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Biomedical subjects

R Browne

Publications and source records attributed to R Browne.

At least 55 records · Page 3Linked to original sources
PubMed1983

Effect of amiloride with or without hydrochlorothiazide on urinary calcium and saturation of calcium salts.

To assess the therapeutic role of amiloride in calcium nephrolithiasis, seven patients with renal stones were evaluated before and after 1 month of treatment each with amiloride (2.5 mg twice daily), hydrochlorothiazide (25 mg, twice daily), and both drugs at the same dosages. Although amiloride alone reduced urinary calcium in only two patients, it caused a slightly more prominent decline in urinary calcium when added to hydrochlorothiazide treatment in five patients. The urinary saturation of stone-forming salts (brushite and calcium oxalate) decreased significantly during treatment with hydrochlorothiazide alone or in combination with amiloride. Although the decrease in brushite saturation was slightly more marked with the combined treatment, the reduction in calcium oxalate saturation was equivalent during the two treatment phases. Although serum potassium was significantly reduced during combined treatment with amiloride and hydrochlorothiazide, this reduction was not as prominent as that occurring during treatment with hydrochlorothiazide alone. The results suggest that the addition of amiloride to hydrochlorothiazide treatment in calcium nephrolithiasis may be advantageous, because of its stimulation, though slight, of the thiazide-induced reduction of urinary calcium and saturation of calcium phosphate and because it may avert the development of severe hypokalemia.

Adult↗
PubMed1979

Genital cancer in wives of penile cancer patients.

We identified the wives or ex-wives of 227 males of the 256 reported with cancer of the penis to the New York State Cancer Registry from Upstate New York from 1960-64. Utilizing the Registry, death certificates, hospital and physician records, we ascertained those wives who developed cancer at any site from 1951-1975. We generated expected numbers of cases of cancer at each site by applying the age specific incidence rates experienced by women of a specific age in a specific year designated by the age of the wife of the index case in each year, estimating withdrawals from age-specific death rates. Thus, our expected numbers are based on the experience of the women in Upstate New York with traits like those of spouses of the men in the same population with cancer of the penis. We found significantly more cases of cancer of the cervix than expected. This was not true for other sites of cancer.

Adult↗
PubMed1979

The neonatal blood count in health and disease. I. Reference values for neutrophilic cells.

Reference ranges for absolute total neutrophils/mm3, absolute immature neutrophils/mm3, and the fraction of immature to total neutrophils (I:T proportion) during the first 28 days of life are developed from 585 peripheral blood counts obtained from 304 normal neonates and 320 counts obtained from 130 neonates with perinatal complications demonstrated to have no statistically significant effect on neutrophil dynamics. Perinatal factors other than bacterial disease which significantly alter neutrophil dynamics include maternal hypertension, maternal fever prior to delivery, hemolytic disease, and periventricular hemorrhage. The predictive value of these reference ranges in identifying bacterial disease in the first week of age varies with the neutrophil factor evaluated and the clinical setting. Neutropenia in the presence of respiratory distress in the first 72 hours had an 84% likelihood of signifying bacterial disease, whereas neutropenia in the presence of asphyxia had a 68% likelihood of signifying bacterial disease. An abnormal I:T proportion had an accuracy of 82% and 61%, respectively, in the same clinical settings. Elevations of either immature or total neutrophils were less specific. Interpretation of abnormal neutrophil factors must include consideration of both infectious and noninfectious perinatal events.

Erythrocyte Count↗
PubMed1979

Cell-mediated immune responses in sporotrichosis.

Cell-mediated immunity (CMI) was evaluated in five patients with cutaneous sporotrichosis and six patients with systemic sporotrichosis. Whereas patients with cutaneous disease showed normal CMI, the patients with systemic disease had significant abnormalities in CMI. Most patients exhibited responses to a sporothrix antigen, measured either in conventional assays of lymphocyte transformation or in preincubation assays. Two patients with protracted illnesses and continued abnormalities in CMI were treated with transfer factor and showed improvement in parameters of CMI and control of their disease.

Adolescent↗
PubMed1979

Response of hypertensive adolescents to dynamic and isometric exercise stress.

