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Biomedical subjects

P Hickman

Publications and source records attributed to P Hickman.

At least 19 recordsLinked to original sources
PubMed1999

Apolipoprotein E polymorphism in indigenous Australians: allelic frequencies and relationship with dyslipidaemia.

OBJECTIVES: To determine the apolipoprotein E (apoE) allelic frequencies and the effect of apoE genotype on lipid concentrations in indigenous Australian subjects. DESIGN: Cross-sectional study. SUBJECTS AND SETTING: 155 indigenous Australians (92 women and 63 men) of mean (+/- standard deviation) age 45 +/- 17 years (SD +/- 50) were recruited without regard to history of atherosclerotic disease, in collaboration with community-based health centres in five indigenous communities in south-east Queensland. For comparison, 113 subjects of European descent and similar age distribution from the Brisbane and Gold Coast regions were also studied. MAIN OUTCOME MEASURES: ApoE allelic frequency; apoE genotype; sex; age; diabetes status; body mass index; history of atherosclerotic vascular disease; and concentrations of total cholesterol, triglyceride, HDL-cholesterol and LDL-cholesterol. RESULTS: The frequency of the apoE4 allele was found to be significantly higher in the indigenous subjects than in the subjects of European descent (P < 0.001). Among indigenous subjects, those with the apoE4 allele tended to have higher triglyceride concentrations and had significantly lower HDL-cholesterol concentrations than those with the apoE3/3 and 3/2 genotypes. CONCLUSIONS: ApoE allelic frequency is likely to be one of the cluster of factors contributing to the high cardiovascular mortality of indigenous Australians.

Adult↗
PubMed1995

Amputation level assessment using lightguide spectrophotometry.

The aim of this experimental study was to investigate whether lightguide spectrophotometry in the visible wavelength range in skin could be used to predict stump healing viability in patients with critical lower limb ischaemia. Remission spectra recorded at two sites (medial and lateral) on the line of a proposed trans-tibial amputation (TTA) and at 10mm intervals along the leg were analysed to give haemoglobin oxygenation (SO2). Degree of tissue hypoxia (DTH) along the leg was defined as the percentage of values along the leg less than 10% SO2. DTH and mean SO2 values were compared with skin blood flow values ((I125) 4-Iodoantipyrine clearance technique) and clinical outcome of trans-tibial amputation, (TTA) or trans-femoral amputation (TFA), in 41 patients. SO2 histograms were also measured in 12 normal subjects for comparison. The results of the study allowed the establishment of criteria for the accurate prediction of flap healing potential. Successful TTAs all displayed a minimum mean SO2 at the medial and lateral measurement sites of 30%, together with a maximum degree of tissue hypoxia of 15% along the limb. The combination of these criteria gave a sensitivity and selectivity of 1.0 for prediction of a successful outcome of TTA.

Amputation, Surgical↗
PubMed1994

Effect of postoperative low-dose dopamine on renal function after elective major vascular surgery.

