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My thoughts about the Hemolytic Uremic Syndrome (HUS) got started
in 1961 along with my attempt to return to Argentina. As I sought
my way in Buenos Aires, I visited Carlos Gianantonio whom I had met
in Caracas the year before during the Pan American pediatric
meetings. At that time he was actively working on HUS which had
become an epidemic in Buenos Aires and other parts of Argentina. I
was impressed by the team effort and devotion of his group to such
heavy demands. They obviously were meeting the challenge at an
amazingly high level under a very crippling physical situation with
shortages of space, laboratories and equipment. His group together
with Dr. Becu, at the time the pathologist at the Children's
Hospital of Buenos Aires (we had met through his mother who was
instrumental in arranging my return to Buenos Aires), wrote some of
the classic papers on HUS. Through the years as Dr. Gianantonio
became more involved in general pediatrics, the administrative
aspects and its orientation in Latin America, he became known for
his deep philosophical questions as to what we are doing and where
we are going. His questions have obvious implications regarding an
agressive approach to our pediatric nephrology patients.
This Pediatric Nephrology series is a focus on salient points which
at the time of each annual seminar are of importance to the
practicing pediatrician and nephrologist, the clinical researcher,
and basic researcher interested in clinical problems. Hence the
format of selected papers and panel discussions to capture the
tenor of the times. More thorough coverage of many of the subjects
can be found in current journals and textbooks listed in the
authors' references. Those searching for the conventional should
look there rather than here since our aim is not to cover each
subject in its entirety but to secure attention to the
controversial aspects of the subjects, dispel the notion that there
is one answer to a question, and raise the level of inclination
toward dynamic problem solving. The basic subject chosen this year
reflects dominant concerns this year and the participants
chosen--speakers and discussants--represent certain views relevant
to the subject at this time. To reflect the tempo and flavor
produced by this unique blend, the discussions are included almost
verbatim. For some this means readability; for others, excess
verbiage. The careful reader will notice that I have been the
chairman of all sessions and have moderated all discussions. This
is in keeping with our aim to ferret out interrelated basic
questions and varying answers to the subjects--seen as related in
problems and solutions. In the discussions, all names have been
deleted.
This is the 11th of the Pediatric Nephrology series created to help
us be in touch with developments which are relevant to the problems
we face daily in clinical practice and the questions we ask and try
to answer in clinical and experimental research. Like volume IX,
this one focuses on one of the subgroups to which we are
committed--the neonates' special fluid and electrolyte
requirements. This volume has more on blood pressure and renal
function and looks at the hormonal regulators. There is greater
depth about intoxications and nephrotic agents, congenital
disorders and mineral metabolism. The exchanges were stimulating
and the controversies were brought out without need of much of my
usual prodding. At Julie Ingelfinger's suggestion, at the end of
each panel discussion I have added a comment to highlight the main
points as I see them. Otherwise, the format remains as in past
editions: the papers given related to the four major topic areas,
each followed by panel and registrant discussion. Although the
transcription is almost verbatim, you will not find the names of
the discussants, purposely omitted to ease my editorial work and to
encourage everyone to speak candidly. Some of the questions and
answers are those submitted to the panelists after the sessions,
incorporated here by request. Also, frequent references are made to
others' work but their names have been omitted.
This Pediatric Nephrology series is a focus on salient points which
at the time of each annual seminar are of importance to the
practicing pediatrician and nephrologist, the clinical researcher,
and basic researcher interested in clinical problems. Hence the
format of selected papers and panel discussions to capture the
tenor of the times. More thorough coverage of many of the subjects
can be found in current journals and textbooks listed in the
authors' references. Those searching for the conventional should
look there rather than here since our aim is not to cover each
subject in its entirety but to secure attention to the
controversial aspects of the subjects, dispel the notion that there
is one answer to a question, and raise the level of inclination
toward dynamic problem solving. The basic subject chosen this year
reflects dominant concerns this year and the participants
chosen--speakers and discussants--represent certain views relevant
to the subject at this time. To reflect the tempo and flavor
produced by this unique blend, the discussions are included almost
verbatim. For some this means readability; for others, excess
verbiage. The careful reader will notice that I have been the
chairman of all sessions and have moderated all discussions. This
is in keeping with our aim to ferret out interrelated basic
questions and varying answers to the subjects--seen as related in
problems and solutions. In the discussions, all names have been
deleted.
This is the 11th of the Pediatric Nephrology series created to help
us be in touch with developments which are relevant to the problems
we face daily in clinical practice and the questions we ask and try
to answer in clinical and experimental research. Like volume IX,
this one focuses on one of the subgroups to which we are
committed--the neonates' special fluid and electrolyte
requirements. This volume has more on blood pressure and renal
function and looks at the hormonal regulators. There is greater
depth about intoxications and nephrotic agents, congenital
disorders and mineral metabolism. The exchanges were stimulating
and the controversies were brought out without need of much of my
usual prodding. At Julie Ingelfinger's suggestion, at the end of
each panel discussion I have added a comment to highlight the main
points as I see them. Otherwise, the format remains as in past
editions: the papers given related to the four major topic areas,
each followed by panel and registrant discussion. Although the
transcription is almost verbatim, you will not find the names of
the discussants, purposely omitted to ease my editorial work and to
encourage everyone to speak candidly. Some of the questions and
answers are those submitted to the panelists after the sessions,
incorporated here by request. Also, frequent references are made to
others' work but their names have been omitted.
My thoughts about the Hemolytic Uremic Syndrome (HUS) got started
in 1961 along with my attempt to return to Argentina. As I sought
my way in Buenos Aires, I visited Carlos Gianantonio whom I had met
in Caracas the year before during the Pan American pediatric
meetings. At that time he was actively working on HUS which had
become an epidemic in Buenos Aires and other parts of Argentina. I
was impressed by the team effort and devotion of his group to such
heavy demands. They obviously were meeting the challenge at an
amazingly high level under a very crippling physical situation with
shortages of space, laboratories and equipment. His group together
with Dr. Becu, at the time the pathologist at the Children's
Hospital of Buenos Aires (we had met through his mother who was
instrumental in arranging my return to Buenos Aires), wrote some of
the classic papers on HUS. Through the years as Dr. Gianantonio
became more involved in general pediatrics, the administrative
aspects and its orientation in Latin America, he became known for
his deep philosophical questions as to what we are doing and where
we are going. His questions have obvious implications regarding an
agressive approach to our pediatric nephrology patients.
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