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Biomedical subjects

A C Kennedy

Publications and source records attributed to A C Kennedy.

At least 19 recordsLinked to original sources
PubMed1984

Abnormal haemostasis and blood viscosity in malignant hypertension.

We have previously shown abnormalities of haemostasis suggestive of intravascular coagulation in patients with malignant hypertension, a condition associated with retinopathy and renal fibrin deposition. To determine whether such abnormalities are specific to malignant hypertension, we have measured several haemostatic and haemorheological variables in 18 patients with malignant hypertension (Group 1), 18 matched healthy controls (Group 2), and 18 patients with non-malignant hypertension (Group 3) matched for renal pathology, blood pressure and serum creatinine with Group 1. Both Groups 1 and 3 had increased mean levels of fibrinogen, factor VIIIc, beta-thromboglobulin, plasma viscosity and blood viscosity (corrected for haematocrit); and decreased mean levels of haematocrit, antithrombin III and platelet count. Mean levels of fast antiplasmin and alpha2-macroglobulin were elevated in Group 1 but not in Group 3. We conclude that most blood abnormalities are not specific to malignant hypertension; are also present in patients with non-malignant hypertension who have similar levels of blood pressure and renal damage; and might result from renal damage as well as promoting further renal damage by enhancing fibrin deposition. However increased levels of fibrinolytic inhibitors in malignant hypertension merit further investigation in relation to removal of renal fibrin.

Adult↗
PubMed1984

Whole-body elemental composition in patients with renal failure and after transplantation studied using total-body neutron-activation analysis.

Whole body elemental composition in seventy-five patients with either renal failure or a kidney transplant was measured by neutron-activation analysis and whole-body counting. Comparison was made with expected normal values and with a control group; between undialysed, dialysed and transplanted patients; and between those receiving dialysis treatment for various periods. A frequent finding was low body calcium, reflecting the prevalence of renal osteodystrophy. Sodium and chlorine were increased in undialysed patients, a consequence of their renal disease. Patients with transplanted kidneys had reduced amounts of most elements, indicating decreased lean body mass, but increased body weight, probably due to excess fat.

Body Composition↗
PubMed1984

Diphtheroid peritonitis associated with continuous ambulatory peritoneal dialysis.

Five patients on continuous ambulatory peritoneal dialysis (CAPD) developed peritonitis caused by diphtheroid bacteria. Peritoneal catheter exit site inflammation and/or discharge preceded all cases and relapses were common. Antimicrobial therapy alone failed to eradicate the bacteria and peritoneal catheter removal was required before peritonitis resolved. Laboratory culture of the diphtheroid bacteria was difficult and prolonged incubation was often necessary. Diphtheroid bacteria are important opportunistic pathogens in immunocompromised patients and should be carefully sought for in all cases of culture-negative CAPD-associated peritonitis.

Adult↗
PubMed1983

[Pharmacokinetics of ketoprofen in the synovial fluid].

Serum and synovial fluid concentrations of ketoprofen were studied after administration of 50 or 100 mg in a single oral dose to patients with rheumatoid arthritis. Results show that ketoprofen is rapidly absorbed. Serum concentrations are similar in patients and healthy subjects. During the initial phase, plasma half-life, which averaged 1.5 to 2 hours in study patients, was similar to that recorded in controls. Significant accumulation of ketoprofen in synovial fluid of patients was demonstrated.

Administration, Oral↗
PubMed1981

Assessment and interpretation of radiopharmaceutical joint imaging in an animal model of arthritis.

An animal model of arthritis in the rabbit was employed to assess the radioactivity contribution of joint tissues to externally monitored scintigram positivity. Bone contained the greatest total amount of radioactivity whether the imaging agent was technetium pertechnetate or pyrophosphate, although the greatest percent increase in the arthritis joints over control joints was seen in synovium. Mid-shaft bone in the same region as the arthritic joint also showed increased radioactivity compared with control.