OBJECTIVE: To determine the effect on renal function of postoperative low-dose dopamine in volume-replete patients after elective, major vascular abdominal surgery. DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: Intensive care unit of a referral hospital in Brisbane, Australia. PATIENTS: 37 patients having elective repair of an abdominal aortic aneurysm or having aortobifemoral grafting; 18 received dopamine, and 19 received placebo. Two patients were excluded from the 5-day analysis because of perioperative death. INTERVENTIONS: Patients were randomly assigned to receive either placebo or a low-dose infusion of dopamine (3 micrograms/kg per minute) in saline. Patients in both groups were given sufficient crystalloid to maintain a urine flow of more than 1 mL/kg per hour during the first 24 postoperative hours. Care in the intensive care unit was otherwise usual and was the same for each group. MEASUREMENTS: Plasma creatinine levels, urea levels, and creatinine clearance were measured preoperatively and postoperatively (at 24 hours and 5 days). Urine flow and the volume of crystalloid during the first 24 hours were recorded. RESULTS: Two postoperative deaths occurred in the dopamine group (from renal failure and myocardial infarction). Four patients had myocardial infarction, three of whom received dopamine. Plasma creatinine levels remained unchanged in both groups. At 24 hours, the mean plasma urea level decreased by 1.07 mmol/L in the dopamine group compared with 1.84 mmol/L in the placebo group, a difference of 0.77 (95% CI, -0.12 to 1.67). The mean 24-hour creatinine clearance increased by 0.165 mL/s (9.89 mL/min) in the dopamine group and by 0.199 mL/s (11.98 mL/min) in the placebo group (P > 0.2). Urine volumes were slightly higher in those receiving dopamine (1.83 mL/kg compared with 1.6 mL/kg, a difference of 0.23 [CI, -0.18 to 0.64]). None of these differences were statistically or clinically significant. CONCLUSIONS: Within the limits of the small size of the study, low-dose dopamine appeared to offer no advantage to euvolemic patients after elective abdominal aortic surgery. However, patients with acute oliguric renal failure were not included in the study.

Acute Kidney Injury↗
PubMed1994

Neutrophils may contribute to the morbidity and mortality of claudicants.

Peripheral arterial occlusive disease is a common cause of morbidity in middle-aged men; 5 per cent of those aged over 50 years suffer from intermittent claudication. While claudication itself is not fatal, claudicants have a mortality rate approximately three times that of non-claudicating men of the same age, mainly from cardiovascular disease. This review examines the evidence for involvement of the neutrophil in this increased mortality and describes the possible pathogenesis. It also discusses how treatment of claudication may modify neutrophil behaviour, reducing subsequent mortality and morbidity rates.

Aged↗
PubMed1994

The white blood cell and peripheral arterial disease.

Peripheral arterial obstructive disease (PAOD) is a common cause of morbidity in middle aged men with 5% of men, over 50 years, suffering from intermittent claudication. Claudication itself does not cause death but claudicants have a mortality three times that expected, mainly from cardiovascular disease. The white blood cell has recently been implicated in the pathogenesis of PAOD. This article will examine the evidence for the involvement of the neutrophil in this increased mortality and describe the possible pathogenesis. It is possible that treatment of claudication could modify white cell responses, reducing subsequent mortality and morbidity.

Arterial Occlusive Diseases↗
PubMed1993

Is mammographic microcalcification of biological significance?

Mammographic microcalcification is a feature of a proportion of breast cancers. Its occurrence does not appear to be significantly associated with age or primary tumour size. Lymph node involvement by tumour is present in 50% of patients with mammographic microcalcification in relation to the primary tumour, but only 24% of patients without microcalcification. A significantly larger number of lymph nodes (61 of 241 nodes) are involved with tumour in patients with, in comparison to those without (59 of 476 nodes) microcalcification (P < 0.001, chi 2 test). These differences suggest a biologically significant role for the deposition of calcium in microcalcifications, which may relate to the process of tumour cell metastasis. This may be of importance in the assessment of patients with cancers which demonstrate microcalcification on mammography.

Breast Neoplasms↗
PubMed1989

Anion gap.

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Acid-Base Equilibrium↗
PubMed1987

Inflammatory abdominal aortic aneurysms.

About 10% of all abdominal aortic aneurysms are characterized by an exuberant inflammatory reaction consisting of a dense white sheath over the aneurysm with peri-aortic fibrosis. The aetiology is unknown. There are characteristic ultrasonic and CT appearances but the condition is usually diagnosed at laparotomy. Surgery is the best treatment, keeping peri-aortic dissection to a minimum. Steroid therapy may occasionally be indicated where the situation is considered inoperable or when the patient declines surgery. If hydronephrosis is present because of ureteric involvement, surgical ureterolysis, as for retroperitoneal fibrosis, should be considered. We report 8 cases treated surgically over a 3-year period, with good results in 6, one postoperative amputation and one late postoperative death.

Aged↗