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Biomedical subjects

R H Chinn

Publications and source records attributed to R H Chinn.

17 recordsLinked to original sources
PubMed1976

Renal stones and urinary infection: a study of antibiotic treatment.

Twenty-two patients in whom renal calculi and urinary infection were closely associated were studied over two to five years. Four patients had previously had stones surgically removed, and five underwent pyelolithotomy during the course of the study. Urinary infection was treated with an appropriate antibacterial agent, and treatment was followed by long-term prophylaxis, usually with cotrimoxazole. A sterile urine was maintained for long periods in all these patients. In four patients, however, apparent stone growth occurred while the urine was sterile. On entering the study 21 of the 22 patients complained of symptoms. After treatment 19 of the 20 patients who were still attending were symptom-free. Six of the 22 patients entered the study with raised levels of serum creatinine; levels fell in four and remained raised in two. This antibacterial regimen, either alone or after surgery, will usually relieve symptoms and may prevent deterioration of renal function.

Adult↗
PubMed1975

A case of hypopituitarism with diabetes insipidus and loss of thirst. Role of antidiuretic hormone and angiotensin II in the control of urine flow and osmolality.

A 20-yr-old male was found to have diabetes insipidus is association with panhypopituitarism but without any focal neurological lesion being identified. He was initially treated with steroid supplements, the features of diabetes insipidus being controlled with a thiazide diuretic. Eighteen months later the patient lost thirst sensation and stopped treatment, subsequently being re-admitted with severe dehydration, oliguria and focal neurological signs. Further investigation, including brain biopsy, confirmed the presence of an atypical pinealoma which was considered inoperable. Measurements of plasma antidiuretic hormone (ADH) and angiotensin II (AII) concentrations during the severe dehydration showed very high levels of AII, but inappropriately low plasma ADH levels for the severity of dehydration. We consider that the evidence obtained from this case supports the view that the oliguria with hypertonic urine present during severe dehydration was due to a direct renal action of the very high AII levels, possibly supplemented by the residual ADH secretion.

Adult↗
PubMed1973

Recurrent hyperkalaemia due to selective aldosterone deficiency: correction by angiotensin infusion.

A patient with recurrent weakness and blurring of consciousness associated with hyperkalaemia due to aldosterone deficiency is reported. The plasma concentrations of renin, angiotensin II, and aldosterone were low and did not increase during sodium deprivation. Blood angiotensin I was also low while renin-substrate concentration was normal. Infusion of angiotensin produced a distinct rise in plasma aldosterone. The patient was treated successfully with fludrocortisol.The results support the concept that the renin-angiotensin system is an important regulator of aldosterone secretion and that in the syndrome of acquired selective hypoaldosteronism the primary abnormality may be a deficiency of renin. It is suggested that a selective lack of aldosterone should be considered in all cases of otherwise unexplained hyperkalaemia.

Adrenal Glands↗
PubMed1970

Falsely high plasma potassium values in patients with hyperaldosteronism.

The common practice of encouraging forearm exercise as an aid to venepuncture is a potent source of erroneously high plasma potassium levels. This may be sufficient to obscure a suspicion of hyperaldosteronism, with possible serious repercussions in hypertensive patients, in whom the diagnosis of hyperaldosteronism has important therapeutic implications. Plasma is preferable to serum for potassium estimations, and forearm exercise should be avoided before venepuncture for potassium measurements.

Adolescent↗