Animals↗
PubMed1981

Diabetic ketoalkalosis due to ectopic ACTH production from an oat cell carcinoma.

A diabetic patient is described who presented with the bizarre biochemical association of hyperglycaemia, ketosis and severe alkalosis. Investigation revealed hypercortisolaemia due to ectopic adrenocorticotrophic hormone secretion from an oat cell carcinoma of the bronchus and post-mortem studies demonstrated clinically unsuspected resolving pancreatitis. a possible mechanism for the metabolic upset is discussed.

Acidosis↗
PubMed1980

Dopamine hydrochloride in oliguric states.

Low-dose dopamine infusion (1 microgram/kg/min) produced a diuresis in early oliguric acute tubular necrosis. No complications were encountered during or after the infusion.

Acute Kidney Injury↗
PubMed1979

Renal function and other factors in obstructive jaundice.

Renal function and other factors that possibly affect the outcome of operation were measured in 24 patients with obstructive jaundice and in 15 non-jaundiced controls. The preoperative features that were associated with a poor postoperative recovery from obstructive jaundice were a raised serum fibrinogen/fibrin degradation product concentration, infection, hypoalbuminaemia and a low glomerular filtration rate. Preoperative serum fibrinogen/fibrin degradation product concentrations were raised in 4 of the 6 jaundiced patients who died after surgery but in none of the controls, in whom there was no mortality. In the jaundiced patients there was a greater incidence of postoperative renal impairment than in the controls. All patients were given mannitol during operation. Further mannitol was required after surgery in 13 of the 24 jaundiced patients in order to maintain urine flow rate despite adequate intravenous fluids being given. In contrast, only 1 of the 15 control patients required post operative mannitol. It is emphasized that repeated doses of mannitol can lead to a profound natriuresis and adequate intravenous saline should be given.

Cholestasis↗
PubMed1979

Whole body elemental composition during drug treatment of rheumatoid arthritis: a preliminary study.

Thirty-two female patients with rheumatoid arthritis were divided into 3 groups and treated for 6 months with prednisolone, depot tetracosactrin, or indomethacin. Their whole body content of calcium, phosphorus, and nitrogen was measured before and after 3 and 6 months' treatment by in-vivo neutron activation analysis. No significant changes in these body elements were observed as a result of the treatments. The average amounts of calcium, phosphorus, and nitrogen were lower than normal in these patients, a finding consistent with the frequent observation of osteoporosis and muscle wasting in rheumatoid arthritis.

Adult↗
PubMed1979

Hypercalcaemia in rheumatoid arthritis: investigation of its causes and implications.

When correction was made for hypoalbuminaemia, 23 of 50 ambulant patients with definite or classical rheumatoid arthritis were found to have hypercalcaemia. When these 23 patients were studied 6 months later, 7 had hypercalcaemia as defined by the correction factor for a low serum albumin level, and 6 of these patients had raised serum ionised calcium concentrations. Biochemical studies in the 23 patients indicated evidence of hyperparathyroidism, namely, hypophosphataemia, increased serum alkaline phosphatase, hyperchloraemia, and reduced tubular reabsorption of calcium. However, serum immunoreactive parathyroid hormone concentrations were normal. Only one patient had an abnormally low serum 25-hydroxy-vitamin D result: this patient had a high level of urinary D-glucaric acid and was receiving phenobarbitone for treatment of epilepsy. The biochemical features suggestive of parathyroid overactivity were particularly found in patients with raised serum calcium levels. The cause of hypercalcaemia in rheumatoid arthritis remains to be explained.

Adult↗
PubMed1978

Solute, amino acid, and hormone changes with coated charcoal hemoperfusion in uremia.

