Search PubMed⌕ Search

Biomedical subjects

D Hull

Publications and source records attributed to D Hull.

At least 37 records · Page 2Linked to original sources
PubMed1992

Liver transplantation for acute fulminant hepatic failure.

Orthotopic liver transplantation (OLT) remains the only option for progressive acute fulminant hepatic failure (FHF). The overall one-year survival is approximately 58% versus 75% for all patients undergoing OLT. Nevertheless, this is superior to the results obtained with medical management alone, which carries a mortality of approximately 60-85%. Seven of 32 patients at Hartford Hospital (22%) received liver transplants for acute FHF; the one-year survival was 57%. Four of seven patients are alive with complete neurologic recovery. One case is presented in detail.

Acute Disease↗
PubMed1991

A randomised single blind trial of a combined mumps measles rubella vaccine to evaluate serological response and reactions in the UK population.

Four hundred and twenty children were randomly assigned to receive either mumps measles rubella (MMR) vaccine (207) or measles vaccine (213) in a single blind study, to investigate the reactogenicity and serology of the MMR vaccine. There was no significant difference between the number of children developing symptoms after MMR vaccination to those developing symptoms after measles vaccination. Both vaccines are associated with a rash, temperature and restlessness five to thirteen days after vaccination. The serological response to measles vaccine was similar in both groups with 92-6% seroconverting with MMR, and 96-8% with measles. Seroconvertion against mumps and rubella with the MMR vaccine was 88% and 96% respectively. This study confirms the safety and efficacy of the MMR vaccine in a UK population.

Drug Combinations↗
PubMed1991

Maternal and umbilical venous plasma lipid concentrations at delivery in the mare.

The concentrations and fatty acid composition of the plasma free fatty acid, triacylglycerol and phospholipid fractions were determined in maternal and umbilical cord vein blood samples taken at delivery from 17 mares. Maternal and umbilical vein plasma free fatty acid concentrations were of a similar order and a positive correlation was found between the two levels suggesting that the equine placenta is permeable to fatty acid. Substantial amounts of the essential fatty acids and their longer chain derivatives were seen in both umbilical vein plasma free fatty acid and phospholipid fractions supporting this view. Certain long chain polyunsaturated derivatives of the essential fatty acids found in the umbilical venous plasma phospholipid fraction were not seen in the maternal circulating lipids. The precursor fatty acids were readily available to both foetal and placental tissues and therefore must have been elongated and incorporated into phospholipid by either or both. Very small amounts of the essential fatty acids were found in adipose stores in the newborn foal and virtually no fat stores at all in the newborn foal liver.

Adipose Tissue↗
PubMed1991

A dose ranging study of ibuprofen suspension as an antipyretic.

A double blind trial was conducted to determine the dose of ibuprofen suspension, which is effective in reducing the body temperature. The principal measure of efficacy was a reduction in axillary temperature of 1 degree C or more three hours after dosing. A second objective of the trial was to compare the incidence and severity of side effects and the palatability of a range of ibuprofen doses. Ninety three children were included in the analysis. All four doses of ibuprofen studied (0.625 mg/kg-5 mg/kg) were associated with temperature reduction and only the lowest dose failed to satisfy the principal measure of efficacy. The influence of dose on the magnitude of the body temperature reduction was significant and the 5 mg/kg dose achieved the largest mean reduction in body temperature (2 degrees C). The tolerability and palatability of all doses studied were excellent. These findings suggest that ibuprofen is a good alternative to paracetamol as an antipyretic.

Child, Preschool↗
PubMed1991

Noncompliance in organ transplant recipients.

The frequency of noncompliance with postoperative medical therapy ranges from 2% to 43% in organ transplant recipients and causes more graft loss than uncontrolled rejection in compliant patients. Retrospective and prospective studies undertaken at our center showed no difference in the rate of noncompliance between males and females or between recipients of cadaveric kidneys and those from living, related donors. Patients less than 20 years of age were statistically the most noncompliant (p = 0.0001) compared with those over 40 years. A significant difference in compliance was seen among blacks, Hispanics, and non-Hispanic whites, with the greatest frequency in blacks. This was not due to race, but to socioeconomic status, with those in the low socioeconomic group the most noncompliant. Problems of noncompliance may be reduced if they are identified early in the treatment course.

