The beneficial effect of estrogens on L-dopa-induced dyskinesias and on tardive dyskinesia has recently been reported. In this open pilot study, conjugated estrogens (CE) were administered to 20 male chronic psychiatric patients (age range: 29-63). All except 1 were still on neuroleptic medication and 8 of them were still receiving an antiparkinsonian agent. Patients were divided into 4 equal groups. Groups I and II (< 51 years old) received daily CE at different doses (1.25 or 2.50 mg) for a period of 6 weeks. Groups III and IV (> 52 years old) were treated identically. A significant decrease (p < 0.006) in intensity or disappearance of one type of dyskinesia was observed in each group (4 of 5 patients). No definite trend was noted in neuroleptic-induced parkinsonism, or apparent change in the mental condition of the patients. The functioning of the extrapyramidal system reveals itself therefore, increasingly complex if this antidopaminergic action of estrogens is added. Indeed, it had been hypothesized lately that in addition to dopamine and acetylcholine, substances like GABA and enkephalin could also be involved in its regulation. The relationship between dopamine and estrogens is interesting as the presence of catechol estrogens, compounds that might play an important role in neuroendocrine regulation, has been demonstrated in some areas of rat brain. Finally, with respect to hormones, the reported prompt and transitory rise in serum prolactin level after electroconvulsive therapy (ECT) may reflect a possible involvement of endorphins, at least in part, in the therapeutic effect of ECT. The possible influence of this form of treatment on extrapyramidal symptoms in relation with this is briefly discussed.
Abstracts 449 skin (wrist, ankle, back) and lesions and weekly urinalyses were done on 38 children in 6 families. One month later a 43-year-old mother, her 5-year-old twins, and an unrelated child, not in the study, had onset of acute nephritis (AGN) within a 14-day period. Findings included hematuria (4/4), proteinuria (3/4), hypertension (3/4), low serum complement and C'3 (4/4), and elevated streptococcal antibodies (4/4). All exhibited impetigo, and lesions in 3 of 3 patients cultured before treatment yielded type 57 streptococci. Throat cultures were negative and no pharyngitis preceded onset. Latent periods for the twins were 19 and 22 days. Type 57 streptococci reappeared on the normal skin of both twins after penicillin therapy, resulting in recurrence of lesions in one. Over a 10-week period 704 cultures from the twins and 4 siblings yielded 297 (42%) positive for group A streptococcus, of which 294 were M-57. Lesions accounted for 42%, normal skin sites for 47 % and nose and throat for 11%. Normal skin sites were positive for the M-57 strain in 4 of 6 children before development of lesions (mean 8 days). This strain was found in the respiratory tract (5 of 6) only after its recovery from normal skin and/or lesions. Impetigo with type 57 but no AGN occurred in 16 other children. This is the first report of the occurrence of type 57 nephritis in this country. Prospective studies document the skin as the initial site of infection in these patients with AGN. The nephritogenic strain was found on normal skin prior to the development of impetigo and reappeared after treatment. 54Kinetics of Peritoneal Dialysis in Children. A. B.
. Although the dose and duration of therapy with cyclophosphamide (cy) are known to influence the incidence of subsequent relapses in children with nephrotic syndrome, other factors which predispose to relapses after cy have not been extensively evaluated. The clinical course of 30 children with steroidsensitive, frequently-relapsing nephrotic syndrome was analyzed. Each of the pts had a renal biopsy at the time of initiation of cy, and all of the children had a complete remission while on cy (2 mg/Kg/d for 12 wks). After cy, one or more relapses occurred in 14 pts, while 16 pts had a sustained remission. There were no significant differences between the two groups of pts concerning: 1) age at onset (4.5 vs 4.9 yrs), 2) interval between onset and cy (6.35 vs 6.52 yrs), and 3) duration of follow-up after cy (4.0 vs 4.4 yrs).The most important factor associated with relapses after cy was the histopathologic lesion. Of the 14 pts with relapses, 9 (64%) had focal and segmental glomerulosclerosis (FGS), whereas only 5 (36%) had minimal change lesions (MCL) (P<0.05).In contrast, only 3 (19%) of the 16 pts in remission had FGS, while 13 (81%) had a MCL (P<0.05).These data indicate: 1) the histopathologic lesion at the time of cy is an important determinant of subsequent relapses and 2) late onset FGS predisposes to relapses after cy. The antihypertensive agent clonidine (C) appears to lower blood pressure (BP) via central alpha-adrenergic stimulation. In order to determine safety and efficacy of this drug, an openlabel study was done in 16 hypertensive children and adolescents (ages 7-18). C (.15 to l.lmg/day) was used when other agents hac failed or were medically undesirable; informed consent was obtained. 