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Biomedical subjects

S Darby

Publications and source records attributed to S Darby.

At least 37 records · Page 2Linked to original sources
PubMed1994

Knowledge of renal histology alters patient management in over 40% of cases.

There is great debate as to whether the benefit gained from the knowledge of renal histology outweighs the risk to the patient from the biopsy procedure. We conducted a prospective study of 276 native renal biopsies performed on 266 patients from a single centre in 1991 to assess the effect of the knowledge of renal histology on patient management. Biopsies were performed under ultrasound guidance using the Trucut biopsy needle. The indications for biopsy were: non-nephrotic proteinuria alone (25), haematuria and proteinuria (28), nephrotic range proteinuria (28), acute renal failure (31), haematuria alone (36), and chronic renal failure (128). Two hundred and sixty-three biopsies were successful. The mean number of glomeruli obtained was 23, range 0-115. Eight patients developed macroscopic haematuria of which two required blood transfusion. The result of the biopsy altered management in 24/28 (86%) of cases of nephrotic range proteinuria, 22/31 (71%) of cases of acute renal failure, 58/128 (45%) of cases of chronic renal failure, 9/28 (32%) of cases with haematuria and proteinuria, 3/25 (12%) of cases with non-nephrotic proteinuria alone, and 1/36 (3%) of cases with haematuria alone. management was altered in 42% of cases overall. These data suggest that knowledge of renal histology is essential in the management of patients with renal disease.

Adolescent↗
PubMed1992

Risk of Kaposi's sarcoma and sexual practices associated with faecal contact in homosexual or bisexual men with AIDS.

The causal agent of Kaposi's sarcoma is unknown. That the disorder is ten times more common in homosexual or bisexual men with the acquired immunodeficiency syndrome (AIDS) than in other human immunodeficiency virus (HIV) transmission groups suggests that a certain aspect of their behaviour exposes them to the agent or facilitates its spread. We therefore assessed social and demographic characteristics, including sexual behaviour, of 65 homosexual or bisexual men with AIDS from London. Sexual practices in which there was contact with partner's faeces before AIDS developed were the main determinants of Kaposi's sarcoma risk. Risk increased with frequency of insertive "rimming" (oral-anal contact): Kaposi's sarcoma developed in 18% of the men with AIDS who reported never having practised insertive rimming compared with 50% who practised it less than once a month, 73% between once a week and once a month, and 75% or more once a week (two-sided exact p-value for trend less than 0.001). 45 men had been interviewed about their sexual practices before AIDS developed, and 20 were interviewed at the time the syndrome developed. The findings were similar and statistically significant when each group was analysed separately. The men with Kaposi's sarcoma also tended to be more sexually active and were more likely to engage in other sexual activities that entailed contact with faeces than were the men who had other features of AIDS only. Other behaviours and exposures, including the use of "poppers" (nitrite inhalants), were not related to Kaposi's sarcoma risk, after taking into account whether the subjects had practised insertive rimming. The data suggest that faecal-oral contact is the main route of transmission of the agent of Kaposi's sarcoma in homosexual or bisexual men with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Definition and estimation of lifetime detriment from radiation exposures: principles and methods.

Although the lifetable methodology is a standard tool in epidemiology and risk assessment, there are a number of differences in the way it has been applied by various advisory committees that have attempted to estimate radiation risks. The most fundamental of these differences concerns the choice of parameter to be estimated: the "excess lifetime risk" is the difference in lifetime risks between exposed and unexposed populations; the "risk of exposure-induced death" is the lifetime risk of dying of a disease attributable to exposure. These two quantities are not the same, even at low doses. Although both quantities have some utility in risk assessment, the "risk of exposure-induced death" comes closer to capturing the total impact of exposure. Other differences between reported risk estimates include details of the calculations, the baseline rates and age distributions of the exposed population, the forms of the models for excess rates, handling of organ-specific doses, and the groupings of cancer sites. These issues are discussed theoretically and illustrated with comparisons of the BEIR V and UNSCEAR reports. Although the risk estimates from these two reports are similar for most cancer sites, it is shown that this happens to be the result of an approximate cancellation of a number of differences that could be quite large.

Environmental Exposure↗
PubMed1992

Sclerosing cholangitis associated with multifocal fibrosis: a case report.

The association of sclerosing cholangitis, retroperitoneal fibrosis, and Riedel's thyroiditis has been reported twice before, and on both occasions the authors successfully used steroids to control the fibrotic process. A further case of fibrosis with this triad of organ involvement in which a combination of surgery and steroid treatment has arrested disease progression is described. This suggests an inappropriate immune response in this type of fibrotic overlap syndrome.

Cholangitis, Sclerosing↗
PubMed1990

Biodegradable emboli and antibody targetting of colorectal and gastric hepatic metastases: a pilot study.

