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Biomedical subjects

N D Finlayson

Publications and source records attributed to N D Finlayson.

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

Clinical features of alcoholic liver disease.

The severity and range of histological liver lesions caused by alcohol abuse varies considerably; these lesions are not specific for alcoholic damage, and diagnosis of alcoholic liver disease depends on obtaining an adequate history of prolonged alcohol abuse and on excluding other known causes of liver disease. The clinical features of alcoholic liver disease vary greatly and they have been classified into various syndromes. However, the syndromes overlap, the histological features underlying them also overlap and they represent part of a wide clinical spectrum. Alcoholic fatty liver occurs more in younger patients and has a much better prognosis than alcoholic hepatitis or alcoholic cirrhosis, but the previous view that alcoholic fatty liver is an innocuous lesion can no longer be maintained. Alcoholic hepatitis and alcoholic cirrhosis cause more severe syndromes and more florid clinical features, and mortality is related to features of liver failure and variceal bleeding. Abstinence is the only means of ensuring the best possible survival.

Cholestasis↗
PubMed1993

Transjugular intrahepatic portasystemic stent shunting for control of acute and recurrent upper gastrointestinal haemorrhage related to portal hypertension.

The insertion of a transjugular intrahepatic portasystemic stent shunt (TIPSS) was evaluated in 22 patients with recurrent upper gastrointestinal haemorrhage related to portal hypertension (bleeding from oesophageal varices 10, gastric varices six, portal hypertensive gastropathy six). TIPSS was successfully performed electively in 15 patients and as an emergency in three patients. Twelve patients have had no further admissions with bleeding after TIPSS. Single episodes of bleeding were noted in six patients after TIPSS associated with shunt thrombosis (two), intimal hyperplasia within the shunt (two), and shunt migration (one). Another patient presented with reaccumulated ascites suggesting poor shunt function but died from massive variceal haemorrhage before further assessment could be performed. There was one death related to the procedure. Two patients developed encephalopathy after TIPSS, in one patient this was controlled by the insertion of a smaller diameter stent within the existing TIPSS. Several complications arose in earlier patients that have not recurred after modification of the initial technique. TIPSS can be life saving and is effective in controlling variceal haemorrhage and rebleeding from oesophageal or gastric varices and portal hypertensive gastropathy. Larger and longer term studies are required, however, to define the role of TIPSS in the overall management of such patients.

Acute Disease↗
PubMed1987

Epistaxis as a cause of hematemesis and melena.

Epistaxis was diagnosed in 10 patients with apparent upper gastrointestinal bleeding, comprising a 0.55% incidence of hematemesis and melena in the population studied. A sufficient amount of blood can be swallowed during epistaxis to cause hematemesis and melena. Recent facial trauma or epistaxis, absence of a history of chronic dyspepsia, and impairment of blood coagulation emerge as strong indicators of the diagnosis and should lead to a careful examination of the nose and nasopharynx for the source of bleeding.

Adult↗
PubMed1985

Retrospective investigation of transfusion-related non-A, non-B viral hepatitis associated with M2 antigen.

A retrospective study of transfusion-related non-A, non-B viral hepatitis was conducted in seven patients. Findings showed that six recipients had been exposed to at least one unit of blood possessing a putative serological marker for non-A, non-B hepatitis, the M2 antigen or anti-M2IgM. The M2 markers were associated with non-A, non-B hepatitis that developed 3-7 weeks after transfusion. It sees increasingly probable that M2 markers may be useful for diagnosis and/or prevention of post-transfusion hepatitis.

Antigens, Viral↗
PubMed1985

Severe oesophageal injury caused by Steradent.

An elderly woman swallowed 2 tablets of a denture-cleansing agent (Steradent) believing them to be her sleeping tablets. This caused severe burning pain in the throat and resulted in a tight postcricoid oesophageal stricture. Treatment by repeated dilatation of the stricture has been only partially successful. Characteristic containers for non-medicinal tablets might help those with poor vision, and medicinal and non-medicinal tablets should never be stored in the same place.

Aged↗
PubMed1983

Alcoholic liver disease in Scotland and northeastern England: presenting features in 510 patients.

