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Biomedical subjects

L R Baker

Publications and source records attributed to L R Baker.

At least 91 records · Page 5Linked to original sources
PubMed1983

Controlled trial of calcitriol in the prevention of bone disease in haemodialysed patients.

Seventy-six patients receiving regular haemodialysis, without biochemical or radiological evidence of renal osteodystrophy, entered a five-year double-blind placebo-controlled trial of calcitriol (1,25-dihydroxycholecalciferol) in the prevention of bone disease. Significantly more patients on placebo developed bone disease as judged by a sustained elevation of plasma alkaline phosphatase or the development of sub-periosteal erosions on hand radiographs. Serum parathyroid hormone fell significantly in the patients receiving calcitriol and was significantly lower than in patients receiving placebo. It is concluded that calcitriol delays and may prevent the development of metabolic bone disease in patients receiving regular haemodialysis therapy.

Adolescent↗
PubMed1983

Bromocriptine improves reduced libido and potency in men receiving maintenance hemodialysis.

Twenty-five men on maintenance hemodialysis commenced a placebo-controlled, double-blind, crossover trial of bromocriptine for erectile impotence. Eight patients on bromocriptine and one on placebo failed to complete the trial due to side-effects and 2 were withdrawn following renal transplantation. Libido or the frequency and/or quality of erections or both improved in 11 of the remaining 14 patients during bromocriptine treatment. A significant (P less than 0.01) improvement in patients' perception of sexual performance occurred on bromocriptine compared with placebo. The 3 patients in whom potency failed to improve had the lowest serum testosterone concentrations. Bromocriptine is usually effective in the management of impotence in males receiving maintenance hemodialysis provided pretreatment serum testosterone is above the lower end of the normal range, but side-effects are relatively common.

Adult↗
PubMed1983

Influence of intraperitoneal dialyzate on blood pressure during continuous ambulatory peritoneal dialysis.

Blood pressure (BP) of patients on continuous ambulatory peritoneal dialysis (CAPD) must be well controlled. The present study tests a clinical impression that BP recordings are higher with dialyzate within the peritoneal cavity than after it is drained out. 8 CAPD patients had systolic BP, diastolic BP and heart rate measured both with dialyzate in situ and after drainage. Paired t-tests showed systolic BP and diastolic BP but not heart rate to be significantly (P less than 0.05) higher with dialyzate in situ. To avoid a false impression of good BP control it is recommended patients on CAPD measure BP with dialyzate in situ.

Adult↗
PubMed1982

Rubella immunity in older children, teenagers, and young adults: a comparison of immunity in those previously immunized with those unimmunized.

Because rubella continues to be a common illness in adolescents and young adults and because it has been suggested that booster rubella immunizations should be performed, we studied antibody prevalence in 459 predominantly adolescent patients in a pediatric group practice. Rubella antibody (PHA titer greater than or equal to 1:13.5) in previously immunized patients (89.6% of 385) was significantly more common than antibody in unimmunized patients and patients with a questionable history of immunization (70.3% of 74) (P less than 0.005). Twenty-three seronegative patients with a documented history of prior immunization were reimmunized and 22 had an IgG (secondary) antibody response and only one an IgM (primary) antibody response. Since all but one of our patients with previous immunization had a secondary immune response following revaccination, it seems likely that the level of protection in previously vaccinated individuals is considerably greater than 90%. Attention today should be directed at finding and immunizing unvaccinated teenagers and young adults and not in major booster vaccine programs.

Adolescent↗
PubMed1981

Radiologic features of the jejunum in hypoalbuminemia.

Although hypoalbuminemia is a recognized cause of jejunal dilatation, the level of serum albumin at which this occurs and its relation to the extent of jejunal dilatation in celiac disease have not been clearly established. Barium follow-through examination was performed in 12 patients with hypoalbuminemia, in 21 patients with celiac disease, some of whom had a reduced serum albumin, and in 14 control subjects. Jejunal width was increased in patients with hypoalbuminemia and there was a highly significant correlation between jejunal width and the level of serum albumin (p less than 0.001). The level of serum albumin at which jejunal dilatation occurred ("albumin threshold") was found to be 27 g/l. Hypoalbuminemia was not found to be an important factor in the jenunal dilatation of celiac disease. There was a close correlation between the presence of edema and ascites and radiologic abnormality in the jejunum, suggesting that these appearances in nephrotic syndrome are due to intestinal edema. This study suggests that the serum albumin should be taken into account when interpreting the caliber of the small intestine.

