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Biomedical subjects

D B Reid

Publications and source records attributed to D B Reid.

At least 37 records · Page 2Linked to original sources
PubMed1991

Early experience with intra-arterial thrombolytic therapy for peripheral arterial occlusion.

The authors present their early experience with local intra-arterial thrombolytic therapy for peripheral arterial occlusions causing limb threatening ischaemia, using streptokinase or urokinase. Ten patients were treated in a period of one year. Five patients had successful recanalisation, two patients had partial success and three patients required major amputation. The indications, contraindications and results of this treatment are reviewed.

Adult↗
PubMed1990

Infected false aneurysms in the groin of intravenous drug abusers.

The hazards of dealing with infected false femoral aneurysms resulting from intra-arterial narcotic injection are highlighted in six patients. Two patients were human immunodeficiency virus positive and three patients were hepatitis B surface antigen positive. Because of these infections exploration of groin swellings as presumed soft tissue abscesses is potentially hazardous without proper proximal vascular control. All patients underwent reconstruction following arterial ligation and five grafts became infected, with life threatening haemorrhage occurring in four patients. Five grafts have subsequently occluded or have been removed without loss of limb viability, although two patients have been regrafted. A high index of suspicion and assessment by a vascular surgeon, with angiography if indicated, is required in any intravenous drug abuser presenting with a groin swelling following injection. Because of the great risk of graft infection, it is suggested that ligation and debridement alone be carried out, with immediate arterial reconstruction only for non-viability.

Adult↗
PubMed1990

Abdominal aortic aneurysm: a preventable cause of death?

Abdominal aortic aneurysm as a cause of death may be preventable by surgery. This paper reviews current theories of aetiology, incidence and detection with particular reference to population screening for aneurysm and to reducing the operative mortality rate by detecting the correctable risk factors of surgical treatment.

Aorta, Abdominal↗
PubMed1989

Myoclonus associated with treatment with high doses of morphine: the role of supplemental drugs.

OBJECTIVE: To estimate the prevalence of important side effects in patients with malignant disease who were receiving high doses of morphine as part of their palliative treatment. DESIGN: Data on patients were collected over 12 months. SETTING: Two palliative care units in Western Australia. PATIENTS: 19 Patients with malignant disease who were receiving morphine either subcutaneously or orally as the main analgesic. 10 Patients receiving a total daily dose of morphine of at least 500 mg orally or 250 mg parenterally were enrolled in the study. The other 9 patients were enrolled after an important problem thought to be related to the morphine had been identified. All of the patients were taking drugs to supplement the treatment. INTERVENTIONS: The dose of morphine or route of administration, or both, was changed in three patients. MAIN OUTCOME MEASURE: Determination of the prevalence of side effects in the patients. Assessment of the relation of any side effects with the supplemental drugs taken by the patients. MAIN RESULTS: Plasma morphine and electrolyte concentrations were measured and a full history taken for each patient. Thirteen of the 19 patients had an important side effect; 12 of them had myoclonus and one had hyperalgesia of the skin. Plasma morphine concentrations were similar in patients with and without myoclonus, ranging from 158 to 3465 nmol/l and 39 to 2821 nmol/l respectively. Eight of the patients with side effects were taking an antipsychotic drug concurrently compared with none of those without side effects. A greater proportion of patients with side effects were taking the antinauseant drug thiethylperazine (6/13 v 2/6) and at least one non-steroidal anti-inflammatory drug (10/13 v 2/6), whereas a smaller proportion were taking a glucocorticosteroid (3/13 v 4/6). The estimated prevalence of important side effects in the total population of patients receiving palliative treatment in the two units was 2.7-3.6%. CONCLUSIONS: Myoclonus as a side effect of treatment with morphine is more likely to occur in patients taking antidepressant or antipsychotic drugs as antiemetics or as adjuvant agents or non-steroidal anti-inflammatory drugs for additional analgesia. If a patient develops myoclonus the best approach may be to change the supplemental treatment.