The effect of degradable starch microspheres (DSM) on the passage of a low molecular weight marker through the liver of patients with metastases was compared with the passage of an anti-carcinoembryonic antigen monoclonal antibody. In all six patients studied DSM reduced the passage of the marker into the systemic circulation. In three patients who received labelled whole antibody, DSM had no effect. In two of three who received antibody fragments a similar delay to the low molecular weight marker was observed. This delay is likely to be a result of the smaller size of the fragments and may represent accumulation within the extravascular space.

Antibodies, Monoclonal↗
PubMed1989

Cancer near potential sites of nuclear installations.

Mortality and census data for 400 districts of England and Wales were analysed with respect to existing sites of nuclear power stations and sites where the construction of such installations had been considered or had occurred at a later date (potential sites). Excess mortality due to leukaemia and Hodgkin's disease in young people who lived near potential sites was similar to that in young people who lived near existing sites. Areas near existing and potential sites might share unrecognised risk factors other than environmental radiation pollution.

Adolescent↗
PubMed1981

Phagocytosis-promoting activity of avian plasma and fibroblastic cell surface fibronectins.

The purpose of this investigation was to determine whether fibronectin preparations from both chicken plasma and cell surface of fibroblasts can promote phagocytosis of gelatin-coated latex particles. Chicken plasma fibronectin was isolated (a) by ammonium sulfate fractionation, chromatography on Sepharose-4B followed by purification on a Sepharose-4B-heparin column; (b) by affinity chromatography on a Sepharose-4B-rat-antifibronectin column; (c) by affinity chromatography on Sepharose-4B-gelatin followed by molecular sieve separation on Sepharose-CL4B; (d) by a dual affinity chromatographic method using a Sepharose-4B-gelatin column and a Sepharose-4B-heparin column. Chicken cell surface fibronectin from fibroblast cultures was purified by ammonium sulfate precipitation followed by chromatography on Sepharose-CL4B. The purity of preparations was examined by polyacrylamide gel electrophoresis in the presence of sodium dodecylsulfate; all samples showing high purity. The opsonic activities of the preparations were measured by the uptake of 125I-labeled gelatin coated latex particles in conjunction with rat liver slice, and peritoneal macrophage monolayer systems. Both the plasma fibronectin and cell surface fibronectin preparations showed substantial opsonic activities in the test systems. Fresh chicken plasma did not reveal any phagocytosis promoting activity due to the presence of some unidentified inhibitor(s). The results showed that an opsonically active protein can be isolated from chicken plasma or serum and this protein is identical to plasma fibronectin. Furthermore, it could be concluded that cell surface fibronectin from chicken fibroblasts also can serve as an opsonin for gelatin coated particles.

Animals↗
PubMed1980

Evaluation of a postal screening questionnaire to identify the physically disabled.

In this study a postal screening questionnaire was compared with an interviewer-administered questionnaire for identifying disabled persons living in the community. Disability was defined as difficulty with specified activities of daily living, specified medical problems which often cause disablement, and frequent use of a formal health or social service. A 91 per cent response rate to the screening questionnaire was obtained from a random sample of 793 adults in a general practice; 89 were classified as "disabled". Seventy-eight per cent of those subsequently interviewed changed their response to at least one item; this figure fell to 29 per cent when frequent use of formal services was excluded from the definition of disability. None of the persons classified as disabled from the postal survey were considered to be non-disabled after interview. Interviews with a sample of persons who did not report disability on the postal questionnaire resulted in no changes in classification. General practitioners (GPs) who completed screening questionnaires on respondents with the help of practice records were aware of only 79 of 206 disability items reported. The GPs were more aware of respondents' difficulties with activities of daily living than of their medical problems.

Disability Evaluation↗
PubMed1976

Extradural analgesia in labour when the breech presents.

A retrospective study was made of the course and outcome of labour in 226 patients in whom a singleton fetus presented by the breech. Patients with macerated stillbirths or who were delivered before the 28th week of gestation had been excluded. Of the 226 patients, 101 received extradural analgesia, 79 received parenteral analgesia and 46 underwent elective Caesarean section. There was no difference in the incidence of breech extraction or emergency Caesarean section in the first two groups of patients. The length of both first and second stages of labour in multiparae was prolonged in the extradural group, but not markedly so. The Apgar scores of the infants delivered vaginally were not significantly different at one minute in both groups but the five minute Apgar score in the infants of primiparae was significantly higher in the extradural group. The Apgar score at one minute in the group delivered by emergency Caesarean section was significantly lower after extradural block but the difference was not significant at five minutes. This study suggests that the management and outcome of labour when the breech presents is not adversely affected by the provision of extradural analgesia.

Adult↗