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Biomedical subjects

R M Ehrlich

Publications and source records attributed to R M Ehrlich.

At least 91 records · Page 5Linked to original sources
PubMed1982

Steroid diabetes in childhood.

Hyperglycemia and glycosuria are known to occur in some children receiving corticosteroids. In a retrospective study 24 such episodes were identified in 17 patients receiving steroids for a variety of primary diseases from 1968 to 1979. Detection based on symptoms averaged 26 days from initiation of steroid treatment, whereas detection based on the presence of glycosuria or hyperglycemia averaged 4.5 days. Acidosis, ketosis, and hyperglycemia (glucose level, greater than 500 mg/dL) occurred in 2, 4, and 8 patients, respectively. Insulin therapy was necessary in 15 episodes in 11 patients, but in three episodes the insulin dosage was reduced while the steroid dosage remained high. Permanent insulin dependence developed immediately in one patient and eventually in three others. Steroid-precipitated diabetes must be anticipated but should not interfere with the treatment of the primary disease.

Adolescent↗
PubMed1982

The HLAB*18,BF*F1 in haplotype in type 1 diabetes.

We have investigated the properdin factor B (BF) locus as a possible marker for Type 1 diabetes. The frequencies of the four BF alleles were determined among 70 Type 1 diabetics with onset before age 18 years. The frequency of BF F1 among the diabetics was increased compared with 206 controls (15.7 vs 3.4%). The relative risk (RR) associated with BF F1 was 5.30. The suggestion that BF is most strongly associated with onset of diabetes under 10 years of age was not supported. HBLA 18 was increased (RR = 4.91) and B7 was decreased in frequency (RR = 0.41) among the 62 diabetics tested compared with 238 controls. An association was observed between HLAB 18 and BF F1 among the diabetics. A study of 12 families in which BF*F1 was segregating suggested that BF*F1 and HLAB*18 are components of a haplotype associated with Type 1 diabetes in this population and that both haplotypes of an affected parent may contribute to the development of Type 1 diabetes.

Adolescent↗
PubMed1982

The incidence of type 1 (insulin-dependent) diabetes in Toronto.

An incidence of 9.0 out of 100,000 children under 19 years of age with Type 1 (insulin-dependent) diabetes was detected in Toronto during a 2 year prospective study. An increased number of cases occurred in the winter months of one of the years but not of the other during the study. The annual incidence was the same in each year. There were slightly more boys than girls but this was not significant. The diabetic children were significantly younger than their non-affected siblings. The incidence of Type 1 diabetes in Toronto is similar to other North American studies.

Adolescent↗
PubMed1982

The significance of lymph nodal involvement in renal angiomyolipoma.

Renal angiomyolipoma, a benign tumor, can involve regional lymph nodes. Although this phenomenon has been reported previously followup information has been scant. We have treated 3 patients who had renal angiomyolipoma with nodal involvement and all had further evidence of tuberous sclerosis. Each patient had hematuria with flank pain and required nephrectomy. In the ensuing 3 to 11 years none of these patients has had evidence of further disease progression. Nodal involvement may reflect the multicentricity of angiomyolipoma or may represent a form of "benign metastasis" but it does not appear to be a harbinger of disease progression.

Adult↗
PubMed1982

Diabetes mellitus in childhood.

This review has attempted to highlight current views on the aetiology and management of children with type 1 diabetes mellitus. Emphasis has been placed on the management of ketoacidosis, the need for education and the use of home blood glucose monitoring. A perspective on new research direction has been given.

Adolescent↗
PubMed1981

Management of malignant hyperthermia.

A case of malignant hyperthermia in a young girl with vesicoureteral reflux and multiple congenital abnormalities is discussed. Malignant hyperthermia is a relatively newly defined problem that is associated with anesthesia. It is being recognized with increasing frequency, particularly in children with multiple musculoskeletal anomalies. The term itself is a misnomer. It is a drug-induced syndrome of hypermetabolism that may represent an inborn error of metabolism. Recognition, prophylaxis and crisis management are reviewed, and the use of dantrolene sodium in the care of patients with malignant hyperthermia is discussed. Because recognition of malignant hyperthermia is an important concern for the practicing urologist, the principles of identifying the patient at risk, as well as managing the crisis, should be familiar to the clinician.

Abnormalities, Multiple↗
PubMed1980

Diabetes insipidus and nonobstructive dilation of urinary tract.

Two cases of diabetes insipidus (hypothalamic and nephrogenic) with massive nonobstructive trabeculation and dilation of the bladder and hydroureteronephrosis are reported. The cases are evaluated thoroughly--radiologically and urodynamically. Treatment options are discussed, including the use of an important new drug, dDAVP. The general subject of diabetes insipidus and its urologic implications is reviewed.

Adult↗
PubMed1980

Use of saralasin to detect renovascular hypertension in childhood.

Current methods to evaluate renovascular hypertension in the pediatric population often requires a general anesthetic. Saralasin, an angiotensin II competitive inhibitor, is a safe, noninvasive technique which can be utilized at the bedside in a salt-depleted child off antihypertensive medication. Two illustrative cases are presented.

Aldosterone↗
PubMed1980

Kidney stones.

The prevalence of kidney stones has steadily risen during this century; passage of a calculus and a positive family history increase the probability of recurrence. Findings from recent studies on the cause of renal calculi have stressed crystallization and crystal aggregation of stone minerals from supersaturated urine, rather than excessive organic matrix. Absence of normal urine inhibitors of calcium salts is also stressed. Formation of calcium oxalate stones is the major problem. Therapy with decreased calcium and oxalate intake, thiazides, phosphate salts and allopurinol in various combinations has substantially decreased the prevalence of recurrent stones. The rationale for the use of allopurinol is that uric acid salts enhance the tendency for calcium oxalate to crystallize from supersaturated urine. The hypercalciuria seen in 30 percent to 40 percent of patients with oxalate stones is usually caused by intestinal hyperabsorption of calcium. Although patients with uric acid calculi constitute only a small fraction of those in whom stones form, they represent a group in whom good medical therapy, based on sound physiologic principles, has proved extremely successful. Renal tubular syndromes lead to nephrocalcinosis and lithiasis through hypercalciuria, alkaline urine and hypocitraturia, the latter an inhibitor of calcium salt precipitation. Recent advances in surgical techniques are discussed, including the rationale for removing staghorn calculi. The ileal ureter and coagulum pyelolithotomy deserve special emphasis.

Acidosis, Renal Tubular↗
PubMed1979

Nontraumatic rupture of renal allografts.

Eight cases of nontraumatic renal allograft rupture were identified in 237 renal transplants performed at UCLA Medical Center. Careful clinicopathologic studies in these patients suggest three principal underlying causes: major graft vessel occlusion, hyperacute or accelerated rejection, and acute rejection. The clinical and pathologic features of these various categories are compared and contrasted.

Cadaver↗