Heroin and thrombocytopenia.
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Heroin Dependence↗
Biomedical subjects
D H Ryan
Publications and source records attributed to D H Ryan.
Diatrizoate enemas: facts and fallacies of colonic toxicity.
Rats were given enemas of Gastrografin in two strengths, Renografin--76, and Tween--80 in a 10% dilution. There were no deleterious effects on the colons with these media used in volumes to fill the colon. Severe changes resulted from volumes which produced overdistention.
Animals↗
The effects of restraint stress on intake of preferred and nonpreferred solutions in rodents.
In these experiments we determined whether stress influenced intake of different flavored test solutions or only those that were preferred. In a series of studies, rats or hamsters were exposed to acute (1 h) or repeated (3 h/day for 3 days) restraint stress immediately followed by access to one of four tastants (saccharin, salt, citric acid, or quinine solutions) paired with water in a 24-h preference test. As rats prefer salt and hamsters do not, both species were used to test the effects of stress on preferred vs. nonpreferred solutions using the same stimulus. Acute restraint inhibited intake of saccharin in rats but had no effect on preference, indicating that suppression of intake was not due to changes in hedonic response. Restraint had no effect on saccharin intake of hamsters but significantly increased salt intake. However, as the preference ratio remained low for the solution (0.26), the stress-induced increase in salt intake was probably associated with a disturbance of sodium and fluid balance rather than a change in sensory perception. This was supported by stress having no effect on intake of nonpreferred solutions in rats or hamsters. Repeated restraint had no effect on salt or saccharin intake of rats when test solutions were presented after stress, but rats showed no preference for saccharin in a subsequent study in which the solution was associated with onset of stress. These results indicate that stress has specific effects on saccharin and salt intake that are not limited to preferred solutions.
Animals↗
A clinical and immunologic study of blood transfusion and postoperative bacterial infection in spinal surgery.
Allogeneic blood transfusion has been implicated as an independent risk factor for postoperative bacterial infection in clinical and animal studies. The association among transfusion, quantitative immunologic factors, and infection was examined in 102 patients undergoing 109 spinal fusion procedures. In 60 procedures, patients received autologous blood only; in 24 procedures, they received at least 1 unit of allogeneic blood, and in 25 procedures, they received no transfusions. Twenty-two patients developed bacterial infections, in 8 cases while in hospital and in 14 cases after discharge. Univariate analysis revealed that patients who received any allogeneic blood and those who received no allogeneic blood differed significantly in the rate of hospital-acquired infection (20.8 vs. 3.5%), length of stay (12.3 vs. 9.7 days), days of fever greater than or equal to 38 degrees C (4.0 vs. 2.9), days on antibiotics (3.9 vs. 2.5), duration of surgery (309 vs. 231 min), blood loss (1343 vs. 887 mL), surgeon, and postoperative drop in natural killer (NK) cells (-174 vs. -42/microL). Multivariate logistic and linear regressions revealed that the number of allogeneic units transfused was the only significant predictor of in-hospital infection (p = 0.016) or days on antibiotics and length of stay. None of the clinical, surgical, or transfusion variables was significantly associated with posthospital infection, although a significantly greater drop in NK cells had occurred in patients who developed infection (p = 0.0035). These data strongly implicate allogeneic transfusion as a risk factor for in-hospital postoperative bacterial infection.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
A Scottish record linkage study of risk factors in medical history and dementia outcome in hospital patients.
The relative risk (RR) of acquiring a hospital diagnosis of dementia was estimated in 101,104 patients (1 in 25 fraction) randomly selected from total admissions to Scottish general hospitals between 1968 and 1977. The patients were allocated to putative at-risk groups according to main diagnosis at time of index admission, and RR of dementia (ICD 9,290) was contrasted between ten risk groups and a reference group. Record linkage was used to reduce admission episodes to individual cases, to link general and psychiatric Scottish Morbidity Records (SMR 1 and SMR 4), to identify subsequent admission diagnoses of dementia, and to establish person-years-at-risk for each case by linking to the Registrar General's mortality file. For males, RR was significantly increased in the 'hypertensive' risk group (RR 3.88:95% CI 2.18-9.89: p < 0.05) and was significantly reduced in the 'arterial disease' risk group (RR 0.57:95% CI 0.34-0.95: p < 0.05). There was a trend towards increased risk in the cerebrovascular category. For females, RR was significantly reduced in the 'cancer' risk group (RR 0.46:95% CI 0.34-0.63: p < 0.05). There was no evidence of significant alteration in RR in a number of other possible risk groups (endocrine, head injury, CNS/NS disease, ischaemic heart disease, peptic ulcer). Morbidity registers provide access to large data sets of low reliability. No attempt was made to distinguish between Alzheimer's disease and multi-infarct dementia cases, which limited scope for comparison with studies focused on Alzheimer's disease. Previous reports positive associations between head injury, thyroid disorder, and subsequent Alzheimer's disease were not replicated.
Aged↗
Apoptosis in the kidney.
Apoptosis is a highly regulated mechanism of cell death. Although apoptosis has a functional role in normal development and tissue homeostasis, aberrant triggering of the process by toxicants may lead to abnormal function or disease. Low level exposures to toxicants that induce apoptosis in kidney may therefore create a critical disturbance in kidney homeostasis, contributing to renal neoplasia or renal disease. In this report, we review the involvement of apoptosis in normal kidney development and in renal disease and discuss some of the toxicants and molecular factors involved in regulation of the process in renal cells.
