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Biomedical subjects

D L Crosby

Publications and source records attributed to D L Crosby.

At least 37 records · Page 2Linked to original sources
PubMed1993

Endemic pemphigus foliaceus. Fogo selvagem.

Fogo selvagem is a form of pemphigus foliaceus indistinguishable on clinical, histologic, immunofluorescence, and ultrastructural grounds from sporadic pemphigus foliaceus found in North America and Europe. It can, however, be distinguished on epidemiologic grounds by its unique geographic distribution. The association of FS with its environment is supported by its limited areas of predilection, that is, between 500 and 800 meters altitude near rivers, and the remission of the disease when patients are removed from this environment. Owing to its obvious environmental trigger, FS may serve as a model for the initiation of autoimmune phenomena. We need merely to find the specific trigger or triggers, and the search is now under way.

Brazil↗
PubMed1992

Policy for controlling pain after surgery: effect of sequential changes in management.

OBJECTIVE: To observe the effects of introducing an acute pain service to the general surgical wards of a large teaching hospital. DESIGN: A study in seven stages: (1) an audit of current hospital practice succeeded by the sequential introduction to the general surgical wards of (2) pain assessment charts; (3) an algorithm to allow more frequent use of intramuscular analgesia; (4) increased use of local anaesthetic techniques of wound infiltration and nerve blocks; (5) an information sheet for patients about postoperative pain; (6) the introduction of patient controlled analgesia; (7) a repeat audit of hospital practice. Data were collected on each patient 24 hours after operation. SETTING: University Hospital of Wales, which has both district general and tertiary referral functions. PATIENTS: 2035 patients over nine months from all surgical specialties (excluding cardiac) at the hospital. General surgical operations were studied in detail and separated into major, intermediate, and minor for data collection. MAIN OUTCOME MEASURES: A change in the median visual analogue pain scores 24 hours after surgery for pain during relaxation, pain on movement, and pain on deep inspiration at each stage of the study. RESULTS: There was a reduction in median visual analogue scores during the study. The median (95% confidence interval) scores for pain during relaxation decreased from 45 (34 to 53) in stage 1 to 16 (10 to 20) in stage 7 for major surgical procedures. Pain on movement decreased from 78 (66 to 80) to 46 (38 to 48), and pain on deep inspiration decreased from 64 (48 to 78) to 36 (31 to 38). The reductions in median scores for intermediate and minor operative procedures showed similar patterns. CONCLUSIONS: The introduction of an acute pain service to the general surgical wards led to considerable improvement in the level of postoperative pain as assessed by visual analogue scores. Simple techniques of regular pain assessment and the more frequent use of intramuscular analgesia as a result of using an algorithm were particularly effective.

Algorithms↗
PubMed1992

Non-specific abdominal pain: the resource implications.

Non-specific abdominal pain (NSAP) is responsible for a significant proportion of emergency surgical admissions with resultant resource implications. The extent of the problem was assessed in a consecutive group of 100 patients, aged between 15 and 35 years, admitted with lower abdominal pain to one general surgical firm. No less than 67 of these patients (67%) were diagnosed as having NSAP (13.29% of all general surgical admissions), most (75%) being female and having a mean hospital stay of 4.1 days. Only 11 patients (11%) had appendicitis and the remaining 22 had miscellaneous gynaecological, urological or gastrointestinal problems. Detailed analysis of the resources used revealed that the mean cost to the NHS of each case of NSAP was 807 pounds, the bulk of which was attributable to the hospital stay. Wider assessment of the problem (by means of postal questionnaire) suggests that the cost to the NHS in Wales is in the region of 6 million pounds per year and may be over 100 million pounds per year in the UK as a whole.

Abdominal Pain↗
PubMed1991

Dermatophytosis mimicking Kaposi's sarcoma in human immunodeficiency virus disease.

Kaposi's sarcoma (KS) is an important finding in patients infected with human immunodeficiency virus (HIV), with a distinctive spectrum of clinical presentations. Three cases of dermatophytosis in HIV-infected patients are presented which clinically mimic the appearance of KS. This new observation underscores the importance of histopathologic examination in the evaluation of skin lesions suspicious for the diagnosis of KS. The other clinical mimickers of KS are reviewed.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Concomitant granuloma annulare and necrobiosis lipoidica. Report of a case and review of the literature.

A case of concomitant granuloma annulare (GA) and necrobiosis lipoidica (NL) is presented. The etiology of these two disorders remains obscure. The similarity of the histopathology in GA and NL might suggest a common origin. However, a review of the 5 previous cases of concomitant GA and NL and recent biochemical, immunological and immunohistochemical studies comparing GA to NL indicates an independent etiology for these two histologically related disorders. Some evidence points toward a closer relationship of NL with diabetes than GA, while GA may be related to delayed-type hypersensitivity reactions.

Arm↗
PubMed1990

Electrocardiographic abnormalities after a transient ischemic attack.

I believe this is the first reported case of neurogenic ECG changes following a transient neurologic insult. The profound and long-lasting ECG changes that followed a brief neurologic derangement adds credence to the theory of actual myocardial damage as the genesis of neurogenic ECG changes.

Aged↗
PubMed1990

The role of the high dependency unit in postoperative care: an update.

The current experience of a high dependency unit established 5 years ago for the postoperative care of high-risk patients undergoing surgery is reported. The resource implications and contributions to the safety and quality of post-operative care, particularly pain relief, are described.

Adolescent↗
PubMed1989

Familial koilonychia.

Koilonychia is a well-recognized clinical sign of iron deficiency occurring either with or without anemia. A case of familial koilonychia with an inheritance pattern consistent with an autosomal dominant trait is presented. Comments on inherited koilonychia and other causes of koilonychia are also included. The possible causes of the nail disorder are discussed.

Anemia, Hypochromic↗
PubMed1988

Effects of ribavirin on neutrophil function.

Ribavirin, a broad spectrum antiviral agent, has been shown to exhibit immunosuppressive activity. This property has raised concerns during clinical trials because candidates for antiviral therapy are those who may develop secondary bacterial infection. We therefore investigated a number of parameters of neutrophil function after the in vitro addition of various concentrations of ribavirin. At pharmacologic concentrations (1.25-7.5 micrograms/mL), percent killing of phagocytized bacteria was increased as measured by an acridine orange fluorochrome microassay, significantly higher at a concentration of 5 micrograms/mL (p less than .02). There was no concomitant adverse effect on adherence, random migration, chemotaxis, opsonization or phagocytosis. The present data indicate that ribavirin has no acute suppressive effect on granulocyte function and may even enhance bacterial killing capabilities for treated patients.

Blood Bactericidal Activity↗
PubMed1987

Abdominal surgery in the elderly.

While the clinical care of elderly patients does not differ in principle from that which applies to other age groups, there are often differences in emphasis and detail. The presence of degenerative disease, multiple pathology, and diminished psychological reserve pose greater demands on technical surgical skill and clinical judgment.

Abdomen↗