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Biomedical subjects

S A Greene

Publications and source records attributed to S A Greene.

At least 73 records · Page 4Linked to original sources
PubMed1988

Growth and endocrine function after renal transplantation.

Longitudinal height data and physical development were assessed in 45 boys and 34 girls after renal transplantation. All children received alternate day steroids and either azathioprine or cyclosporin A for immunosuppression. There was a significant increase in growth velocity after transplantation in prepubertal children. Growth velocity declined at the expected age of the normal pubertal growth spurt, however, with delay in the appearance of secondary sexual characteristics. Overnight hormone profiles in 17 adolescent subjects with short stature or maturational delay, or both, showed blunting of growth hormone and gonadotrophin pulsatility. It is likely that long term steroid treatment after renal transplantation induces the clinical and endocrine picture of delayed puberty. Failure of growth to accelerate at this time is a cause of short stature, which may have an effect on adult height.

Adolescent↗
PubMed1988

Growth and endocrine function in steroid sensitive nephrotic syndrome.

Longitudinal height data and physical development were assessed in 29 boys and 12 girls taking long term steroid treatment for steroid sensitive nephrotic syndrome. Growth in both boys and girls, assessed by changes in height standard deviation score (delta Ht SDS), worsened significantly with chronological age. There was a significant negative correlation between delta Ht SDS and duration of treatment in boys, but not in girls. There was no correlation between delta Ht SDS and relapse rate or the use of cyclophosphamide. In the boys, Ht SDS decreased significantly only after the age of 10 years and was associated with delay in the appearance of secondary sexual characteristics. Eight adolescent boys were assessed endocrinologically by an overnight hormone profile. Blunting of the pulsatility of growth hormone and gonadotrophins was seen in six. Normal profiles were seen in two subjects who were both off steroid treatment at the time of study. Abnormal endocrine function in adolescent boys treated long term for steroid sensitive nephrotic syndrome corresponded with the clinical picture of delayed onset of puberty, which accounted for severe growth retardation in a substantial proportion of subjects.

Adolescent↗
PubMed1988

Comparison of cardiopulmonary effects of isoflurane and halothane after atropine-guaifenesin-thiamylal anesthesia for rumenotomy in steers.

Cardiopulmonary effects were assessed in 12 yearling steers anesthetized with guaifenesin and thiamylal sodium, intubated, and allowed to breathe isoflurane or halothane in oxygen spontaneously. Light surgical anesthesia, determined using eye position as a clinical indication of anesthetic depth, was maintained during surgical placement of a rumen cannula. Heart rate and respiratory rate were measured while the steers were standing quietly (baseline). Atropine (0.06 mg/kg of body weight, IM) was given after baseline measurements were taken. Heart rate, respiratory rate, arterial blood pressures, pHa, PaCO2, PaO2, arterial [HCO3-], esophageal temperature, and end-tidal anesthetic concentration were measured every 15 minutes for 90 minutes after induction of anesthesia. Mean heart rate increased significantly (P less than 0.05) above baseline in the isoflurane group at 15 and 30 minutes. Mean respiratory rate increased significantly (P less than 0.05) above baseline in the halothane group at 45 minutes. At 45 minutes, mean respiratory rate was lower (P less than 0.05) in the isoflurane group, compared with that in the halothane group. Mean values for arterial blood pressures and arterial gases were similar for both agents at comparable times. Mean end-tidal isoflurane concentrations were less than mean end-tidal halothane concentrations at each comparable time during maintenance of similar anesthetic depth. Maintenance of anesthesia with isoflurane resulted in higher heart rates and lower respiratory rates, compared with maintenance of anesthesia with halothane in these steers.

Anesthesia, General↗
PubMed1987

Hyperglycemia with and without glycosuria: effect on inulin and para-amino hippurate clearance.

