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Biomedical subjects

D A Shaw

Publications and source records attributed to D A Shaw.

At least 37 records · Page 2Linked to original sources
PubMed1985

Hyperbaric oxygen and multiple sclerosis: short-term results of a placebo-controlled, double-blind trial.

In a study of 120 patients with chronic multiple sclerosis the effects of treatment with 100% oxygen at 2 atmospheres absolute for 90 min daily for a total of 20 exposures were compared with those of normal air at normal pressure for a similar length of time within the same compression chamber. No patient in either group showed any improvement on the Kurtzke disability status scale. 12 of 51 patients in the hyperbaric-oxygen group and 3 of 47 control patients improved on the Kurtzke functional systems scale on the subjective bowel/bladder parameter only. Such a degree of improvement can also be achieved with medication for urinary symptoms, but none of the patients in this study received such medication. The short-term results of this trial do not support the claims made for hyperbaric oxygen in the management of multiple sclerosis.

Adolescent↗
PubMed1984

An outbreak of Serratia marcescens infections in a neonatal unit.

Over a 15-month period 732 babies were admitted to a neonatal unit, and Serratia marcescens was isolated from 153 (21%). In one-fifth (34) a clinical infection (9 major and 25 minor) developed. Major infection was associated with high mortality and morbidity and 2 cases presented after the neonatal period. No environmental reservoir was found. Colonised symptom-free neonates were considered to be the source, with transmission by staff-baby contact despite adequate hand-washing. Overcrowding was believed to be responsible for the difficulties experienced in eradicating this transmission.

Cross Infection↗
PubMed1984

Carotid endarterectomy in patients with transient cerebral ischaemia.

A randomised controlled trial of endarterectomy in patients with carotid artery disease showed that operation significantly reduced the frequency of transient ischaemic attacks (TIA) in the relevant vascular territory. Because of the high post-operative morbidity in the surgical group, the trial was abandoned before conclusions could be drawn as to the influence of endarterectomy on long-term survival or on the incidence of subsequent strokes.

Aged↗
PubMed1984

Immunohistochemical localization of basement membrane components during hair follicle morphogenesis.

Specific antisera were used to investigate the distributions of several basement membrane zone (BMZ) components, namely, bullous pemphigoid antigen (BPA), heparan sulfate proteoglycan (HSPG), laminin, and type IV collagen, during the development of hair follicles in late embryo rats. BPA was not visible by indirect immunofluorescence in the BMZ before epidermal involution but appeared in all regions of BMZ after this had occurred. As follicular length increased during maturation, the distribution of BPA was no longer uniform, being reduced or absent from the BMZ around the lower part of the elongating follicle. HSPG was associated with the basal cell layer prior to the appearance of hair follicle primordia and became BMZ-associated before birth but after follicle buds were first observed. HSPG was also found to be associated with the basal cell surfaces in the epidermis, but not in the hair follicle. Laminin and type IV collagen were continually present in epidermal and follicular BMZ both before and during development of hair follicles and were later present in the dermal papilla matrix. From these observations we conclude that (1) laminin and type IV collagen are functionally important for BMZ integrity before and during epidermal and follicular maturation, (2) HSPG may have a cell surface function in epidermis as well as roles in BMZ organization and properties, and (3) the distribution of BPA is indicative of its association only with regions of tissue not involved in morphogenetic change. We also suggest that the cell-matrix interactions documented for BPA, HSPG, laminin, and fibronectin may depend on the type of tissue involved and its state of development, differentiation, or repair.

Animals↗
PubMed1981

Prognosis in nontraumatic coma.

We conducted serial neurologic examinations on 500 patients in nontraumatic coma to identify factors predicting recovery. Overall, 81 patients (16%) led an independent life at some point within the first year; the remainder either died without recovery from coma (61%), never improved beyond the vegetative state (12%), or regained consciousness but remained dependent on others for daily activities (11%). Functional recovery did not depend on age but was to some degree related to the cause of coma (subarachnoid hemorrhage and other cerebrovascular disease having the worst recovery; hypoxia-ischemia, intermediate; and hepatic and miscellaneous causes, best) and especially to early clinical signs of brain dysfunction. Even within hours of the onset of coma, only one of 120 patients lacking two of corneal, pupillary, and oculovestibular responses ever regained independent function. The study identifies clinical features of comatose patients that appear within the first week and that are important for predicting recovery and designing future therapeutic trials.

Adult↗
PubMed1980

Reduction of oral tetracycline of lipolysis of triglycerides in hair lipid.

Oral tetracycline hydrochloride (Amphocycline) reduced significantly (P less than 0.05) the mean free fatty acid/triglyceride (FAA/TG) ratio in hair lipid, from 1.56 to 0.47 after treatment for 4 weeks, and to 0.64 after treatment for 8 weeks in 15 young men and women undergoing treatment for acne vulgaris. In a second similar group of 16 subjects who received the same oral therapy with antibiotic but who also applied a 10% (w/v) solution of ethyl lactate twice daily to affected areas on the face, the mean FFA/TG ratio was also reduced significantly (P less than 0.05) from 1.25 to 0.61 (after 4 weeks) and to 0.64 (after 8 weeks). In a third group of 16 subjects, whose only treatment was local application of ethyl lactate solution, the mean FFA/TG ratio was essentially unchanged throughout the period of treatment from 1,15, being 1.50 and 1.22 after 4 weeks and 8 weeks, respectively.

