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Biomedical subjects

R R Bailey

Publications and source records attributed to R R Bailey.

At least 253 records · Page 14Linked to original sources

Acebutolol in the treatment of patients with hypertension and renal functional impairment.

Eleven patients with hypertension and varying degrees of stable renal functional impairment were treated with the beta adrenoreceptor blocking drug, acebutolol (Sectral). Parameters of renal, cardiovascular and respiratory function were measured immediately prior to treatment and again after four and 12 weeks. In five patients the blood pressure was well controlled throughout the 12-week period on 400mg of acebutolol each morning, in three the blood pressure was satisfactory after four weeks treatment with 400mg each morning but control had been lost by 12 weeks, while in the remaining three patients 800mg each morning was ineffective. There was no significant change in the mean glomerular filtration rate of the 11 patients but in two of these patients with severe, but stable, chronic renal failure the introduction of acebutolol was associated with a decline in renal function and the onset of uraemic symptoms. One of these patients showed an improvement when the acebutolol was discontinued but the other required regular dialysis treatment. Beta adrenoreceptor blockers should be used cautiously in severe renal failure.

Acebutolol↗

Urinary tract obstruction and renal failure due to uterine prolapse.

Three women are described in whom obstructive uropathy was found secondary to uterine prolapse. Two of these patients had severe renal failure. It is important to exclude this condition in any woman presenting with renal functional impairment. Potentially damaging urinary tract obstruction should be considered in every patient with a uterine prolapse.

Female↗

Serum beta2-microglobulin in the assessment of renal function.

This study was undertaken to compare the serum beta2-microglobulin (beta2-m) as a test of renal function with the plasm creatinine and the glomerular filtration rate as estimated by the 24 hour endogenous creatinine clearance and the single injection 51Cr EDTA clearance method. Of the 33 patients with a variety of renal diseases and the four healthy volunteers studied, an excellent correlation was found between the serum beta2-m concentration (measured by radioimmunoassay) and the plasma creatinine, the creatinine clearance and the 51Cr EDTA clearance. When a more simple and less expensive method becomes available for the measurement of serum beta2-m it could prove a useful test of renal function. The assay of beta2-m in the urine could prove valuable for assessing whether proteinuria is glomerular or tubular in origin.

Beta-Globulins↗

Sisomicin in the treatment of severe or complicated urinary tract infections.

Sisomicin is a new aminoglycoside aminocyclitol antibiotic with pharmacological similarities to gentamicin and tobramycin. Fourteen of 24 patients with a severe or complicated urinary tract infection were cured by treatment with a 4-14 day course of sisomicin. In three patients the organism was not eliminated, in one there was a relapse with the same organism while in the remaining six patients a new pathogen (a gram-positive organism in five of these six) appeared within three to six days of completing the course of treatment. The initial infecting organism was therefore eradicated in 20 of the 24 patients treated. This drug should prove beneficial for the treatment of severe gram-negative sepsis.

Adult↗

Renal vein renin concentration in the hypertension of unilateral reflux nephropathy.

Hypertension is a frequent complication of reflux nephropathy. The cause of this hypertension is unknown. Our study was undertaken to assess the possible role of the renin-angiotensin system in the hypertension associated with unilateral reflux nephropathy. We selected for study 17 normotensive and 12 hypertensive patients with strictly unilateral reflux nephropathy. There were 3 normotensive and 2 hypertensive patients with a renal vein renin ratio exceeding 1.5. Of these 3 normotensive patients 1 had evidence from divided renal function studies to suggest functional renal ischemia. No consistent evidence was obtained to support the concept that the renin-angiotensin system has a primary role in the non-malignant hypertension of unilateral reflux nephropathy.

Angiotensin II↗

Tamm-Horsfall protein in the glomerular capsular space.

Tamm-Horsfall protein was detected within the capsular space by immunofluorescence in 7 of 72 consecutive patients on whom renal immunopathological studies were performed. Three patients showed prominent aggregates or crescentic collections affecting 30-50% glomeruli; the remaining four patients showed smaller aggregates between lobules. All patients showed pathological evidence of tubulointerstitial disease. It is suggested that Tamm-Horsfall protein in the capsular space is a sign of intratubular urinary backflow and that Tamm-Horsfall antiserum is a useful addition to the reagents used in the immunofluorescence study of renal biopsies.

Adult↗

Oliguria and its sequelae.

Fifty-nine patients were seen with oliguria in 1975. Forty had acute renal failure (ARF) and 19 rapidly reversible oliguria (RR). The causes of the oliguria were medical (64%), surgical (27%) and obstetrical (9%). The following were valuable in the assessment of patients with oliguria: urine sodium concentration (UNa) and osmolality, coagulation studies and high dose intravenous urography. Patients presenting with a high UNa or a coagulation abnormality were more likely to have ARF. Central venous pressure monitoring was helpful in the initial management but the administration of diuretics was not. Twenty patients with ARF were treated conservatively and the remainder by dialysis. Infection was both the commonest complication of ARF and the most frequent cause of death. Seventy percent of those with ARF died. Death was more common in the elderly or patients with a medical aetiology. The mortality of ARF remains high in spite of advances in the management of its metabolic and infective complications because of the acceptance of more high risk patients. An improved awareness of the preventable causes of oliguria is apparent.

Acute Kidney Injury↗

Tobramycin in the treatment of severe and complicated urinary tract infections.

Tobramycin is an aminoglycoside aminocyclitol antibiotic with pharmacological similarities to gentamycin. Twenty-one of 30 patients with a severe or complicated Gram-negative urinary tract infection were cured by treatment with a 5-day course of tobramycin. No side effects were noted. This drug should prove beneficial for the treatment of severe Gram-negative sepsis, and promises to be particularly valuable for infections due to Pseudomonas aeruginosa. Dosage schedules for administering tobramycin to patients with renal function impairment are presented, together with some observations on its intravenous injection by bolus. A single dose of tobramycin has proved effective for initiating the antibacterial treatment of patients with acute pyelonephritis. The important concept of the differing concentrations of an antibiotic in the urine from kidneys of unequal function is discussed.

Acute Disease↗

Prazosin in the treatment of patients with hypertension and renal functional impairment.

Prazosin was used as an additional antihypertensive agent for treating 38 patients with hypertension and renal functional impairment. The drug was effective in 29 of these patients at a mean daily dose of 7 mg. The mean blood pressure fall in these 29 patients was 28/22 mm Hg. The most frequent (10 patients) and important side effect of prazosin treatment was dizziness, which occurred on standing of after exertion and was seen either after the first dose or after a large dose increase. The "first-dose phenomenon" was a result of severe postural hypotension and was eliminated by using a starting dose of 0-5 mg every 12 hours, with the first dose being given before retiring to bed. Dosage increments were limited to 0-5 mg, beginning late in the evening. Eleven patients had a significant improvement in renal function, while a further eight patients had stable renal function. In no patient was there a deterioration in renal function which could be attributed to prazosin.

Female↗

Nalidixic acid.

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Drug Resistance, Microbial↗