Search PubMed⌕ Search

Biomedical subjects

R A Sells

Publications and source records attributed to R A Sells.

At least 91 records · Page 5Linked to original sources
PubMed1978

Failure to suppress adrenal function in congenital adrenal hyperplasia (21-hydroxylase deficiency). Three case reports.

Three patients, aged 14, 16, and 32 years respectively, with congenital adrenal hyperplasia (21-hydroxylase deficiency) are described. Excessive adrenal activity and ACTH secretion could not be suppressed with doses of corticosteroids sufficient to cause iatrogenic Cushing's syndrome, even though part of the steroid dosage was administered in the late evening. The resistance to feed-back suppression was of the same order as that seen in Cushing's syndrome. Adrenalectomy was performed in the 16-year-old girl, and was followed by a menarche. Adrenalectomy was considered inadvisable in the other two patients.

Adolescent↗
PubMed1977

Herpes zoster and paralytic ileus: a case report.

A case of herpes zoster presenting as intestinal obstruction is described. Clinical and radiological evidence of intestinal obstruction was obtained. The mechanisms by which herpes zoster may cause an ileus are discussed.

Herpes Zoster↗
PubMed1977

A rare presentation of splenic rupture.

Traumatic rupture of the spleen is a well known problem, complicating many types of abdominal injury. In contrast, a spontaneous rupture is a rare occurrence, mainly associated with a large spleen resulting from infections, the most common in this country being infectious mononucleosis. It is also a rare complication of leukaemias and lymphomas and the case presented here demonstrates a peculiar diagnostic problem.

Adult↗
PubMed1975

Controlled clinical trial comparing early with interval cholecystectomy for acute cholecystitis.

The traditional management of acute cholecystitis is initial conservative treatment with antibiotics followed by elective cholecystectomy. Although early cholecystectomy has often been advocated, there has been only one randomized controlled clinical trial comparing the two methods of treatment. This paper reports the preliminary results of such a trial in which 32 patients have been studied so far. Of the 17 patients managed conservatively, there was a misdiagnosis in 2 (11-8 per cent). In the remaining 15 patients with acute cholecystitis 3 (20 per cent) required urgent operation because of failure of medical treatment. Elective cholecystectomy was not technically difficult. Of the 15 patients treated by early cholecystectomy, there was a misdiagnosis in 1 (6-8 per cent). Surgery was technically difficult in 2 patients but cholecystectomy was possible in all. The former 2 patients required blood transfusion, but in the remainder the estimated blood loss was only slightly more than in the elective group. There was no mortality in either group nor any complication directly attributable to the biliary surgery. The incidence of minor postoperative complications was only slightly greater in those treated by early operation. The length of postoperative stay was similar in both groups but those treated conservatively spent an average of 11 more days in hospital. The preliminary results indicate that those treated by early cholecystectomy spend less time in hospital and avoid the complications of failed conservative treatment without the added risk of increased postoperative mortality and major complications.

Acute Disease↗
PubMed1972

Glucose and insulin metabolism after pancreatic transplantation.

After removal of the pancreas pigs develop hyperglycaemia and ketosis. Both orthotopic and heterotopic transplants prevent hyperglycaemia but the animals so treated display markedly different patterns of glucose and insulin metabolism. Orthotopic graft recipients have normal glucose tolerance curves with raised plasma insulin levels. The glucose tolerance curves of heterotopic graft recipients show significant hypoglycaemia and very marked hyperinsulinaemia. These results are explicable by the diversion of the two pancreatic hormones from the liver, and possibly by the effect of ischaemia and denervation on the pancreas.

Acidosis↗