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Biomedical subjects

G J Beirne

Publications and source records attributed to G J Beirne.

At least 19 recordsLinked to original sources
PubMed1986

Procainamide pharmacokinetics in patients on continuous ambulatory peritoneal dialysis.

The pharmacokinetics of procainamide in patients on continuous ambulatory peritoneal dialysis have been studied. A mean peak plasma concentration of 3.2 +/- 0.6 microgram/ml was achieved about 2 h after a single 500-mg oral procainamide hydrochloride dose. The procainamide elimination half-life ranged from 6.1 to 15.3 h. Apparent oral clearance, 183.7 +/- 63.2 ml/min, was less than half that observed in healthy adults suggesting markedly reduced dosage requirements. Continuous ambulatory dialysis patients exhibit similar procainamide pharmacokinetic parameters as do end stage renal disease patients, most notably a prolonged elimination half-life and reduced oral clearance.

Acecainide↗
PubMed1979

"Spontaneous" atheroembolic disease as a cause of renal failure in the elderly.

An 86-year-old man with previous normal renal function was hospitalized because of renal insufficiency. He had a long history of atherosclerotic heart disease, mild hypertension and pulmonary embolism, requiring anticoagulant therapy. In view of the normal-sized kidneys and absence of casts in the urinary sediment, a diagnosis of atheroembolic renal disease was made. The patient's renal function deteriorated, but he refused hemodialysis. Death occurred within a few weeks. At autopsy, severe aortic atherosclerosis was observed and atheroembolic renal disease was confirmed as the cause of renal failure. Occasionally, renal failure can be the sole manifestation of spontaneous atheroembolic disease. This possibility should be considered if the physician is called upon to establish the diagnosis when renal insufficiency develops in atherosclerotic patients.

Acute Kidney Injury↗
PubMed1977

Pseudomonas aeruginosa bacteremia in a dialysis unit. 1. Recognition of cases, epidemiologic studies and attempts at control.

Infections commonly occur in patients undergoing dialysis and have been related to diminished host resistance of uremic patients, the arteriovenous fistulas and bacteriologic contamination of dialysis fluids. The occurrence of four cases of bacteremia due to Pseudomonas, three of which were type 7, and the presence of this serotype in the dialysis fluids suggested an important association between infection and growth of bacteria in the fluids. Attempts to reduce levels of bacteria in the dialysis fluid were unsuccessful using dialysate free of glucose in clinical trial, despite in vitro studies demonstrating poor growth of Pseudomonas in this medium. A filter placed with the recirculating system was only partially successful. The second paper of this series traces the portal of entry of bacteria from dialysate to the blood through reutilized coils.

Cross Infection↗
PubMed1977

Pseudomonas aeruginosa bacteremia in a dialysis unit. 11. Relationship to reuse of coils.

Blood for culture was obtained over a six week period from 17 patients undergoing long-term hemodialysis. Bacteremia was detected during 18 of 201 dialyses. Blood drawn during fifteen of these dialyses contained pseudomonas aeruginosa. Ten of the 17 patients (59 per cent) had a Pseudomonas bacteremia some time during the study. Only one patient was symptomatic. The frequency of positive cultures was related to reuse of coils. No cultures were positive until after the fifth use, but by the tenth use, 41 per cent of the dialyses were associated with bacteremia. All coils that were used repeatedly and 32 of 48 of those used only once, grew Ps. aeruginosa when filled with media and incubated. This suggests that the coils were inoculated during dialysis and that benzalkonium chloride, the sterilizing agent, was unable to eradicate this organism. With repeated uses, the number of residual bacteria in the coil became large enough to cause detectable bacteremia during dialysis.

Cross Infection↗
PubMed1975

Hydrocarbon exposure and chronic glomerulonephritis.

63 adult patients with advanced renal failure were interviewed to evaluate their exposure to chronically contacted or inhaled toxic substances. Grading of exposure revealed that patients with biopsy-proven primary proliferative glomerulonephritis and patients with a clinical presentation consistent with glomerulonephritis had significantly greater exposure than patients with a variety of other renal diseases. Patients with proliferative or suspected glomerulonephritis also had significantly more exposure than age and sex matched controls without renal disease. Hydrocarbon solvents were the most frequent agents of exposure. Further studies to define a possible pathogenic relationship between hydrocarbon exposure and glomerulonephritis are warranted.

Adult↗
PubMed1975

Renal response to short-term hypocapnia in man.

This study examines the renal response to moderate hyperventilation in healthy man. Eight men hyperventilated for 26 hr (PaCO2 approximately 30 to 32 mm Hg) in normoxia (barometric pressure, PB approximately 740 mm Hg) and hypobaric hypoxia (PB approximately530 mm Hg). Anaerobic samples of arterial blood and urine were studied at two-hour intervals. Plasma [HCO3-] fell with time during sustained hypocapnia and after 26 hr was reduced 2.5 mEq/liter, with plasma pH compensated approximately 60%. Statistically significant changes in renal H+ handling were observed within the initial 2 hr of hyperventilation and were evident over the first 12 hr. Over 26 hr, mean total HCO3-excretion in hypocapnia was 10.2 mEq above control and mean total acid excretion (UVTA + UVNH4+) was 17.5 mEq below control. An increased urinary excretion of cations, especially sodium, accompanied the decrease in acid excretion. Plasma lactic acid accumulation was negligible. We conclude that renal mechanisms contribute significantly and relatively quickly to plasma pH compensation during the early phase of adaptation to hypocapnia in man.

Acid-Base Equilibrium↗