Ascites↗
PubMed1981

Diffuse interstitial renal tuberculosis--an unusual cause of renal failure.

Three immigrant patients are described with diffuse interstitial renal tuberculosis. Two had associated pulmonary tuberculosis and the third had tuberculous peritonitis. Excretion urography gave no clue to the diagnosis. At the time of diagnosis by renal biopsy two patients had severe chronic renal failure. In one, renal impairment had progressed during the course of anti-tuberculous treatment. The third patient showed marked fluctuations in renal function, and improvement appeared to relate to concomitant corticosteroid therapy. The importance of this particular form of renal tuberculosis has not previously been emphasized.

Adult↗
PubMed1980

Use of 1,25(OH)2-vitamin D3 in prevention of renal osteodystrophy: preliminary observations.

Hypercalcaemia regularly occurs when "prophylactic" 1,25-dihydroxyvitamin D3 (1,25[OH)2D3) in a dose of 1.0 microgram daily is given to haemodialysis patients without clinical biochemical or radiological evidence of osteodystophy. This dose is too large for such patients. Hypercalcaemia may persist for several weeks after withdrawal of 1,25(OH)2D3, particularly when previous attempts at control by dosage reduction have failed. Hypercalcaemia is better managed by stopping 1,25(OH)2D3, albeit temporarily, than by reducing the dose.

Adult↗
PubMed1979

Dietary treatment of idiopathic hypercalciuria.

Eighty-eight urinary tract stone formers (74 men) with idiopathic hypercalciuria were treated by dietary calcium restriction alone. Short-term control of hypercalciuria was achieved in only 27 patients and all but 12 eventually escaped control. Failure of control was twice as likely in patients with severe hypercalciuria. Almost all patients lived in a hard water area. In such areas at least, attempts to control hypercalciuria by diet alone are likely to fail and early introduction of additional treatment is advisable. In most severe hypercalciurics, such treatment should be introduced from the start.

Calcium↗
PubMed1979

Acute renal failure due to bacterial pyelonephritis.

Five patients who presented with acute renal failure in association with urinary tract infection are reported. Renal function improved rapidly on antibacterial therapy and no alternative cause for acute renal failure could be identified. None had previously been known to have renal disease but three of the five had taken considerable amounts of analgesics. The unusual severity of renal functional impairment resulting from urinary tract infection in these patients is unexplained but may relate to previous analgesic abuse and/or delay in treatment. Since acute non-obstructive pyelonephritis may result in severe reversible renal failure, this diagnosis must be considered in patients presenting with acute uraemia.

Acute Kidney Injury↗
PubMed1976

A comparison of the clearance of urographic contrast medium (sodium diatrizoate) by peritoneal and haemodialysis.

1. The clearance of isotopically labelled sodium diatrizoate by haemodialysis was measured in vitro, with simulated extracellular fluid, and in vivo in eleven patients, at varying rates of fluid or plasma flow. Clearance was also measured in five patients undergoing peritoneal dialysis. In all instances simultaneous measurements of urea clearance were made and the diatrizoate/urea clearance ratio was calculated. 2. In haemodialysis studies, diatrizoate and urea clearances showed a linear increase with increasing 'extracellular fluid' or plasma flow through the dialyser diatrizoate/urea clearance ratio fell. 3. The clearance of diatrizoate in vivo was slightly less than clearance in vitro at corresponding flow rates, but the diatrizoate/urea clearance ratio showed no significant difference. 4. Diatrizoate and urea clearances during peritoneal dialysis were very much lower than during haemodialysis but the diatrizoate/urea clearance ratios were within the same range. 5. The rapid removal of diatrizoate in patients with renal failure requires haemodialysis.

Diatrizoate↗
PubMed1976

Transport and metabolism of h-gibberellin a(1) in dioecious cucumber seedlings.

The transport of (3)H-GA(1) through hypocotyl segments of cucumber (Cucumis sativus L.) was found to be nonpolar. The transport of (3)H-GA(1) was increased by pretreatment with relatively high concentrations of either IAA or Ethephon (2-chloroethylphosphonic acid). Hypocotyl segments from plants of a gynoecious genotype transported more (3)H-GA(1) than those of an androecious. The metabolism of (3)H-GA(1) in hypocotyl segments was neither related to the sex genotype of the cucumber plant nor influenced by pretreatment with Ethephon. The primary metabolite of GA(1) was suggested to be GA(8). Two other suspected metabolites were not identified. Differences in the endogenous GA of gynoecious and androecious plants could not be accounted for by transport differences.

Journal Article↗