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Biomedical subjects

F J Milne

Publications and source records attributed to F J Milne.

At least 73 records · Page 4Linked to original sources
PubMed1982

The malignant phase of essential hypertension in Johannesburg Blacks. A prospective study.

During a 1-year period all Black patients admitted to two medical wards in the Johannesburg General Hospital were screened for malignant hypertension. Of the 62 patients eligible for inclusion in the study, 51 were thought to have essential malignant hypertension (hospital prevalence 2,2%). There was a striking absence of the cardiovascular and hypertensive risk factors usually described -- excessive smoking, alcohol consumption and obesity. The presenting features and complications were similar to those described in other series. Cardiac failure was present in 45% of the patients, neurological complications in 33%, and advanced renal failure in 47%. Twenty patients required dialysis. No evidence of ischaemic heart disease or atheromatous vascular disease was found. Red cell fragmentation was present in 25% of the patients. The hospital mortality rate was 25%. Only 24% of the patients had previously been diagnosed as having hypertension, although 43% had been examined by a doctor during the preceding 2 years. Of the patients discharged to the hypertension clinic, only 28% returned for short-term follow-up. Malignant hypertension is therefore a major medical and social problem in the Johannesburg Black community.

Adult↗
PubMed1982

Isolation and identification of steroids from gonadal vein blood of the fetal horse.

Direct connection of the artery of a fetal ovary to the carotid artery of the mare allowed collection of a large volume of blood over a 30-min period. Extraction of steroids and their fractionation was followed by separation of the steroids by alumina adsorption chromatography, and Sephadex LH-20 and Celite partition chromatography. Further resolution of the material by HPLC led to the identification of dehydroepiandrosterone (DHA) by nuclear magnetic resonance and mass spectrometry. Other compounds were isolated, which remain to be identified fully, but in the 8th month of pregnancy the principal steroid secreted by the fetal ovary was apparently DHA.

Animals↗
PubMed1981

The role of the advanced clinical nurse in a hypertension clinic.

The use of advanced clinical nurses (ACNs) has enabled expansion of the Hypertension Clinic at the Johannesburg Hospital. The ACNs care for elderly patients whose hypertension is stable and who require a minimum of drugs. Blood pressure control in this group of patients is satisfactory and the default rate is low. The ACN therefore appears acceptable, at least to the patient. However, problems of continuing education, evaluation and official recognition remain. The case for allowing the ACN to prescribe from a limited pharmacopoeia is presented.

Humans↗
PubMed1981

Iron absorption in patients on regular dialysis therapy.

Various haematological, ferrokinetic and iron absorption measurements were carried out on 15 patients with chronic renal failure who were undergoing regular haemodialysis. There was no evidence that the rate of iron absorption was impaired significantly by the depressed erythropoietic activity present in these patients. In contrast, there was a significant inverse correlation between the rate of iron absorption and the serum ferritin concentration, which has been shown to be an index of the size of the iron stores. This relationship, which was shown with both small (3 mg) and large (50 mg) doses of ferrous iron, was no different from that previously noted in subjects with normal renal function. These results suggest that iron deficiency in patients with chronic renal failure undergoing regular haemodialysis can be adequately prevented or treated with oral iron therapy, since the absorptive mechanism for iron appears to be normal.

Female↗
PubMed1980

Nephrotic syndrome during captopril therapy.

Captopril, an angiotensin-converting enzyme inhibitor, is being evaluated as an antihypertensive agent. We report on a patient who developed the nephrotic syndrome while on captopril 450 mg/d. Her urinary protein excretion was 5-7 g/24 h, plasma albumin concentration was 25 g/l, plasma cholesterol was 16,2 mmol/l, and she had oedema. Renal biopsy showed subepithelial deposits on the basement membrane.

Aged↗
PubMed1979

Bilateral pleural effusions associated with generalized primary lymphoedema and erysipelas. A case report and the probable pathogenesis.

A case of bilateral pleural effusion in association with generalized primary lymphoedema and erysipelas, but without yellow dystrophic nails, is reported and the probable pathogenesis of the condition discussed. It is known that the primary defect lies in decreased lymphatic drainage. However, the consequent intravascular hypovolaemia and secondary hyperaldosteronism have not previously been demonstrated.

Adult↗
PubMed1979

Bone disease in patients on maintenance haemodialysis using softened or de-ionized water.

A clinical, biochemical and radiological study was carried out in 28 patients on maintenance haemodialysis in order to assess the prevalence of bone disease, particularly with regard to osteomalacia and/or osteopenia. The patients were selected from dialysis units using softened or deionized water, and the aluminium levels measured in the different water supplies. The results showed that symptomatic osteomalacia/osteopenia occurs more frequently in the units using softened water, which has a higher aluminium content, than in the de-ionized water unit. The patients dialysed on softened water also have significantly higher serum calcium and phosphorus levels. It is suggested that in Johannesburg, water softening alone is inadequate, and that the high aluminium levels in our water may be responsible for accelerated osteomalacia/osteopenia.