The response of the clearance of inulin (Cin) and para-amino hippurate (CPAH) to acute hyperglycemia with and without glycosuria was investigated in ten, healthy non-diabetic subjects. Standard methodology (UV/P) was used, with a mean clearance calculated from three, 15-minute urine collection periods. Each subject was studied at three levels of blood glucose (mmol/liter) concentration, mean (SE): Level 1, fasting, 4.5 (0.1); Level 2, hyperglycemia below renal threshold for glucose, 7.2 (0.1); Level 3, hyperglycemia with glycosuria, 12.6 (0.5). There was a significant rise in mean Cin (ml/min/1.73 m2) when changing from Level 1 (112[3]) to Level 2 (121[5]), with no further increase on changing to Level 3 (122[4]). With glycosuria Cin fell in some subjects. Mean CPAH (ml/min/1.73 m2) increased through Level 1 (560[27]) to Level 3 (603[34]), with consequently no change in mean filtration fraction at the three levels of glycemia. Our observations show a rise in glomerular filtration rate with mild hyperglycemia below renal threshold, with no further increase during hyperglycemia sufficient to produce glycosuria.

Adult↗
PubMed1987

Growth hormone response to a standardised exercise test in relation to puberty and stature.

Growth hormone (GH) was measured before and 10 minutes after a standardised bicycle exercise test (duration 15 minutes) in 37 short children (group 1: mean (SD) age 12.8 (3.5) years; mean (SD) bone age 10.4 (3.6) years; mean (SD) height standard deviation score (SDS) -2.8 (0.7], 16 tall children (group 2: mean age 12.9 (2.8) years; mean bone age 13.9 (1.4) years; mean height SDS 3.0 (0.8], and 30 normal children (group 3: mean age 13.3 (3.2) years; mean bone age 12.8 (3.4) years; mean height SDS -0.4 (0.8]. Results of GH are expressed as mean (SEM). The pre-exercise GH was similar in the three groups (group 1, 8.0 (2.3) mU/l, group 2, 8.5 (2.5) mU/l, and group 3, 8.3 (2.3) mU/l). There was a significant rise in GH after exercise in all three groups. GH after exercise was higher in group 2 (35.1 (2.5) mU/l) compared with groups 1 and 3 (17.8 (3.0) and (20.8 (3.2) mU/l). Post-exercise GH was less than 10 mU/l in 29 children (34% total; 49% group 1, 6% group 2, and 34% group 3). There was a positive relation between post-exercise GH and both bone age and public hair stage. Multiple regression analysis revealed that relevant predictors of a rise in GH with exercise were different for the sexes in these children with varying stature: for boys, bone age and pubic hair stage; for girls, height and height SDS. All the tall girls were in puberty. No statistical relation was observed between post-experience GH and cardiovascular response to exercise, time of day of exercise, time of eating before exercise, and plasma insulin or insulin to glucose ratio at time of exercise. We conclude that the GH response to the physiological stimulus of exercise is higher in puberty compared with childhood. Therefore, although children may be suspected of having GH deficiency after a failure of GH to increase after exercise, a non-response may be a normal finding in prepubertal children, independent of stature.

Adolescent↗
PubMed1987

Anticonvulsant drugs, growth, and development.

Height and stage of puberty of 67 children with epilepsy were measured before beginning treatment with anticonvulsant drugs and annually to a maximum five years' treatment. Blood concentrations of the drugs used (phenytoin, sodium valproate, carbamazepine, ethosuximide, and phenobarbitone) were monitored throughout. No significant deviation in growth patterns was detected.

Adolescent↗
PubMed1987

Deposition and clearance of particles inhaled by beagle dogs previously exposed to SO2.

The effect of preexisting pulmonary disease on the deposition and retention of inhaled relatively insoluble radiolabeled particles was studied. Two dogs were exposed to 500 ppm sulfur dioxide 2 h/day, 5 days/week for 16 weeks and two dogs were sham-exposed to filtered air for the same period. Dogs exposed to sulfur dioxide developed chronic bronchitis during this exposure period. After the bronchitis had been established for 10 weeks, all 4 dogs were exposed by inhalation to 1.7 micron aerodynamic diameter 134Cs-labeled fused aluminosilicate particles (FAP) and the exposures to SO2 were discontinued. The bronchitis resolved within 4 weeks after SO2 was discontinued. Dogs were periodically whole-body counted and excreta were periodically collected and counted over a 385-day period following the 134Cs exposure. Deposition of the [134Cs]FAP in the pulmonary region averaged 42% for control dogs and 16% for dogs exposed to SO2; deposition in extrapulmonary regions of the respiratory tract averaged 58% for control dogs and 84% for dogs exposed to SO2. Although deposition patterns were different, early and long-term clearance pathways and rates were the same for all dogs, as indicated by analysis of whole body, excreta, and tissues for their burdens of 134Cs.

