Biomedical subjects
R R Bailey
Publications and source records attributed to R R Bailey.
Goodpasture's syndrome with normal renal function.
Two young men with anti-glomerular basement membrane (anti-GBM) antibody-induced Goodpasture's syndrome are described. Despite the characteristic renal morphological features and high titers of anti-GBM antibody, they had normal renal function. Both patients recovered spontaneously without treatment and remain well with normal renal function more than four years after presentation. The use of more sensitive diagnostic techniques has demonstrated that there is a broad spectrum of clinical severity in this disease and that mild cases can be expected to have a good outcome.
Quick prediction of creatinine clearance without the necessity of urine collection.
The Cockcroft-Gault formula enables a rapid prediction of the creatinine clearance (CCr) to be made without having to collect urine and using the variables of plasma creatinine, body weight, sex and age. The formula was used to predict the CCr in 100 consecutive patients and comparisons made with the measured CCr and the 51chromium EDTA clearance. The advantages of being able to quickly predict the creatinine clearance using this formula are discussed.
Vitamin K deficiency developing in patients with renal failure treated with cephalosporin antibiotics.
Five patients developed vitamin K-related abnormalities in blood coagulation during treatment with parenteral cephalosporin or cephamycin antibiotics. All the patients had significantly impaired renal function and complicated medical problems. The coagulation defect was corrected with vitamin K therapy.
Treatment of uncomplicated urinary tract infections with a single dose of co-trimoxazole.
Sixty-four women with an uncomplicated urinary tract infection were randomly allocated to receive treatment with either an 0.96 g, 1.92 g or 2.88 g single oral dose of co-trimoxazole or a conventional five-day course of co-trimoxazole. The success of each group was comparable although it is suggested that a single dose should be at least 1.92 g (four tablets Septrin or Bactrim). This study confirmed previous work that single dose therapy was effective and well tolerated, preferred by the patients and side effects were minimal. This approach to treatment should be strongly encouraged.
Malignant hypertension developing while on captopril.
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Systemic disorders affecting the kidney.
The renal lesion may be the most serious manifestation of a systemic disease. In the past six years 112 patients have had a renal biopsy as part of the evaluation of a systemic disorder. These patients are documented and some of the important observations highlighted. The greatest benefits have been in assessing the extent and severity of the renal involvement and using this information to make decisions regarding management and prognosis.
Netilmicin in the treatment of severe or complicated urinary tract infections.
Netilmicin is a new aminoglycoside antibiotic with pharmacological similarities to gentamicin, tobramycin and sisomicin. Fourteen of 15 patients with a severe or complicated urinary tract infection were cured by treatment with a seven day course of netilmicin. In one patient the infecting organism was not eradicated. No significant side effects were noted and no ototoxicity was detected. Four patients had a significant, but reversible, deterioration in renal function as defined by an increase in the plasma creatinine of 0.03 mmol/l or greater. Work in experimental animals has shown netilmicin to be significantly less ototoxic and nephrotoxic than other clinically available aminoglycosides. If this finding is confirmed in large-scale comparative trials in man, netilmicin should prove a most useful and effective new antibiotic for the treatment of severe gram-negative sepsis.
Plasma and urine concentrations of acebutolol and its acetyl metabolite in patients with renal functional impairment.
This study was undertaken to examine the elimination of orally administered acebutolol and its major acetyl metabolite in four healthy controls and seven patients with varying degrees of renal functional impairment. Analysis of acebutolol and its metabolites was undertaken using a high performance liquid chromatographic method. Plasma concentrations of acebutolol and the acetyl metabolite were greater in patients with renal functional impairment than in controls. The elimination of acebutolol did not appear to be influenced by impaired renal function. However the elimination of the acetyl metabolite decreased as renal function diminished. Acebutolol has a major non-renal route of elimination, but the acetyl metabolite (also a beta-adrenoreceptor blocking drug) is primarily excreted by the kidney and may accumulate in renal failure.
Disseminated mucocutaneous herpes simplex type 2 infection in a renal transplant recipient: response to adenine arabinoside (Vidarabine).
A 27-year-old woman with a well-functioning cadaveric renal transplant presented with recurrent mucocutaneous herpes simples type two infection associated with a severe systemic illness. Two courses of treatment with adenine arabinoside (Vidarabine) were associated with rapid healing of the herpetic lesions and an improvement in her general condition. Treatment was associated with nausea but no toxic effect were noted.
Cimetidine and thrombocytopenia.
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Potentiation of warfarin action by sulphinpyrazone.
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Comparative trial of sulphadiazine-trimethoprim (co-trimazine), co-trimoxazole and sulphamethizole in the treatment of uncomplicated urinary tract infections.
A combination of sulphadiazine and trimethoprim (co-trimazine) has been developed specifically for the management of urinary tract infections. The pharmacokinetics of co-trimazine make it possible to use lower doses of both the sulphonamide and trimethoprim than in co-trimoxazole, while maintaining clinical efficacy. One hundred and twenty women with a urinary tract infection were randomly allocated to a five-day course of treatment with either co-trimazine (sulphadiazine 410 mg and trimethoprim 90 mg 12-hourly), co-trimoxazole (sulphamethoxazole 800 mg and trimethoprim 160 mg 12-hourly) or sulphamethizole (1 g 8-hourly). The respective cure rates were 95, 98 and 90 percent. No serious side effects of therapy were encountered. Co-trimazine proved to be an effective antibacterial combination for the treatment of uncomplicated urinary tract infections.
A renal lesion in ankylosing spondylitis.
2 patients with ankylosing spondylitis (A Sp) were found to have renal lesions similar to those seen in IgA nephropathy. In 1 patient the changes were extremely severe and progressive and in the other they were mild. Vascular changes were also noted in 1 patient. The findings suggest an immune complex mediated glomerulonephritis and support an earlier report that there may be a specific renal lesion in patients with A Sp. The significance of IgA deposition in the mesangium, and of an increase in the serum levels of IgA in some patients with A Sp is unclear.
A renal lesion in a woman with Reiter's disease.
A 17 year old girl with Reiter's disease had extensive involvement of the entire urinary tract in addition to arthritis, vaginitis, and ocular involvement. In addition to a severe urethritis, cystitis and ureteritis there was evidence of glomerular and tubular dysfunction and abnormalities were seen on renal biopsy. The patient was treated with a five week course of doxycycline and made a slow but complete recovery.
Diuretic dependence and diuretic-induced oedema.
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Lithium and the kidney.
Three middle-aged women treated with lithium carbonate for a manic-depressive illness have had complicating nephrogenic diabetes insipidus, renal tubular acidosis, acute reversible renal functional impairment in association with hypercalcaemia, or irreversible chronic renal damage. Renal toxicity developed in the presence of normal levels of lithium in the serum. The possibility of permanent renal damage as a result of long-term lithium therapy is of major concern.
Generic equivalents of frusemide.
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