A study of 510 patients in Scotland and northeastern England with histological evidence of alcohol-induced liver disease showed no difference in the age of presentation between males and females. Single men and widowed females were particularly susceptible to alcoholic liver disease. The social class distribution was similar to the population in general. Women were more reluctant to volunteer a history of alcoholism than men, they had a higher incidence of previous psychiatric illness (usually due to alcohol abuse) and they developed liver disease at lower consumption thresholds of alcohol than men. Patients under 40 years of age were more likely to have alcoholic fatty liver and less likely to have active cirrhosis than those over 40. Most often, the presenting symptoms were non-specific and tended to be related to the gastrointestinal system, particularly in women. Five per cent of patients were asymptomatic and 14% came to hospital for conditions other than alcoholic liver disease. Important clues to asymptomatic alcoholic liver disease included hepatomegaly, clubbing of the fingers and abnormal liver function tests. Gastro-oesophageal varices accounted for 40% of instances of haemorrhage and the mortality from upper gastrointestinal bleeding was 17%. Anaemia was the most common haematological abnormality. Alcoholic hepatitis was observed more frequently in the Glasgow area then elsewhere.

Adult↗
PubMed1981

Laparoscopy and radioisotope imaging in the investigation of suspected liver disease.

We have reviewed the clinical and investigative details of 141 patients who underwent laparoscopy in order to determine how best this technique can be used. The clinical history and biochemical investigations usually only indicated some form of hepatobiliary disease, but all patients with spider telangiectasia, splenomegaly, or esophagogastric varices had diffuse parenchymal liver disease, and further investigation was only required to detect its cause. Laparoscopy succeeded in 129 patients (91%), and serious complications occurred in six (4%). The appearance of the liver did not accurately reflect the underlying pathology, indicating the need for biopsy in all cases. Laparoscopy and 99mTc-sulfur colloid liver imaging each failed to detect a few hepatic malignancies, but none were missed by both investigations combined, and similar results were obtained for parenchymal liver disease. Scanning and laparoscopy proved a highly accurate diagnostic combination.

Humans↗
PubMed1981

Clinical value of bile salt tests in anicteric liver disease.

Fasting and postprandial serum bile salt concentrations and intravenous glycocholate disappearance were studied in 20 patients with anicteric liver disease who had only minor abnormalities of conventional liver function tests. Abnormalities in the fasting or two hour postprandial conjugated cholate concentrations were found in all but one of the patients who had an abnormality in bilirubin concentration. In these patients, fasting and postprandial conjugated cholate concentrations were raised on average three and two times respectively above the upper limit of the reference range, while bilirubin concentration was raised only 50%. Postprandial conjugated cholate concentrations were also abnormal in two patients with normal bilirubin concentrations. Measurement of fasting and postprandial conjugated chenodeoxycholate concentration and intravenous glycocholate disappearance proved less informative than the fasting and postprandial conjugated cholate test. These results suggest that, where bilirubin concentrations are normal or only slightly raised, measurement of serum fasting and two hour postprandial conjugated cholate concentrations may prove helpful in the detection of minor abnormalities in hepatic anion transport.

Adult↗
PubMed1981

Differential timing of maximal postprandial concentrations of plasma chenodeoxycholate and cholate: its variability and implications.

The concentrations of conjugated chenodeoxycholate and cholate in serum have been measured in 26 controls and 19 patients with liver disease before and after taking a fat-containing meal. The times at which maximum bile salt concentrations occurred varied considerably between individuals. In the majority of cases maximal concentrations of the two bile salts occurred simultaneously but in 3 subjects maximal concentrations of chenodeoxycholate were found 15-60 min prior to maximal cholate concentrations. The measurement of bile salt concentration in a single sample taken 2 h after the fatty test meal would have produced two false-negative results in the patients with liver disease. It is concluded that the jejunal absorption of dihydroxylated bile salts may not be significant in the majority of individuals and that the protocol for assessment of liver function by postprandial bile salt analysis should include at least two blood samples collected at 1.5 and 2 h after ingestion of the test meal.

Chenodeoxycholic Acid↗