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Biomedical subjects

A T Lambie

Publications and source records attributed to A T Lambie.

At least 19 recordsLinked to original sources
PubMed1989

Sheep-acquired severe Chlamydia psittaci infection in pregnancy.

There have been five confirmed cases of severe Chlamydia psittaci infection during pregnancy, three having been treated in Edinburgh, Scotland. The most recent case is presented and previous experience is reviewed. The illness usually causes thrombocytopenia with disseminated intravascular coagulation, renal failure and hepatic dysfunction during the late second and early third trimester. The outcome for the fetus is usually fatal and the infection only resolves after delivery or abortion. The main hope is for education to prevent infection occurring in susceptible populations.

Abortion, Incomplete↗
PubMed1989

The kallikrein-kinin and renin-angiotensin systems in nephrotic syndrome.

We previously found that virtually all patients with nephrotic syndrome (NS) excrete supranormal amounts of urinary kallikrein; it is known that activity of the renin-angiotensin system (RAS) is increased in some such patients. We therefore studied the relationship between urinary kallikrein excretion (UKa) and plasma renin activity (PRA) in 16 patients with NS. Compared with healthy controls, PRA was normal in 8 subjects and elevated in 8; UKa was elevated in the high-renin group (40.4 +/- 5.2 nkat/24 h, normals 12.0 +/- 1.1). UKa was also elevated in the normal renin group (25.7 +/- 2.4 nkat/24 h) but to a significantly lesser degree. Significant activity in plasma against a specific substrate of glandular and renal kallikreins was observed in 8 of 10 patients with NS. Such activity was not found in plasma of 17 patients with glomerulonephritis without NS, or in 10 healthy controls. The results are in keeping with previous suggestions of a functional link between the renal kallikrein-kinin system (KKS) and the RAS, but indicate that the renal KKS is activated in NS, in some cases independently of the RAS. It is possible that renal kallikrein reaches the systemic circulation in some patients with NS.

Adult↗
PubMed1985

Urinary kallikrein and systemic prostacyclin synthesis during sodium chloride infusion in normal man.

An intravenous infusion of 3 litres of sodium chloride solution (saline: 150 mmol/l) was given over 1 h to normal subjects. During and immediately after the infusion, renal plasma flow increased in the majority of subjects, but the rise was not statistically significant. Significant increases in urine flow, sodium excretion, urinary kallikrein excretion and urinary excretion of dinor-6-keto prostaglandin (PG) F1 alpha, a measure of systemic PGI2 synthesis, were noted. Plasma renin activity and plasma protein concentration were significantly lowered by the infusion. At 2 h after the end of the infusion, although urine flow fell significantly, sodium excretion had not decreased. The reduction in plasma renin activity and plasma proteins persisted, and excretion of kallikrein and the PGI2 metabolite returned to control values. Overall, urinary kallikrein excretion correlated significantly with urine flow and with sodium excretion. Peak kallikrein excretion occurred in the second 30 min of the infusion, and preceded maximal urine flow and sodium excretion. The results suggest that increased systemic synthesis of PGI2 occurs in response to an acute infusion of sodium chloride, and may be an adaptive response of the vasculature to volume expansion. They support a role for the renal kallikrein-kinin system in the early diuretic and natriuretic response to saline infusion; the reduction in plasma renin activity and plasma protein concentration may be involved in both the early response and the persistent natriuresis 2 h after the infusion.

6-Ketoprostaglandin F1 alpha↗
PubMed1984

Hypocalcaemic cataract as a presenting symptom of renal insufficiency.

A young man of 17 years presented with bilateral reduced vision because of cataracts. Investigations showed a low level of serum calcium along with other evidence of renal failure. The cataracts were mainly in the posterior pole (cupulliform); faint peripheral cortical opacities were also present--in the form of about a dozen half-loops straddling the equator and extending about half way towards the axial centre of the lens.

Adolescent↗
PubMed1983

Thyroid status in patients with chronic renal failure.

Serum thyroid hormone concentrations have been measured in 21 patients with chronic renal failure, treated conservatively and compared with values from 19 control subjects. Many patients had serum total T3 and T4 concentrations below the reference ranges. The concentrations of free T4 and free T3 and the free thyroxine index were significantly lower in patients with abnormal total concentrations of the thyroid hormones than in the controls. Both the free and the total concentrations of T4 correlated inversely with the degree of renal failure. The concentration of thyroxine binding globulin (TBG), fell within the reference range in each of the patients, but was significantly lower in the patient group when compared with the controls. These TBG concentrations, however, were not sufficiently decreased to explain the low total thyroid hormone concentrations found in the patients. The affinity of TBG for T4 and T3 in the patient and control groups was not significantly different. The TSH response to TRH was diminished in many of the patients, but the measurement of other pituitary hormones indicated that pituitary function was normal in these patients. The possible mechanisms responsible for the changes observed in thyroid and pituitary hormones are discussed.

