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Biomedical subjects

J Waldron

Publications and source records attributed to J Waldron.

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

Lithium treatment: a comparison of once- and twice-daily dosing.

The effects of once- and twice-daily dosing with lithium carbonate were compared in a non-blind, cross-over study on 20 consecutive patients with mood disorders. Mental status, side effects and target organ function were examined after a minimum of a 1-month treatment with each regimen. Eighteen patients completed the study and 2 withdrew because of side effects. There were no significant differences between the 2 groups on the Hamilton Rating Scale for Depression, the Bech-Rafaelsen Mania Scale, the UKU Side Effects Scale or in serum lithium, electrocardiogram and urine volumes. Most blood tests showed no significant difference between the 2 treatment schedules except for white blood cells, ionized calcium and phosphate concentration. The once-daily regimen was associated with a higher white cell count, increased serum phosphate and elevated serum ionized calcium. We conclude that patients are able to tolerate once-daily dosing with lithium carbonate as well as twice-daily dosing.

Adolescent↗
PubMed1992

Therapeutic sleep deprivation in a depressed patient: prolongation of response with concurrent thyroxine.

A 53-year-old woman with major depression was studied throughout 7 trials of therapeutic sleep deprivation (SD). Under conditions where the patients was either medication-free or receiving antidepressant therapy, improvement with SD was followed by full relapse on returning to sleep. Four SD sessions conducted while the patient was receiving thyroxine each resulted in remission, sustained for several days. These results suggest that the beneficial effects of SD may be mediated by thyroid hormones, or associated activity in the hypothalamic-pituitary-adrenal axis.

Antidepressive Agents↗
PubMed1992

Plasma catecholamine levels following topical application versus infiltration of adrenaline for nasal surgery.

Plasma catecholamine concentrations were measured after vasoconstrictor solutions were administered either by instillation (Moffett's method) or by submucosal infiltration in twenty patients undergoing elective nasal surgery. Following infiltration with 4.4 ml of 1:80,000 adrenaline and 2% lignocaine, plasma adrenaline concentrations increased by 44.3 times to a peak of 9.9 nmol.l-1 (1813 pg.ml-1) within one minute. In contrast the peak level of adrenaline in the patients receiving Moffett's solution containing 1 ml of 1:1,000 adrenaline was 1.27 nmol.l-1 (232 pg.ml-1) occurring 10 minutes after instillation of the solution. The difference in the adrenaline concentrations between the groups was statistically significant (P less than 0.01). The lack of sympathoneuronal response was confirmed by simultaneous measurements of plasma noradrenaline concentrations, which did not change significantly. The operative field was subjectively assessed to be better in the infiltrated patients and the mean operating time and measured blood loss were less in this same group of patients.

Administration, Topical↗
PubMed1992

Ligation of the external carotid artery for severe epistaxis.

Epistaxis which is not controlled by anterior and posterior nasal packing is usually treated by ligation or embolization of the arterial supply to the nose. Transantral ligation of the maxillary artery, or embolization of its branches, have recently been considered the treatments of choice. Ligation of the external carotid artery has the advantage of being a short procedure which can be readily performed under local anesthesia, and does not require particular surgical expertise or the use of specialized equipment. This procedure, in combination with ligation of the ipsilateral anterior ethmoidal artery, controlled the bleeding in 14 of 15 patients over a nine-year period. There were no deaths and no significant complications. Although ligation and embolization of the maxillary artery are of proven efficacy, ligation of the external carotid artery is similarly effective and its simplicity may still make it the procedure of choice in some situations.

Adult↗
PubMed1991

Quantitative assessment of lung pathology in idiopathic pulmonary fibrosis. The BAL Cooperative Group Steering Committee.

