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Biomedical subjects

W Andrews

Publications and source records attributed to W Andrews.

At least 37 records · Page 2Linked to original sources
PubMed1990

Renal stone formation following medical treatment of renal candidiasis.

Two very low birth weight infants who developed renal candidiasis with pelvicalyceal fungal concretions were treated medically with Amphotericin B and 5 Fluorocytosine. Two months following cessation of therapy, the fungal concretions decreased in size, became sterile and developed calcification in residual debris. The calcifications was still present at demise in one patient and at 18 months follow up in the other. These calcifications occurred in the absence of simultaneous furosemide therapy.

Amphotericin B↗
PubMed1990

Chlamydia trachomatis pneumonitis: a case study and literature review.

Chlamydia trachomatis was cultured from the lung and eye of an 11-day-old infant who had rapidly deteriorating respiratory symptoms. Chlamydia trachomatis inclusion bodies were identified on thick Epon sections and by electron microscopy. We discuss the unusual presentation and review the published histopathological lung findings.

Chlamydia Infections↗
PubMed1985

Towards ICD 10: the attitudes of Australian and New Zealand psychiatrists.

About 15% of practising psychiatrists in Australia and New Zealand responded to a brief postal questionnaire. This sample appears reasonably representative of the various groups within the profession and of the geographical distribution of the clinicians. Ninety-one per cent of the respondents thought it was important to have a reliable classification; 83% thought that ICD 10 should incorporate specific diagnostic criteria; and 78% were of the view that ICD 10 should have a multiaxial system. Overall, DSM-III is used twice as often as ICD 9, and only 12% of psychiatrists do not use DSM-III at all. A very small minority (6%) use some other classification system. The results of this survey are discussed against the background of the intended introduction of ICD 10 in about 1990. Preliminary preparations for it are already in progress.

Attitude of Health Personnel↗
PubMed1984

Influence of DR matching in cadaveric renal transplants performed with cyclosporine. A retrospective analysis of one center.

A retrospective analysis of 300 consecutive cadaveric renal allografts performed at our institution between August 1, 1981, and December 1, 1983, was performed to evaluate the influence of DR typing on graft and patient survival. All patients were treated with low-dose steroids and cyclosporine as the only means of immunosuppression. The group included 246 primary graft recipients and 54 retransplants. DR information was available on the donor and the recipient in 225 of these patients, and it was unavailable on the donor and/or recipient in 75 patients. In 49% of the cases in which information was available, 2 alleles were identified in the donor and in the recipient; in the remainder only 1 allele was identified in either the donor or recipient. The results were analyzed according to HLA/DR match and mismatch. Twelve-month graft survival for the 2-DR-match recipients was 67%, versus 78% for the 1-DR match and 76% for the O-DR match. These differences were not significant. For the O-DR mismatch, the one-year actuarial graft survival was 74%, for the 1-DR mismatch 78%, and for the 2-DR mismatch 79%. Again, there was no significant difference. There was no impact of DR matching on patient or graft survival up to 18 months. Additionally, no difference was found in any of the groups regarding the number of treated rejection episodes per patient or the amount of steroid received per patient at the end of a year. These results suggest that cyclosporine negates the effect of DR matching in cadaveric renal transplantation.

Cyclosporins↗
PubMed1983

Reduction of neonatal heat loss by an insulated head cover.

When exposed to a cool environment, the newborn infant responds by nonshivering thermogenesis. The increased heat production is at the expense of body fuel and energy stores. A significant quantity of heat is lost from the head because of its large surface area and the high metabolic activity of the neonatal brain. The purpose of this study was to determine whether dry cranial heat loss could be significantly reduced by covering the head with highly insulated material, and to determine whether plastic lined hats decreased evaporative heat loss. A total of 46 fullterm and premature infants were studied. Hats insulated with material made of olefin and polyester reduced cranial dry heat loss by 73% and 63%. Plastic lined hats reduced evaporative heat loss by 68%. The insulated and lined hats proved to be a simple and safe method of effectively reducing dry and evaporative heat loss.

Alkenes↗
PubMed1981

Thyroid cancer: some basic considerations.

From these data and data from the literature, our recommended treatment for well-differentiated cancer is as follows: For papillary cancer, resection should be adequate to encompass the entire tumor, which in most cases would be complete lobectomy and possibly isthmusectomy. Prophylactic neck dissection is of no value; therapeutic modified neck dissection should be done for stage II disease. Follicular cancer can be treated by lobectomy (for small lesions) or subtotal thyroidectomy. Although total or near-total thyroidectomy may be required in selected patients with large primary cancers or in those with extensive capsular invasion or extrathyroid extension, the number of cases indicating this is small. There were only a few such patients with large primaries requiring total thyroidectomy in this study. Total thyroidectomy is best avoided in most cases. considering the price of hypoparathyroidism and the lack of a significant improvement in survival compared with lesser ablative techniques. Postoperative ablation with iodine-131 did not improve survival in staged patients with papillary cancer (the number of patients with follicular cancer was too small for analysis). Postoperative thyroid suppression by exogenous thyroid hormone postoperatively appeared to improve survival. Although the data were not adequate for evaluation in follicular cancer, there seems to be no reason not to use this postoperatively in high risk patients with either papillary or follicular cancer.