Adult↗
PubMed1977

Tensile strength of fascia lata sutures following gamma radiation.

Gamma radiation (Co-60) is used to sterilize biological sutures. We wished to compare the effect of gamma-radiation in doses of 2.7 and 4.0 Mrads on the tensile strength of human fascia lata sutures obtained from the same cadaver. Five variables of tensile strength viz. Breaking Elongation, Breaking Load, Yield Point Load, Work of Rupture and Elastic Stiffness were determined for each suture. For Breaking Elongation the mean strength for the 4.0 Mrad dose was 3% less than for 2.7 Mrad dose (P less than 0.05); for Breaking Load 11% less (P less than 0.01); for Yield Point Load 9% less (P less than 0.02); for Work of Rupture 14% less (P less than 0.01); and for Elastic Stiffness 8% less (P less than 0.02). Irradiation with 4.0 Mrads, does not greatly change the tensile strength characteristics of fascia lata sutures.

Adult↗
PubMed1977

Ultimate tensile strength of gamma irradiated human scleral sutures.

Scleral sutures were prepared by hand from the equatorial region of 53 paired donor eyes. The weakening produced by two doses of gamma Co-60 radiation (2.7 and 4.0 Mrads) was compared using measurements of tensile strength; the strength of unirradiated scleral sutures was also measured, for comparison. The three variables of tensile strength, viz. Breaking Elongation, Breaking Load, and Work of Rupture was determined for each suture. As compared to unirradiated sutures, Breaking Elongation decreased on irradiation (P less than 0.01), but the two doses of irradiation were not statistically significant (P greater than 0.05); Breaking Load increased on irradiation (P less than 0.01), but the two doses of irradiation were again not significant (P greater than 0.05). Only 4.0 Mrads irradiated scleral sutures, as compared to unirradiated ones, showed a statistically significant reduction (P less than 0.01) for Work of Rupture. No definite relationships were found by regression analysis among the tensile strength variables and the independent variables of sex and various storage times for the 4.0 Mrad data. Work of Rupture showed a negative relationship to the age of donors, though the change with age was small.

Dose-Response Relationship, Radiation↗
PubMed1975

Excretion of inhibitors of calcification in urine. Part I. Findings in control subjects and patients with renal stones.

The total excretion of inhibitors of in vitro calcification was measured (in inhibiting units per day) in 24-hour urine samples of 11 control subjects and 20 patients with renal calculi. A semiquantitative method incorporating the rachitic rat cartilage technique was used. In both groups there was a significant positive correlation between the number of inhibiting units per day and the daily urine volume. The mean number of inhibiting units per day was significantly (P smaller than 0.05) higher in the stone patients than in the controls. However, the stone-formers had significantly larger (P smaller than 0.01) 24-hour urine volumes. When corrections were made for urine volume there was no significant difference between the two groups. These data suggest that the underlying abnormality responsible for renal stone formation is not a persistent decrease in the total concentration of urinary inhibitors of calcification.

Adult↗
PubMed1975

Excretion of inhibitors of calcification in urine Part II. Findings in patients with chronic renal failure.

By means of a semiquantitative method incorporating the rachitic rat cartilage technique, the total urinary inhibitory activity with respect to calcification was compared in 11 control subjects and 20 patients with renal failure. The patients had significantly lower mean values of inhibiting units per day than did the control subjects. Both groups showed a significant positive correlation between the number of inhibiting units per day and urine volume. When urine volume was taken into account in the comparison, the numbers of inhibiting units for patients continued to be lower than the numbers for controls. These findings are consistent with the hypothesis that the increase of inhibitory activity observed in uremic serum is secondary to a decrease in excretion of the responsible factor (or factors) in the urine, and that the factor (or factors) in serum responsible for the inhibition are identical to those in the urine.

Adult↗