Humans↗
PubMed1991

Effects of altering umbilical flow and umbilical free fatty acid concentration on transfer of free fatty acids across the rabbit placenta.

The transfer of free fatty acids across the placenta perfused in situ was studied in anaesthetized rabbits in late gestation. In the first series of experiments, umbilical flow rate was varied between 0.6 and 4.0 ml/min in nine rabbits. Although increasing umbilical flow rate significantly decreased the free fatty acid concentration in the umbilical venous effluent (P = 0.0001), placental clearance of free fatty acids from the maternal circulation was not significantly changed by alterations in umbilical flow rate. In the second series of experiments, the materno-fetal free fatty acid concentration gradient was varied between + 1.58 mmol/l and -2.81 mmol/l in eight rabbits. There was a significant relationship between increasing materno-fetal gradient and increasing transfer of free fatty acids across the placenta (P less than 0.001). Moreover, net transfer of free fatty acids into the umbilical circulation was observed even with zero concentration gradient. Net transfer of free fatty acids from fetus to mother occurred when umbilical arterial free fatty acid concentration exceeded maternal arterial concentration by 1.3 mmol/l.

Analysis of Variance↗
PubMed1990

Liver transplant for metastatic neuroendocrine tumor.

Generally, the results of liver transplantation for metastatic liver disease have not been favorable. One exception has been the unique group of neuroendocrine tumors, the slow growth of which allows liver transplantation to effectively palliate and control symptoms. We report two cases: (a) A 51-year-old man who underwent orthotopic liver transplantation and resection of the pancreatic primary tumor for a nonfunctioning malignant neuroendocrine tumor with features of both carcinoid and islet-cell glucagonoma remains symptom-free and without evidence of tumor recurrence at 13 months follow-up. (b) A 47-year-old man who underwent orthotopic liver transplantation and Whipple resection for a metastatic islet-cell tumor in the head of the pancreas is fully recovered at 5 months follow-up.

Humans↗
PubMed1990

Noncompliance in organ transplant recipients.

Noncompliance with medication and follow-up care was evaluated in 538 renal, 50 heart, and 13 liver transplant recipients. In a retrospective review of 260 kidney transplant recipients followed from three months posttransplant, the incidence of medication noncompliance was 18%. It was 15% in a prospective study of 196 kidney recipients from 1984 to 1987. Patients most likely to become noncompliant were young and in a lower socioeconomic group. There was no significant difference in the incidence of noncompliance with respect to cadaveric vs. living-related donor kidney source, or in male vs. female patients. There was a higher incidence of noncompliance in blacks and Hispanics, but that may have been due to a higher incidence of lower socioeconomic status in those groups. Noncompliance can occur many years posttransplant and was seen in heart and liver transplant recipients. In the retrospective study, 91% of kidney transplant recipients who were noncompliant with medications and follow-up care either lost their grafts or died. Noncompliant behavior was usually not predictable and was often without an identifiable reason. Efforts to increase compliance, such as better patient selection, more education, and simplified medical regimens may have reduced the incidence of noncompliance in recent patients.

Black or African American↗
PubMed1990

D(+)-glyceric aciduria: etiology and clinical consequences.

A family comprising mother, father, and five children is described. Four of the children were found to excrete massive amounts of D(+)-glyceric acid in their urine. This was verified by gas chromatography-mass spectrometry and the configuration determined by capillary gas chromatography of O-acetylated menthyl esters. The excretion ranged from 10.8 to 19.9 mmol/24 h. The remaining child and the parents showed no evidence of this unusual metabolite. The virtual absence of clinical manifestations in this family was particularly interesting. Only two of the children showed any clinical abnormality and this was limited to mild microcephaly and speech delay; the other two children found to excrete large amounts of D(+)-glycerate were healthy and developmentally normal at 7 y and 9 y of age. There was a marked increase in the excretion rate of D(+)-glycerate in response to both oral fructose and serine loading. These results are consistent with a deficiency of D(+)-glycerate kinase and indicate the potentially benign nature of this disorder.

Administration, Oral↗