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Biomedical subjects

T M Barratt

Publications and source records attributed to T M Barratt.

At least 109 records · Page 6Linked to original sources
PubMed1982

Urinary calculi in children. A 5 to 15-year follow-up with particular reference to recurrent and residual stones.

Between 1965 and 1974 188 children were operated on for urinary calculi; 150 cases of non-metabolic stones have been followed up for 5 to 15 years to assess the results of surgery and to evaluate recurrent and residual calculi. Of 132 cases completely cleared of stones at initial surgery 11 had a recurrence; 8 of the recurrences developed amongst 33 patients who remained persistently infected post-operatively. Reoperation was necessary in 8 cases to stop renal deterioration. Amongst 18 patients with residual calculi only 7 required reoperation; small residual fragments were effectively controlled with long-term antibiotic therapy and close supervision.

Child↗
PubMed1982

Acute renal failure complicating cardiopulmonary bypass surgery.

Acute renal failure developed in 24 (5.3%) of 456 children undergoing cardiopulmonary bypass surgery during a 2-year period. It was more common in younger children, in those with complex cardiac lesions, and in those with long overall bypass times. Fourteen (58%) recovered renal function; renal failure was responsible for death in only two. Early vigorous peritoneal dialysis is advocated after cardiopulmonary bypass surgery if there is oliguria (less than or equal to 1.0 ml urine/kg per hour) resistant to volume repletion, dopamine infusion and diuretics, intractable fluid overload, or hyperkalaemia.

Acute Kidney Injury↗
PubMed1982

Effect of indomethacin on lymphocyte response to mitogens in puromycin aminonucleoside nephrosis in the rat.

The mitogen response of peripheral blood lymphocytes to phytohaemagglutinin is depressed in rats with nephrotic syndrome induced by the administration of the aminonucleoside of puromycin. The mitogen response is normal after the administration of aminonucleoside of puromycin, but before the nephrotic syndrome develops. Nephrotic syndrome serum depresses the mitogen response of normal lymphocytes. This effect is attenuated by treatment of nephrotic rats with indomethacin, independently of any change in plasmas albumin concentration. Indomethacin in vitro has no effect. These studies suggest that the impaired response of nephrotic lymphocytes to phytohaemagglutinin is a secondary consequence of the nephrotic state, probably attributable, at least in part, to increased prostaglandin production in the nephrotic syndrome.

Animals↗
PubMed1981

Gonadal function in boys with steroid-responsive nephrotic syndrome treated with cyclophosphamide for short periods.

Semen analysis was undertaken in 19 men over the age of 18 years who had been treated during childhood for steroid-responsive nephrotic syndrome with a single course of cyclophosphamide 3 mg/kg bodyweight for 8 weeks. A further 4 men who received two such courses of treatment were also studied. Plasma total androgens and gonadotropins were also determined. A comparison group consisted of medical students investigated as potential donors for artificial insemination. Lower ejaculate volumes and sperm densities with a higher percentage of immotile and abnormal forms were detected in patients who had received cyclophosphamide. However, the abnormalities were not severe enough to suggest infertility. Plasma total androgens were lower in the patients, but there were no differences in gonadotropic hormones. The data suggest that a course of treatment with cyclophosphamide known to influence the natural history of the nephrotic syndrome is not necessarily followed by a severe abnormality of sperm production; nevertheless, great caution is still required in the use of the drug.

Adolescent↗
PubMed1980

Spectrum of 2,8-dihydroxyadenine urolithiasis in complete APRT deficiency.

APRT deficiency may be totally benign or life threatening. The importance of early recognition/diagnosis is thus stressed. Urolithiasis (2,8-DHA stones: the precipitating factor in all cases) is treatable. With early recognition and treatment allopurinol without alkali and a diet low in purine homozygotes have remained clinically and biochemically normal to date. 'Uric acid' stones in children must always be suspect and subjected to sophisticated analysis. Diagnosis from red cell APRT activity may also have its pitfalls.

Adenine↗
PubMed1980

HLA, atopy, and cyclophosphamide in steroid-responsive childhood nephrotic syndrome.

