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Biomedical subjects

R Shepherd

Publications and source records attributed to R Shepherd.

108 records · Page 6Linked to original sources
PubMed1981

Association of HLA and renal cell carcinoma.

HLA-A,B,C, and DR antigen frequencies were studied in a patient population with a history of renal cell carcinoma. HLA-DR5 was found in 54% of patients, which is significantly elevated over control values (20%; p less than .01). On the other hand, HLA-A,B, and C locus antigen frequencies were not abnormal compared to controls.

Adenocarcinoma↗
PubMed1980

Improved growth and clinical, nutritional, and respiratory changes in response to nutritional therapy in cystic fibrosis.

To investigate the role of nutritional factors in growth and in the clinical, nurtitional, and respiratory status in cystic fibrosis, we studied 12 problem CF patients from six months before to six months after a period of supplemental parenteral nutrition. During the initial six months' observation period on appropriate conventional therapy, the patients (aged 0.5 to 11 years) had inadequate growth and weight gain, a total of 21 active pulmonary infections, and, despite dietary supplements, inadequate ad libitum nutrient intakes. After nutritional therapy, providing a balanced consistent hypercaloric intake for 21 days, catch-up weight gain occurred by one month and continued at six months; catch-up in linear growth was observed by three months and continued at six months. In addition, significantly fewer pulmonary infections were observed in the six months' post-therapy (n = 3), sustained and significant improvements were noted in clinical score and plumonary function, and there was a marked improvement in well-being and ad libitum nutrient intake. We conclude that adequate nutritional support can favorably affect growth, clinical status, and the course of chronic pulmonary disease in problem cases of CF.

Body Weight↗
PubMed1980

An investigation of Encephalitozoon cuniculi in the wild rabbit Oryctolagus cuniculus in Victoria, Australia.

Sera from 823 wild rabbits (Oryctolagus cuniculus) collected from a number of geographic regions of Victoria, Australia over the past eight years were examined for antibodies to Encephalitozoon cuniculi, along with sera from 46 hares (Lepus europaeus) (Pallas) and 57 New Zealand wild rabbits. No sera were positive, implying that this common laboratory rabbit parasite is absent from wild rabbits in these areas. However, wild rabbits were found to be readily infected by the oral route with small numbers of tissue-culture-grown spores of E. cuniculi. A possible explanation for the absence of encephalitozoonosis in wild rabbits is that E. cuniculi infection places them at a biological disadvantage for survival. The natural hygiene habit of wild rabbits may also significantly decrease post-natal infection.

Animals↗
PubMed1980

Criteria for the selection of second-generation platinum compounds.

Our selection of a potential second-generation platinum compound began with an initial short list of 8 compounds selected on the basis of antitumour and toxicity studies in mice. We now report further, more detailed investigations of the renal toxicity and antitumour activity of one of these compounds, cis-dichloro trans-dihydroxy bis isopropylamine platinum (IV) (CHIP), in comparison with cis-dichloro diammine platinum (II) (Neoplatin). CHIP was a more effective anti-tumour agent against both alkylating-agent sensitive and resistant strains of the Yoshida sarcoma (YSS and YSR respectively) than was Neoplatin. In addition CHIP produced negligible kidney toxicity as measured by blood urea levels. We have also compared the effects of these two drugs on nuclear-protein phosphorylation, in an attempt to gain insight into their molecular mode of action. Both Neoplatin and CHIP induced increased nuclear-protein phosphorylation in the YSS tumour cells, and loss of condensed chromatin. However, CHIP also induced increased nuclear-protein phosphorylation and loss of condensed chromatin in the YSR tumour cells. These changes correlated well with cell death. In addition Neoplatin, but not CHIP, treatment caused increased nuclear-protein phosphorylation in kidney tissues. This correlated with kidney damage as measured by blood urea levels. These selection criteria suggested that CHIP would be a more selective antitumour agent than Neoplatin, and will provide a basis for its comparison with the other 7 compounds.

Animals↗
PubMed1978

Successful pregnancy in a 44-year-old haemodialysis patient.

A 44-year-old patient had been treated by intermittent haemodialysis for almost three years when she presented with a 28-week pregnancy. Successful delivery of a healthy but small infant was achieved by Caesarean section at 36 weeks. The successful outcome of this pregnancy was attributed to close control of the haemoglobin concentration and blood chemistry, and to increased frequency of dialysis. The relative value of various chemical tests of fetal maturity in the presence of maternal renal failure are discussed.

Adult↗
PubMed1977

Protracted diarrhoea in infancy. Analysis of 82 cases with particular reference to diagnosis and management.