Adenocarcinoma↗
PubMed1976

Respiratory load compensation in infants.

We have studied the respiratory compensation for elastic loads in 15 term and preterm infants. Elastic loads, approximately equal to the infant's effective elastance, were applied to the airway for five breaths while tidal volume and mask pressure were monitored. Motion of the rib cage and abdomen were monitored simultaneously with magnetometers. The studies were done both in active or REM sleep and in quiet or non-REM sleep. During quiet sleep the load immediately reduced the tidal volume by about 50% but a progressive increase in tidal volume occurred over the next four loaded breaths. During active sleep load compensation was disorganized with respect to both tidal volume and frequency, and compensation was significantly less. Active sleep was also characterized by marked rib cage distortion. We suggest that during active sleep there is tonic inhibition of the intercostal muscles, allowing the diaphragm to distort the rib cage. This distortion impairs load compensation by a direct mechanical effect and indirectly by initiating an intercostal-phrenic reflex.

Abdomen↗
PubMedDate not supplied

Pharmacokinetic evaluation of a new oral cyclosporine formulation.

STUDY OBJECTIVE: To compare the pharmacokinetics of a new oral cyclosporine preparation with those of cyclosporine solution diluted in Isocal and the intravenous formulation. DESIGN: Randomized, crossover trial. SETTING: Tertiary care referral center. PATIENTS: Seven pediatric liver transplant recipients who were receiving oral cyclosporine as part of their immunosuppressive regimen. All patients completed the study. INTERVENTIONS: Pharmacokinetic studies were performed with the intravenous and oral dosage forms. Patients received one dose of intravenous cyclosporine, and then were randomized to receive their usual oral cyclosporine dose incorporated into a chocolate wafer or mixed with Isocal. After a minimum of 3 days, the alternative preparation was administered. Serial cyclosporine blood samples were collected at predetermined intervals for 12 hours after the third dose for each regimen. Concentrations were determined by high-performance liquid chromatography. The data for the three dosage forms were fit simultaneously with a two-compartment model. MEASUREMENTS AND MAIN RESULTS: No difference was seen in F, ka, Cmax, and tmax between the two oral cyclosporine preparations (p > 0.05). No new rejection episodes occurred during the study period. CONCLUSIONS: We conclude there is no difference in the bioavailability of the oral solution and the chocolate formulation. We believe the new preparation may increase patient compliance and ensure administration of a complete dose compared with the currently marketed solution.

Administration, Oral↗
PubMedDate not supplied

Hepatocellular carcinoma in children associated with Gardner syndrome or familial adenomatous polyposis.

PURPOSE: Gardner syndrome, a variant of familial adenomatous polyposis, is characterized by colonic polyps that undergo malignant change and benign and malignant extracolonic lesions. Tumors frequently associated with Gardner syndrome include carcinoma of the ampulla of Vater, papillary carcinoma of the thyroid, and, in children, hepatoblastoma. The childhood malignancies often precede the appearance of other manifestations by several years. PATIENTS AND METHODS: Two patients are described. Gardner syndrome was diagnosed in a 15-year-old girl with fibrolamellar hepatocellular carcinoma after desmoid tumors and colonic polyposis developed. Classic hepatocellular carcinoma was also diagnosed in a 9 1/2-year-old boy with familial adenomatous polyposis. RESULTS: In patient 1, the diagnosis of fibrolamellar hepatocellular carcinoma preceded the diagnosis of Gardner syndrome by almost 2 years. The diagnosis was confirmed by identifying a germline mutation of the adenomatous polyposis coli (APC) gene. This is the first patient reported with fibrolamellar hepatocellular carcinoma associated with Gardner syndrome. Patient 2 had a strong family history of familial adenomatous polyposis but no manifestations of Gardner syndrome. He was not tested for the APC mutation. The current literature and previously reported cases of hepatocellular carcinoma in patients with Gardner syndrome or familial adenomatous polyposis are reviewed. CONCLUSIONS: Because hepatocellular carcinoma is uncommon in the pediatric and adolescent population, it is important to consider the possibility of Gardner syndrome or familial adenomatous polyposis in these patients.

Adenomatous Polyposis Coli↗