The diagnosis and classification of most interstitial lung diseases requires histologic evaluation of lung tissue, obtained by an open lung biopsy to confirm the diagnosis. In addition, it is generally accepted that response to therapy in idiopathic pulmonary fibrosis (IPF) is related to the relative degree of cellularity and fibrosis present. Because only a qualitative assessment of the relative extent and severity of these changes is generally provided, correlation with clinical and physiologic alterations is difficult. This report describes results of a semiquantitative assessment by four pathologists of inflammatory/exudative changes, fibrotic/reparative changes, and airway alterations, in addition to an overall assessment of cellularity and fibrosis in 50 patients with IPF. In 10 randomly selected biopsies examined twice in a blinded fashion, absolute agreement between assessments for a given pathologist varied between 54 and 64% (mean = 57.5%) and in the majority of instances the agreement was greater than would have occurred by chance. There was good agreement for most variables across the four raters on the 101 samples. The mean score for some of the parameters reported by a given rater deviated occasionally from those of the other raters, but no single rater was consistently different from the other raters. A principal component factor analysis revealed that the pathologic features fell into four general groupings: alveolar wall metaplasia, fibrosis, honeycombing, smooth muscle, and vascular changes fell into one group; severity and extent of cellularity in the alveolar wall into a second group; severity and extent of cellularity in the alveolar space into a third group; and interstitial young connective tissue along with granulation tissue in the airways formed the fourth group.(ABSTRACT TRUNCATED AT 250 WORDS)

Biopsy↗
PubMed1990

Acoustic reflectometry as an aid to the diagnosis of glue ear.

In assessing the usefulness of the acoustic reflectometer we have evaluated its performance on a selected group of patients, finding it to be of equivalent predictive value to those screening tests in common use. We feel that the advantages of the instrument combined with its performance will provide the general practitioner with a useful diagnostic aid.

Acoustic Impedance Tests↗
PubMed1990

Laser resection of localized subglottic amyloidosis.

A case of localized amyloidosis of the subglottis is described. Urgent endotracheal intubation and later tracheostomy were required for upper airway obstruction. The amyloid was completely resected endoscopically using the CO2 laser. There is no evidence of recurrence two-and-a-half years after surgery.

Aged↗
PubMed1990

Complications of emergency and elective tracheostomy: a retrospective study of 150 consecutive cases.

The complications associated with 150 consecutive tracheostomies in adults were reviewed. A standard technique was used in all but five operations. The number and type of complications were compared between emergency and elective cases and between local and general anaesthetic cases. Only minor complications were observed. No deaths occurred attributable to the tracheostomy and there were no cases of symptomatic tracheal stenosis. Persistent tracheocutaneous fistulae occurred in five cases, of which four had been in situ for over 6 months, three had a previous tracheostomy and one had received radiotherapy to the region. Two unsightly scars required revision. The authors recommend the use of a simple standard technique with the insertion of a 'rescue' suture. Close postoperative supervision by nursing staff specially trained in the care of tracheostomies is of paramount importance in avoiding hypoxic complications secondary to displacement of the tracheostomy tube. Recent moves away from tracheostomy should only continue if the alternatives prove to have an even lower complication rate.

Adult↗
PubMed1989

Reduction of fractured nasal bones; local versus general anaesthesia.

This prospective study was designed to asses whether the results of reducing simple fractures of the nasal bones were different using local or general anaesthesia. Two consecutive groups of 50 patients had their fractures manipulated under (a) general, or (b) local anaesthesia. The results of reduction as assessed by the patients and surgeons were not significantly different between the 2 groups. The reoperation rate for nasal obstruction and external deformity was similar in the 2 groups. We suggest that fractured nasal bones may be reduced under local anaesthesia without detriment to the results. This represents a significant saving of hospital resources.

Adolescent↗
PubMed1988

Temporal bone fractures: a clinical diagnosis.

Temporal bone fractures may be complicated by intracranial haemorrhage, C.S.F. leakage and infection, damage to the middle and inner ear and damage to the seventh and eighth cranial nerves. Accurate early diagnosis is important to enable adequate investigation and prompt treatment of any complications. We present eight cases seen in a 12 month period in which a temporal bone fracture was not diagnosed at presentation in spite of a full clinical examination and standard skull radiographs. Five of these cases developed complications which resulted in their referral. The absence of a visible fracture on plain skull radiographs does not exclude a fracture, and those patients with clinical signs of a fracture should be treated appropriately and further investigations performed. Therefore the clinical examination is vital in diagnosing temporal bone fractures and must include careful otoscopy together with assessment of the function of the seventh and eighth cranial nerves.

Adult↗
PubMed1986

The sleep of remitted bipolar depressives: comparison with sex and age-matched controls.

The sleep of 10 bipolar patients was recorded for five consecutive nights following their recovery from a depressive episode. In all respects except the number of arousals, their sleep did not differ reliably from that of 10 sex and age-matched control subjects. We conclude that sleep measures are unlikely to be useful as trait markers of a depressive diathesis in bipolar disorder.

Adult↗