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Biomedical subjects

B T Brown

Publications and source records attributed to B T Brown.

9 recordsLinked to original sources
PubMed2000

Urinary retention in patients with BPH treated with finasteride or placebo over 4 years. Characterization of patients and ultimate outcomes. The PLESS Study Group.

OBJECTIVES: Knowledge regarding the incidence and prevalence of acute urinary retention and the ultimate outcome is very limited. The purpose of the present analysis was to document the natural history and outcomes of acute urinary retention (AUR) further specified as being either precipitated or spontaneous, and to evaluate the potential benefit of finasteride therapy. MATERIALS AND METHODS: Three thousand and forty men with moderate to severe symptoms of BPH and enlarged prostate glands by digital rectal examination were enrolled into the 4-year placebo-controlled PLESS trial and were evaluated for occurrences of AUR and BPH-related surgery. Men in the study were seen every 4 months; discontinued patients were followed up 6 months after discontinuation and again at the end of the 4-year trial. Complete 4-year data on outcomes (occurrence of AUR or BPH-related surgery) was available for 92% of the enrolled subjects in each treatment group. An endpoint committee, blinded to treatment group and center, reviewed and categorized all study-related documentation relating to retention and surgery. RESULTS: Over the 4-year period, 99 of 1,503 placebo-treated patients (6.6%) experienced one or more episodes of AUR in comparison with 42 or 1,513 finasteride-treated patients (2.8%; p<0. 001). Approximately half of the episodes of retention were spontaneous and clearly BPH-related, while the other episodes were precipitated by another factor (PAUR). After spontaneous AUR, subsequent surgery was performed in 39 of 52 (75%) placebo-treated patients versus 8 of 20 (40%) finasteride-treated patients (p = 0. 01). BPH-related surgery was less common in men who had a prior episode of PAUR (26% in the placebo group and 14% in the finasteride group). CONCLUSION: There is a continual risk of spontaneous and precipitated acute urinary retention in men with moderate to severe lower urinary tract symptoms and an enlarged prostate gland. Fewer patients who developed precipitated AUR than spontaneous AUR go on to need subsequent BPH-related surgery. Significantly fewer finasteride-than placebo-treated patients developed AUR, and among those men, fewer ultimately needed BPH-related surgery.

Finasteride↗
PubMed1979

Guanethidine sulfate in the prevention of autonomic hyperreflexia.

Autonomic hyperreflexia constitutes the only medical emergency seen in spinal cord injury patients. Uncontrolled hypertension and bradycardia can result in seizures and death. The acute treatment of the syndrome has ranged from medical ganglionic blockers to topical anesthetic agents to surgical procedures. The oral use of 10 mg. guanethidine sulfate 3 times daily successfully prevented the major symptoms of the syndrome in 200 spinal cord injury patients with lesions above T5. Toxicity has been mild and the drug is recommended until the patients are voiding and are capable of self-care.

Autonomic Nervous System↗
PubMed1979

External sphincterotomy at the 12 o'clock position.

Transurethral resection of the external sphincter was done at the 12 o'clock position 61 times in 60 men. There was a 2.8 per cent incidence of postoperative impotence and a 75 per cent cure of vesicoureteral reflux but there was only a 65 per cent success rate of decreasing post-voiding residual urine after 6 months. The techniques and applications of the procedure are discussed.

Adult↗
PubMed1979

Pentolinium for control of reflex hypertension in spinal cord injured patients.

Ganglioplegia was produced by intravenous infusion of pentolinium tartrate 5 mg to control reflex hypertension in 29 patients with chronic spinal cord injuries undergoing 32 elective surgical procedures. The patient group with lesions above the first thoracic segment (T1) demonstrated significant but moderate intraoperative elevation of both systolic and diastolic pressure whether pentolinium was given prior to or during surgical stimulation. Patients with lesions below T1 had no significant pressure elevations with either mode of therapy. Pentolinium ganglioplegia can safely maintain blood pressure within reasonable limits in these patients; some increase in dosage may be required in patients with lesions above T1.

Adolescent↗
PubMed1977

Agranulocytosis associated with procainamide therapy--report of a case.

The case of a 69-year-old woman with procainamide-induced agranulocytosis is reported, and literature reports of 14 other such cases are reviewed. The patients was exposed to procainamide, prescribed for atrial fibrillation, for 26 days, with a daily dose of 1.5 to 4 g and a total dose of 57.5 g. She recovered from agranulocytosis after discontinuation of the drug and hospital treatment for 16 days. Among the reported cases of procainamide-induced agranulocytosis, the daily dosage ranged from 750 mg to 4.5 g; the total ingested dose before agranulocytosis was observed ranged from 36.5 to 316.3 g. Patients treated with procainamide should be instructed to report any soreness of the mouth, throat or gums; unexplained fever; or any symptoms of upper respiratory tract infection. If white blood cell counts indicate bone marrow depression, the drug should be withdrawn and appropriate evaluation begun at once.

Aged↗