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Biomedical subjects

H L Butler

Publications and source records attributed to H L Butler.

7 recordsLinked to original sources
PubMed1986

Apparent gut excretion of Tc-99m-DISIDA in a case of extrahepatic biliary atresia.

Our patient had DISIDA scan at 39 days of age to exclude biliary atresia. Gut excretion was seen 18 h after injection and the diagnosis of neonatal hepatitis was made. Because of continued elevated liver function values, liver biopsy was performed and demonstrated findings consistent with biliary atresia. Exploratory laparotomy performed 8 days after the scan showed patent cystic duct, bile duct, and gallbladder, but an atretic common hepatic duct. This case is an example of documented biliary atresia demonstrating gut excretion on the DISIDA scan.

Bile Ducts↗
PubMed1986

Munchausen syndrome by proxy.

Munchausen syndrome by proxy is a form of child abuse in which a disorder of the child is fabricated by a parent. Although often considered rare, it may have been overlooked frequently in the past. The reported cases of children with Munchausen syndrome by proxy range in age from infancy to 8 years. Their "illnesses" consist of fabricated histories, inflicted physical findings, altered laboratory specimens, and induced disorders. The perpetrator usually is the child's mother, who may have Munchausen syndrome. Consequences of the syndrome may include painful tests, frequent hospitalizations, potentially harmful treatment, and death. The diagnosis can be made when medical and social histories are characteristic of the syndrome and clinical findings are absent, suggestive of induced illness, or resolve upon separation of the child and parent. Suspicion of the syndrome should be discussed with the family once the safety of the child is insured, and the case should be reported under the child abuse reporting law of the state. Social, family, and medical histories must be obtained and verified, and court intervention should be considered. Four patients who illustrate typical features of the syndrome are described.

Child↗
PubMed1981

Depressed neutrophil chemotaxis in infants with cow's milk and/or soy protein intolerance.

Neutrophil chemotaxis and random migration were studied in 11 infants with active cow's milk and/or soy protein intolerance and in an additional four infants following clinical recovery. Results were compared to 15 age-matched control subjects. Infants with active intolerance exhibited depressed chemotaxis and enhanced random migration. The four recovered infants had values similar to those of control subjects.

Animals↗
PubMedDate not supplied

Metoclopramide pharmacokinetics and pharmacodynamics in infants with gastroesophageal reflux.

The pharmacokinetics and pharmacodynamics of metoclopramide oral solution were evaluated in six infants (0.9-5.4 months) with gastroesophageal reflux (GER) following the initial and 10th dose of 0.15 mg/kg administered every 6 h. Metoclopramide pharmacodynamics were assessed by pre- and post-dose comparison of esophageal pH monitoring data and clinical evaluation of improvement in GER symptoms. A significant reduction in the number of episodes of pH less than 4 for greater than 5 min and the longest episode of GER was seen between the predose and 10th dose (steady-state) evaluation periods. Four of the 6 patients had a 75% reduction in reflux time and demonstrated improvement in clinical symptoms by the 10th dose. Metoclopramide pharmacokinetics were best characterized by a one-compartment open model following the first and 10th doses. Metoclopramide serum concentrations (mean +/- SD) ranged from 56.2 +/- 23.5 to 32.7 +/- 13.2 ng/ml within a 6-h dosing interval at steady state. There were no significant differences between the first versus tenth dose values for Tmax (2.0 +/- 0.5 versus 2.2 +/- 0.4 h), Kel (0.14 +/- 0.03 versus 0.17 +/- 0.04 h-1), Vdarea (4.9 +/- 0.4 versus 4.4 +/- 0.6 L/kg), or clearance (0.66 +/- 0.16 versus 0.67 +/- 0.13 L/h/kg). The youngest subject (3.5 weeks) had a metoclopramide t 1/2 of 23.1 h following initial dose, which decreased to 10.3 h at steady-state. Care should be exercised in using the 0.15 mg/kg dose in infants less than 1 month of age as prolonged clearance may produce excessive serum concentrations.

Absorption↗