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1.
Eur J Clin Nutr ; 48(7): 503-6, July 1994.
Artigo em Inglês | MedCarib | ID: med-7147

RESUMO

We retrieved a series of measurements made 35 years ago of the concentration of inorganic phosphate (P) in the serum from 56 cases of severe protein-energy malnutrition at the Tropical Metabolism Research Unit, Jamaica. There is no record of whether or not the cases were randomly selected. The samples were obtained within 4 days of admission and except in 3 cases there was no follow-up. The average age was 12 months. The children have been classified retrospectively from the notes as marasmus (11 cases), kwashiorkor (22 cases) and marasmic kwashiokor (23 cases). In all 11 children died (fatality rate 20 percent), eight of them from the group with marasmic kwashiorkor. Weight-for-age, length-for-age and weight-for-length have been calculated as Z-scores. Nearly all serum phosphate concentrations were low (mean 1.41 mmol.1-1, SD 0.444, range 0.50-2.45) compared with the normal value at this age of about 2 mmol.1-1. The serum P was significantly less depressed in the marasmic children (P=0.042), but there was no relation between serum P and any of the anthropometric measurements, nor with outcome (death or survival). There was, however, a significant relationship with the degree of oedema. Death was related to age - the children who died were younger (mean difference 3.8 months; P=0.01; 95 percent confidence interval 0.23-6.43). It took about 3 weeks of feeding a milk-based diet for serum phosphate to reach normal levels. There have been few previous measurements of serum P in malnutrition. We agree with previous authors that the low serum values are evidence of phosphate depletion and suggest that phosphate might be added to the electrolyte solutions used in the early stages of recovery. However, reports of adverse effects indicate that this should be done with great care (AU)


Assuntos
Lactente , Humanos , Transtornos da Nutrição Infantil/sangue , Fosfatos/sangue , Desnutrição Proteico-Calórica/sangue , Estatura , Peso Corporal , Transtornos da Nutrição Infantil/classificação , Transtornos da Nutrição Infantil/dietoterapia , Transtornos da Nutrição Infantil/mortalidade , Intervalos de Confiança , Seguimentos , Fosfatos/deficiência , Desnutrição Proteico-Calórica/classificação , Desnutrição Proteico-Calórica/dietoterapia , Desnutrição Proteico-Calórica/mortalidade , Valores de Referência , Estudos Retrospectivos , Índice de Gravidade de Doença , Taxa de Sobrevida , Fatores Etários
2.
West Indian med. j ; 42(Suppl. 1): 14, Apr. 1993.
Artigo em Inglês | MedCarib | ID: med-5171

RESUMO

One hundred pregnant women between 24 and 28 weeks' gestation attending the antenatal clinic at the Mount Hope Women's Hospital and the Port-of-Spain General Hospital were admitted to the study. Women with a history of evidence of renal disease, diabetes chronic hypertension, cardiovascular disease, proteinuria or any other chronic medical illness were excluded. Urine and blood samples were collected at the first and each subsequent visit and bi-weekly if the subject was hospitalised. The urinary and serum concentrations of total calcium, magnesium and phosphate were measured by atomic absorption spectrometry. After delivery, the patients' notes were analysed to determine the development of pre-elcampsia (PE). The purpose of the study was to evaluate urinary calcium, magnesium and phosphate as early predictors of PE. Eight women satisfied the criteria for PE and differed from the 92 normotensives as shown (Table). Urinary calcium and magnesium and birthweight were significantly lower in PE as compared to normal pregnant women. The gestational age, urinary phosphate and serum values were no different in the two groups (AU)


Assuntos
Humanos , Feminino , Gravidez , Pré-Eclâmpsia/etiologia , Cálcio/urina , Magnésio/urina , Fosfatos/urina , Creatinina/urina
3.
West Indian med. j ; 39(3): 186-9, Sept. 1990.
Artigo em Inglês | MedCarib | ID: med-14321

RESUMO

This paper describes a 9-year-old girl with primary hypophossphatemic ricketts, an uncommon cause of bowed legs. A simple screening for patients presenting with bowed legs is suggested and the importance of using age-related standards for comparison of biochemical results is emphasized (AU)