Acne Vulgaris↗
PubMed1980

Intracranial disease in non-Hodgkin's lymphoma.

In an eighteen month period ending October 1978, nine cases of intracranial Non-Hodgkin's lymphoma were diagnosed in this centre. Eight patients had lymphomatous meningitis and one, multiple intracerebral lymphoma deposits. The commonest presentation was with multiple cranial nerve palsies. Despite treatment five patients died within one month of diagnosis and at autopsy three patients were found to have extensive lymphoma involving the meninges. Three patients remain in remission after combination chemotherapy and radiotherapy. The incidence, clinical features, management and prognosis for this condition are discussed.

Adolescent↗
PubMed1978

Polyunsaturated fatty acids in treatment of acute remitting multiple sclerosis.

One hundred and sixteen patients with acute remitting multiple sclerosis (MS) took part in a double-blind controlled trial of treatment with polyunsaturated fatty acids and were randomly allocated to one of four groups. Two groups received linoleic acid, one alone as a spread and one with gamma-linolenic acid in capsules (Naudicelle); and two control groups received oleic acid, one as a spread and one in capsules. Rates of clinical deterioration and frequencies of attacks were not significantly different between treated and control groups. Exacerbations were shorter and less severe in patients receiving a high dose of linoleic acid than in controls, but those receiving a lower dose--that is, Naudicelle--showed no such difference. Thus supplementing the diet with 20 g linoleic acid marginally affected the duration and severity of relapses of MS but had no effect on overall disability. The dose of Naudicelle used provided insufficient supplementation.

Adult↗
PubMed1978

Hypothyroidism with true myotonia.

A patient with subclinical hypothyroidism who presented with true myotonia is described. There was no evidence that either he or members of his family had dystrophia myotonica or myotonia congenita. Treatment with thyroxine resolved his symptoms completely.

Adult↗
PubMed1977

A prospective study of nontraumatic coma: methods and results in 310 patients.

Neurological signs and outcome are compared in the first 310 patients from a continuing prospective study of coma not caused by trauma or drugs. Sixteen percent of the patients achieved an independent existence within a month; severe disability or the vegetative state developed in 25% of patients comatose for six hours and in 79% of those still in coma after a week. The chance of regaining an independent existence was greater in patients who, by one day, obeyed commands or moved the limbs appropriately in response to noxious stimuli or who had attained any of the following: orienting eye movements, normal responses to oculocephalic or oculovestibular stimulation, or normal muscle tone. Conversely, the chance of regaining an independent existence fell in patients who, after one day, had either extensor responses of the limbs or failed to move them in response to noxious stimuli or who lacked eye opening, pupillary reactions, corneal responses, or any eye movement in response to oculovestibular or oculocephalic stimulation. Beyond these general guidelines, numbers of patients with particular signs are presently too small for confident prediction of outcome.

Adolescent↗
PubMed1976

Rapid regular respiration in unconscious patients.

Respiratory frequency has been studied by strain gauge and impedance pneumography in a group of unconscious patients suffering from a variety of medical conditions, and has been compared with breathing in control subjects during wakefulness and sleep. Seventeen of 25 comatose patients had breathing patterns amenable to computerized statistical analysis of respiratory rate which demonstrated abnormalities in all patients studied. Unconscious patients breathed more rapidly and regularly than controls. Rapidity of respiration was not consistently associated with any specific central nervous system lesion, and was usually accompanied by coexistent pulmonary disease. Increasing regularity of respiration correlated well with deepening of coma and accurately reflected ultimate outcome even when other clinical signs were unchanging.

Adolescent↗
PubMed1976

Cervical myelopathy in rheumatoid arthritis.

Preliminary analysis of a follow-up study of one hundred patient with rheumatoid arthritis has lead to the following tentative conclusions: AAS is a common complication of rheumatoid arthritis. The incidence of AAS correlates with the duration of the disease. AAS is not necessarily associated with progressive myelopathy. AAS does not significantly affect survival in rheumatoid arthritis. AAS alone is not an indication for surgical operation, but this should be considered when there is intractable pain or progressive myelopathy.

Arthritis, Rheumatoid↗
PubMed1975

Cryptococcal meningoencephalitis.

A patient was admitted to hospital with an apparent psychiatric disturbance. When she became stuporous the cerebrospinal fluid was cultured but proved sterile. The latex test showed that serum was positive for cryptococcal antigens, and cryptococcal meningoencephalitis was diagnosed. Amphotericin B was given but when she developed a toxic reaction it was replaced by flucytosine. She responded well to flucytosine alone and no side effects appeared on continued treatment. Cryptococcal meningitis may present as a psychiatric disturbance, and serological tests are invaluable aids to diagnosis.

Adult↗