function is advocated for children who survive acute renal failure following cardiac surgery.

Acute Kidney Injury↗
PubMed1991

Autosomal recessive hypoparathyroidism with renal insufficiency and developmental delay.

Four children (two boys and two girls) with hypoparathyroidism, renal insufficiency, and developmental delay are described. They were the products of consanguineous marriages in three related Asian families presenting over a six year period. All the children died within the first 15 months of life despite treatment. Postmortem examination on one child showed absent parathyroid glands. We believe these children represent a previously undescribed syndrome that appears to be inherited in an autosomal recessive manner.

Child, Preschool↗
PubMed1990

Indices of intact serum parathyroid hormone and renal excretion of calcium, phosphate, and magnesium.

Up to date reference ranges were established for fasting renal excretion of calcium, phosphorus, and magnesium on 101 healthy children aged 2-15 years. A normal range for intact parathyroid hormone was also measured. The indices of calcium and magnesium excretion showed no correlation with age or sex so that a common range for all children could be established. The 97th centile values for urinary calcium:creatinine and magnesium:creatinine ratios were 0.69 mmol:mmol and 1.05 mmol:mmol respectively. The calculated tubular maximum for phosphate/litre of glomerular filtrate (TmPO4/GFR) showed no correlation with age with a geometric mean value of 1.67 mmol/l. The normal range for intact serum parathyroid hormone for the age group was 11-35 ng/l, which is lower than the adult normal range using the same assay. There was an inverse correlation between TmPO4/GFR and intact parathyroid hormone in this group of normal children.

Adolescent↗
PubMed1990

How do parents of babies interpret qualitative expressions of probability?

One hundred mothers and 50 medical students and doctors were interviewed to examine their understanding of eight common probability expressions as they are used in statements of the kind that doctors regularly make to mothers of babies. Respondents were asked to translate each term into a number on a scale from 0 to 10. There was a wide range of interpretation of the expressions, and significant differences were found between the mothers and medical group for seven of the expressions. Most mothers expressed a preference for receiving information in numerical terms. We advise that verbal probability expressions should be restricted, and more information presented in numerical terms.

Communication↗
PubMed1990

Inter-observer variation in interpretation of chest X-rays.

139 chest x-rays of children with solid tumours or leukaemia were examined independently by three observers (a radiologist and two physicians) and a consensus report determined. There was total agreement between observers on 40 x-rays (29%). The radiologist agreed with the consensus report on a significantly greater number of x-rays (91%) than both physicians (62% and 46%). There was a high incidence of over-reporting of abnormalities by both physicians. This study reinforces the need for regular dialogue between radiologists and clinicians for optimum interpretation of chest x-rays.

Bronchography↗
PubMed1989

Pulmonary function in childhood leukaemia survivors.

Little is known of pulmonary function in survivors of acute lymphoblastic leukaemia (A.L.L.); this is despite the fact that some drugs used, most notably methotrexate, have well-recorded pulmonary toxicity, and the most common infections during therapy in most series are of upper and lower respiratory tract. As part of a survey of all cancer survivors attending the Royal Hospital for Sick Children in Edinburgh, 38 leukaemic patients, who had completed treatment 3 months to 14 years 6 months (median 6 years and 8 months) prior to survey were assessed with regards to their respiratory status. Each patient completed a questionnaire and had spirometry and lung volumes measured; 30 patients additionally had transfer factor for carbon monoxide (TCO) measured. There were 21 children, 11 adults, and 6 patients in the age range between child and adult. Of the 26 adults and children studied with complete data available, 17 (65%) had one or more low values for vital capacity (VC), total lung capacity (TLC), residual volume, or TCO. Mean VC, TLC and TCO were significantly lower than the mean of the predicted values (P less than .001). Gas transfer per unit lung volume (KCO) was normal in all cases. Few patients had symptoms of respiratory disease. There was an increased incidence of low TCO in patients diagnosed under 8 years of age. Impairment of lung growth could be a contributing factor to the observed abnormalities in pulmonary function. Impairment of pulmonary function in survivors of A.L.L. may be of significance for them in later life.

Adolescent↗
PubMed1989

Superior QRS axis in ventricular septal defect.

The relation between the superior orientation of the QRS axis and the anatomical site of the defect in the ventricular septum in patients with a ventricular septal defect was studied. Of 1031 patients with a ventricular septal defect, 64 (6.2%) had a superior axis on their electrocardiogram. In 59% of these patients the defect was in the inlet portion of the ventricular septum or affected this area. None of the cases was classified as an isolated ventricular septal defect of the persistent atrioventricular canal type. While there is an association between a superior axis and perimembranous inlet ventricular septal defect, a superior QRS axis does not characterise a ventricular septal defect as being of the atrioventricular canal type.

Echocardiography↗
PubMed1989

Juvenile chronic myelogenous leukemia and neurofibromatosis in infancy presenting as ocular hemorrhage.

A patient presenting with intraocular hemorrhage at 4 weeks of life was suspected of having sustained a nonaccidental injury. Juvenile chronic myelogenous leukemia (JCML) was diagnosed, and subsequently the patient developed the signs of neurofibromatosis. There is an association between the two conditions, but the poor prognosis from JCML may mean that evolving neurofibromatosis is overlooked, particularly if a family history of the disease is not obtained.

Eye Hemorrhage↗
PubMed1989

Skin rash after completion of therapy for leukemia in childhood.

The medical records of 58 patients who were surviving after completing treatment for acute lymphoblastic leukemia were reviewed to determine the incidence of skin rash occurring after their treatment had ended. Twenty-eight (48%) developed a rash within 3 months of completing treatment. In the majority this was erythematous, affected the face, and in all patients was transient. There was an increased incidence of rash in those patients who had eczema or asthma or who had a family history of eczema or asthma. It would seem prudent to warn parents of this phenomenon and reassure them of it's benign nature.

Erythema↗