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L H Harrison

Publications and source records attributed to L H Harrison.

At least 109 records · Page 6Linked to original sources
PubMed1988

A day care-based study of the efficacy of Haemophilus b polysaccharide vaccine.

To assess the efficacy of the Haemophilus b polysaccharide vaccine following licensure and to evaluate the risk of Haemophilus influenzae type b (Hib) disease in the week following vaccination, we conducted a day care-based case-control efficacy study using cases of invasive Hib disease ascertained through active surveillance in areas with a total population of 34 million. For each patient 18 to 59 months old, up to three 18- to 59-month-old controls were chosen from the same day care classroom. Using conditional logistic regression, the vaccine efficacy was estimated to be 45% (95% confidence interval = -1% to 70%) and did not change significantly after accounting for potential biases. In addition, three (3%) of 104 patients vs five (2%) of 207 controls were vaccinated within seven days before the patients' dates of admission (odds ratio = 1.8, 95% confidence interval = 0.3 to 10.2), which does not suggest an increased risk of Hib disease in the week following immunization. This study suggests that the efficacy of the currently used HBPV is less than expected from previous studies and points out the usefulness of case-control studies for monitoring vaccine efficacy following licensure.

Bacterial Capsules↗
PubMed1988

Testicular germ cell tumors in HLA-genotype non-twin brothers.

The diagnosis of metastatic testicular carcinoma in a thirty-three-year-old man and his nineteen-year-old brother is reported. Histologically, the tumor of the older brother consisted predominantly of embryonal carcinoma with minor components of seminoma and adult teratoma; the tumor of the younger brother consisted entirely of embryonal carcinoma. Since previous reports suggest the possibility that the HLA genotype may be a factor in the etiology of testicular cancer, we typed the parents and four children of this family. The two affected brothers shared a paternal HLA-A3, Cw-,B7,DR2 haplotype that had not been transmitted to the two other living siblings. Analysis of the distribution of HLA haplotypes of the affected non-twin brothers of this family and those of three other non-twin pairs of brothers that have been reported showed that the affected pairs in each family shared one HLA haplotype. The differences between the expected and the observed distribution of HLA haplotypes in the four sibling pairs is not statistically significant, perhaps because of the small number of patients typed. Two of the four pairs shared a common haplotype. Additional family studies are required to establish a genetic origin of testicular tumors and to determine whether or not a "testicular carcinoma disease" gene is linked to the HLA complex. A large number of multicase families will be required for linkage analysis.

Adult↗
PubMed1988

A rapid method for determining the need for mechanical support of the right ventricle.

Right ventricular failure following cardiac surgery must be rapidly diagnosed and treated to minimize injury to the heart. Switching from aortic to pulmonary artery perfusion during cardiopulmonary bypass is a method of rapidly testing the adequacy of right ventricular function and supporting the ventricle if necessary. A centrifugal pump has been used for long-term support for two cases managed in this manner.

Assisted Circulation↗
PubMed1988

End stage renal disease associated with acquired cystic disease and neoplasia.

Acquired renal cystic disease is a recently recognized disease entity that primarily afflicts patients on chronic hemodialysis. The incidence of acquired renal cystic disease in patients with end stage renal disease ranges from 30 to 95 per cent. The major complications of acquired renal cystic disease appear to be neoplasia and hemorrhage. Neoplasia has been demonstrated in up to 45 per cent of all end stage kidneys with acquired cystic disease. Our surgical experience with 7 cases of end stage renal disease is reported. Acquired renal cystic disease was noted in 4 of the 7 cases (57 per cent) and renal neoplasia was evident in all 7. Worldwide experience to date in combined pathology and radiology series of patients undergoing hemodialysis demonstrates that acquired cystic disease, "tumor" (usually adenoma or oncocytoma) and renal carcinoma occur at respective rates of 47.1, 4.8 and 1.5 per cent. Since the pathologist will detect more tumors and cysts than the radiologist, these figures probably are an underestimate of the true incidence. Long-term surveillance of patients harboring end stage kidneys is recommended beginning with a baseline ultrasound.