Adult↗
PubMed1979

Asymptomatic arsine nephrotoxicity. A case report.

A completely asymptomatic patient with arsine nephrotoxicity is described. The light and electron microscopic appearances of the kidney biopsy specimen are documented. The pathogenesis of the lesions, the usual manifestations of arsine exposure, and how these differed from those seen in our patient, are discussed.

Acute Kidney Injury↗
PubMed1979

A precursor role for DHA in a feto-placental unit for oestrogen formation in the mare.

Plasma levels of total oestrogens and dehydroepiandrosterone (DHA) were measured by radioimmunossay in samples taken from various blood vessels in both maternal and fetal compartments in 11 Pony mates. High concentrations of oestrogens (greater than 100 ng/ml of plasma), expressed as oestrone equivalents, were found in the fetal circulation. On both the fetal and maternal sides, oestrogen concentrations were lower in blood going to than from the placenta. DHA concentrations, on the other hand, were higher in blood flowing to the placenta from the fetus. The fetal gonads were seen as the source of DHA, which was present in remarkably high concentrations (greater than 800 ng/ml of plasma) in venous samples from fetal ovaries and fetal testes. A precursor role in placental oestrogen formation is suggested for DHA secretion by the fetal gonads.

Animals↗
PubMed1978

Acute renal failure after use of radiographic contrast media.

The nephrotoxic effects of radiographic contrast media (RCM) used for excretory urography and angiography are described in 9 patients. These effects are usually temporary and reversible, but may be permanent. Predisposing factors resulting in renal damage are identified and discussed. These include diabetes, dehydration, myelomatosis, chronic renal failure of many causes and repeated administrations of contrast media with a short period. Suggestions are made in order to reduce the incidence and severity of functional renal impairment after administration of contrast media.

Acute Kidney Injury↗
PubMed1978

Acne, hypervitaminosis A and hypercalcaemia. A case report.

The ingestion of vitamin A, which is often prescribed for the treatment of acne, may lead to hypervitaminosis A. This syndrome has a wide spectrum of clinical features, hypercalcaemia being of special note since it has been reported in 4 previous cases only. Hypervitaminosis A has been described as resulting from excess ingestion of vitamin A for prevention of sunburn and treatment of minimal brain dysfunction. With the present glut of health foods, this condition should be borne in mind when patients present with symptoms of hypercalcaemia and liver dysfunction.

Acne Vulgaris↗
PubMed1978

Septic abortion with renal failure treated by hysterectomy.

Acute renal failure is a serious and life-threatening complication of septic abortion. The documented mortality rate varies between 30% and 65%. Initial management of the patient with this complication is directed towards resuscitation which should be carried out in an intensive care unit. If significant clinical improvement has not taken place within the first 12--24 hours, then hysterectomy should be considered as an emergency procedure. In 6 of the 7 patients described, it is thought that early hysterectomy was the crucial factor contributing towards their survival. The presence of diffuse intravascular coagulation, which was seen in all our patients, is an added indication for surgical intervention, and its role in the pathogenesis of acute renal failure is discussed.

Abortion, Septic↗
PubMed1978

When to investigate and when to treat hypertension.

When a raised blood pressure is found, a thorough clinical assessment and a few simple investigations are sufficient in the average patient. There are certain clear indications for treatment, but there is a grey zone where suggestions only can be offered. The importance of follow-up examinations, drug side-effects and associated risk factors is stressed.

Adult↗
PubMed1976

Cross-matching assays of cell-mediated immunity for transplant patients.

Assays of cell-mediated immunity before transplantation were performed on 34 patients who were defined as being at high risk by the presence of preformed lymphocytotoxic antibodies and/or HL-A incompatibilities at FOUR locus. Assays for cell-mediated lympholysis type I (cml I) were performed in donor serum, and for CML II in recipient serum, to assess the possible effect of blocking factors in the patients' sera. A positive (greater than 5% specific Cr release) and in particular a greater than 10% Cr release correlated strongly with graft rejection. The correlation between CML II and graft survival was unimpressive. No clinically beneficial blocking factor was demonstrable in the patients's sera in that 5 of 6 patients with a positive CML I but a negative CML II rejected their grafts. Conversely, 6 of 8 patients with a positive CML II and a negative CML I had excellent long-term courses. The use of CML I assay in the selection of grafts for patients at high risk is recommended.

Cadaver↗