Isometric handgrip and dynamic exercise stress tests were performed on 109 hypertensive and 74 normotensive subjects 14 to 17 years old. The hypertensive subjects had resting systolic or diastolic pressures persistently above the 95th percentile on four consecutive examinations. Blood pressures and ECGs were recorded during isometric handgrip (25% maximum effort for four minutes) and bicycle ergometry until the subject was exhausted. The hypertensive subjects increased systolic pressure by an average 16 mm Hg with isometric exercise and 53 mm Hg with dynamic exercise. Control subjects had similar pressure changes, averaging 18 and 54 mm Hg, respectively. During isometric handgrip stress, diastolic pressures increased 12 mm Hg in hypertensive subjects and 18 mm Hg in control subjects. Only two hypertensive adolescents developed systolic pressures exceeding 200 mm Hg during dynamic exercise stress, and none developed systolic pressures above 200 mm Hg during isometric exercise stress. None of the normotensive or hypertensive subjects developed cardiac arrhythmias and the prevalence of ST segment depression during maximal stress was less than 2% in both groups. Therefore, in adolescents with mild to moderate hypertension the risk of developing significant ECG or hemodynamic abnormalities during mild isometric or heavy dynamic exercise is small. We believe the decision to restrict physical activity of an adolescent with elevated pressures should be based on the development of abnormal ST segment depression, cardiac arrhythmias, or excessive blood pressures at the time of exercise stress testing.

Adolescent↗
PubMed1977

The differential leukocyte count in the assessment and outcome of early-onset neonatal group B streptococcal disease.

The usefulness of the differential white blood cell count in distinguishing early-onset group B streptococcal disease from other causes of neonatal respiratory distress was studied in 45 infants with culture-proved infection. The initial diagnosis was hyaline membrane disease in 19 infants, wet lung syndrome 13, and other causes of respiratory distress in 13. Thirty-nine (87%) had abnormal absolute neutrophil counts, 25 with neutropenia and 14 with neutrophilia. The absolute immature neutrophil count was elevated in 19 infants (42%). Forty-one infants (91%) had an abnormal immature neutrophil to total neutrophil ratio. All infected infants were identified when both the absolute total neutrophil count and ratio were used. The differential white cell count appears to be a useful tool for screening infants presenting with respiratory distress in the first 48 hours of life and for separating early-onset group B streptococcal disease from other causes of neonatal respiratory distress.

Diagnosis, Differential↗
PubMed1975

Photon absorptiometric analysis of bone density in primary hyperparathyroidism.

The density of bone in the distal third of the radius was measured in 13 men and 17 women with primary hyperparathyroidism. The bone density was significantly reduced (as compared to age-matched controls) in 7 of 11 postmenopausal women. However, it was reduced in only 2 of 13 men and in 1 of 6 premenopausal women. Thus, most of the postmenopausal women with primary hyperparathyroidism had low bone density, whereas most men and premenopausal women with this condition had normal bone density. The results support the conclusion that oestrogen deficiency may contribute to the development of bone disease by sensitising bone to the action of parathyroid hormone.

Adult↗
PubMedDate not supplied

Treatment of "high-flow" priapism with superselective transcatheter embolization: a useful alternative to surgery.

PURPOSE: To review the efficacy of treatment of high-flow priapism with superselective transcatheter embolization. METHODS: Over a 2-year period, we reviewed five patients who were treated for traumatic high-flow priapism with superselective embolization. All patients underwent diagnostic angiography that demonstrated a communication between the cavernosal artery and the corpora cavernosa. Each identified fistula was embolized using gel-foam, blood clot, microcoils, or a combination of these. RESULTS: All five patients had successful detumesence of priapism postprocedure. There was normal recurrence of early morning erection with successful detumescence for each patient within a 2- to 4-week period. Two of five patients (40%) presented with recurrence of priapism at 6 months and required a repeat embolization procedure. At 1 year, four of the five patients (80%) had normal erectile function. CONCLUSION: Superselective transcatheter embolization is a useful therapeutic modality in the treatment of high-flow priapism. It provides equivalent rates of detumesence when compared to surgical techniques, and appears to have a greater success in preserving erectile function.

Adult↗
PubMedDate not supplied

Antibiotic-associated colitis: effects of antibiotics on Clostridium difficile and the disease in hamsters.

Fifteen isolates of Clostridium difficile from hamsters and human patients were inhibited or killed by low concentrations of metronidazole, vancomycin, penicillin, and ampicillin; the isolates were often reesistant to tetracycline, cephalosporins, trimethoprim-sulfamethoxazole, clindamycin, erythromycin, and aminoglycosides. Antibiotics to which C. difficile was susceptible were able to prevent or postpone the colitis caused by clindamycin in hamsters. Colitis could be produced by treatment of hamsters with any one of these antibiotics. Production of colitis not only involved selection of resistant variants, but in some instances seemed to result from the acquisition of organisms after treatment, their persistence despite treatment, or from subinhibitory cecal concentrations of antibiotic (explainable by either pharmacologic factors or enzymatic inactivation). As in humans, no organisms other than C. difficile have been implicated conclusively as etiologic agents of colitis in hamsters. Our results suggest it may be wise to use isolation precautions for patients with colitis caused by C. difficile.

Animals↗