Cardiopulmonary resuscitation of old people.
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Aged↗
Biomedical subjects
A R Bird
Publications and source records attributed to A R Bird.
Trephine biopsy of the bone marrow.
We present a review of trephine biopsy of the bone marrow based on an experience of approximately 10 000 examinations. It is our view that, in adults, examination of material obtained by aspiration combined with a trephine biopsy allows for the most thorough morphological assessment of the marrow. Morbidity is limited to transient discomfort to the patient, and even bilateral procedures are conveniently performed on outpatients. There is no absolute contraindication to combining aspiration and trephine biopsy, but in severe bleeding disorders due to acquired or congenital coagulation factor deficiencies replacement therapy is indicated and the patient should be observed in hospital for 24 hours following the procedure. Thrombocytopenia is not associated with significant bleeding from the biopsy site in our experience. The advantages of the trephine biopsy are that it allows better overall assessment of cellularity and morphology and is indispensable in cases where aspiration has failed or where infiltration due to the myeloproliferative syndrome or to haematological and non-haematological malignancies has occurred. With marrow hypoplasia and granulomatous disorders involving the marrow, the trephine biopsy is indispensable for diagnosis.
Biopsy, Needle↗
Microcytic anaemia and haemoglobinopathy in Cape Town children.
Patients with thalassemia as well as those with iron deficiency typically have red cell microcytosis and hypochromia. In view of the large number of children with microcytic anaemia or an isolated microcytosis seen at the Red Cross War Memorial Children's Hospital, the frequency with which a low red cell mean corpuscular volume (MCV) was associated with the presence of thalassaemia or with an abnormal haemoglobin was investigated. Of 730 patients with an MCV of 60 fl or less, 46 (6.4%) were found to carry the beta-thalassaemia gene and 20 children (2.7 %) had an abnormal haemoglobin, most commonly haemoglobin E. The prevalence of thalassaemia was greatest among Coloured patients and abnormal haemoglobins were found exclusively in this group of children. The implications of these findings are discussed.
Anemia↗
The classification of acute leukaemia in childhood.
In 1976 a French, American and British (FAB) cooperative group proposed a morphological classification of acute leukaemia which they hoped would prove more reproducible than previous classification. We present our preliminary experience with this classification, based on a 2-year study of 39 patients. Cytochemical and cell surface marker characteristics of the leukaemic cells were also studied. We found this classification to be satisfactory but some problems were noted in regard to its reproducibility, especially in acute lymphoblastic leukaemia (ALL). Cell surface markers were absent in the majority of cases of ALL ("null cell" type), while the remainder had T-cell characteristics. No B-cell types were seen. Cytochemical staining patterns clearly distinguished ALL from acute myeloid leukaemia (AML) and also helped to categorize AML into its subtypes. The implications of our finding are discussed.
Acute Disease↗
Effects of exercise and plane of nutrition on nutrient utilization by the hind limb of the sheep.
Net uptake, by the hind limb, of oxygen and a number of energy substrates was measured in sheep fed semicontinuously at maintenance or 1.5 times maintenance, while standing at rest or walking on a moving-belt treadmill at 0.7 ms-1, on a 10 degrees slope for 60 min. Exercise caused a six- to sevenfold increase in hind-limb oxygen uptake, due mainly to increased blood flow, assisted by an increase in the oxygen-carrying capacity of arterial blood. Major changes in nutrient supply and utilization included hyperglycaemia, hyperlactacidaemia, free fatty acid (FFA) mobilization, and substantially increased uptakes of glucose and FFA by the hind limb. Acetate uptake was unchanged during exercise in maintenance-fed sheep, but was significantly increased in sheep fed at levels above maintenance. Plane of nutrition had little effect on hind-limb uptake of other nutrients in resting or exercising animals. Plasma FFA were clearly the most important respiratory fuels for exercising muscle, but a previous finding that acetate utilization was negligible during exercise was not confirmed. Possible reasons for this discrepancy between present and earlier results are discussed.
Animals↗
Cytomegalic virus infection of bowel in adults.
Cytomegalic virus infection of the bowel in 2 adult patients is reported. The controversies related to this rare pathology are evaluated, particularly the role of cytomegalic inclusion virus (CMV) as a primary or secondary pathogen in bowel.
Adult↗
Paraproteinaemia in general practice.
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Adult↗