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Biomedical subjects

M E Callender

Publications and source records attributed to M E Callender.

At least 19 recordsLinked to original sources
PubMed1992

Dynamic hepatic scintigraphy in the screening of psoriatic patients for methotrexate-induced hepatotoxicity.

We report the use of dynamic hepatic scintigraphy in the assessment of the hepatic status of psoriatic patients before and during methotrexate therapy. Eighty-seven paired dynamic scans and percutaneous liver biopsies were performed in 63 patients. The liver biopsies were graded according to Warin et al. with fibrosis of grade 2 or worse being a strong indication for withdrawal of methotrexate. The sensitivity of dynamic hepatic scintigraphy in detecting fibrosis of grade 2 or worse was 83.3% and the specificity was 81.5%. The predictive value of a normal scan for fibrosis of grade 0-1 was high (98.5%) although the predictive value of an abnormal scan for fibrosis of grade 2 or worse was low (25%). Dynamic hepatic scintigraphy may therefore offer a means to reduce the number of liver biopsies necessary in patients receiving methotrexate for psoriasis.

Adult↗
PubMed1992

Erythropoietic protoporphyria, transfusion therapy and liver disease.

A 28-year-old man who had suffered from erythropoietic protoporphyria since infancy was referred because of worsening photosensitivity. Conventional therapy with beta-carotene, terfenadine and topical sunscreens was ineffective or not tolerated, and he was treated with transfusions of washed packed cells. Unexpectedly, his photosensitivity deteriorated further, his whole blood protoporphyrin levels doubled and he developed abnormal liver function tests. This is the first report of such an adverse response to blood transfusion therapy for erythropoietic protoporphyria and may have been related to subclinical hepatitis or the increased iron load associated with blood transfusion.

Adult↗
PubMed1991

The nicotinic acid provocation test and unconjugated hyperbilirubinaemia.

It has been suggested that the nicotinic acid provocation test is useful in the diagnosis of Gilbert's syndrome. We compared the response to intravenous nicotinic acid of patients with Gilbert's syndrome and with chronic liver disease. There was no significant difference in the mean rise in unconjugated serum bilirubin between the two groups. A sensitivity of 70% and specificity of 60% were obtained. All of 5 patients with chronic liver disease and a raised fasting unconjugated serum bilirubin had positive tests. We suggest that the nicotinic acid test is positive in unconjugated hyperbilirubinaemia regardless of cause. It is of no value in differentiating Gilbert's syndrome from liver disease.

Bilirubin↗
PubMed1990

D-penicillamine therapy in patients with HBsAg-negative chronic active hepatitis and major prednisolone-induced adverse effects.

Six patients with histologically proven HBsAg-negative chronic active hepatitis (CAH), who were initially treated successfully with prednisolone with or without azathioprine, developed unacceptable adverse effects due to prednisolone. In all six patients the liver disease relapsed on reduction of the prednisolone dose and they subsequently entered a trial of low dose D-penicillamine. Two of the patients required early withdrawal of D-penicillamine and a third patient, who had a good clinical and biochemical response initially, developed heavy proteinuria at 14 months. In the remainder, D-penicillamine was well tolerated and the liver disease satisfactorily controlled permitting reduction of the prednisolone dose to 2.5 mg daily. We conclude that in this subgroup of patients with HBsAg-negative CAH and major prednisolone-induced adverse effects, D-penicillamine is an effective alternative therapy although side effects are common.

Adult↗
PubMed1988

Delayed sudden death after ingestion of MCPP and ioxynil: an unusual presentation of hormonal weedkiller intoxication.

A patient who died in asystole less than 18 h after ingestion of 'Clovercide Extra', a combination hormonal weedkiller containing ioxynil and 4-chloro-2-methyl phenoxypropionic acid, is described. Previous reports describe coma as an early event following ingestion of these herbicides. In contrast our patient, although showing other characteristic features, including metabolic acidosis, tachycardia, pupillary constriction and pyrexia, remained conscious until the terminal event. Absence of coma does not appear to be related to a more favourable outcome.

2-Methyl-4-chlorophenoxyacetic Acid↗
PubMed1988

Anticoccidial efficacy of narasin in battery cage trials.

Narasin is a polyether monocarboxylic acid antibiotic produced by Streptomyces aureofaciens. An extensive series of battery cage trials was conducted to evaluate the efficacy of narasin against recent field isolates of the pathogenic species of chicken coccidia. Statistical analyses of the results of these studies revealed that each successive increase in the concentration of narasin produced a significant reduction in the severity of cecal and intestinal lesions when compared with those in infected nonmedicated controls. Increasing the concentration of narasin also produced significant improvements in weight gain and feed efficiency when compared to gain and feed efficiency of infected nonmedicated controls. Maximum weight gain of birds infected with Eimeria tenella alone was obtained at a narasin concentration of 60 ppm, but birds infected with E. tenella plus intestinal species of coccidia, when medicated with 80 ppm narasin had weight gains significantly greater than those of birds medicated with 60 ppm narasin. Weight gain improvement decreased at narasin concentrations greater than or equal to 100 ppm. Results of these studies confirm the effectiveness of narasin in controlling coccidial infections produced by recent field isolates of the pathogenic species of chicken coccidia.

Animals↗
PubMed1988

Anticoccidial efficacy of narasin in floor pen trials.