Aerosols↗
PubMed1987

Effect of yohimbine on xylazine-induced hypoinsulinemia and hyperglycemia in mares.

Serum insulin and plasma glucose concentrations were determined in 8 mares. Four IV treatments were studied: xylazine (1.1 mg/kg of body weight); yohimbine (0.125 mg/kg); yohimbine (0.125 mg/kg) followed 5 minutes later by xylazine (1.1 mg/kg); and 5 ml of isotonic saline solution as a control. Blood samples were collected before (time 0) and at 5, 15, 30, 60, 120, and 180 minutes after drug administration. Serum insulin concentration decreased and plasma glucose concentration increased in mares given xylazine. Plasma glucose concentration was unchanged in control mares and in mares given yohimbine or yohimbine followed by xylazine. Serum insulin concentration was unchanged in mares given saline solution, but transiently increased in mares given yohimbine alone. Treatment with yohimbine prevented xylazine-induced hypoinsulinemia and hyperglycemia.

Animals↗
PubMed1986

Pharmacy initiatives to reduce clindamycin use.

The effectiveness of clinical pharmacists and attending physicians in altering the prescribing of metronidazole and clindamycin by resident physicians was evaluated, and the effect of these changes on antibiotic costs was determined. In July 1983, clinical pharmacists and attending physicians educated resident physicians about the efficacy and cost-effectiveness of substituting metronidazole for clindamycin in the treatment of intraabdominal and pelvic infections. A three-month educational program was implemented, which included distribution of a newsletter and involvement of clinical pharmacists in patient rounds. The use patterns of these drugs were then monitored for a 12-month period. A total of 425 treatment periods for 414 patients were reviewed, representing 91% of all therapy with metronidazole and clindamycin. Metronidazole use increased from 18.2% one month after implementation of the educational program to a plateau of 50% by November. Clindamycin expenditures decreased by more than 50% from the previous fiscal year, resulting in a savings of $33,469 to the pharmacy. The prescribing patterns of resident physicians were altered and cost savings were realized as a result of a comprehensive educational program that focused on substituting metronidazole for clindamycin. The program's success was enhanced because an equally efficacious agent was available and because of the participation of clinical pharmacists in patient rounds.

Anti-Bacterial Agents↗
PubMed1986

Cardiopulmonary effects of continuous intravenous infusion of guaifenesin, ketamine, and xylazine in ponies.

Eight ponies were anesthetized with a solution containing 50 mg of guaifenesin, 1 mg of ketamine, and 0.5 mg of xylazine X ml-1 of 5% dextrose in water. Anesthesia was induced by IV injection (1.1 ml X kg-1), followed by continuous IV infusion at 2.75 ml X kg-1 X hr-1. Heart rate, rate-pressure product, mean pulmonary artery pressure, and standard bicarbonate were not significantly changed throughout the study. Systolic, diastolic, and mean arterial pressures and left ventricular stroke work index were significantly decreased at 5 and 15 minutes after a bolus of the anesthetic solution was injected. Systolic blood pressure returned to within the base-line range at 30 minutes, but diastolic and mean arterial pressures were significantly decreased throughout the study. Cardiac index and arterial pH were decreased at 5 minutes only. Systemic vascular resistance was significantly decreased 60 minutes after bolus injection was given. Hypoventilation, as indicated by increased PaCO2, occurred 5 minutes after bolus injection was given.

Anesthesia, General↗
PubMed1985

Growth and sexual development in children with meningomyelocele.

