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Biomedical subjects

L Rees

Publications and source records attributed to L Rees.

At least 91 records · Page 5Linked to original sources
PubMed1984

Hyponatraemia in the first week of life in preterm infants. Part I. Arginine vasopressin secretion.

Continuous sequential urinary arginine vasopressin measurements in 14 preterm, ventilated infants suggest that both osmoreceptor and volume receptor systems are able to stimulate the prolonged secretion of arginine vasopressin from 26 weeks' gestation. The kidney is able to respond to arginine vasopressin stimulation from the first day of life and from 26 weeks' gestation. A maximum urine osmolality not exceeding 550 mOsm/kg was reached which varied with hydration of the infant. Excretion of arginine vasopressin and urine osmolality increased during deterioration of respiratory illness, mask ventilation, bilateral pneumothoraces, and severe intraventricular haemorrhage. The data show that inappropriate arginine vasopressin secretion is common during illness in the first week of life in preterm infants and that strict attention must be paid to water balance during this time.

Arginine Vasopressin↗
PubMed1984

Hyponatraemia in the first week of life in preterm infants. Part II. Sodium and water balance.

Serial measurements of plasma sodium, sodium balance, water intake, and urine volume were made for a mean period of 5.9 days in 10 preterm infants of mean gestation 30.5 weeks and mean birthweight 1506 g. In five infants weighed regularly, estimates of insensible water loss averaged 2.6 (range 1.4 to 6.2) ml/kg/hour. High insensible water losses were the cause of hypernatraemia that occurred in two of the 10 infants. Net sodium balance was negative during the study and represented contraction of the extracellular fluid volume associated with weight loss. The negative sodium balance did not seem diminished by increasing sodium intake and there was no evidence that sodium intake need exceed 3 to 4 mmol/kg/day. Hyponatraemia was not due to changes in sodium balance but to water retention associated with inappropriate increases in urinary arginine vasopressin excretion and urine osmolality in 8 of 10 infants. Frequent, accurate measurements of body weight and of plasma sodium are the two most reliable indicators of changes in water balance.

Age Factors↗
PubMed1983

The development of psychosomatic medicine during the past 25 years.

The past 25 yrs has seen the evolution from concepts based on specificity of stimulus, mediating pathway and target organ response to concepts embodying the multifactorical nature of psychosomatic disorders in which various combinations of causal factors operate within a particular disorder which is therefore heterogeneous rather than homogeneous. The recognition of the importance of social and psychological factors in all varieties of illness attests not only the psychosomatic unity of the organism, but a dynamic continuum of organism--environmental interaction. Many illnesses involve not only psychosomatic sequence of events in their productions but also somato-psychic sequences as well, sometimes resulting in a vicious circle. The wider recognition of the role of social and psychological factors in all illness has led to the remarkable expansion of consultation and liaison psychiatry in all branches of medicine and surgery. Further notable developments are the more precise and appropriate application of various forms of individual and group psychotherapy and therapies based on learning theories such as behaviour therapy, biofeedback and various relaxation techniques. We may conclude by hoping that further advances may be expected with the application of rigorous scientific methodology especially in longitudinal studies of random and representative samples of the disorder and the general population in which genetic and constitutional factors, neurophysiological, biochemical, endocrinological and other intrinsic changes interact with a variety of social and environmental factors in the multifactorial aetiology of disease.

Grief↗
PubMed1983

Continuous urine collection in the study of vasopressin in the newborn.

We have evaluated the use of urinary vasopressin (AVP) measurements in human newborns to see if urinary AVP excretion is a true reflection of the plasma level. AVP was measured in 37 simultaneously collected plasma and urine samples. The correlation coefficient was 0.8 (p less than 0.001). AVP extracted in duplicate from six urine samples was measured by bioassay and radioimmunoassay. The correlation coefficient was 0.85 (p less than 0.05). To facilitate long-term urine collection we have developed a urine collecting tray to fit a standard incubator or cot. Urinary AVP as measured in 24-hour urine collections in 37 normal infants. AVP excretion was higher in the first 48 h of life than subsequently. Continuous 4-hour urine collections were made in 1 sick infant to assess AVP excretion when urine flow is variable.

Animals↗
PubMed1982

Plasma prolactin and growth hormone levels in manic patients treated with pimozide.

During two weeks' treatment of 11 manic patients with pimozide there was close correspondence between the timecourse of improvement in clinical ratings and the rise in plasma prolactin between the second and fourteenth day. There were no significant differences in growth hormone levels during the manic episodes compared to recovery. These findings are discussed in relation to the role of dopamine in the release of prolactin and growth hormone, and in the pathogenesis of mania.

Adult↗
PubMed1980

Vasopressin concentrations in the neonatal period.

Vasopressin concentrations were measured in the cord blood of thirty infants, thirteen delivered vaginally and seventeen by Caesarean section. There was no correlation with maternal values but the concentration following vaginal delivery (13.5 microunits/ml +/- 7.9 SD) was significantly higher than that following Caesarean section (4.2 microunits/ml +/- 6.6 SD). Gestational age did not affect the concentrations, which fell during the first week of life and then rose gradually in term and pre-term infants. High levels were found in seven sick babies. There was no correlation in the first 3 weeks of life between plasma vasopressin and plasma or urine osmolality in well and sick babies.

Cesarean Section↗
PubMed1979

Gradual reintroduction of full-strength milk after acute gastroenteritis in children.

46 children (26 boys and 20 girls) admitted with mild acute gastroenteritis were randomly allocated to a regimen of continuing on full-strength milk, or to one of taking clear fluids until the diarrhoea settled before full-strength milk was reintroduced either immediately, or gradually in quarter-strength steps. There was no difference in length of hospital stay between the three groups.

Acute Disease↗
PubMed1979

Mycoplasma hominis. A cause of neonatal meningitis.

Two cases of Mycoplasma hominis meningitis in the newborn are described. These infants demonstrate the need to consider M. hominis as a cause of neonatal meningitis, especially if the Gram stain is negative, conventional cultures yield no growth, and there is a history of maternal infection. CSF cultures on appropriate medium can quickly confirm the diagnosis.

Adult↗
PubMed1978

Sex hormone changes underlying menstrual disturbances on haemodialysis.

Sequential changes in luteinising hormone (LH), follicle stimulating hormone (FSH), oestradiol (E2), progesterone (PROG), prolactin (PRL) and testosterone (T) were studied throughout the menstrual cycle in ten women on regular haemodialysis. At the time of study seven women were menstruating and three had secondary amenorrhoea. Only one patient had regular menses. In none of the 15 cycles studied was there a normal luteal phase with an adequate PROG rise, although 9 cycles (4 patients) had E2 changes suggesting that ovulation may have occurred. Increased PRL and T levels were found in 9 and 6 women respectively. These hormonal abnormalities can be related to the menstrual disturbances and explain the low fertility seen in these patients. Bromocriptine or prednisolone may prove useful in their treatment.

Adolescent↗