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Biomedical subjects

A R Patel

Publications and source records attributed to A R Patel.

At least 73 records · Page 4Linked to original sources
PubMed1982

The pedestrian problem: a 12-month review of pedestrian accidents.

Three hundred and sixty-one pedestrians involved in road accidents in the course of a year have been studied. Fourteen of the pedestrians died following hospital admission, and analysis of data from Strathclyde Police showed that another 16 pedestrians died at the roadside. Certain characteristics of the whole group are reviewed and a plea is made for more appropriate use of available statistics in the production of practical road safety legislation.

Accidents, Traffic↗
PubMed1982

Erythrocyte survival in patients with porcine xenograft aortic and mitral valves.

Ten patients with porcine xenograft aortic and mitral valve prostheses were studied three to 36 months (mean 15 months) postoperatively for evidence of hemolysis. Studies included complete blood count, reticulocyte count, red cell indices, percentage of schistocytes on blood smears, bilirubin concentration, lactic dehydrogenase, serum iron, total iron binding capacity, haptoglobin, serum folate and vitamin B12 levels, Coombs' test, methemoglobin reduction test, autologous 51Cr erythrocyte survival, and urinary examination for iron and hemosiderin. All patients were hemodynamically stable. Nine patients had normal valve function and no evidence of hemolysis. One patient with paravalvular aortic regurgitation had mechanical hemolytic anemia with a negative Coombs' test. Porcine valve xenografts do not seem to be associated with hemolysis unless complicated by a paravalvular leak.

Anemia, Hemolytic↗
PubMed1982

Intravascular aggregation after acute intracranial hypertension by epidural balloon compression in cats.

The authors have studied the effect of acute intracranial hypertension produced by placement of an epidural balloon (control group) in cats, on cerebral perfusion, evoked responses, and hematological parameters. These elements were measured in similarly injured animals which underwent isovolemic hemodilution with dextran 75, after relief of intracranial hypertension. Four hours after balloon deflation, perfusion was markedly impaired in 30% of the control group, and was reduced to 11% in the dextran-infused group. The suppressed N1 amplitude of somatosensory evoked responses on the compression side, the reduced platelet aggregability, and the erythrocyte-deformability by intracranial hypertension were all significantly more restored in the dextran-infused group after decompression. The percentage of platelets with volumes between 21.75 and 48.75 cu mu (normal 9.75 to 12.75 cu mu) significantly increased after decompression. Activation of platelets during intracranial hypertension leads to an increase in platelet volume from platelet aggregation, and correlates with a decrease in platelet aggregability. It was also suggested that reduction of erythrocyte deformability was not caused by erythrocyte aggregation. The authors emphasize the role of intravascular factors such as vascular obstruction by platelet aggregates, and difficulty in passage of erythrocytes through capillaries due to reduced deformability, in the disturbance of the microcirculation following acute intracranial hypertension. The protective effect of dextran 75 by inhibition of platelets as well as hemodilution is stressed.

Animals↗
PubMed1981

Edwardsiella tarda osteomyelitis in a patient with SC hemoglobinopathy.

Edwardsiella tarda is a recently identified gram-negative organism of the family Enterobacteriaceae. Reports of human infections with E tarda have been infrequent. We review 14 cases of systemic edwardsiellosis reported in the literature and report a case of E tarda osteomyelitis in a patient with sickle cell-hemoglobin C disease. In our case the remains of a snake may have been the source of the organism. Systemic edwardsiellosis is rare, and it may present as meningitis, endocarditis, bacteremia, liver abscess, or osteomyelitis. In 12 of 15 cases reported, systemic E tarda infection occurred in patients suffering from additional debilitating illnesses.

Aged↗
PubMed1981

Road traffic accident related morbidity as seen in an accident and emergency department.

This paper describes some of the findings of a prospective study of victims of road traffic accidents arriving at the Western Infirmary's Accident and Emergency Department over a period of 12 months. More than half the accidents occurred during leisure hours thus likely to stretch the resource of the hospital services. More than a third of the total number of patients were young male drivers. Serious injuries were significantly more often sustained among pedestrians who were often older. Victims of motor-cycle accidents less often escaped serious injuries. Blood ethanol studies on a small sample suggested that male pedestrians were often highly intoxicated. A public health education programme is regarded as a primary measure in preventing a large proportion of serious morbidity and mortality especially amongst pedestrians.