Animals↗
Phase II evaluation of teniposide and ifosfamide in refractory adult acute lymphocytic leukemia: a Southwest Oncology Group Study.
The Southwest Oncology Group undertook a phase II study of teniposide (VM-26) and ifosfamide in refractory adult acute lymphocytic leukemia. The 49 evaluable patients were heavily pretreated; 15 of these had received only one prior induction attempt. Two treatment regimens were used. Eighteen patients received VM-26 (30 mg/m2) on Days 1-5 and ifosfamide (1000 mg/m2) by continuous iv infusion on Days 1-5. When acceptable toxicity was observed, the dose of VM-26 was increased and 30 patients received VM-26 (50 mg/m2) on Days 1-5 in addition to ifosfamide. Complete remission (CR) was observed in two patients who received the lower-dose VM-26 regimen and in six patients who received the higher-dose regimen. Of the eight patients who achieved CR, six were found among the 15 patients who had received only one prior induction therapy. Hematologic toxicity was the major toxic effect observed, with 41 patients (84%) having wbc counts less than 1000/microliter during induction therapy. Nonhematologic toxicity was dose-limiting in seven patients for the following reasons: hematuria (four patients), neurological disturbance (one), and mucositis (two). The combination of VM-26 and ifosfamide is capable of producing CR in refractory acute lymphocytic leukemia in adults with manageable toxicity. Inclusion of the combination in a multidrug consolidation regimen for newly diagnosed patients is an appropriate avenue for further study.
Adolescent↗
Phase II evaluation of amsacrine (m-AMSA) in solid tumors, myeloma, and lymphoma: a University of Arizona and Southwest Oncology Group Study.
A phase II trial was conducted to determine the clinical activity of amsacrine (m-AMSA) in patients with heavily pretreated solid tumors, myeloma, and lymphoma at the University of Arizona Cancer Center. Additionally, m-AMSA was evaluated at other Southwest Oncology Group institutions in breast cancer, myeloma, melanoma, and oat cell cancer of the lung. At a dose of 120 mg/m2 given iv every 28 days, 12 partial responses were observed in 221 patients evaluable for response. Some antitumor activity was observed in breast cancer (four responses of 65 patients), non-Hodgkin's lymphoma (three of nine), Hodgkin's disease (two of five), and sarcoma (two of 15). A partial response was also documented in one of two patients with cervical cancer. Among the 135 patients treated at the University of Arizona who were extensively evaluated for toxic effects, only myelosuppression and anemia were seen in a significant number of patients. At this dose and schedule, 29% of patients developed leukopenia of less than 3000 cells/mm3, 16% developed a thrombocytopenia of less than 100,000 cells/mm3, and 29% had an acute fall in hemoglobin of greater than or equal to 2 g/100 ml. In addition, two patients suffered grand mal seizures which were not clearly drug-related. These results suggest that further study of m-AMSA in lymphoma, sarcoma, and cervical cancer is warranted.
Adolescent↗
Doxorubicin and ifosfamide combination chemotherapy in previously treated acute leukemia in adults: a Southwest Oncology Group pilot study.
The Southwest Oncology Group did a limited institutional pilot study of the combination of doxorubicin and ifosfamide in the treatment of previously treated adult patients with acute leukemia. Thirty-four patients received one or two courses of the combination. All patients had received prior chemotherapy and 32 had received prior anthracycline chemotherapy. Three patients died before their responses could be fully evaluated. Fourteen patients achieved complete remission (41%) and one patient achieved partial remission. The complete remission rate was 27% for patients with acute myeloblastic leukemia (myelomonoblastic leukemia, monoblastic leukemia, and erythroleukemia) and 89% for patients with acute lymphocytic and undifferentiated leukemia (ALL). Toxic effects included severe hematologic reactions in 33 of 34 patients, hematuria in six patients, altered sensorium in one patient, and congestive heart failure in one patient. The safety of the combination was established and toxic side effects of this therapy were tolerable. The 89% complete remission rate for previously treated patients with ALL suggests that the combination of doxorubicin and ifosfamide may be particularly effective in ALL.
Acute Disease↗
Age-specific hospital incidence rates in dementia. A record linkage study of first-admission rates to Scottish hospitals (1968-1987).
A random sample (n = 101,104) was taken from total general hospital admissions to Scottish hospitals (1:25 fraction) during the period 1968-1977. Record linkage was used to connect general hospital and psychiatric hospital morbidity records (SMR 1 and SMR 4). Patients with a subsequent admission with dementia (principal diagnosis ICD 9,290) were identified from the general hospital sample on follow-up. Age-specific first-admission rates for dementia were calculated for the hospital population considered. First-admission rates ranged from 41.9 (per 100,000 person-years-at-risk, PYR) for male patients aged 60-64 years to 514.2 in the age band 80 years and over. The equivalent figures for female patients were 40.8 (per 100,000 PYR) and 723.1. Epidemiological research has shown an approximate doubling of prevalence rates every 5 years after the age of 60 years, and the age-banded hospital admission rates in the present study are consistent with this underlying pattern. Expected first-admission rates in dementia were calculated from admission rates in dementia and community prevalence reported in previous studies. Expected rates were contrasted with the rates observed in the present study. An estimated 6-7% of prevalent dementia cases and between 11 and 14% of 'expected dementia admissions' achieved a recorded main diagnosis of dementia, and proportions were stable across age bands in the case of both measures. The wide discrepancy between expected and observed admission rates suggests relative underreporting of dementia as a principal diagnosis in hospital statistics.
Age Distribution↗