Adenoma↗
PubMed1988

Biochemical, genetic, and epidemiologic characterization of Haemophilus influenzae biogroup aegyptius (Haemophilus aegyptius) strains associated with Brazilian purpuric fever.

Brazilian purpuric fever (BPF) is a recently recognized fulminant pediatric disease characterized by fever, with rapid progression to purpura, hypotensive shock, and death. BPF is usually preceded by purulent conjunctivitis that has resolved before the onset of fever. Both the conjunctivitis and BPF are caused by Haemophilus influenzae biogroup aegyptius (formerly called H. aegyptius). Isolates from 15 BPF cases, mainly from blood or hemorrhagic cerebrospinal fluid, case-associated isolates from 42 persons in towns where BPF cases occurred, and control strains from 32 persons in towns without BPF cases were characterized biochemically, genetically, and epidemiologically. Results indicated that a single clone was responsible for all BPF cases identified in six Brazilian towns from 1984 through 1986. All of 15 (100%) case strains were the same clone as was 1 of 32 (3%) control strains (P = less than 10(-8). Isolates of the clone were preferentially intrarelated by DNA hybridization (99% relatedness, hydroxyapatite method at 60 and 75 degrees C) and were separable from other H. influenzae biogroup aegyptius strains (approximately 90% relatedness at 60 degrees C and 82% relatedness at 75 degrees C). All isolates of the BPF clone and no other strains contained a 24-megadalton plasmid of restriction endonuclease type 3031, were of a single multilocus enzyme mobility type, were of a single sodium dodecyl sulfate-polyacrylamide gel electrophoresis type, and were in one of two ribosomal DNA restriction patterns. All BPF clone isolates reacted with monoclonal antibodies produced from a case strain; only 3 of 62 (5%) other strains reacted with this monoclonal antibody. Ninety percent of BPF clone strains and 27% of other strains were relatively resistant to sulfamethoxazole-trimethoprim.

Bacterial Proteins↗
PubMed1988

Radiologic contribution to the management of patients undergoing extracorporeal shock wave lithotripsy.

Since its first clinical application in 1980, the use of extracorporeal shock wave lithotripsy (ESWL) has dramatically changed the treatment of urinary tract stone disease. More than 80% of patients with urolithiasis will undergo ESWL as a first line therapy. Detection of stones, appropriateness of ESWL treatment, successful stone therapy, termination of the ESWL procedure, and evaluation of treatment complications are all dependent on radiologic input. The application of adjuvant interventional radiologic percutaneous techniques will extend the use of ESWL to an additional 15% of patients and reduce the need for surgical intervention. Additionally, percutaneous techniques can be used to improve success rates in problematic cases and to treat complications related to the ESWL procedure. This article discusses the pre- and postprocedural radiologic evaluation of patients undergoing ESWL. Adjuvant interventional radiologic techniques useful in the management of these patients are also discussed.

Humans↗
PubMed1987

Primary renal lymphoma. Does it exist?

Although secondary renal involvement from systemic lymphoma is common, primary lymphoma of the kidney is not well recognized. One case is reported and 27 cases purported to be primary tumors are reviewed. From these cases three conclusions have been drawn: it is reasonable to assume that renal lymphoma can be a primary lesion; almost all patients with primary renal lymphoma will develop extrarenal lymphomatous disease shortly after diagnosis of their renal tumor; and survival for more than 1 year after diagnosis is rare.

Angiography↗
PubMed1987

Extracorporeal shock wave lithotripsy in childhood.

Extracorporeal shock wave lithotripsy is the treatment of choice for the majority of upper urinary calculi in adults. Technical limitations, including patient size and concerns over post-treatment stone fragment passage, have made the application of extracorporeal shock wave lithotripsy in children less clearly defined. We report the successful application of the Dornier lithotriptor in the management of 18 children (22 kidneys) with upper urinary calculi.

Adolescent↗
PubMed1986

Postoperative anatrophic nephrolithotomy bleeding.