In a study designed to confirm our preliminary report of associations between HLA-B12, atopy, and relapse following cyclophosphamide treatment in steroid-responsive nephrotic syndrome (SRNS), we again found a higher incidence of HLA-B12 in SRNS children (44%) than we did in controls (24%). The association of HLA-B12 with short time-to-relapse after cyclophosphamide treatment of SRNS was also confirmed, but that with atopy in SRNS children was not, though we observed a similarly high incidence of atopy in them as before.

Asthma↗
PubMed1979

IgA immune complexes in Henoch-Schönlein purpura.

Raised levels of IgA immune complexes were found in 13 of 18 children with Henoch-Schönlein purpura irrespective of whether they developed nephritis or not. In contrast, only those children who developed nephritis had raised levels of IgG immune complexes as well. In 2 children with nephritis, two discrete peaks of IgA complexes were found, corresponding to 4 x 10(5) to 8 x 10(5) and 2.5 x 10(6) to 4 x 10(6) daltons. IgG complexes were found only in the larger-molecular-weight peak. Such differences in immune complexes may underlie the different manifestations of this disease.

Adolescent↗
PubMed1979

Complete deficiency of adenine phosphoribosyltransferase: a third case presenting as renal stones in a young child.

We report a third case of 2, 8-dihydroxyadenine stones in a child with a complete lack of the adenine salvage enzyme--adenine phosphoribosyltransferase (APRT). The propositus, a 20-month-old girl of consanguineous Arab parents, presented with multiple urinary tract infections and supposed 'uric acid' stones in the right renal pelvis and left ureter. Both parents and one brother were heterzygotes for the defect, in keeping with an autosomal recessive mode of inheritance. In contrast with the other purine salvage enzyme disorder of childhood with true uric acid stones (the Lesch-Nyhan syndrome), uric acid excretion was normal in all family members. As in our previous case, treatment with allopurinol, without alkali, has eliminated the urinary excretion of 2, 8-dihydroxyadenine: the stones were removed surgically. 2, 8-Dihydroxyadenine should be considered in any child thought to have uric acid stones and tests made to distinguish the two compounds.

Adenine↗
PubMed1978

Renin and blood-pressure in children with renal scarring and vesicoureteric reflux.

Plasma-renin-activity (P.R.A.) was raised in 9 of 15 hypertensive children with pyelonephritic scarring secondary to urinary-tract infection and vesicoureteric reflux and also in 8 of 100 normotensive children with such scars. P.R.A. was much less likely to fall with age in normotensive children with renal scarring than in normal children. The identification of hyperreninaemic normotensive children with renal scarring is important, since P.R.A. may prove to be of value in early identification of children at risk of developing hypertension. A longitudinal follow-up is proposed to establish this hypothesis.

Adolescent↗
PubMed1978

Renal vein renin measurements in children with hypertension.

Renal venous renin activity was measured in 50 children with hypertension. Main renal vein and segmental renal vein sampling was feasible in children as young as 15 months. In all cases in which there was a clear difference in renin secretion between the kidneys--that is, a main vein renin ratio above 1.5--surgery, when undertaken, successfully restored normal blood pressure. Most of the children with main renal vein renin ratios below 1.5 had bilateral disease or apparently normal kidneys. Segmental renal vein sampling contributed useful information additional to that provided by main renal vein measurements and permitted identification of local sources of renin production. In children with renal transplants who developed hypertension renal vein renin measurements helped in determining the cause and facilitating the management of the raised blood pressure.

Adolescent↗
PubMed1978

Circulating immune complexes in steroid-responsive nephrotic syndrome.

We analyzed serums from 39 children with steroid-responsive nephrotic syndrome for the presence of circulating soluble immune complexes. Seventeen of 18 children in relapse had raised levels of IgG complexes: median titers were significantly higher in these patients than in control children (P less than 0.001) or in nephrotic children in sustained remission (P less than 0.001). Seven of nine children followed sequentially had raised complex levels in early remission but became normal after six weeks in remission. In contrast to patients with systemic lupus erythematosus these IgG complexes were not able to bind C1q. Serums from five patients in relapse contained complexes intermediate in size (2 to 2.5 X 10(6) daltons) as compared to those seen in systemic lupus erythematosus, and four of the five had small complexes as well (3 to 5 X 10(5) daltons). These findings suggest that immune complexes may have a pathologic role in steroid-responsive nephrotic syndrome, but the mechanism by which proteinuria is effected remains unclear.

Adolescent↗