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Biomedical subjects

M Heaney

Publications and source records attributed to M Heaney.

7 recordsLinked to original sources
PubMed1999

Primary antibody deficiency and Crohn's disease.

Five patients with primary antibody deficiency were investigated because of intermittent but persistent diarrhoea of several years duration despite immunoglobulin replacement therapy. We found no evidence of Giardia lambia or other intestinal pathogens to explain their gastrointestinal symptoms. All five had definite radiological evidence of small bowel Crohn's disease and three had histological specimens available with abnormalities consistent with Crohn's disease. One patient had a non-caseating granuloma in an oral ulcer. A second patient with stricturing disease in the small bowel had a mucosal inflammatory infiltrate with non-caseating granulomas. A third had transmural inflammation but no granulomas. All five patents were diagnosed as having Crohn's disease and have responded symptomatically to steroid therapy.

Adult↗
PubMed1999

Using care pathways in pressure area management: a pilot study.

Care pathways are a method of managing, delivering and documenting care. A pilot study of a care pathway system in pressure area management was conducted in two clinical areas. Results from this pilot study indicate that the pathway approach to pressure area management is both useful and valid as a means to enhance clinical decision-making and to facilitate comprehensive pressure area management and the completeness of care documentation. Implementation of the pathway requires a facilitator to provide support and education and to monitor and maintain the change process.

Critical Pathways↗
PubMed1994

Anticardiolipin, anticentromere and anti-Scl-70 antibodies in patients with systemic sclerosis and severe digital ischaemia.

OBJECTIVE: Following observation of weakly positive anticardiolipin (aCL) antibodies in four of eight patients with systemic sclerosis (SSc) and severe digital ischaemia requiring amputation, the association between the presence of these and other antibodies and severe peripheral ischaemia in patients with SSc was examined. METHODS: ACL antibodies (IgG and IgM), anticentromere and anti-Scl-70 antibodies were measured in a further 60 patients with SSc over a one year period. Thirty one of the 68 patients in whom aCL antibodies were assayed had 'severe ischaemia', having suffered digital ischaemia severe enough to warrant amputation (13 patients), surgical debridement or admission for intravenous vasodilator therapy. RESULTS: There was no difference in aCL positivity between those with severe ischaemia and those without, nor between those who had amputations and those who had not. Three of the 31 patients (10%) with severe ischaemia had IgG and eight (26%) IgM aCL antibodies in weak to moderate titre compared to 10 (27%) and 6 (16%) respectively of the remaining patients (p = 0.06 for IgG and p = 0.25 for IgM, Fisher's exact test). Seventeen of the 31 patients (55%) with severe ischaemia were anticentromere antibody positive compared with nine of 37 (24%) without ischaemia (p = 0.01). Six patients with severe ischaemia had anti-Scl-70 antibodies compared with two of the 37 without ischaemia (p = 0.08). CONCLUSIONS: The findings do not support an association between aCL antibodies and severe ischaemia in SSc, but confirm the previously reported association between anticentromere antibodies and severe peripheral ischaemia. Although anti-Scl-70 antibodies were present only in a small number of patients, there was also a tendency for these to be associated with severe ischaemia, suggesting that patients with either anticentromere or anti-Scl-70 antibodies should be considered at risk of digital loss.

Adult↗
PubMed1992

Acute limited normovolemic hemodilution can be safely used in a malnourished model.

This study investigates the effects of acute limited normovolemic hemodilution (ALNH) on intestinal healing in a malnourished animal model. Twenty rabbits were randomized into three Groups: Group 1 = control; Group 2 = ALNH (removal 35% blood volume and maintenance of normovolemia with 3:1 crystalloid infusion) followed by retransfusion (RT) after small bowel anastomosis (ANA). Group 3 had a restricted diet for 3 weeks preoperatively to cause a 15 percent to 20 percent weight loss. A six cm segment of small bowel (SB) was resected and anastomosed (ANA) in all animals. Blood pressure (BP), transserosal oxygen tension (TsPao2), hematocrit (Hct), colloid oncotic pressure (COP), wet-to-dry weight ratios (WW/DW), hydroxyproline (OH-Pro) content, and tensile strength (TS) of the ANA and a segment of adjacent SB were determined. BP did not change from baseline (BL) in Group 2 during ALNH; however, it rose significantly after RT (P less than 0.05). BP decreased significantly during ALNH in Group 3 (P less than 0.05) and did not rise above baseline after RT. There was no significant change in TsPao2 from BL within groups during the experiment. The Hct and COP decreased significantly after ALNH in Groups 2 and 3 after ALNH compared to BL (P less than 0.05). After RT the Hct and COP increased and by Day 8 the Hct had risen to BL values in Group 3 but not in Group 2 (P less than 0.05), whereas COP values were not significantly different from BL in either group. There was no difference in WW/DW or TS between or among the three groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Anastomosis, Surgical↗
PubMedDate not supplied

Renal involvement by Rosai-Dorfman disease: CT findings.

Rosai-Dorfman disease is a rare disease characterized histologically by proliferation of histiocytes and has clinical features suggestive of a lymphomalike disease. Lymph nodes and extranodal sites might be involved, but renal involvement is rare. We present computed tomographic findings in three cases of renal involvement by Rosai-Dorfman disease. Two cases showed renal hilar masses and one case showed subcapsular hypodense infiltration. Renal involvement by Rosai-Dorfman disease has a characteristic appearance and should be included in the differential diagnosis of renal hilar masses or subcapsular hypodense infiltration.

Adult↗