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Biomedical subjects

K J Breen

Publications and source records attributed to K J Breen.

At least 19 recordsLinked to original sources
PubMed1990

Multiple muscle enzyme release with psychiatric illness.

Associations (p less than .001) between serum concentrations of lactate dehydrogenase (LDH) and glutamic oxaloacetic transaminase (SGOT) were observed in physically well patients with mania (N = 100, r = .70), depression (N = 138, r = .51), chronic schizophrenia (N = 85, r = .68), and schizoaffective or atypical psychosis (N = 39, r = .52) discharged from 1978 through 1981. In contrast, there was a negligible association between these enzymes in 90 nonpsychiatric inpatient control subjects. Patients with mania (229.0 +/- 106.1 IU/l) showed significantly (t = 3.16, p less than .002, two-tailed) higher lactate dehydrogenase (LDH) levels than control subjects (191 +/- 41.7 IU/l) and a 14% incidence of abnormally high serum LDH levels vs. 1% among control subjects. Results were unchanged when patients taking neuroleptics were excluded. These results indicate that psychiatric illness, especially mania, induces release of LDH and SGOT, occasionally to unusually high levels. This is similar to previous reports of muscle creatine phosphokinase release in psychiatric patients. Presumably, these enzymes are released from skeletal muscle in association with agitation, with muscle tension, or with blood stasis and local tissue hypoxia consequent to hypoactivity.

Aspartate Aminotransferases↗
PubMed1987

Planned pregnancy in a patient who was receiving home parenteral nutrition.

A planned pregnancy with a satisfactory outcome is reported in a 33-year-old woman who had received long-term home parenteral nutrition after a massive volvulus, with resection of almost the entire small intestine, six years previously. No obstetric complications were observed and a normal baby girl was delivered by caesarean section. The only nutritional complication that was encountered was aching pain in the limbs and weakness at 20 weeks' gestation, which was due possibly to calcium deficiency and/or the metabolic bone disease that is peculiar to long-term parenteral nutrition and to other unidentified nutrient deficiencies.

Adult↗
PubMed1986

The effects of age and chronic liver disease on the elimination of temazepam.

The pharmacokinetics of the newer 1, 4 benzodiazepine temazepam were evaluated in 16 healthy subjects aged 18-92 years and in 15 cirrhotic patients, to ascertain the effect of ageing and liver disease. The data were analysed both by classic two compartment and by non-compartmental methods. The mean elimination half-life in the control subjects was 15.5 h, considerably longer than previous estimates. No correlation was found between age and pharmacokinetic parameters. The cirrhotic group showed no statistically significant difference in the pharmacokinetic parameters nor in the urinary recovery of the dose from the control group. Temazepam plasma protein binding was assessed in a second group of 9 cirrhotics of similar severity to the main group and in matched controls. When these binding data were applied to the mean clearance data, a modest although not statistically significant, reduction in free drug clearance was observed in the cirrhotic group. This study adds further support to the observation that drugs which undergo ether glucuronidation have normal elimination patterns in patients with liver disease. Temazepam may prove to be a useful hypnotic sedative in patients with liver disease.

Adult↗
PubMed1986

Hepatic vein occlusion (Budd-Chiari syndrome): problems in diagnosis and management.

Seven patients demonstrating the difficulties in diagnosis and management of hepatic vein occlusion are presented. The syndrome may present in an acute form with upper abdominal pain, abdominal swelling, ascites and tender hepatomegaly or in a chronic form, mimicking cirrhotic ascites. The clinical features, predisposing factors, liver scan and liver biopsy may all suggest the condition, but hepatic venography is essential for diagnosis and as a preliminary to treatment. It is suggested that early side to side portacaval anastomosis is the current treatment of choice.

Aged↗
PubMed1985

Jejunal uptake of thiamin hydrochloride in man: influence of alcoholism and alcohol.

The jejunal uptake of 35S-thiamin hydrochloride was examined using an intestinal perfusion technique in six young students (group 1), 12 recently drinking alcoholic men (group 3) and in 6 non-drinking men age-matched with the alcoholic men (group 2). The acute effect of alcohol on thiamin uptake was also examined in the alcoholic subjects. At a perfusate thiamin concentration of 0.5 mumol/l, median thiamin uptake was 34.4, 10.4, and 6.8 ng/cm/min in groups 1, 2, and 3 respectively, while for 8.0 mumol thiamin/l, median uptake was 277.2, 102.3, and 98.0 ng/cm/min for these groups respectively. Alcohol, 50 g/l, added to the perfusate gave a 28.9% decrease in uptake of 0.5 microM thiamin, which was not statistically significant. These findings suggest that neither alcoholism nor acute exposure to alcohol limits jejunal uptake of thiamin hydrochloride. Differences noted between young and old controls need further study.

Adult↗
PubMed1982

Effects of cimetidine and ranitidine on hepatic drug metabolism.