We reviewed 530 patients treated with anatrophic nephrolithotomy during a 14.5-year period. Significant postoperative renal bleeding occurred in 34 cases (6.4 per cent). The average postoperative blood transfusion requirement in this group was 5,279 cc. Bleeding patients were significantly older and they had worse renal function compared to the nonbleeding group. If bleeding did not begin immediately it usually started 5 to 8 days postoperatively. Bleeding dyscrasias were identified in 6 patients and correction allowed nonoperative management in 4. Epsilon aminocaproic acid was helpful only in the treatment of patients with slow, lower volume bleeding. Eight patients required 9 open renal explorations to control bleeding. Two arteriovenous fistulas and 1 false aneurysm were identified. An attempt at angiographic embolization of an arteriovenous fistula was unsuccessful. Only 1 patient required a nephrectomy (1 of 34 or 2.9 per cent) and there was no mortality. A treatment plan for this complication is described.

Adult↗
PubMed1985

Pediatric anatrophic nephrolithotomy.

A 15-year experience with pediatric anatrophic nephrolithotomy was reviewed. There were 11 procedures performed in 10 patients. Average patient age was 9.43 plus or minus 1.54 years (standard error of the mean). Preoperative urine cultures were positive in 6 of 11 cases. Metabolic or structural defects were identified in all patients. Postoperative morbidity was minimal. Adequate followup was available in 9 patients, for an average length of 4.6 plus or minus 0.96 years. Stones recurred in 7 of 9 patients (78 per cent) but in 2 the new calculi were small and asymptomatic. Anatrophic nephrolithotomy can be performed safely in children but a high incidence of structural and metabolic abnormalities predisposes these patients to recurrent stones.

Adolescent↗
PubMed1985

Unilateral duplex horseshoe kidney with ectopic ureterocele.

We have reported a case of horseshoe kidney, a common renal fusion anomaly. Because of the 25% incidence of associated genitourinary anomalies, we believe that the diagnosis of horseshoe kidney in pediatric patients should initiate a thorough urologic evaluation, including intravenous urography and real-time sonography.

Child, Preschool↗
PubMed1985

Vasoactive intestinal polypeptide in cardiac myxoma.

A case of left atrial myxoma is reported in which tumor tissue was found to contain high levels of vasoactive intestinal polypeptide. This finding further supports the concept that myxomas are true neoplasms and may explain some of the poorly understood clinical manifestations of this tumor.

Female↗
PubMed1985

Prevention and treatment of postoperative infection.

Strategies for the prevention, early recognition, and management of postoperative infections in urologic patients are described. It is suggested that clinicians consider the extent of the patient's exposure to hospital pathogens as well as the hospital's unique bacteriology when devising antibiotic strategies for postoperative infections.

Anti-Bacterial Agents↗
PubMed1985

Current challenges in etiology and diagnosis of nosocomial sepsis.

Diagnostic tests and monitoring techniques for bacteremic patients are reviewed. It is concluded that a better understanding of the physiologic mechanisms underlying the bacteremic insult would result in more effective methods of intervention and treatment. Clinicians are urged to be scrupulous in the use and maintenance of urinary catheters, IVs, and respirators.

Adult↗
PubMed1984

Cardiovascular parameters after acute myocardial infarction and streptokinase administration in patients receiving coronary artery bypass grafts.

In 16 patients requiring coronary artery bypass grafting (10 control and 6 streptokinase patients), we compared the preoperative, operative, and postoperative cardiovascular parameters. Streptokinase patients had an acute myocardial infarction and attempted reperfusion with streptokinase before coronary artery bypass grafting. One patient failed to recannalize with streptokinase and one patient had reocclusion after withdrawal of heparin necessitating coronary artery bypass grafting. Examination of hemodynamic parameters revealed a lower preoperative mean blood pressure and an elevated pulmonary artery wedge pressure in streptokinase patients. The elevated pulmonary artery wedge pressure persisted through the postoperative period of observation. These results indicate that only minor differences exist between control and streptokinase patients. Emergency and elective coronary artery bypass grafting can be safely performed in patients treated with streptokinase for acute myocardial infarction without associated cardiogenic shock.

Blood Pressure↗