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Biomedical subjects

A N Graham

Publications and source records attributed to A N Graham.

29 records · Page 2Linked to original sources
PubMed1991

Missed arteriovenous fistulae and false aneurysms in penetrating lower limb trauma: relearning old lessons.

The difficulties in detecting vascular injuries associated with penetrating limb trauma are greater than generally appreciated, and any delay in diagnosis will compromise management and potentially may lead to amputation. Established lessons regarding the mode of presentation and early management of these injuries have to be relearned and are illustrated by three recent case reports of clinically unrecognized lower limb vascular injuries later discovered to be arteriovenous fistulas and false aneurysms. The diagnosis of these lesions may depend on the identification of subtle clinical signs followed by early preoperative angiography, the potential value of which is entirely dependent on the surgeon's acumen and level of awareness.

Adolescent↗
PubMed1987

Hypokalaemic and electrocardiographic effects of aminophylline and salbutamol in obstructive airways disease.

The hypokalaemic and electrocardiographic effects of nebulised salbutamol (2.35 mg x 2, 120 min apart) and intravenous aminophylline (6 mg/kg followed by 0.5 mg/kg/hr infusion) alone and in combination, were investigated in eight patients with stable asthma. Both agents produced significant hypokalaemia, mean maximum for salbutamol 0.55 mmol/l, mean maximum for aminophylline 0.29 mmol/l. Salbutamol increased the QTc interval and depressed T-wave amplitude whilst aminophylline decreased PR interval. These effects were increased when they were given in combination but were highly variable between individuals. It is likely that arrhythmias may be precipitated in patients with hypoxaemia, acidosis or those with preexisting cardiovascular disease.

Administration, Inhalation↗
PubMed1986

Endstage renal failure due to polycystic kidney disease managed by continuous ambulatory peritoneal dialysis.

Over a five and one half year period, four of nine patients with endstage renal failure due to polycystic kidney disease managed by continuous ambulatory peritoneal dialysis (CAPD) developed peritonitis following intestinal perforation. Two patients had colonic perforation associated with diverticular disease, one necrosis of the terminal ileum, and one acute appendicitis. Two of the patients died subsequent to these complications. The survivors had early transfer to haemodialysis. In contrast, over the same period, only two of 125 patients with renal failure due to other causes and managed by CAPD had acute intestinal perforation. In both cases this was associated with acute appendicitis. Both patients survived. All episodes of peritonitis in CAPD patients with polycystic kidneys demand very close monitoring, cessation of CAPD, and early surgical intervention. CAPD is relatively contraindicated in such patients.

Female↗
PubMed1986

The hemodynamic effects of aminophylline and salbutamol alone and in combination.

We have studied the hemodynamic effects of salbutamol and aminophylline in eight patients with obstructive airways disease. Aminophylline was administered intravenously as a bolus and an infusion for 150 minutes. Salbutamol was administered by nebulizer after 30 minutes and at the end of the infusion. Compared with placebo, salbutamol decreased ventricular afterload (decreased preinjection period and preinjection period to left ventricular ejection time ratio and diastolic blood pressure). Aminophylline decreased total electromechanical systole, corrected for heart rate, only (mean decrease -10.7 msec; range -6.5 to -15.1), indicating a mild positive inotropic effect. When both active treatments were combined, the effect on total electromechanical systole, corrected for heart rate, was potentiated (mean decrease -23.3 msec; range -19.1 to -33.1). Neither aminophylline nor the combination affected heart rate or blood pressure, suggesting no increase in myocardial oxygen consumption. The hemodynamic effects of aminophylline and salbutamol are potentiated in combination but are unlikely to be harmful in patients with obstructive airways disease.

Adult↗
PubMed1985

Takayasu's disease associated with generalised amyloidosis.

A case of Takayasu's disease in a young Caucasian female is described. The major complications which developed over the ten year course of the disease include nephrotic syndrome, severe refractory hypertension, aortic valve regurgitation associated with aneurysmal dilatation of the ascending aorta, and recurrent congestive heart failure. Amyloid deposits have been demonstrated in the aorta, atrial appendage, aortic valve, and renal cortex. The association of amyloidosis and Takayasu's disease is discussed.

Adult↗
PubMed1984

Ergotamine toxicity and serum concentrations of ergotamine in migraine patients.

Twenty-five migraine patients (9 males and 16 females) aged 22-71 who had used between 7 and 60 mg ergotamine tartrate per week for 1.5-30 y volunteered to participate in the study. Side-effects attributable to ergotamine were wide ranging and included daily headache and pain in the limbs. Wide variation in sensitivity to the drug was observed and side-effects were not always proportional to the dose of ergotamine. Random serum ergotamine concentrations were estimated in all patients and 10 of them volunteered to take a 2 mg oral challenge of ergotamine tartrate. Ergotamine was not detected in 44% of the random estimations even though all patients exhibited clinical signs of ergotamine tartrate overdose. The remaining 56% estimations all showed low drug concentrations. After the 2 mg oral challenge of ergotamine in the 10 patients, significantly higher concentrations, but still within therapeutic range, were detected in the sera when compared with mean concentrations achieved after the same oral dose of the drug in healthy, non-migrainous subjects.

Adult↗
PubMed1978

Near-drowning in an infant: case report.

A case is presented of an infant who may have been immersed in water for 15 minutes, presenting apparently dead by instant assessment criteria, who was resuscitated and rehabilitated to make an excellent recovery.

Child, Preschool↗