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Biomedical subjects

D Hunter

Publications and source records attributed to D Hunter.

At least 217 records · Page 12Linked to original sources

Osteomyelitis of the clavicle after Swan-Ganz catheterization.

Osteomyelitis of the clavicle is an uncommon complication of Swan-Ganz catheterization. The diagnosis should be suspected when the clinical features of fever and sterno-clavicular pain are present. Traditional roentgenograms may be falsely normal early in the disease. Radioactive isotope scanning may be helpful in establishing the diagnosis sooner, followed by tomography or computed tomography to better define the abnormality. Therapy should include long-term parenteral antibiotics and possible surgical removal.

Cardiac Catheterization↗

The prenatal prediction of thrombocytopenia in infants of mothers with clinically diagnosed immune thrombocytopenia.

The management of the pregnant patient with immune thrombocytopenia is complicated by the unavailability of the fetal platelet count. Since the transplacental passage of antiplatelet antibodies mediates infant thrombocytopenia, measurement of maternal platelet-associated IgG might predict infant outcome. We related the maternal platelet count and platelet-associated IgG level to the infant's platelet count in 41 pregnancies in 38 patients who were clinically diagnosed as having immune thrombocytopenia. Fifteen of 39 live-born infants were thrombocytopenic at delivery. Maternal platelet-associated IgG was predictive of infant platelet count but maternal platelet count was not; only one of the 20 infants delivered of the 18 thrombocytopenic mothers with normal platelet-associated IgG was affected, whereas 11 of 12 thrombocytopenic mothers with elevated platelet-associated IgG had thrombocytopenic infants. Five infants died in utero between 18 and 28 weeks' gestation, but otherwise there was no significant morbidity in the live births. Measurement of platelet associated IgG in mothers with immune thrombocytopenia during pregnancy can be used to predict infant thrombocytopenia, although it does not predict the severity of the thrombocytopenia.

Adult↗

Thrombocytopenia in preeclampsia and eclampsia.

1. The lack of a general agreement on the definition of PE makes the interpretation of laboratory findings in different series of these patients difficult. 2. Thrombocytopenia is the most common hemostatic abnormality in patients with PE and is caused by platelet consumption. 3. There is little concrete evidence that thrombin mediates the thrombocytopenia in most of these patients. 4. Immune mechanisms or severe vasospasm with resultant endothelial damage may contribute to the thrombocytopenia in some patients.

Anemia, Hemolytic↗

Peripheral nerve injection injury with steroid agents.

The possible neurotoxic effects of five commonly used steroid agents were examined. Using histologic studies and studies of the microneural circulation, it was found the steroids can indeed cause neurotoxicity. The injection site was critical in effecting injury. Only intrafascicular injection caused damage. The damage produced varied with the agent used. Dexamethasone (Decadron) caused minimal damage, while hydrocortisone (Solu-Cortef) and triamcinolone hexacetonide (Aristospan) caused widespread axonal and myelin degeneration. Disturbance in the blood-nerve barrier correlated with the changes noted on light and electron microscopy, but is thought to be coincidentally and not causally related. In conclusion, it was shown that the intrafascicular injection of commonly used steroid agents had a direct toxic effect on peripheral nerve-fibers and caused a disruption of the blood-nerve barrier. Use of the more toxic agents in the vicinity of peripheral nerves should probably be avoided.

Animals↗

Incidence of treated alcoholism in north-east Scotland, Orkney, and Shetland fishermen, 1966-70.

The psychiatric case register for the north-east of Scotland has been used to calculate the rates for first contact with a diagnosis of alcoholism by fishermen and non-fishermen in the years 1966-70. In each of these years the fishermen had higher rates than non-fishermen as a whole and also higher rates than the non-fishermen from social class IV, which is the social class to which most fishermen belong. The smaller differences between the rates of fishermen and non-fishermen in 1969 and 1970 relative to 1966, 1967, and 1968 may reflect a preferential "shedding" of older alcoholic fishermen at a time when there was a greater than usual contraction in the size of the work force. Differences between the rates for fishermen and non-fishermen were also evident in the age groups 20-29, 30-39, 40-49, and 50-59, being most pronounced in the 20-29 group. The findings are consistent with fishing being an occupation with a high risk for alcoholism.

Adolescent↗

Gait patterns of depressed patients and normal subjects.

