Hospitals In Calgary Research Articles

Gastrointestinal Manifestations of Hemolytic Uremic Syndrome

A restrospective study of 76 children with hemolytic uremic syndrome (HUS) who were admitted to the Alberta Children's Hospital in Calgary, Alberta between January 1982 and December 1988 was undertaken to explore the gastrointestinal manifestations of the syndrome. The children (mean age of 4.0 ± 3.1 years) presented primarily during the summer months with a microangiopathic hemolytic anemia (Hgb 94 ± 26 g/L), thrombocytopenia (platelets 87 ± 83 x 109/L), and acute renal failure (oligoanuria with a BUN of 26 ± 15 mmol/L, and a creatinine of 294 ± 90 μmol/L). Forty‐three children required dialysis for 10 ± 17 days. The duration of hospitalization was 17 ± 17 days. Four children died of complications attributable to HUS. The following symptoms and gastrointestinal manifestations of HUS were noted: fever (33%), vomiting (80%), abdominal discomfort/tenderness (59%), diarrhea (100%), hemorrhagic colitis (79%), rectal prolapse (13%), colonic stricture (3%), colonic perforation (1%), intussusception (1%), indirect hyperbilirubinemia (49%), and elevated hepatocellular enzymes (58%). Of the last 29 children studied, 19(66%) had elevated levels of amylase and lipase in the presence of acute renal failure, and six (21%) had a marked elevation of lipase (more than four times normal) with additional supportive evidence of pancreatitis. The additional supportive evidence included persistent elevation of lipase after the resolution of acute renal failure in four children, a marked increment in lipase in association with abdominal pain and an abnormal ultrasound of the pancreas after the initiation of oral feeding in a fifth child, and pancreatic exocrine and endocrine necrosis at autopsy in a sixth child. This study reviews the gastrointestinal manifestations of HUS in a large series of patients and presents data to suggest that pancreatitis is a relatively common complication of HUS.

Benign osteoblastoma of the spine in childhood

Osteoblastoma of the spine is a rare but important cause of back pain in children. Ten children with this tumor were treated at the Alberta Children's or Foothills Hospital in Calgary, Alberta, between 1974 and 1986. There were seven boys and three girls; the age at diagnosis ranged from 2 to 16 years (average 11 years). In nine patients the tumor involved the posterior vertebral elements. One of the cervical lesions was in the vertebral body. Three patients had tumor in the extradural space. The commonest symptom was pain in the back and neck. Bone scans were positive in all patients, and computerized tomography scans were abnormal in the eight patients who had this imaging performed. Nine children were treated with laminectomy and removal of the abnormal pedicle and facet. Two patients required two operations each because of incomplete tumor excision at the first operation; in these, subsequent surgery gave complete relief of symptoms and radiographic studies showed no further tumor. In three other patients, tumor removal was incomplete, and one patient received postoperative radiation therapy. Bone grafts were placed in four patients. The diagnosis of benign osteoblastoma was confirmed histologically in nine patients. The outcome was good in all cases, with excellent pain relief. The follow-up period has varied from 8 to 153 months (average 66 months) and there have been no recurrences. Based on this experience, complete excision of spinal osteoblastomas is recommended whenever possible. However, a satisfactory outcome may be achieved following incomplete excision and bone grafting.

Drug Testing Is Integral Part Of Winter Olympic Games

The odds are that no prominent athlete at the XV Winter Olympic Games now under way will test positive for a banned, performance-enhancing substance. It's quite possible, in fact, that no athletes at these Olympic games will test positive for such substances. That is not to say, however, that the use of such compounds has been abandoned by athletes. Evidence, much of it anecdotal, suggests that some athletes, always seeking the slim edge that separates the victorious from the also-rans, now use banned substances in ways that elude detection. And some athletes are turning to new substances yet to be controlled by the Olympic Medical Commission. At a press briefing at Foothills Hospital in Calgary, site of the Olympic doping control laboratory, Bruce Challis, the chief medical officer for the Olympic Winter Games Organizing Committee, suggested that the chances of identifying an athlete using drugs, certainly at the medal level, would be very low. At ...

Screening of jaundiced neonates for glucose-6-phosphate dehydrogenase deficiency.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is transmitted as an X-linked recessive disorder, and thus female infants are expected to be only rarely affected. Review of the records of 1,478 jaundiced newborn infants (728 boys and 750 girls) screened for G6PD deficiency at the Foothills Provincial Hospital in Calgary showed 41 (5.6%) boys and 17 (2.2%) girls with this disorder. In view of the unexpected and unexplained high frequency of G6PD deficiency in female infants, I recommend that screening for this disorder be done in selected jaundiced infants regardless of sex.

A Comparison of Myo-Electric and Standard Prostheses — A Case Study of a Pre-School Aged Congenital Amputee

The major advantages of early fitting with a standard prosthesis, are related to future acceptance, skilled use, and functional use of the prosthesis. Increasingly more parents of juvenile amputees are requesting myo-electric prostheses for their children. This study explored the areas of acceptance and adjustment, skill level, and functional use of a myo-electric prosthesis compared to a standard prosthesis with a child selected from the Juvenile Amputee Clinic list at the Alberta Children's Hospital in Calgary, Alberta, Acceptance and adjustment were measured by the Prosthetic Adjustment Scale and by parent interviews: Skill level and functional use of the prostheses were measured by simple instruments devised by the writer. Differences in skill level, acceptance, and functional use between the standard and the myo-electric prostheses were outlined and discussed. This study lends support to the idea of early myo-electric fitting.