Assuntos
Humanos , Criança , Feminino , Hipofosfatasia/complicações , Raquitismo/etiologia , Osteotomia , Fosfatos/uso terapêutico , Vitamina D/uso terapêutico
4.
West Indian med. j ; 21(1): 46, Mar. 1972.
Artigo em Inglês | MedCarib | ID: med-6307

RESUMO

The therapeutic role of phosphate solutions in the management of hypercalcemic states has been well established, but the mechanism by which phosphate lowers the serum calcium is unclear. The two major possibilities are that phosphate produces its effect by inhibiting bone resorption or stimulating bone formation. Total urinary hydroxyproline (OHPr) is an index of collagen metabolism and rises when there is excessive bone resorption. The effect of the phosphate on urinary OHPr excreation in patients with such metabolic bone diseases as Paget's disease, secondary hyperparathyroidism, osteogenesis imperfecta and osteoporosis was studied, and in all these conditions, oral phosphate supplementation reduced urinary OHPr and a cessation of phosphate was immediately followed by a rise in urinary OHPr levels. In further studies on dogs the effect of phosphate supplementation on collagen synthesis in vivo was estimated by measuring the incorporation of labelled proline into bone collagen. The results show that phosphate supplementation increased the rate of collagen synthesis but resorption was little influenced. It is proposed that phosphate lowers the serum calcium by promoting collagen synthesis and stimulating new bone formation (AU)


Assuntos
21003 , Cães , Osso e Ossos/metabolismo , Fosfatos/metabolismo
5.
Clin Sci ; 41(6): 505-18, Dec. 1971.
Artigo em Inglês | MedCarib | ID: med-14786

RESUMO

The acid excretion of patients with sickle-cell anaemia has been studied. There is a mild defect in urinary acidification and a decreased H+ excretion in response to ammonium chloride loading. The acidification defect was not corrected by oral administration of a phosphate solution. Infusion of sodium sulphate solution in subjects who were avidly reabsorbing sodium produced equal degrees of urine acidification in patients and controls. Studies on bicarbonate reabsorption were inconclusive. We conclude that patients with sickle-cell anaemia have a mild form of incomplete distal renal tubular acidosis (AU)


Assuntos
Humanos , Adolescente , Adulto , Masculino , Feminino , Ácidos/urina , Anemia Falciforme/urina , Acidose Tubular Renal/complicações , Acidose Tubular Renal/tratamento farmacológico , Compostos de Amônio/urina , Anemia Falciforme/complicações , Anemia Falciforme/metabolismo , Bicarbonatos/metabolismo , Sangue , Creatinina/urina , Concentração de Íons de Hidrogênio , Fosfatos/uso terapêutico , Sódio/metabolismo , Sulfatos/metabolismo , Urina , Cloreto de Amônio/diagnóstico , Cloreto de Amônio/metabolismo
6.
Pediatrics ; 39(3): 400-11, Mar. 1967.
Artigo em Inglês | MedCarib | ID: med-13060

RESUMO

The renal function of 32 malnourished Jamaican children was investigated by serial tests from admission until recovery. It has been established that in the malnourished as compared to the recovered children there are several functional renal lesions. There is a reduction in G.F.R and R.P.F., and evidence of impaired tubular function as shown by aminoaciduria, occasional renal concentration, and inability to excrete an acid load. There is no demonstrable difference in G.F.R. or R.P.F. between the edematous and non-edamatous malnourished children. With recovery there was steady improvement in renal function. The etiology of these lesions may be related to the deficiencies of magnesium and potassium which are known to occur in malnourished children.(Summary)


Assuntos
Humanos , Lactente , Masculino , Feminino , Rim/fisiopatologia , Desnutrição Proteico-Calórica/fisiopatologia , Aminoácidos/urina , Edema/etiologia , Taxa de Filtração Glomerular , Jamaica , Testes de Função Renal , Deficiência de Magnésio/etiologia , Fosfatos/urina , Deficiência de Potássio/etiologia , Deficiência de Proteína/urina
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