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Biomedical subjects

M B Scott

Publications and source records attributed to M B Scott.

11 recordsLinked to original sources

Respiratory failure in children with acquired immunodeficiency syndrome and acquired immunodeficiency syndrome-related complex.

Acute respiratory failure has a high mortality in patients with acquired immunodeficiency syndrome (AIDS). This study was undertaken to determine the etiology of acute respiratory failure and the outcome of children with AIDS and AIDS-related complex. Records of 31 children with AIDS or AIDS-related complex admitted to the pediatric intensive care unit for acute respiratory failure throughout a 46-month period were reviewed. Acute respiratory failure was due to Pneumocystis carinii pneumonia in 13, cytomegalovirus pneumonia in six, bacterial pneumonia in five, severe bacterial sepsis in four, Candida pneumonia in two, and a giant cell pneumonia in one patient. In addition, 11/19 patients with acute respiratory failure due to P carinii pneumonia or cytomegalovirus had superinfections with bacteria or Candida. Of the total of 19 primary and secondary bacterial infections, Pseudomonas aeruginosa was responsible in ten and Klebsiella pneumoniae in three children. Five children (16%) survived until pediatric intensive care unit discharge; three died within 6 months. The causes of acute respiratory failure were not significantly different in survivor and nonsurvivor groups. It is concluded that, in addition to P carinii pneumonia and cytomegalovirus pneumonia, bacterial infections (especially due to Pseudomonas and other Gram-negative organisms) are important causes of respiratory failure. The high mortality and grim ultimate prognosis seen may have implications for pediatricians attempting to identify the proper limits of medical intervention for this group of patients.

AIDS-Related Complex

Phenoxybenzamine in neurogenic bladder dysfunction after spinal cord injury. I. Voiding dysfunction.

Phenoxybenzamine is a welcomed adjunct in the pharmacologic management of patients with neurogenic bladder dysfunction resulting from spinal cord trauma. Side effects are infrequent. Bladder balance was predictably and effectively achieved and maintained in patients with 1) lower motor neuron lesions, 2) upper motor neuron lesions and coexisting autonomic dysreflexia and 3) intact sympathetic innervation and upper motor neuron bladders. The response was unpredictable in patients with upper motor neuron lesions without coexisting dysreflexia.

Adrenergic Fibers

Phenoxybenzamine in neurogenic bladder dysfunction after spinal cord injury. II. Autonomic dysreflexia.

Phenoxybenzamine blockade of the alpha receptor site can abolish the vascular and internal sphincter responses in patients with chronic recurrent autonomic dysreflexia associated with bladder filling or contraction. The life-threatening hypertensive response is suppressed by this medication. Therefore, the drug is a beneficial adjunct in the pharmacologic management of autonomic dysreflexia. When the drug is used patients can be maintained free of a catheter. The drug had no serious side effects at the dose regimen used. One particularly significant advantage is its long duration of action--patients occasionally can skip doses of medication and not suffer acute symptoms.

Autonomic Nervous System

Erections and sexual function in post-sphincterotomy bladder neck patients.

A study of 131 patients who underwent sphincterotomy and bladder neck incision was done to determine changes in postoperative erectile and sexual function. A complete, permanent loss of erectile function was noted in 8.2 per cent of the patients and diminished erectile function was noted in 16.8 per cent. Unchanged or improved erections were noted in 74.8 per cent of the patients, while a complete loss of ability to engage in vaginal sexual intercourse, which had been present preoperatively, was sustained by 3.9 per cent of patients with diminished erections suffered no impairment of their preoperative sexual ability. Unaltered, improved or induced sexual function was present in 96.1 per cent of the patients postoperatively.

Adult

Use of the iced cystogram to differentiate bladder neck and external sphincter obstruction.

An iced cystogram was done on 31 patients with neurogenic bladder and voiding dysfunction. We observed 5 distinguishable patterns upon which therapeutic measures to improve balance could be based. We found the iced cystogram to be a simple, inexpensive yet reliable technique to assess detrusor sphincter imbalance. With the information obtained from this study the therapeutic options were delineated more clearly and the results of the treatment were made more predictable.

Contrast Media

Salmonella infection and the genitourinary system.

Six cases of severe salmonella genitourinary infection and a case of salmonella septicemia after prostatectomy are reported. The mechanism whereby the urinary tract is involved in salmonellosis is described, as are the different manifestations of genitourinary salmonellosis. Host factors predisposing to the development of genitourinary salmonella infection include other urologic pathology, malignant neoplasms and states of depressed immunity. Recommendations are made with regard to the diagnosis and management of this sometimes lethal condition.

Adult

Papillary adenocarcinoma of prostate.

Papillary adenocarcinomas of the prostate are rare tumors which may arise from the prostatic ducts and the utricle; 2 cases are described. The diagnosis of these tumors is best established by cystourethroscopy and transurethral resection. The more common prostatic acinar adenocarcinoma is frequently associated with these tumors. The histopathologic recognition of papillary adenocarcinoma of the prostate and its differentiation from acinar adenocarcinoma is important since the natural history and response to treatment may be different.

Adenocarcinoma, Papillary

Renal angiomyolipoma: two varieties.

Two cases of symptomatic renal angiomyolipoma are presented, and their distinctive clinical, radiologic, and histologic features are discussed. In the first case the scout film demonstrated radiolucency of the tumor which helped to distinguish it from carcinoma. In the second case, which was associated with tuberous sclerosis, the renal lesion was large and unifocal, and the local lymph nodal involvement with tumor raised the possibility of malignant transformation.

Child

Accounts.

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Communication