Cimetidine has been shown to impair elimination of a number of drugs metabolized by the hepatic mixed-function oxidase enzymes. It is uncertain whether this is related to its histamine H2-receptor antagonism or to its intrinsic structure. Ranitidine is a more potent H2-receptor antagonist and has a completely different structure. Cimetidine (1 gm/day for 7 days) induced a 23% and 35% fall in mean systemic clearance of antipyrine and theophylline, whereas ranitidine (300 mg/day 7 days) had no significant effect on the clearance of either drug. Our data suggest that the inhibition of drug metabolism by cimetidine is not related to histamine H2-receptor antagonism.

Adult↗
PubMed1979

Prevalence of hepatitis B in a general hospital: screening of patients and staff.

Hepatitis B surface antigen (HBsAg) was sought over a six-month period in patients and staff members of the intensive care, cardiothoracic, and haematology/oncology units of a large general hospital. In addition, HBsAg was sought in all inpatients, outpatients and staff members at one point in time during August, 1977. A positive HBsAg state occurred with a prevalence of 1.55% in the three intensively studied units (cardiothoracic unit, 0.88%; haematology/oncology unit, 1.65%; and intensive care unit, 3.1%) and 0.9% for the point prevalence survey of hospital patients excluding the three intensively monitored areas. Very few of these patients had disorders traditionally associated with hepatitis B antigenaemia. In the survey of staff members, 0.72% of results were HBsAg positive. Of the factors examined, the most important determinant of the hepatitis B positive state both in patients and in staff members was their country of origin (that is, being born in southern or eastern Europe or in Asia).

Adolescent↗
PubMed1978

The diagnosis of reflux oesophagitis: an evaluation of five investigative procedures.

Five methods of diagnosis have been compared prospectively in 43 patients referred for suspected reflux oesophagitis. A final diagnosis of reflux oesophagitis, as defined by the presence of at least two of the three features of typical symptoms, abnormal endoscopic findings, and abnormal findings on oesophageal biopsy, was made in 27 patients. Observer error in the interpretation of endoscopic and histological appearances was small. Measurement of resting pressure of the lower oesophageal sphincter (LES) failed to identify individual patients with reflux oesophagitis, although the mean pressure in 26 patients with oesophagitis (10.1 +/- 5.2 mm Hg) was significantly lower that in 13 patients without oesophagitis (16.8 +/- 10.2 mm Hg, P less than 0.005). Barium studies were unhelpful, as a hiatus hernia was present in only 14 and barium reflux in only 11 of the 27 patients with oesophagitis. Acid perfusion (Bernstein test) was positive at 15 minutes in 23 of the 27 oesophagitis patients, but was falsely positive in seven of the 14 patients without oesophagitis. By accepting only those responses to acid perfusion which were positive at or before seven minutes, the false positive responses were reduced to one out of the 14 patients. Typical symptoms and/or an early positive Bernstein response will correctly identify most patients with reflux oesophagitis, but the diagnosis should be confirmed by endoscopy and biopsy when important therapeutic decisions are pending.

Esophagitis, Peptic↗
PubMed1978

Dietary therapy of gastrointestinal disorders.

Diet therapy is mandatory in only a very small number of GIT disorders. While the available evidence does not support its use in other conditions, many physicians will wish to make an individual decision regarding diet therapy according to the patient's symptoms, to the patient's attitudes and expectations and very importantly, to the financial and social implications of the diet in question.

Colitis↗
PubMed1977

Incidence of antibiotic-related diarrhoea and pseudomembranous colitis: a prospective study of lincomycin, clindamycin and ampicillin.

An existing intensive drug monitoring system was used to study the occurrence of pseudomembranous colitis and diarrhoea in 100 patients treated with lincomycin and clindamycin. In order to give perspective to the results an equal number of matched patients treated with ampicillin were also studied. The incidences of diarrhoea in both groups were similar (11% in the lincomycin-clindamycin group and 8% in the ampicillin group). One patient developed pseudomembranous colitis associated with two prolonged courses of lincomycin therapy. The results suggest that the risks associated with the use of lincomycin are acceptable if the drug is given for the approved specific indications.

Adult↗
PubMed1976

Lincomycin-clindamycin-associated psuedomembranous colitis.

Five cases of lincomycin-clindamycin-associated acute pseudomembranous colitis, demonstrating a spectrum of clinical, histological and radiological severity, were encountered over a five-months period. All patients presented with watery diarrhoea without the passage of macroscopic blood or pus. Two patients were seriously ill with fulminant colitis, but responded rapidly to corticosteroids given parenterally and supportive therapy. The diagnosis of acute colitis should be considered in all patients developing diarrhoea during or up to three weeks after beginning therapy with lincomycin or clindamycin and can be confirmed by sigmoidoscopic examination. Withdrawal of the antibiotic and symptomatic treatment is appropriate for mild cases of colitis, but our experience suggests that corticosteroid therapy is safe and effective in severe cases. Indiscriminate use of these antibiotics should be avoided.

Acute Disease↗