Eighty-two cases of protracted diarrhoea in infancy presenting over a 6-year period have been analysed, with particular reference to diagnosis and management. The patients fell into 1 of 2 categories according to whether a specific diagnosis was established or not. A diagnosis (category 1) was established in 59 (72%), the commonest diagnoses being coeliac disease (33-2%), secondary disaccharide intolerance (12-2%), and cows' milk protein intolerance (12-3%). Other diagnoses included primary sucrase-isomaltase deficiency, Shwachman's syndrome, ulcerative colitis, ganglioneuroma, defective opsonization, staphylococcal pneumonia, and Hirschsprung's disease. Despite intensive investigation in diagnosis could not be established in 23 (28%) infants (category 2). Age of onset of symptoms in this group tended to be earlier than in category 1 patients, and 6 (7%) presented with diarrhoea dating from birth. Of particular interest in these 6 patients was the high incidence of associated extraintestinal anomalies, and of sibs who had died after protracted diarrhoea dating from birth. 4 of these 6 infants died, accounting for a mortality of 5% for the whole series. The remaining 17 (21%) patients in category 2 presented at a mean age of 4-9 weeks with a range of 1-18 weeks. All these 17 patients made an excellent response after institution of a chicken-based dietary formula, the details of which are presented. The pathophysiological mechanisms which may be operating in infants with protracted diarrhoea are discussed.

Animals↗
PubMed1976

Clinical comparison between glucose and sucrose additions to a basic electrolyte mixture in the outpatient management of acute gastroenteritis in children.

In a double-blind trial in 94 children attending outpatients the value of glucose or a sucrose addition to a basic electrolyte mixture for the management of acute gastroenteritis was compared. Of the children treated with added sucrose 10% failed to respond compared with 27% of those treated with added glucose. This difference was significant (P=0-05), but the time to recovery in those in the two groups who responded to treatment was not significantly different. Thus, despite theoretical advantages, there was no practical advantage in using glucose rather than sucrose. A 5% sucrose electrolyte solution with its relatively low osmolality, ready availability, and ease of preparation is recommended as the treatment of choice in the outpatient management of acute gastroenteritis in infancy.

Child, Preschool↗
PubMedDate not supplied

Wilson's disease in an Australian aborigine.

Wilson's disease is due to a genetically determined defect inherited as an autosomal recessive trait. Most reported cases have been caucasoid. This report describes a case of Wilson's disease in an Australian Aboriginal girl, only the second such case reported.

Child↗
PubMedDate not supplied

Energy expenditure in infants in health and disease.

Measurement of energy balance represents a basic theoretical concept in the determination of nutritional and fluid requirements in humans in health and disease. Infants have special nutrient requirements, more limited reserves and relative immaturity of organ function. Energy requirements of infants have been based either retrospectively on intakes required to achieve normal growth or on equations derived from energy expenditure studies performed early this century. Recently, improved techniques for studying resting energy expenditure (REE), total energy expenditure (TEE) and metabolically active body compartments in infants have facilitated more accurate estimates of energy requirements. Such studies indicated that current reference values for energy requirements are overestimates, and that compared with measured values, predicted values vary markedly between the various predictive equations with wide co-efficients of variation. In disease states with altered body composition, such as cystic fibrosis and end-stage liver disease, predictive equations markedly underestimate both energy and fluid requirements. In cystic fibrosis, both TEE and REE are 25% higher than values in healthy infants. In extrahepatic biliary atresia, energy expenditure per unit body cell mass is markedly elevated, suggesting that this is a catabolic condition in infants. Current estimates of energy and fluid requirements in both health and disease in infants need reappraisal. Bedside and free living energy expenditure methodology should be used to define accurately components of energy requirement in individual infants.

Biliary Atresia↗
PubMedDate not supplied

Congenital nasolacrimal duct obstruction: natural history and the timing of optimal intervention.

Nasolacrimal duct obstruction (NLDO) is a relatively common clinical problem. Debate continues about optimal management. Intervening early and intervening late each have advantages and disadvantages. We reviewed the world literature on NLDO. We assembled information on occurrence, natural history, and results of treatment. Spontaneous remission data were used to derive the probability of continued obstruction versus age. The prevalence a hypothesized treatment-resistant form of NLDO was estimated. Symptomatic NLDO probably occurs in 5 to 6% of infants. Given a symptomatic case under the age of 14 months, the probability of spontaneous remission within the following month appears to be approximately one of three. Probe failure risk increases with age, doubling every 6 months. Increasing probe failure risk may be due to self-selection. Preliminary analysis of management strategies suggests that lacrimal duct probing at age 4 months in the office is the most cost-effective strategy. Further descriptive studies of NLDO remission and treatment are indicated.

Age Factors↗