Forty-five children (25 girls; 20 boys) with meningomyelocele (MMC) were assessed for growth, skeletal maturation and pubertal development. The spinal defects were operated on shortly after birth and all children required cerebral drainage for hydrocephalus. Standard deviation scores for height, sitting height, sub-ischiac leg length, head circumference, weight and bone age were compared with aged-matched data from a normal Swiss population. The children with MMC were shorter (height SDS boys -2.34 +/- 1.57; girls -2.01 +/- 1.57, mean +/- SD, P less than 0.0005), secondary to a decrease in trunk and lower limb length: Arm length was normal. The head circumference was increased, significantly in the girls (SDS + 1.49 +/- 1.21, P less than 0.005). Weight was decreased in both sexes, this being significant in the boys (SDS -1.11 +/- 1.23, P less than 0.005); however, comparison of weight with height suggested that children with MMC were relatively obese. Bone age was significantly advanced in both boys (SDS + 1.07 +/- 2.13, P less than 0.025) and girls (SDS + 1.36 +/- 1.77, P less than 0.0001). Secondary sex characteristics appeared early in both boys and girls and one girl and one boy presented with puberty advanced by several years. Cryptorchidism occurred in 25% of boys with MMC.

Adolescent↗
PubMed1985

Urine albumin to creatinine ratio-response to exercise in diabetes.

Albuminuria was studied in 40 diabetic children before and after a standardised exercise test, and also in 21 normal children; the results are expressed as geometric mean (95% range) of urine albumin:urine creatinine ratio (mg/mg). There was no significant difference between the mean resting albumin:creatinine ratio in the two groups, or between these ratios before and after exercise in the normal children. In the diabetic children, however, the mean urine albumin:creatinine ratio after exercise was significantly higher than both the value before exercise and the postexercise value of the normal children, with 10 of 40 diabetic children showing a value after exercise greater than the 95% range of the geometric mean of the control group. The diabetic children were also studied by random urine albumin:creatinine ratios and split (erect:supine) 24 hour urine collection; none was abnormal.

Adolescent↗
PubMed1985

Memory blood glucose reflectance meter and computer: a preliminary report of its use in recording and analysing blood glucose data measured at home by diabetic children.

We report a portable blood glucose reflectance meter with a non-volatile memory designed to record and store for a period of up to 99 days measurements of blood glucose performed at home under everyday circumstances. This information can be transferred at intervals to a desk-top computer, when rapid and detailed analysis of blood glucose control can be made. The data can then be stored and analysed over a prolonged period of time, thereby facilitating studies of the relationship between blood glucose control and the development of diabetic microvascular disease.

Adolescent↗
PubMed1984

Sulfur dioxide-induced chronic bronchitis in beagle dogs.

This study was done to produce a model of chronic bronchitis. Twelve beagle dogs were exposed to 500 ppm sulfur dioxide (SO2) for 2 h/d, 5 d/wk for 21 wk and 4 dogs were sham-exposed to filtered ambient air for the same period. Exposure effects were evaluated by periodically examining the dogs using chest radiographs, pulmonary function, tracheal mucous clearance; and the cellular and soluble components of bronchopulmonary lavage fluids. Dogs were serially sacrificed after 13 and 21 wk of exposure and after 6 and 14 wk of recovery. Clinical signs produced in the SO2-exposed dogs included mucoid nasal discharge, productive cough, moist rales on auscultation, tonsilitis, and conjunctivitis. Chest radiographs revealed mild peribronchiolar thickening. Histopathology, tracheal mucous clearance measurements, and lavage cytology were consistent with a diagnosis of chronic bronchitis. It is concluded that repeated exposure to 500 ppm SO2 for 21 wk produced chronic bronchitis in the beagle dog. Complete recovery occurred within 5 wk following cessation of SO2 exposure.

Animals↗
PubMed1984

Management of secondary diabetes mellitus after total pancreatectomy in infancy.

We report five children who required total pancreatectomy in the neonatal period for life threatening hypoglycaemia. Subsequent diabetes was managed with once daily subcutaneous insulin, oral pancreatic extract, and a controlled carbohydrate diet. Daily home blood glucose profiles in four of these children were different from those of 14 C-peptide negative children with type 1 insulin dependent diabetes--in the pancreatectomy group there was less variation in blood glucose throughout the day with a fall after breakfast as against a rise after breakfast in the type 1 group. Hyperglycaemia (greater than 10 mmol/l) with or without ketonaemia was extremely rare in the pancreatectomy group. Despite neonatal convulsions, physical growth and development have been normal. Hypoglycaemia, usually after food refusal, has been a major problem. In addition, there have been considerable emotional and family disturbances despite the excellent metabolic control, which presumably reflect the cumulative difficulties in managing such young children with diabetes.

Blood Glucose↗