Search PubMedSearch

Biomedical subjects

D Allen

Publications and source records attributed to D Allen.

At least 109 records · Page 6Linked to original sources

A case of cavitating pneumonia in AIDS.

Tuberculosis is a common cause of cavitating pneumonia in Singapore. In patients with the human immunodeficiency virus (HIV), cavitary pneumonias mimicking tuberculosis can mislead the clinician, delaying diagnosis, resulting in increased morbidity. We describe a HIV seropositive patient with cavitating pneumonia in whom the diagnosis of Pneumocystis carinii pneumonia (PCP) was ultimately established only on bronchoscopy.

AIDS-Related Opportunistic Infections

Advanced breast cancer in Egyptian women: clinical features and response to endocrine therapy. The Anglo-Egyptian Health Agreement Collaborative Study.

Response to endocrine therapy and its relationship to the clinical features of the disease were studied in 84 Egyptian patients with inoperable, locally advanced or metastatic breast cancer. Twenty-four premenopausal patients were treated by oophorectomy with or without concurrent prednisolone. Only one of 20 evaluable patients achieved an objective response. Median time to progression for premenopausal patients was 3 months. Sixty postmenopausal patients received tamoxifen 10 mg twice daily either alone or with prednisolone. Fourteen of 57 (25%) evaluable patients achieved an objective response (four complete remission, 10 partial remission). Median duration of response was 13 months and median time to progression for all postmenopausal patients was 5 months (range 1-30 months). The outcome for postmenopausal patients was similar to that found in a parallel study at Guy's Hospital, London. The response rate for premenopausal Egyptian patients was, however, disappointing and lends support to the claim that breast cancer in Egyptian women is particularly aggressive.

Adult

Repair of a ruptured calcaneal tendon by transposition of the tendon of the peroneus longus muscle in a goat.

Traumatic rupture of the calcaneal tendon was diagnosed in a 3-year-old female goat. Clinical features included tarsal hyperflexion and diffuse swelling in the area of the calcaneal tendon. Surgical repair consisted of debridement of devitalized tissue and transposition of the tendon of the peroneus longus muscle to bridge the calcaneal tendon defect. Adequate postoperative immobilization followed by gradual introduction of tendon loading allowed a favorable outcome.

Animals

Surgical treatment of sacral fracture in a horse.

An 8-year-old Arabian stallion had signs of severe tailhead pruritus and slowly progressive loss of tail tone for 3 months. Palpation per rectum and radiography of the sacrocaudal region revealed a transverse, ventrally displaced fracture of the caudal portion of the sacrum. Surgical decompression and tail amputation resulted in complete recovery of athletic and reproductive function. Evidence of cauda equina neuritis was not seen on histologic examination of nerve roots obtained at surgery.

Amputation, Surgical

The effects of repeated doses of clomipramine and alprazolam on physiological, psychomotor and cognitive functions in normal subjects.

The effects of a 10 day administration of clomipramine (25-50 mg t.i.d.), alprazolam (0.25-0.75 mg t.i.d.) and placebo were assessed in normal volunteers in a double-blind cross-over study. A battery of physiological, psychomotor and cognitive tests was administered both before and 3 h after drug on days 1, 5 and 10. The effects of alprazolam on EEG and evoked potentials were characteristic of benzodiazepines; clomipramine had little effect. In contrast, reaction speed was markedly slowed by clomipramine but little affected by alprazolam. Neither drug produced any accumulation of effect on a verbal recall task but neither did tolerance develop to the acute impairments produced by active treatments. Alprazolam produced an increase in levels of forgetting, especially on day 5. Subjective ratings for mood and bodily symptoms were adversely affected by clomipramine but little altered by alprazolam. It is suggested that some of the differences between drug treatments may be due to differences in the speed of onset of tolerance.

Adult

Theory of eccentric photorefraction (photoretinoscopy): astigmatic eyes.

An optical analysis of eccentric photorefraction (photoretinoscopy) of astigmatic eyes is presented. The size and the angular tilt of the dark crescent appearing in the subject's pupil are derived as a function of five variables: the ametropia of the eye (Dsph, Dcyl, axis), the eccentricity of the flash, e, and the distance of the camera from the subject's eye, dc. A simplified solution and a solution of the inverse problem, which enable one to calculate the degree of ametropia from the size and the tilt of the crescent, are also presented. If the crescent is smaller than the pupil, both the size and the tilt of the dark crescent are independent of the pupil size. The angular tilt of the crescent is also independent of the eccentricity. Characteristic changes of the crescent as a function of the cylinder axis are illustrated for compound and mixed astigmatisms. The validity of the theoretical predictions was experimentally verified on a model eye.

Astigmatism

Intracranial trauma associated with extraction of a temporal ear tooth (dentigerous cyst) in a horse.

Heterotopic polyodontia is typically associated with a sinus and a fistulous tract with a secreting membrane which extends to an ectopic tooth attached to the temporal bone. Recommendations for treatment include complete excision of the tract, the dental component, and the lining of the alveolar socket. Iatrogenic cerebral trauma was encountered during surgical extraction of an ectopic tooth. At post-mortem examination a second ectopic tooth was found compressing the right side of the cerebellum.

Animals

Dose-response profiles of plasma growth hormone and vasopressin after clonidine challenge in man.

