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Biomedical subjects

D Brophy

Publications and source records attributed to D Brophy.

7 recordsLinked to original sources
PubMed2001

Combined iliac angioplasty and infrainguinal revascularization surgery are effective in diabetic patients with multilevel arterial disease.

The success of percutaneous transluminal angioplasty (PTA) in the treatment of common and external iliac atherosclerotic lesions has been established for the general population. However, several studies have suggested that the presence of diabetes may reduce the effectiveness of iliac angioplasty, particularly in the setting of limb-threatening ischemia requiring concomitant lower extremity revascularization. This study compared the results of iliac artery PTA performed in conjunction with infrainguinal bypass for limb-threatening ischemia for diabetic (DM) and nondiabetic (non-DM) patients. Between 1991 and 2000, 159 PTA were performed in 126 patients (DM = 99/79%, non-DM = 27/21%) in conjunction with subsequent infrainguinal bypass for limb-threatening ischemia (gangrene = 42%, ulcer = 36%, rest pain = 22%). These patients were followed prospectively using a computerized vascular registry. Stents were placed in 34 (21.4%) cases for suboptimal angioplasty results. In this study the combined use of standard surgical and endoluminal modalities for the treatment of multilevel arterial occlusive disease resulted in excellent cumulative patency and limb salvage rates. The presence of diabetes did not alter these favorable results. Multimodal vascular therapy may be used effectively in diabetic patients with limb-threatening ischemia due to multiple levels of arterial occlusion.

Aged↗
PubMed1995

Do alpha-blockers have a role in lower urinary tract dysfunction in multiple sclerosis?

Lower urinary tract dysfunction is a major cause of morbidity in patients with multiple sclerosis. alpha 1-Adrenergic receptors are present at the bladder neck, where increased tone may be responsible for urinary retention and diminished flow rates. A randomized placebo controlled study was designed to test the hypothesis that blockade of these receptors using the selective alpha 1-adrenergic receptor antagonist indoramin would improve bladder emptying in patients with multiple sclerosis. Peak and mean urinary flow rates, residual volume and symptom score were evaluated at trial entry and again after 4 weeks in 18 men with multiple sclerosis. There was a mean 41% improvement in peak flow rate in the actively treated group compared with a 7.4% deterioration in the placebo group (p < 0.05). Residual volume improved in both groups. Patients taking indoramin reported a greater improvement in urinary symptoms. Modulation of the alpha 1-receptor may have a role in the management of lower urinary tract dysfunction in multiple sclerosis.

Adrenergic alpha-Antagonists↗
PubMed1980

Acute tubular necrosis after renal transplantation.

We evaluated the influence of dialysis requiring acute tubular necrosis on patient survival, and kidney survival and function in all 182 patients who needed dialysis immediately after transplantation at the University of Minnesota Hospitals. When compared to matched control patients not requiring dialysis, there was no difference at any point in patient survival. At 1 month there were more kidneys lost in the patients who developed acute tubular necrosis, but this difference was not present at 3 months or later. Acute tubular necrosis is a relatively innocent complication of renal transplantation and, if one avoids assaulting patients with invasive diagnostic procedures, does not give rise to an increased mortality nor, in the long run, to an increased loss of kidneys. Therefore, kidneys should not be discarded because of fear they might develop this complication.

Acute Disease↗