Adolescent↗
PubMed1982

Disseminated aspergillosis occurring in patients with respiratory, renal, and hepatic failure.

Respiratory, renal, and hepatic insufficiency developed in five patients who had been admitted to hospital for a variety of reasons. Although in four cases Aspergillus had been isolated from tracheal secretions before death, the significance of this finding was not fully appreciated, and in all five the diagnosis of aspergillosis was made at necropsy. Since treatment has to be started early if it is to be effective, patients with any combination of respiratory, renal, and hepatic failure should have their tracheal secretions examined daily. If Aspergillus is cultured, and hyphae are present in a fresh smear, and the patient has features of a generalised infection without an obvious site of infection, treatment for aspergillosis should be considered.

Acute Kidney Injury↗
PubMed1982

Role of prostaglandins in mediating excretion by the kidney of an intravenous infusion of sodium chloride in normal human subjects.

1. Normal male subjects were given a rapid infusion of 3 litres of sodium chloride solution (150 mmol/l) with or without pretreatment with indomethacin. 2. There was marked individual variability in the rate at which the infused sodium chloride solution was subsequently excreted which was not related to the urinary sodium excretion in the previous 24 h. 3. There was no relationship between urinary prostaglandin E excretion during the 24 h preceding the sodium chloride infusion and the rate at which different individuals subsequently excreted sodium and water. 4. Renal plasma flow was significantly higher during the sodium chloride infusion than in the post-infusion recovery period, both with and without pretreatment with indomethacin, although it was significantly lower during each period in subjects pretreated with indomethacin. 5. Urinary prostaglandin E excretion was significantly decreased after the infusion of sodium chloride solution. 6. Indomethacin slightly decreased the rate of excretion of sodium and water. 7. Prostaglandins have a role in, but are not the main determinants of, the excretion of an intravenous infusion of sodium chloride. 8. The results do not support the suggestion that prostaglandin E produced within the kidney, as indicated by urinary prostaglandin E excretion, exerts a natriuretic action.

Adult↗
PubMed1981

The introduction of problem-based learning projects into a clinical correlation course in the first year of the Edinburgh medical curriculum.

Thirty hours were allotted to problem-based learning projects in the first year of a new medical curriculum in Edinburgh. Those projects have been very successful in encouraging student initiative and in satisfying the students' desire for contact with patients, relatives and medical staff early in the curriculum. The difficulties involved in this form of teaching and the shortcomings of the exercise are discussed.

Attitude of Health Personnel↗
PubMed1977

Echocardiography in uraemic pericarditis with effusion.

Serial chest radiology and echocardiography were performed in seven patients undergoing chronic haemodialysis who developed pericarditis. Echocardiography was helpful in making an early diagnosis of a pericardial effusion in the absence of specific clinical or radiological signs of an effusion. It also enabled changes in the thickness of a pericardial effusion to be detected, which was of value when clinical features suggestive of cardiac tamponade occurred during dialysis, and showed that the effusion could increase in size despite the use of regional heparinisation for dialysis. Resolution of a pericardial effusion could be defined accurately using echocardiography, whereas this was not possible clinically or radiologically. It is concluded that serial echocardiography is a good method of monitoring a pericardial effusion in dialysis patients.

Adult↗
PubMed1976

Intracellular acid-base heterogeneity in nucleated avian erythrocytes.

1. Intracellular hydrogen ion activity, [H+]i, was extimated in human erythrocytes and in nucleated avian erythrocytes from measurements of the distribution of ammonia and 5,5'-dimethyloxazolidine-2,4'-dione (DMO) between intracellular and extracellular fluid. 2. In human erythrocytes there was no difference between values for [H+]i derived from measurements of either DMO or ammonia. 3. In avian erythrocytes, [H+]i(ammonia) was consistently greater than [H+]i(DMO), indicating significant acid-base heterogeneity of the intracellular water. The degree of heterogeneity was assessed by reference to a theoretical model of two compartments of equal size. 4. Experiments with nuclei isolated from avian erythrocytes suggested that DMO is not bound to nucleoproteins, and that the nucleus may be more acidic than the cytoplasm.

Animals↗