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Biomedical subjects

M Duggan

Publications and source records attributed to M Duggan.

46 records · Page 3Linked to original sources
PubMed1979

Severe ulcerative herpes of mouth and eye following measles.

Malnourished children in the north of Nigeria who had had a severe attack of measles were prone to deep ulcers of the mouth and eyes. Herpes simplex virus was isolated from 17 of 25 of the mouth ulcers which were erosive, slow to heal and caused much suffering and loss of weight. Herpes virus was also identified, either by immunofluorescent staining or viral culture, in the corneal scrapings of the eye ulcers from 16 of 34 children. These ulcers healed slowly in two to six weeks leaving damaging scars which impaired vision and caused blindness in some cases. It is suggested that measles leads to profound depression of cell mediated immunity in malnourished children with the consequence that secondary herpes simplex infections become abnormally severe and erosive.

Body Weight↗
PubMed1979

Ischaemic heart disease-an hypothesis to integrate the role of insulin, fibre and sucrose.

The theory that a high dietary cholesterol and saturated fat intake has an aetiological role in coronary artery disease is inadequate. So are those theories based upon insulin, upon refined carbohydrate and upon dietary sucrose. An alternate hypothesis is presented. Central to it is prolonged hyperinsulin-aemia. This, acting synergistically with the changes in lipide metabolism secondary to the effects of dietary fibre and sucrose, is crucial to atherogenesis. There is abundant evidence for an association of insulin and vascular changes, both in vitro and in epidemiological studies. Laboratory and epidemiological evidence also exists for an effect of fibre and soluble carbohydrate on cholesterol synthesis and excretion, both as itself and as bile acid. A scheme is presented to demonstrate these complex inter-relationships and their role in vascular diseases.

Animals↗
PubMed1975

Meningococcal antigen in diagnosis and treatment of group A meningococcal infections.

Meningococcal antigen was measured by countercurrent immunoelectrophoresis in the blood and cerebrospinal fluid of 200 patients with group A meningococcal meningitis. Antigen was detected in the blood of 27 (13.5 per cent) patients. These patients had a worse prognosis and a higher incidence of allergic complications, such as arthritis and vasculitis, about 5 days after the start of antibiotic treatment. Antigen was found in the CSF of 129 (67.5 per cent) patients); antigen often persisted in the cerebrospinal fluid despite antibiotic treatment before admission. A combination of immunoelectrophoresis and routine bacteriologic study was used in the diagnosis of 162 (84.8 per cent) patients with meningococcal meningitis. High levels of antigen and a slow antigen disappearance were associated with neurologic damage. The antigen is stable and may be detected from specimens of cerebrospinal fluid dried on filter paper.

Antigens, Bacterial↗
PubMed1973

Trial of chloramphenicol for meningitis in northern savanna of Africa.

In a controlled trial chloramphenicol proved as effective and much cheaper than penicillin for the treatment of group A meningococcal meningitis in Zaria, Nigeria. A short course of five days cured most patients. Adults and older children were soon able to take chloramphenicol by mouth, which reduced the cost and simplified treatment.It is suggested that chloramphenicol is a suitable alternative to sulphonamides for the treatment of meningococcal meningitis in those parts of Africa where the organism is sulphonamide-resistant.

Administration, Oral↗
PubMedDate not supplied

The role of surgery and laser ablation in oesophageal carcinoma.

Between January 1990 and December 1994 oesophagectomy was carried out in 42 patients and comparison made with 38 who had palliative laser therapy. Apart from six patients referred after being unresectable at surgical exploration there were no agreed selection criteria, although the laser patients were in general older (mean 64 V 73 year) with a higher proportion of cardiorespiratory co-morbidity (14 per cent V 18 per cent). Lateral margins were involved in 14 per cent of known palliative resections with 50 per cent having positive nodes. The mean operating time was three hours and two chest drains inserted electively were removed after 3.6 days with mean drainage of 817 ml. The mean ICU stay was 5.4 days and 3 had radiological leaks; all but one settled conservatively. The 90 day mortality was 11.9 per cent for surgery and 34 per cent for laser patients. Twenty-three patients (61 per cent) required further courses of laser-therapy for benign anastomotic stenosis. Including the initial treatment of both groups 6.0 procedures per patient year were required in the laser groups compared with 1.1 for surgery. The 1, 2 and 3 year survival was 60 per cent, 31 per cent, 39 per cent for surgery compared with 24 per cent, 8 per cent, 3 per cent for laser--12 surgical patients are still alive and well at mean of 29 months (range 16-68). Surgery where possible with acceptable morbidity and mortality offers good palliation and long-term survival is possible; selection criteria for palliation only need to be defined.

Adult↗
PubMedDate not supplied

Quality care in an era of retrenchment.

UNLABELLED: SOURCE AND PURPOSE: Constraints in the healthcare delivery system are resulting in unprecedented challenges to quality nursing care. In response to concerns expressed by readers in a JSPN survey, we solicited input from prominent SPN members. CONCLUSIONS: Quality care can be sustained through nurses' creativity, flexibility, leadership, and collaboration. The context for quality care is an organizational environment with attention to critical analysis, careful resource utilization, and improved outcomes. PRACTICE IMPLICATIONS: Nurses can not only maintain premium standards of quality care but, by assuming leadership, help shape the future of health care.

Cooperative Behavior↗