The objective of the study was to determine dose-response relationships of growth hormone, vasopressin, blood pressure, heart rate, and behavioral responses to clonidine. Ten healthy male volunteers were tested with each of three doses of clonidine (0.7, 1.4, and 2.1 micrograms/kg) with at least 1 week between tests. All doses gave a significant growth hormone response with a peak at 50 min. The high dose gave a significantly higher response than either the medium dose or the low dose, which did not differ from each other. Within individual subjects, there was a consistency of response to the different doses; thus, three of the volunteers had responses of 5 ng/ml or higher to the low dose. Those three subjects had higher growth hormone peaks after the highest dose than did six other subjects. Vasopressin showed a drop following clonidine after the two higher doses. Systolic blood pressure dropped following clonidine, showing a significantly greater drop for the medium and high doses than for the low dose. Diastolic blood pressure also showed a drop, but responsiveness did not differ between doses. There was significant dryness of mouth produced by clonidine, but no difference between doses. There was a significant sedative effect following clonidine which was greater for the high dose than for the medium or low dose. The finding that some subjects had a growth hormone peak of 5 ng/ml or greater after the low dose supports the hypothesis that use of a low dose strategy may be useful in confirming supersensitivity in conditions where increased responsiveness is suspected. The lack of difference between blood pressure responses to the medium and high doses of clonidine--doses that have different effects on growth hormone--supports the hypothesis that differences in responsiveness of presynaptic and postsynaptic alpha 2-adrenergic receptors exist.

Adult

Gene amplification on chromosome band 11q13 and oestrogen receptor status in breast cancer.

We have analysed DNA from 183 primary breast cancers for amplification or rearrangement of a number of cellular proto-oncogenes, focusing primarily on a cluster of markers on the long arm of chromosome 11. Two of these oncogenes, INT2 and HST1, both of which encode members of the fibroblast growth factor family, are implicated in the generation of virally induced mammary tumours in mice. Here we confirm earlier reports that the q13 region of chromosome 11, in which these genes are tandemly linked, is modestly amplified in approximately 15% of primary human breast cancers. This amplification is confined, with one exception, to cases in which the oestrogen receptor (ER) levels are in excess of 20 fmol/mg protein (P = 0.001). However, DNA amplification does not usually result in detectable expression of either the INT2 or HST1 gene. The data imply that some other gene in the vicinity must contribute to the development of a subset of ER-positive tumours and that assessing the amplification of this region of DNA may be of value in defining a separate category of ER-positive tumour.

Adult

DNA index, S-phase fraction, histological grade and prognosis in breast cancer.

DNA index and S-phase fraction (SPF) were measured by flow cytometry on paraffin embedded tissue from 140 primary breast tumours. The results of DNA analysis were compared with the size, degree of axillary node involvement, histological grade and steroid receptor content of the tumours, as well as with the patients' subsequent clinical course. Forty-four (31.4%) of the 140 tumours were diploid. S-phase fraction was evaluable for 134 (95.7%). The median SPF of the whole population was 7.1%, with diploid tumours having a significantly lower median SPF (3.2%) than aneuploid (10.1%, P less than 0.001). Both aneuploidy (P = 0.002) and high SPF (P less than 0.001) were strongly associated with high histological grade. There was no significant association between either DNA ploidy or SPF and tumour size, nodal status or steroid receptor content. An SPF below the median was strongly associated with better relapse-free survival (P = 0.008), overall survival (P = 0.004) and survival after relapse (P less than 0.001). Ploidy did not correlate significantly with clinical course. Multivariate analysis using the Cox model suggested that, while SPF gave prognostic information independent of tumour size or nodal status, this independent significance was lost when histological grade was included in the analysis.

Adult

Evaluation of a special behaviour unit for people with mental handicaps and challenging behaviour.

A descriptive evaluation is provided of a hospital-based unit for people with mental handicaps and challenging behaviours. The characteristics of clients admitted to the unit over a 15-month period are described, together with admission and discharge patterns, and treatment interventions undertaken. The progress of four clients is studied in detail via single-case studies. While reductions in levels of challenging behaviour occurred during admission, these changes were not generally maintained at follow-up. Implications for future service design are discussed.

Adult

Day hospital care.

Explore the source record for details and available documents.

Consumer Behavior

Evaluation of equine digital Starling forces and hemodynamics during early laminitis.

A carbohydrate overload model was used in 8 horses to evaluate Starling forces and hemodynamics of the digit during the prodromal stage of acute laminitis. A pump-perfused extracorporeal digital preparation was used to evaluate blood flow, arterial pressure, venous pressure, capillary pressure, isogravimetric capillary filtration coefficient, osmotic reflection coefficient, and vascular compliance. From these data, pre- and postcapillary resistances and pre- to postcapillary resistance ratios were determined. Vascular and tissue oncotic pressures were estimated from plasma and lymph protein concentrations, respectively. The osmotic reflection coefficient, an estimation of capillary permeability, was determined by means of the lymph protein wash-down technique. Using the collected data, tissue pressure in the digit was calculated by use of the Starling equation. In the isolated digit, mean isogravimetric capillary pressure was 55.13 mm of Hg, mean plasma and lymph oncotic pressures were 22.29 mm of Hg and 7.2 mm of Hg, respectively, the mean osmotic reflection coefficient was 0.66, the mean capillary filtration coefficient was 0.003 ml/min/mm of Hg/100 g, and mean interstitial fluid pressure was 44.82 mm of Hg. The high capillary pressure appeared to be caused by high vascular resistance from the venous side, predisposing to enhanced capillary filtration and interstitial fluid accumulation.

Animals