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Biomedical subjects

W W Barrie

Publications and source records attributed to W W Barrie.

At least 37 records · Page 2Linked to original sources

Venous assessment using air plethysmography: a comparison with clinical examination, ambulatory venous pressure measurement and duplex scanning.

Air plethysmography was compared with clinical assessment, ambulatory venous pressure measurement and duplex ultrasonography in 103 unselected limbs with venous disease and ten normal control limbs without such disease. Measurements of venous function obtained by air plethysmography showed considerable overlap between groups of limbs classified on the basis of clinical condition or by the presence of popliteal incompetence detected by duplex scanning. The measurement of venous refilling time using air plethysmography correlated poorly with that obtained by venous cannulation (rs = 0.58). The residual volume fraction did not correlate with ambulatory venous pressure measurement (rs = 0.04). Air plethysmography was not found to be as useful as previously reported. The residual volume fraction should not be accepted as a substitute for ambulatory venous pressure measurement, which remains the 'gold standard' test of venous function.

Blood Pressure Determination↗

Investigation and significance of short saphenous vein incompetence.

In this study, 186 limbs with varicose veins or venous skin changes were examined using duplex ultrasonography. Limbs were classified on the basis of short saphenous or popliteal venous incompetence and the number of limbs with venous ulceration (active or healed) recorded. Short saphenous incompetence did not produce a significant increase in the incidence of ulceration, whereas popliteal reflux produced an increase in the risk of ulceration which was statistically significant when compared with limbs without reflux in these two veins (chi 2 = 4.55, P = 0.003). There was no significant difference in the proportion of limbs with concomitant long saphenous reflux between these two groups. Short saphenous reflux is not important in the pathogenesis of venous ulceration. Popliteal reflux is an important factor in the pathogenesis of venous ulceration. More attention should be paid to the surgical correction of popliteal reflux when present in limbs with venous ulceration that fail to heal by conservative measures.

Adult↗

Congenital antithrombin III deficiency causing mesenteric venous infarction: a lesson to remember--a case history.

Congenital antithrombin III deficiency is an uncommon but important cause of venous thrombosis, usually presenting with recurrent or atypical venous thromboembolism. Its importance lies in the fact that early recognition can lead to treatment in the acute stage, which can prevent propagation of the disease, and further prophylactic treatment may reduce the incidence of further episodes. The authors present a case of mesenteric venous infarction associated with congenital antithrombin III deficiency and briefly discuss the diagnosis, surgical implications, and treatment of this disorder.

Antithrombin III Deficiency↗

Late false aneurysm formation along an axillobifemoral graft.

False aneurysm formation is a rare complication of prosthetic arterial reconstruction other than at the anastamosis. Several aetiological mechanisms have been postulated. We report the development of a false aneurysm along the course of a prosthetic graft, with local communication between aneurysm and graft at more than one site. Possible causes of this type of graft failure are discussed.

Aged↗

Cosmetic results of early breast carcinoma treated with wide local excision, external beam radiotherapy and iridium-192 boost.

Cosmetic results of 80 patients with axillary lymph node negative or unknown T1 and T2 carcinoma of the breast who were treated with wide local excision, external beam radiotherapy and iridium-192 boost, were evaluated by the patient and the radiotherapist at 18-36 months. Their overall cosmetic results were assessed as good, very good or excellent by 80% of the patients. The radiotherapist's assessment was similar but in general the patients score was more favourable. After a follow-up of 24-72 months recurrence was found in only one patient at 40 months. This approach offers good cosmesis with low local recurrence rates in early breast carcinoma patients with negative axillary lymph nodes.

Adult↗

Recurrent acute renal failure due to a rectal villous adenoma.

A case is reported in which a rectal villous adenoma was complicated by severe fluid and electrolyte depletion producing recurrent renal failure. The pathophysiology of the depletion syndrome and its complications are discussed. Successful management by acute haemodialysis and early surgical resection of the tumour is described.

Acute Kidney Injury↗

A controlled trial of pentoxifylline (Trental 400) in intermittent claudication: clinical, haemostatic and rheological effects.

A formulation of pentoxifylline (Trental 400) has been claimed to increase claudication distance by improving red cell deformability and decreasing blood viscosity and platelet aggregation. In order to test this claim 30 stable claudicants recruited from one population took part in a double-blind randomised trial of placebo versus pentoxifylline. Both placebo and pentoxifylline treated patients improved subjectively and increased their claudication distance over the study period. Analysis of the blood results showed that the only apparent change was a tendency towards increased red cell filtration in the group treated with pentoxifylline; but no significant difference was found between claudicants and normal controls in the degree of red cell filterability nor did red cell filterability correlate with claudication distance. Pentoxifylline did not affect claudication distance or have any useful effect on blood flow properties, calling into question both its efficacy and suggested mode of action.

Adult↗