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Biomedical subjects

B H Barbour

Publications and source records attributed to B H Barbour.

At least 19 recordsLinked to original sources
PubMed1977

Sympathetic nerve hyperactivity in high-renin hypertension effects of saralasin infusion.

We found increased levels of catecholamines in some patients who had high-renin hypertension. To study relations between angiotensin and the sympathetic nerves further, we infused saralasin, a blocker of angiotensin II, into 11 hypertensive patients being evaluated for renovascular hypertension. There were variable responses of mean arterial pressure, plasma renin activity, and norepinephrine levels. When high-renin hypertensive patients with increased levels of norepinephrine were compared with those having high renin and normal levels of norepinephrine, they showed a lesser decrease in mean arterial pressure--5 +/- 5% versus 14 +/- 4%, P less than 0.05--a decrease in plasma renin activity of 20 +/- 17% versus an increase of 77 +/- 24% (P less than 0.01), and a decrease in norepinephrine levels of 42 +/- 7% versus an increase of 10 +/- 23% (P less than 0.05) (means +/- SE). The evidence suggests that patients with high-renin levels are heterogeneous and that the primary mediator of the hypertension is sympathetic tone hyperactivity in those with increased levels of norepinephrine and angiotensin excess in those with normal levels of norepinephrine.

Adolescent↗
PubMed1976

Barbiturate intoxication. Morbidity and mortality.

The complications encountered in caring for 185 patients intoxicated with barbiturates were reviewed. The population consisted of 142 patients with long-acting barbiturate concentrations of 8 mg per 100 ml or greater, 20 patients with short-acting barbiturate concentrations of 3 mg per 100 ml or greater and 23 consecutive patients with short-acting barbiturate intoxication referred for monitoring. Pneumonia was the major cause of morbidity and mortality and correlated best with the initial depth of coma and the use of an endotracheal tube in treatment. Cardiovascular instability manifested by pulmonary edema was the next leading cause of morbidity and mortality and correlated best with the initial depth of coma and the quantity of intravenous fluid administered. In retrospect, use of eliminative measures such as dialysis would probably not have altered the outcome in most of the patients who died and attempts at forced diuresis may have contributed to several deaths. Particular emphasis should be placed on the problems of sepsis and fluid therapy in the management of these patients.

Adolescent↗
PubMed1976

Renal damage in systemic lupus erythematosus with normal renal function.

Renal biopsies were performed on 12 patients with definite systemic lupus erythematosus (SLE) with normal renal function. Three had had previous nephropathy which responded to treatment, with return of urinalysis and function to normal. Specimens were studied using light microscopy (LM), immunofluorescence (IF), and electron microscopy (EM). Mild to moderate abnormalities were found in all patients. Changes by LM (primarily hypercellularity) were found in 11 specimens (no glomeruli were obtained in one) and classified as inactive. IF studies were positive in eight of the 12 biopsies with either focal or diffuse distribution of IgG, IgM, and/or C3. EM changes were observed in all cases and were of mild to moderate severity. They included focal to multifocal glomerular hypercellularity, basement membrane thickening, foot process fusion, and mesangial and intramembranous electron dense deposits. No subepithelial or subendothelial deposits were found. Microtubular structures were present in three specimens. These data suggest that careful study of renal biopsy specimens may reveal evidence of kidney involvement in all patients with SLE.

Antibodies, Antinuclear↗
PubMed1975

Clinical use of NISR 440 polycarbonate membrane for hemodialysis.

1. In order to accredit the NISR440 Polycarbonate Membrane for clinical studies, the following was accomplished and/or established: a. Casting and synthesis were increased from the laboratory level to production scale. b. Quality control of permeabilities and physical properties was within +/- 5%, from membrane lot to lot and within the same roll. c. The target properties of the Artificial Kidney Program (NIH) were reached(7): 1) Middle M. W. solute permeability of marked molecules was established by 3 different laboratories and averaged: Vitamin B12 - 296 x Cuprophan¿; Inulin 3.6 x Cuprophan¿; Bacitracin 2.94 x Cuprophan¿. 2) Low M. W. species permeabilities were approximately the same as Cuprophan¿, to avoid a depletion syndrome. 3) Hydraulic permeability was essentially the same as Cuprophan¿ (UF rate 1.25 to 2.0 x Cuprophan¿) to avoid dehydration and hypotension. 4) Burst strength was 1.5 to 2.0 x Cuprophan¿. d. Toxicology studies were all negative in spot and in serial lot testing. e. Non-thrombogenicity tests (Lindholm test) were up to 36.6% better than Cuprophan¿. f. No protein adsorption was found. g. The membrane could be produced in the wet and dry state with the same permeability and physical properties. 2. In an earlier clinical study at USC, it was established that: a. There were no toxic effects manifested in patients in 25 episodic studies. b. Clearances forlow M. W. solutes and hydraulic permeabilities were, as targeted, approximately the same as Cuprophan¿. c. In 4 1/2 mos of a double blind study of 6 patients, no significant toxic effects were noted for either the patients on Cuprophan¿ or NISR 440 Polycarbonate Membrane. Two patients had an increase of hematocrit. 3. The ability to heat seal the membrane in the periphery and in channels through many layers, combined with its relative rigidity when wet, make possible clinical hemodialyzer designs approximately the size of a package of cigarettes and inexpensive to produce.

Adult↗