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Biomedical subjects

D Gibbons

Publications and source records attributed to D Gibbons.

At least 73 records · Page 4Linked to original sources
PubMed1969

Some effects of motor-car driving on the normal and abnormal heart.

Electrocardiograms were recorded in experienced motor-car drivers accustomed to busy city traffic while driving their own cars along familiar routes. The majority with normal hearts or a history of coronary heart disease increased their heart rates; brief periods when the rate exceeded 140/min. were recorded in both groups. ST changes not caused by tachycardia developed in 3 out of 32 normal drivers. Of 24 drivers with coronary heart disease 13 increased their ST and T abnormalities, the changes being gross in six. A further five developed multiple ventricular ectopic beats. Two coronary drivers experienced anginal pain and two left ventricular failure. Healthy motor-racing drivers increased their heart rates to 180/min. in the few minutes before the start of a race and to above 200/min. while racing.Little or no change in the plasma catecholamine levels was noted in three coronary subjects immediately after a city drive compared with resting levels. All the racing drivers showed a considerable increase in noradrenaline, and in one instance adrenaline, immediately after racing.Persons in whom angina is easily provoked when driving or who are in borderline left ventricular failure should be advised not to drive.

Adult↗
PubMedDate not supplied

ThinPrep Pap Test. Accuracy for glandular disease.

OBJECTIVE: Although the ThinPrep Pap Test is replacing conventional Pap smears in many clinical practices, experience with the identification of glandular lesions is limited. In this study, ThinPrep cytology of glandular lesions was evaluated in a large, inner city teaching hospital with high rates of glandular abnormality. STUDY DESIGN: Six months of ThinPrep diagnoses in 1998, following nearly 100% conversion of the laboratory to the ThinPrep Pap Test, were compared to January-December 1997 conventional smear diagnoses for glandular disease. Biopsy confirmation was evaluated for these cases. Findings on all biopsy-confirmed glandular cases were also compared to findings on cytology. RESULTS: Similar overall rates of glandular cytology were found. For conventional smears (12 months), 46 cases were diagnosed out of 43,289 smears (0.11%). For ThinPrep cytology (six months), 36 cases were diagnosed out of 25,783 slides (0.14%, P = NS). In the year 1997, 9 biopsy-confirmed conventional smear diagnoses of adenocarcinoma in situ (AIS) or adenocarcinoma were noted versus 10 for six months of 1998 for the ThinPrep method. A statistically significant reduction in the number of miscellaneous nonglandular (squamous) biopsy diagnoses were found with ThinPrep glandular cytology (14 vs. 4 cases, P < .05). For known biopsy-confirmed glandular cases of AIS or adenocarcinoma, a statistically significant reduction in the cytology false negative rate was noted with the ThinPrep method (17 vs. 4 cases, P < .02). CONCLUSION: The ThinPrep method provides more accurate diagnoses of glandular disease, with an increase in both sensitivity and specificity for glandular lesions.

Adenocarcinoma↗
PubMedDate not supplied

Fine needle aspiration diagnosis of combined hepatocellular carcinoma and cholangiocarcinoma. A case report.

BACKGROUND: The finding of a dual cellular population in a liver fine needle aspirate, in the appropriate clinical context, raises many differential diagnoses, including combined hepatocellular carcinoma and cholangiocarcinoma, a relatively rare form of primary liver carcinoma. CASE: A hepatitis C-positive patient with cirrhosis and rapidly worsening liver failure underwent fine needle aspiration of two radiologically detected liver masses. Abundant material composed of two cell populations, one typical of hepato-cellular carcinoma and one with features of mucin-producing adenocarcinoma, were found. Both components were positive for low molecular weight cytokeratins, the hepatocellular carcinoma component was positive for carcinoembryonic antigen (CEA) (B18 isoform) in a typical canalicular pattern, and the cholangiocarcinomatous component was positive for high molecular weight cytokeratins and CEA (isoforms B18 and D14). Both components were negative for alpha-fetoprotein. CONCLUSION: Identification of a dual cell population, such as this, in a liver fine needle aspirate should raise the possibility of a combined hepatocellular carcinoma and cholangiocarcinoma and is unlikely to represent metastatic disease. This variant of hepatocellular carcinoma is rare and constitutes 1-5% of primary liver carcinomas. It is important to make this diagnosis and to separate this tumor from the usual hepato-cellular carcinoma and metastatic carcinoma, since it may give rise to pure cholangiocarcinomatous metastatic deposits, adding to the diagnostic difficulties.

Aged↗
PubMedDate not supplied

Incidence of cervical dyskaryosis in Ireland: report of a five-year audit.

The implementation of a national cervical screening programme in Ireland will require agreement on achievable standards in reporting cervical cytology similar to those published by the NHS cervical screening programme. Due to the opportunistic nature of screening in the Republic of Ireland, national incidence figures for uterine cervical disease are not available. An audit of our practice was performed to find the incidence of human papilloma virus related cervical disease in our population. Our laboratory reported 158,066 cases from 1996-2000. The overall rate of dyskaryosis increased from 3.6% to 7.9%, mostly due to increased low grade dyskaryosis (up from 2.3% to 6.0%). High grade dyskaryosis also increased (from 1.3% to 1.9%), particularly in the under-25 year age group who account for a growing proportion of high grade dyskaryosis (from 15.4% of all high grade diagnoses in 1996 to 23.0% in 2000). The positive predictive value of a diagnosis of high grade dyskaryosis remained stable between 76.0 and 79.5%. While opportunistic screening data may not be directly applicable to the entire screening population it is hoped that these data may form a foundation on which to estimate national incidence figures and define achievable standards for cervical screening cytology in Ireland.

Adult↗