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Biomedical subjects

H V Braren

Publications and source records attributed to H V Braren.

5 recordsLinked to original sources
PubMed1994

Exposure of intestinal segments to hemiacidrin: analysis of metabolic and histological effects using a rat model.

Using a previously reported rat model, we examined the effects of intestinal perfusion with hemiacidrin on calcium and magnesium homeostasis, and inspected the intestinal segments for histological alterations following exposure to the solution. Intestinal irrigation with hemiacidrin resulted in a significant increase in serum magnesium. Urinary excretion rates of calcium increased 8-fold and magnesium excretion rates increased 5-fold over control values. Hemiacidrin appeared to have detrimental effects on the integrity of the intestinal mucosa, and irrigation should be done with caution in patients whose urinary tract has been reconstructed with intestinal segments.

Animals↗
PubMed1992

Long-term metabolic effects of urinary diversion: a comparison of myelomeningocele patients managed by clean intermittent catheterization and urinary diversion.

We previously reported that chronic urinary diversion through intestinal segments may have adverse effects on bone and mineral metabolism. This study examined the long-term health of patients managed by urinary diversion (94% by ileal conduit) for neuropathic bladders secondary to myelomeningocele defects and compared them to a control population of myelomeningocele patients managed by intermittent catheterization. Of the patients 93 were studied by personal interview, chart review, morphometric analysis, serum studies and dual-photon bone density determination. Average followup was 23 +/- 6 years in the urinary diversion group and 17 +/- 5 years in the intermittent catheterization group. Fractures occurred in 40% of the patients in both groups. Patients with a urinary diversion had an increased need for surgery to correct spinal curvature (57% versus 40%) and a significantly increased incidence of complications resulting from orthopedic procedures (17% versus 3%, p less than or equal to 0.05). There was also an adverse effect on renal function. The urinary diversion group had an increased incidence of radiographic renal deterioration (57% versus 8%, p less than 0.001), nephrolithiasis (43% versus 2%, p less than 0.001), pyelonephritis (60% versus 21%, p less than 0.001) and intermittent metabolic acidosis (20% versus 5%, p = 0.05). Surgery was required in 37% for stomal complications and in 17% for ureterointestinal stricture. Linear growth was adversely affected by urinary diversion. Patients with urinary diversion had decreased lengths for all morphometric parameters and a greater percentage of them were at or below the 10th percentile standards. Serum electrolytes, liver function studies, vitamin D3 and parahormone showed no differences in the 2 groups. No patient had a significant metabolic acidosis at the time of study. Bone densities were significantly diminished in both groups and not significantly different. This study strongly suggests that urinary diversion through intestinal segments is associated with adverse effects on bone health.

Bone Density↗
PubMed1984

Percutaneous nephrostomy in neonates, infants, and children.

In a 20-month period, 13 percutaneous nephrostomies were placed in 10 pediatric patients ranging in age from one day to six and one-half years. The procedure was successful in all cases with no significant complications. Final diagnoses included ureteropelvic junction obstruction, ureterovesical junction obstruction, posterior urethral valves, and pyonephrosis. Localization of the obstruction as detected on initial antegrade nephrostography was found to be incomplete or incorrect in three patients. In one patient, both ureteropelvic and ureterovesical junction obstruction were present. In the other two patients, the misdiagnosis probably related to the difficulty of filling a distended, obstructed ureter prior to drainage.

Age Factors↗
PubMed1983

Practical experience with percutaneous nephrostomy: avoidance of common technical pitfalls.

In our 18-month experience with percutaneous nephrostomy (PCN) at Vanderbilt University Hospital and Veterans Administration Hospital (Nashville), a total of 47 PCNs were attempted with a success rate of 96%. The procedure is rapid, offers low morbidity, and has been readily accepted. Some variations of the standard procedure to avoid common technical difficulties include (1) using a combination of real-time ultrasonography and fluoroscopy as a guidance system, (2) maintaining the position of the Chiba needle during the entire procedure, (3) choosing the optimal puncture site, and (4) exercising care in tract dilatation.

Adolescent↗