Narasin is effective against all species of chicken coccidia when tested in short-term battery cage experiments. The efficacy of narasin at concentrations of 20, 40, 60, 80, and 100 ppm was evaluated in ten floor pen trials in which commercial broiler production conditions were simulated. To provide intentional exposure to different levels of coccidia challenge, the litter of some pens was seeded with oocysts of each of the pathogenic species of chicken coccidia, whereas some pens were left nonseeded. Weight gain, feed efficiency, and lesion score data from the ten trials were analyzed as one randomized block experiment. Medication with narasin resulted in a significant reduction in lesion scores and significant improvement in weight gain and feed:gain ratios when compared with scores and gain of nonmedicated controls for both seeded and nonseeded pens. Each increase in narasin concentration up to 100 ppm for the seeded pens and up to 80 ppm for the nonseeded pens resulted in a significant reduction in cecal lesion scores. Although maximum weight gain in the seeded pens was obtained with 40 ppm narasin, concentrations greater than or equal to 60 ppm narasin were significantly better than the 40 ppm concentration in improving feed:gain ratios. These results confirm the effectiveness of narasin in controlling coccidiosis in broilers exposed to oocysts in the litter of floor pens. Furthermore, a clear relationship between the response to narasin and the level of oocyst challenge was demonstrated.

Animals↗
PubMed1987

Diversity of autoantibodies in patients with antimitochondrial antibody and their diagnostic value.

A retrospective analysis of clinical and laboratory features of 102 patients, whose sera contained antibody to mitochondria, showed that primary biliary cirrhosis was diagnosed in 50% of them. Immunofluorescence showed that the sera of the patients with primary biliary cirrhosis all had the M2 antimitochondrial antibody staining pattern. A new staining pattern, designated M2(1), which could be mistaken for the M2 pattern, was not found in any patients with either primary biliary cirrhosis or chronic active hepatitis. Other serological variables such as antibody to mitochondria in IgM class, to multiple nuclear dots, and to the XR antigen, were associated with primary biliary cirrhosis, and taken in association with antimitochondrial antibody of M2 type, contribute to the diagnosis of the disease.

Antibodies, Antinuclear↗
PubMed1987

Regional lipiodolized chemotherapy for cholangiocarcinoma associated with oral contraceptives.

We describe a case of cholangiocarcinoma in a young woman, who presented with cholestatic jaundice following oral contraceptive ingestion. Following diagnostic laparotomy she received intra-arterial 'lipiodolized' chemotherapy. Intravenous mitozantrone was given for 2 years and she is asymptomatic, with computed tomographic evidence of tumour response, 27 months after diagnosis. We suggest that this form of treatment is of value for cholangiocarcinoma.

Adenoma, Bile Duct↗
PubMed1986

Acute fatty liver of pregnancy and diagnosis by computed tomography.

A 39 year old woman was admitted to a maternity unit at 34 weeks' gestation with nausea, vomiting, and jaundice. Her condition deteriorated, and she was transferred to hospital, deeply unconscious and hypotensive. The diagnosis of acute fatty liver of pregnancy was initially suggested by the typical history of prodromal malaise and vomiting and the rapid onset of hepatic encephalopathy with profound hypoglycaemia and only small increases in transaminase activities. Computed tomography was performed: there was no enlargement of the liver or spleen, but the attenuation value over the liver indicated appreciable fatty infiltration of the liver, establishing the diagnosis of acute fatty liver of pregnancy. Computed tomography is of value in the diagnosis of liver disease of late pregnancy, and this technique may become the method of choice for the investigation of acute fatty liver of pregnancy.

Acute Disease↗
PubMed1986

Differential effect of ARA-AMP on serum DNA polymerase activity and serum HBV-DNA in chronic hepatitis B virus infection. A possible reason for lack of efficacy.

An uncontrolled pilot study of adenine arabinoside monophosphate intramuscularly (ARA-AMP) for 5 days at 10 mg/kg/day and 23 days at 5 mg/kg/day in divided doses, was conducted in 15 consecutive patients known to be HBeAg-positive for a minimum of 12 months. Two patients were lost to follow-up (1 having developed an hepatoma). Of the remaining 13, 11 remained HBeAg-positive at 1 year. During treatment, the median serum DNA polymerase (DNAp) activity fell from 592 cpm to 203 cpm/200 microliters. Of 12 patients initially positive for DNA polymerase, complete inhibition during treatment occurred in 6 and was permanent in 2, who developed anti-HBe. In the remaining 4 and in 6 further patients in whom inhibition was substantial but incomplete, DNAp activity rose to pretreatment levels within 1 month of completing treatment. All these patients remained DNAp + HBeAg-positive at one year. Serum HBV-DNA was measured in 7 patients, 6 who were initially DNAp-positive and 4 of whom had complete inhibition of DNAp during treatment. All 7 remained positive for HBV-DNA during treatment. Although side-effects were common there were no significant changes in biochemical or haematological parameters during or subsequent to therapy. Over the subsequent 48 months 2 more patients have developed an hepatoma and a further 5 have lost HBeAg; the 4 patients who remain alive and HBeAg-positive all had chronic persistent hepatitis initially.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Gastrointestinal hormones in alcoholic patients with and without liver disease.

To assess the effects of both alcoholism and liver disease on gastroentero-pancreatic hormones, fasting and post-prandial concentrations were analysed in the following four groups: (1) Alcoholic subjects with liver disease; (2) Alcoholic subjects without liver disease; (3) Control subjects with liver disease; (4) Control subjects without liver disease.Liver disease was associated with increased fasting serum glucose, plasma insulin, pancreatic polypeptide, gastrin and vasoactive intestinal polypeptide. Alcoholism in the absence of liver disease did not influence either the fasting or post-prandial concentrations of serum glucose, plasma gastrin, insulin, pancreatic polypeptide, gastric inhibitory polypeptide, N- and C-terminal glucagon or vasoactive intestinal polypeptide. Alcoholism with liver disease depressed plasma gastric inhibitory polypeptide concentrations. The results suggest that the abnormalities in gastroenteropancreatic hormone in alcoholics are likely to be related to liver disease which is often concurrent.

Adult↗