This investigation assesses the effect of two-hour activated charcoal hemoperfusion using a column containing 300 g of acrylic hydrogel-coated activated charcoal either alone or combined with hemodialysis on small and "middle molecule" removal in uremic patients. Comparison was made with standard five-hour hemodialysis. Two patients with dialysis encephalopathy were treated with four-hour combined hemoperfusion/hemodialysis without beneficial clinical effects. Hemoperfusion increased the clearance rates of creatinine and urate when combined with dialysis. Hemoperfusion alone removed 1.3 +/- 0.6 g (mean +/- SD) of creatinine and 0.6 +/- 0.2 g of urate, while combined hemoperfusion/hemodialysis removed 1.7 +/- 0.6 g of creatinine and 1.0 +/- 0.5 g of urate in a two-hour period. Both treatment schedules removed less solute than standard five-hour hemodialysis but were associated with comparable "middle molecule" removal. Hemoperfusion accounted for additional amino acid removal when combined with hemodialysis, while hemoperfusion alone produced significant reduction only in the amino acid cystine. Changes in the hormones thyroxine, triiodothyronine, human growth hormone, and insulin were noted during the procedures. Acceptable falls in platelet counts and fibrinogen occurred with hemoperfusion. Coated charcoal hemoperfusion may prove to have a role in the management of uremic patients, although the acrylic hydrogel-coated charcoal hemoperfusion device requires combination with techniques allowing fluid and electrolyte removal.

Amino Acids↗
PubMed1978

The estimation of whole-body zinc and Zn turnover in rheumatoid and osteoarthritis using 65Zn tracer.

1. A method of estimating whole-body zinc, and Zn balances using a two-compartment model in combination with whole-body counting of 65Zn, is described. The method is applied to patients with rheumatoid and osteoarthritis. 2. The results suggested that there was not a wide variation in whole-body Zn and Zn turnover in individuals with these two diseases and no clearcut difference between patients with one or the other.

Adult↗
PubMed1978

Hyperprolactinaemia in renal disease.

Basal prolactin concentrations in 357 patients with renal disease of defined pathology have been compared with those in 210 control subjects. Elevated prolactin concentrations were found in 113 renal patients (32%) including 53 patients in whom elevated concentrations were possibly attributable to drug therapy. In the remaining 60 patients who had hyperprolactinaemia not attributable to drugs, elevated concentrations (P less than 0.005) were found exclusively in patients with impaired renal function. A significant correlation was observed between prolactin and creatinine concentrations in these patients (r = 0.45 P less than 0.005) and prolactin reverted towards normal after successful renal transplantation. A significant arteriovenous prolactin concentration difference across the kidney (mean 16% range 8-29% P less than 0.02) was found in seven patients with non-renal non-endocrine disease. It is concluded that the hyperprolactinaemia found commonly in patients with impaired renal function is only partly attributable to drug therapy. The positive correlation between prolactin and creatinine reversion of prolactin towards normal after successful transplantation and arteriovenous hormone concentration differences across the normal kidney suggests that the kidney has a important role in prolactin metabolism. Abnormal regulation of prolactin secretion in renal failure may also be involved.

Adolescent↗
PubMed1978

The relationship between uric acid and potassium in normal subjects.

The serum uric acid concentration in normal healthy subjects has been studied in relation to sex, height, weight, lean body mass measured from total body potassium and predicted from the Hume-Weyers formula (1971), total body potassium, plasma potassium and urea, and packed cell volume. The strongest correlation was found with sex, but height, weight, total body potassium, lean body mass (measured and predicted) also correlated significantly with serum uric acid concentration. However, when the sex variable was removed, the other factors lost their significant correlation. Finally, total red blood cell and plasma volumes were predicted (Hume and Goldberg, 1964) and from these an estimate of total plasma uric acid, total plasma potassium, and total red blood cell potassium obtained. Measured total body potassium was found to correlate well with total plasma potassium and total red blood cell potassium independent of sex. Total plasma uric acid correlated well with measured total body potassium when both sexes were considered and when separated into male and female groups the males retained a significant correlation as did the female group.

Adolescent↗