8 patients (P) had post-transplant hypertension; 6, chronic nephritides, 1, polycystic-hamartomatous kidneys; and 1, essential hypertension. 10 of 16 P had BP controlled on C plus diuretic; in another 5, all with severe hypertension, C clearly improved BP control, but other agents were still required. No control was obtained in only one P (allograft renal artery disease in whom surgical repair failed). No P had hematologic or chemical abnormalities induced by the drug. Except for somnolence in 8 P, no problems occurred while regularly taking C. However, 1 of the 10 P on C plus diuretic had 2 episodes of hypertension with encephalopathy within 16 hours of drug discontinuation due to vomiting. In 2 additional patients rebound hypertension was suspected but not proven. 2 P on C plus additional agents had episodes of symptomatic hypotension when C was added to their regimen. Thus C appears to be a useful and generally safe agent in children; however, rebound hypertension makes it important to determine patient compliance and awareness of the effect of vomiting episodes before the drug is prescribed. T/2 for children on hemdialysis varies with the efficiency of dialysis. Supported in part by NIH grants RR-75 and RR-5624. U M NOR ME HUS .COMPARISON OF SUPPORT- NEWBORN INFANT RENIN-ANGIOTENSIN-ALD STER NE SYS
s c i nt i g r a p h i c flow and s t a t i c images. C o n t a c t B-scan u l t r a s o n o g r a m s s h a r e d them a s a n e c h o i c c o l l e c t i o n s w i t h s t r o n g through t r a n sm i s s i o n . Both m o d a l i t i e s d e t e c t e d kidney o b s t r u c t i o n secondary t o t h e lymphocele.A l l p a t i e n t s r e q u i r e d s u r g i c a l d r a i n a g e b e c a u s e t h e lymphocele o b s t r u c t e d t h e t r a n s p l a n t e d kidney o r p e l v i c l y m p h a t i c s . A l l p a t i e n t s h a v e r e t a i n e d t h e i r a l l o g r a f t s which a r e f u n c t i o n i n g s a t i s f a c t o r i l y . THE EFFECTS OF CHANGING FROM DAILY TO ALTERNATE DAY STEROIDS ON THE HYPERLIPIDEMIA OF CHILDREN WITH KIDNEYTRANSPLANTS. Kaiser, B.A., Potter,D.E., U n i v e r s i t y o f C a l i f o r n i a Medical c e n t e r , San Francisco. C a l i f o r n i a . U.S.A.Hyperlipidemia i s a problem o f most p a t i e n t s who have r e c e i v e d kidney t r a n s p l a n t s and t h e use o f s t e r o i d s i s f e l t t o be one o f t h e major causes o f t h i s problem. To e v a l u a t e t h e e f f e c t o f d a i l y (QD) vs a l t e r n a t e day (QOD) s t e r o i d s on serum c h o l e s t e r o l (C) and t r i g l y c e r i d e (T) l e v e l s , we c m p a r e d t h e l i p i d l e v e l s o f t h e c h i l d r e n r e c e i v i n g QD t o those r e c e i v i n g QOD prednisone. I n a d d i t i o n , we f o l l o w e d t h e changes i n C and T i n 9 c h i l d r e n who were changed from QD t o QOD prednisone a f t e r t r a n s p l a n t a t i o n . The serum C and T l e v e l s were compared i n 15 c h i l d r e n r e c e i v i n g QD prednisone (242+46 mg% and 150+98 mg% r e s p e c t i v e l y ) t o 26 c h i l d r e n r e c e i v i n g QOD prednisone (242t49 mg% and 1 2 4~5 9 mg% r e s p e c t i v e l y ) and t h e r e was no s i g n i f i c a n t d i f f e r e n c e . However, i n 9 c h i l d r e n who were changed from OD t o QOD prednisone a t 6 months a f t e r t r a n s p l a n t and then f o l l o w e d f o r 1 year, serum C and T decreased. While r e c e i v i n g QD prednisone, serum C increased from 257t65 mg% p r e -t r a n s p l a n t t o 268c75 mg% (p=ns) and serum T decreased from 2 6 2~2 1 2 t o 168t78 mg% (p=ns). A f t e r t h e change from qD t o QOD p r e d n i s o n e , t h e serum C d e c r e a s e d t o 211k48 mg% (~4 . 0 1 ) and T decreased t o 120t70 mg% (pQ.02) i n 1 y e a r . During t h i s p e r i o d t h e prednisone dose was decreased from 1.3tD.4 t o 0.7t0.3 mg/kg QOD. The change from QD t o QOD s t e r o i d s and decreasing s t e r o i d doses i s associated w i t h a decrease i n t h e degree o f h y p e r l i p i d e m i a a f t e r r e n a l t r a n s p l a n t a t i o n .Haycock, G Ennland. HIGH DOSE INTRAVENOUS METHYLPREDNISOLONE (IVMP) VERSUSOrta-Sibu, N.,. B . , C h a n t l e r , C . , Bewick, M. Guy's H o s p i t a l , London, - Few c o n t r o l l e d t r i a l s o f d i f f e r e n t a n t i -r e j e c t i o n p r o t o c o l s have be...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.