Search PubMed⌕ Search

Biomedical subjects

D J Allison

Publications and source records attributed to D J Allison.

At least 109 records · Page 6Linked to original sources
PubMed1982

Analysis of fatalities from acute narcotism in a major urban area.

The incidence of acute, fatal narcotism in San Francisco was determined to be 3.2% of all deaths (10 882) subject to medical examiner's inquiry in a five-year period. Heroin was responsible for the greatest number of these cases, usually accompanied by alcohol or other abused drugs. The median concentration of the heroin metabolite, morphine, in the blood in fatal cases was 20 microgram/dL. Death from propoxyphene, the second most frequently encountered narcotic, was generally determined to be suicidal, while death from heroin was judged to be accidental. The highest rate occurred in black males between the ages of 21 and 30 years. The three most consistent findings were positive identification of the drug in the body (100% of the cases), pulmonary edema (90.4% of the cases), and microscopic liver changes (71.1% of the cases).

Adolescent↗
PubMed1981

Percutaneous needle biopsy of the lung.

A total of 160 percutaneous needle biopsies of pulmonary lesions were performed in 149 patients. Cytological and bacteriological examination of the biopsy material yielded clinically useful information in 87% of these patients. False-negative diagnoses were made in 6%, but there were no false-positive diagnoses. In most patients the biopsy obviated the need for a diagnostic thoracotomy. The principal complication of the procedure was pneumothorax, which occurred in 24% of patients; the pneumothorax, however, was usually very small and only two of these patients required treatment with a pleural drain. There were no deaths in the series. It is concluded that percutaneous needle biopsy is an effective and relatively safe method of obtaining diagnostic material from a pulmonary lesion.

Adolescent↗
PubMed1981

Increased sensitivity and accuracy of phaeochromocytoma diagnosis achieved by use of plasma-adrenaline estimations and a pentolinium-suppression test.

26 patients with suspected phaeochromocytoma underwent selective venous sampling: a tumour was identified and removed in 18.4 of these patients did not have sustained hypertension, and the only persistent abnormality was an elevated plasma-adrenaline level. The increased plasma-catecholamine concentrations in the tumour patients were not suppressed by pentolinium 2.5 mg i.v., whereas the levels in the 8 non-tumour patients were lowered to the normal range. Calculations based on the arteriovenous differences of adrenaline and noradrenaline suggest that adrenal medullary secretion contributed less than 2% of circulating noradrenaline in the non-tumour patients. Plasma-adrenaline, however, is derived almost entirely from the adrenal gland, and its estimation appears superior to that of noradrenaline in the detection of a small adrenal phaeochromocytoma.

Adrenal Gland Neoplasms↗
PubMed1981

Therapeutic arterial embolisation of the spleen: a new cause of free intraperitoneal gas.

Case histories of two patients are presented in whom splenectomy was required for haematological disorders, but because surgery was contraindicated had therapeutic arterial embolisation of the spleen performed as an initial alternative. A significant improvement in the haematological state was achieved in both cases but one of the patients required drainage of a splenic abscess three months later. In both patients the embolisation caused the early appearances of extravascular gas in the spleen and in one patient a pneumoperitoneum also occurred. The possible aetiological factors involved in this phenomenon are discussed, together with the potential role of splenic embolisation. It is concluded that therapeutic embolisation may be a useful alternative to splenectomy in selected poor-risk patients, but carries a significant risk of inducing a splenic abscess. Intrasplenic or intraperitoneal gas may appear as an apparently benign incidental finding in the early post-embolisation period.

Adult↗
PubMed1981

Reoperations for hyperparathyroidism.

During a 20 year period, 27 patients have undergone reoperations for primary hyperparathyroidism. Hypercalcemia has been successfully controlled in 21 of the 27 patients after a total of 64 operations. Reasons for failure at initial exploration included surgical error in 12, multiple gland disease in five, unusual parathyroid gland location in five, carcinoma of the parathyroid gland in two and unknown in three. A variety of techniques were used to localize missing parathyroid glands prior to reoperation. Selective venous sampling was the most helpful but gave correct localizing information in only nine of 18 patients. Postoperatively, hypoparathyroidism was temporary in two patients and permanent in four. Recurrent laryngeal nerve injury was temporary in one patient, permanent and unilateral in two and bilateral in one patient. Reoperations for hyperparathyroidism are associated with increased morbidity and decreased success. Most importantly, failure at the initial operation is preventable in most patients.

Adolescent↗
PubMed1980

Combined temporal arteriography and selective biopsy in suspected giant cell arteritis.

Superficial temporal arteriography was studied by selective biopsy of abnormal arterial segments and random biopsy of the main stem in 33 patients with clinically supected giant cell arteritis. Of the total of 33 temporal arteriograms 9 showed definite abnormalities (7 in the periphery and 2 in the main stem). Selective biopsy of the 7 peripheral abnormal segments showed arteritis in only 2, narrowing of the vessels in the remainder being due to atheroma (3) and fibrointimal thickening (2)--that is, 5 'false positives' for temporal arteritis on arteriography. Histological evidence of arteritis was found in 9 patients, only 5 of whom had clearly abnormal arteriograms--that is, 4 'false negatives'. Thus temporal arteriography appears to have low sensitivity for identifying arteritic lesions and also frequently gives 'false positive' results. It is concluded that temporal arteriography is not a satisfactory alternative to biopsy, and that its value as an adjunct to selective biopsy is limited because of its frequent failure to detect lesions found histologically.

Aged↗