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D Dickson

Publications and source records attributed to D Dickson.

At least 181 records · Page 10Linked to original sources
PubMed1995

Risk factors for leg ulcer recurrence: a randomized trial of two types of compression stocking.

Patients with recently healed leg ulceration were entered into a study of leg ulcer recurrence. In all, 188 patients [69% women, mean age = 72 (SD = 12) years] were entered into the study, of whom 166 were considered suitable for ready-made stockings and were randomized to one of two class II below-knee compression stockings and followed for at least 18 months. The remaining patients required either made-to-measure stockings (5) or could not tolerate stockings owing to friable skin and were treated by other methods (17). Overall cumulative recurrence rate was 26% after 1 year and 31% at 18 months. Independent risk factors for (RR = 2.34, p = 0.021) and unsuitability for stockings (RR = 2.52, p = 0.013). The randomized groups had similar stockings, 25 (15%) could not put their stockings on at all and 43 (26%) were only able to put them on with great difficulty. The two stocking types differed significantly in this regard when analysed for trend.

Aged↗
PubMed1995

Comparison of Doppler echocardiographic methods with heart catheterisation in assessing aortic valve area in 100 patients with aortic stenosis.

OBJECTIVE: To examine the practicability and accuracy of Doppler echocardiographic methods in determining aortic valve area. METHODS: Aortic valve areas determined by three methods using Doppler echocardiography (applying the continuity equation and the modified Gorlin formula using data from Doppler echocardiography and right heart catheterisation) were compared with values obtained by heart catheterisation. PATIENTS: 100 consecutive patients with aortic stenosis aged between 34 and 83 years (mean (SD) 66 (10)). RESULTS: Differences in individual patients' measurements of aortic valve area by the three Doppler techniques varied by up to 0.56 cm2 compared with values obtained by heart catheterisation. On average, values obtained from Doppler echocardiographic methods lay up to 51% below and 78% above those obtained by heart catheterisation. CONCLUSIONS: All three Doppler echocardiographic methods were practicable in routine clinical practice for patients of all ages, but they were of limited accuracy when compared with the aortic valve areas found invasively using the invasive Gorlin equation. However, these deviations may not always be due to inadequacies of the Doppler methods: they could also be caused by limitations in the Gorlin formula. Doppler methods can be repeated if required, they allow examination of the morphology of the valve, and they subject the patient to considerably fewer risks than the invasive procedure. An adequate strategy in determining the severity of aortic valve stenosis would be to calculate the valve area by Doppler echocardiography as well as considering the valvar aortic pressure gradient. The valve area alone should not be relied on exclusively, as has been the increasing practice in the past few years.

Adult↗
PubMed1995

Apolipoprotein E genotype and Lewy body disease.

To determine whether apolipoprotein E (APOE) genotype affects neuropathology in Lewy body disease (LBD), we examined 18 cases of LBD that did not have concurrent Alzheimer's disease by the CERAD criteria. We obtained APOE genotypes, determined diffuse beta-amyloid plaque (A beta P) and Lewy body densities in multiple brain regions, and graded the intensity of CA2-3 ubiquitin-positive neurites, vacuolar change, nigral pathology, amyloid angiopathy, and subpial amyloid deposition. The APOE allele frequencies were as follows: epsilon 2, 0.14 +/- 0.07; epsilon 3, 0.64 +/- 0.08; and epsilon 4, 0.22 +/- 0.03. The mean A beta P density was lower in APOE epsilon 3/3 cases (14.5 A beta Ps per mm2) than in the groups with the APOE epsilon 2 (67.0) or APOE epsilon 4 (46.6) alleles. This difference was due largely to the difference between A beta P density in the APOE epsilon 2 group and the APOE epsilon 3/3 group (F = 5.525, p < 0.02). CA2-3 neuritic degeneration was greater in those with the APOE epsilon 4 allele than in those with the APOE epsilon 3/3 genotype (grade = 1.9 +/- 1.3 versus 0.938 +/- 0.9; Kruskal-Wallis test statistic = 6.962, p < 0.05). These data are consistent with the hypothesis that APOE genotype may affect neuropathology in LBD.

Aged↗
PubMed1995

Intestinal pseudo-obstruction and ischemia secondary to both beta 2-microglobulin and serum A amyloid deposition.

We present the case of a 61-year-old man on long-term hemodialysis in whom early colonic ischemia and pseudo- obstruction were caused by amyloid deposition of both the beta 2-microglobulin and AA type. The light microscopic diagnosis of amyloidosis was confirmed by Congo red birefringence, immunohistochemistry, and electron microscopy. The two types of amyloid had separate distributions within the colon. While both types affected submucosal and serosal blood vessels, the beta 2- microglobulin amyloid also formed large masses that displaced smooth muscle cells and was associated with Class II major histocompatibility-positive multinucleated giant cells. The pathogenesis of this uncommon occurrence of two amyloids and the role of chronic inflammation in amyloidogenesis are discussed.

Colitis, Ischemic↗