Accidents, Traffic↗
PubMed1980

Prevention of skateboard injuries.

Skateboarding has become extremely popular in the United Kingdom, and it is estimated that over two million skateboards have been sold. Previous surveys have shown the dangers of the sport, fractures of the limbs being a particularly common form of injury. Consequently the provision of skateboard parks and the wearing of adequate protective clothing were considered necessary to reduce to severity of the injuries sustained. Our survey does not support this view, and suggests that fractures are more likely to occur in people with full protective clothing and skating in a park. The reasons for this are discussed. It is also suggested that expert instruction in the use of the skateboard has been neglected as a means of accident prevention.

Adolescent↗
PubMed1980

Serum ferritin levels in hematologic malignant neoplasms.

Data from 90 patients with a variety of hematologic malignant neoplasms were studied to determine the relation between changes in serum ferritin concentration and the clinical status of the patients. Patients with Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, blastic crisis of chronic myelocytic leukemia, acute myeloblastic leukemia and acute lymphoblastic leukemia were found to have significantly elevated serum ferritin levels. Further study of serum ferritin concentration in certain hematologic malignant neoplasms might provide a valuable insight into the role of serum ferritin determination in the diagnosis and follow-up of patients with malignant diseases.

Female↗
PubMed1980

Two new sickle cell syndromes: HbS, Hb Camden, and alpha-thalassemia; and HbS in combination with Hb Tacoma.

Hemoglobin variants having electrophoretic mobility more rapid than that of HbA were identified in combination with sickle hemoglobin in two patients at the Cook County Hospital. Neither individual had symptomatic hematologic disease. In one patient, the rapidly migrating hemoglobin had the amino acid substitution characteristic of Hb Tacoma (beta-40 arg leads to ser), a mildly unstable variant. In the other patient, Hb Camden (beta-131 gln leads to glu) was identified, and the hematologic findings also indicated that he has alpha-thalassemia trait. In the patient with HbS-Camden--alpha-thalassemia, globin synthesis was unbalanced (alpha/beta 0.66), and HbS represented only 19.5% of the total hemoglobin. The latter finding suggests that under conditions of limited alpha-chain availability beta Camden may combine with alpha subunits at least as efficiently as does betaA. HbS represented 56% of the hemoglobin of the patient with HbS Tacoma, although the rate of synthesis of beta Tacoma by her reticulocytes was consistently greater than that of betaS. A time-course synthesis study demonstrated a progressive increase in the specific activity of beta Tacoma in relation to that of betaS, suggesting that the unstable beta-chains of Hb Tacoma underwent selective intracellular degradation. This process appears to explain the disparity between the rates of synthesis of the two beta chains and the relative representation of HbS and Hb Tacoma in the patient's erythrocytes.

Adolescent↗
PubMed1979

Fibrosarcoma of the mediastinum.

Fibrosarcoma is a rare primary malignant tumor of the mediastinum. Three cases are presented with different presenting symptoms and clinical manifestations. Thoracotomy with biopsy of the mass is the only method for arriving at a definitive histologic diagnosis.

Adult↗
PubMed1979

Persistent ST segment elevation in left ventricular aneurysm before and after surgery.

Post-myocardial infarction aneurysms are often accompanied by persistent ST segment elevations. To determine whether or not these ST segments regress following successful surgery for left ventricular aneurysms, serial electrocardiograms were studied in 74 patients and compared to changes of heart size and NYHA Functional Class. The mean postoperative follow-up period was 18.2 months (range 3 to 52 months). The mean precordial sigma ST elevation preoperatively was 5.27 mm. and 4.71 mm. after surgery (P less than 0.025). For the highest ST segment of an individual lead, the mean values were 1.9 mm. before surgery and 1.88 mm. postoperatively (P less than 0.1). Although clinical improvement occurred in 66 (89.2 per cent) by NYHA class and x-ray evidence of improvement was seen in 46 (62.2 per cent), a degree of ST elevation remained in all cases and was less elevated in only 19 (25.7 per cent). After surgery for left ventricular aneurysm, ST segments tend to remain elevated with little apparent relation to reduction of heart size or clinical improvement.

Adult↗