Showing papers by "Ronald M. Lauer published in 1977"

The effect of body weight and its changes on children's blood pressures

Abstract: Obesity has been shown to be an important factor in hypertension of adults. The purpose of this study is to examine the relationships between blood pressures and measures of body size and obesity in the school age. In two school screens in 1971 and 1973, 6005 children were examined, of which 2872 were screened in both surveys. Height, weight, blood pressures and triceps skinfolds were obtained. Using deviations from regression, data were age/sex standardized. Systolic (SBP) and diastolic (DBP) blood pressures were correlated with weight (r=0.41 for SBP and 0.29 for DBP). Similar correlations were observed for height, skinfold and relative weight. Follow-up SBP was correlated with initial SBP (r=0.38), initial weight (r=0.32), and change in weight (r=0.24). A multiple regression equation based on initial SBP explained 14% of the variability in follow-up, while an equation based on initial SBP and weight and change in weight explained 22%. The other variables did not add to the prediction. Change in SBP was correlated with initial SBP (r=-0.51), and change in weight (r=0.17); 26% of the variability in the change in SBP over 2 years was explained by initial SBP alone, while 33% was explained by an equation based on initial SBP, weight and change in weight. Similar results were observed for diastolic blood pressure. These data show that significant portions of the change of blood pressures in children can be explained by relative changes in body weight.

Ontogenesis of autonomic innervation in mammilian myocardium

Abstract: Indomethacin (IND) has recently been shown effective in closing the patent ductus arteriosus (PDA) in small premature infants. However, this mode of therapy has not been evaluated in older infants or children. We have given IND to 6 patients (pts.) with isolated PDA's ranging in age from 51 days to 6 years. All pts. had typical auscultatory findings of a PDA, widened pulse pressure and 5 pts. had electrographic evidence of left ventricular hypertrophy. Four pts. demonstrated cardiomegaly and increased pulmonary blood flow on chest x-ray. Three pts. had the diagnosis of PDA confirmed by cardiac catheterization to exclude associated cardiac anomalies. Echocardiography in 5 pts. revealed LA/AO ratios ranging from 1.2 to 2.0. IND was given orally in a dose ranging from 0.2 mg/kg to 1 mg/kg (1 pt.). Four pts. received 0.3 mg/kg for 2 doses 24 hours apart. In all 6 pts., the clinical & laboratory findings of a PDA remained after the course of IND was completed. Documentation of the patency of the PDA was demonstrated at surgery in 3 pts.; 3 additional pts. are awaiting surgical ligation. Our data suggest that there is an age-related mechanism for prostaglandin inhibition which was probably absent after 50 days of age in our pts. At the present time there seems to be no role for IND in the medical therapy of PDA's in older infants and children.