The authors compared the gait patterns of 15 patients with affective disorders with those of 15 normal control subjects. The procedure involved a frame-by-frame analysis of a film of each subject walking at normal speed. Angle measurements were made of the hip and knee at their maximum extension during a single gait cycle (one stride). The results generally support the hypothesis that depressed patients walk with a lifting motion of the leg, whereas normal control subjects propel themselves forward.

Adolescent↗

Nerve allograft response: a quantitative immunological study.

The nerve allograft response between closely and distantly related inbred strains of rats was investigated. Lewis rats (RTl1) and Fischer rats (RTl1) have only minor histocompatibility differences, whereas Buffalo rats (RTlb) and ACI rats (RTla) differ from Lewis rats at the major histocompatibility locus. Lewis rats served as the recipient animals; the other three strains of rats provided donor nerves. The 51 Cr release cytotoxicity assay was used to asses antigen recognition. The results showed sensitization with ACI and Buffalo nerves as early as Day 8. When the donor and recipient were matched (Lewis/Fischer), sensitization occurred very late (Day 80). By contrast, with skin allografts, sensitization occurred early with all strains (Day 10), even when the animals differed only at the minor histocompatibility loci. Histological changes were similar in all three donor strains (Fischer, Buffalo, ACI). The strain of origin of the nerve could not be deduced by an unbiased examiner.

Animals↗

Observations on the occurrence of Salmonella cholerae-suis and other salmonellas in two herds of feeder pigs.

Modified brilliant green agar (BGA), Muller-Kauffmann tetrathionate, Rappaport's and selenite F broths were compared for their efficiency in isolating salmonellas from pigs and their excreta. It was concluded that BGA and Rappaport's broth were the media of choice. Where searches were made for Salmonella cholerae-suis alone, the use of a trehalose McConkey agar provided a rapid method of differentiating S. cholerae-suis, which does not ferment trehalose, from the majority of other salmonellas, which do ferment trehalose. Casualties were collected from two farms where infection with S. cholerae-suis was endemic. The isolation rates of S. cholerae-suis from different carcase sites were compared in order to determine the relative importance of the salivary, upper respiratory and faecal routes of excretion. S. cholerae-suis was isolated from numerous carcase sites in carriers including the salivary glands, tonsils, trachea and lungs. However, isolations from the nasal passages, mouth, pharynx and gastro-intestinal tract of carriers were either infrequent or absent. When, in a further study, S. cholerae-suis was isolated from only 3/414 faeces, 1/170 nasal swabs and not at all from 170 oral swabs taken from live pigs, it was concluded that there must be more significant modes of transmission than from the salivary glands, upper respiratory or gastro-intestinal tracts. Cannibalism was considered to be a possibility. In contrast to S. cholerae-suis, other salmonellas were frequently isolated from randomly collected faeces and from the gastro-intestinal tract as well as other sites in casualties.

Animals↗

Clinical and experimental aspects of injection injuries of peripheral nerves.

Injury to peripheral nerves complicating deep intramuscular injections of antibiotic and other agents is well recognized and can result in significant permanent neurological deficit. The purpose of this paper is to review the subject of nerve injection injuries, and report on a series of recent experimental studies carried out in this laboratory designed to improve our understanding of the pathophysiology of this condition and help provide a rational basis for its treatment. A wide variety of chemotherapeutic, prophylactic, and local anaesthetic agents in common use were injected into the sciatic nerve of the adult Wistar rat. Both intrafascicular and extrafascicular injections were examined. Results revealed that the site of injection was the most crucial factor in determining the degree of nerve fiber injury. Following intrafascicular injection, the degree of injury varied significantly, depending upon the specific agent injected. The most severe injuries were associated with wide-spread axonal and myelin degeneration. Pathological alterations in the nerve were evident as early as 30 minutes following injection injury. Regeneration was a constant finding in nerve damage by injection of the various agents. The mechanism of injury appeared to be a direct toxic effect of the injected compound on neural tissue, with an associated break down of the blood-nerve barrier.

Anesthetics, Local↗

Paranoid states of middle life. Familial occurrence and relationship to schizophrenia.

Paranoid states beginning in middle life were selected from a case register. A search among the sibs of those probands uncovered no paranoid states and schizophrenia was no more common than in the general population. The implications for the aetiology of paranoid states and for the relationship between these and schizophrenia are discussed.

Adult↗