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Biomedical subjects

A Busuttil

Publications and source records attributed to A Busuttil.

At least 127 records · Page 7Linked to original sources
PubMed1992

Nerve conduction as a means of estimating early post-mortem interval.

Methods in current practice for ascertaining time of death are largely based on the cooling of the body after death and are somewhat unreliable. A theoretical relationship is known to exist between the decline in the properties defining nerve conduction and time after death caused by the gradual cessation of metabolic activity in nerves. A number of such properties were measured in rats during life and after death. In most cases the relationship was found to be inconsistent. The chronaxie of the strength duration curve for the sciatic nerve was, however, found to increase consistently and reproducibly in a linear fashion over the first 90 min after death to a plateau value which was maintained beyond 135 min. These findings are discussed as the possible basis of a forensic method of determining the duration of the "post mortem interval" within the first few hours after death.

Action Potentials↗
PubMed1992

The certification and disposal of the dead in major disasters.

When a major disaster occurs in which there are a large number of fatalities, many tasks have to be undertaken in a very short time and under great pressure. By considering in advance the potential difficulties which may be encountered it is possible to plan ways of overcoming, or at least minimizing, some of these problems. In this paper we have ventilated some of the problems concerning the certification and disposal of the victims of a major disaster, as seen from the pathologist's point of view.

Death Certificates↗
PubMed1992

Glucose metabolism and hypoglycaemia in SIDS.

Once a child is born its survival depends on the maturation of the blood glucose homeostatic control mechanisms. When this fails or where there is an inborn error of metabolism the infant is susceptible to potentially fatal hypoglycaemic episodes. A variety of environmental stresses, either singly or in combination, such as inappropriate or low caloric intake, acute infections of childhood, endotoxaemia, fever, xenobiotic exposure, oxidative stress or anaphylaxis, can greatly exacerbate the deficiency of the normal homeostatic compensatory mechanism and result in the onset of hypoglycaemia. Various inborn errors have been found in infants who died of SIDS. Our approach to this problem has been to use the six microsomal glucose-6-phosphatase proteins as a model system to study defects in carbohydrate metabolism in cases of SIDS. Initial studies determined the ontogeny of the glucose-6-phosphatase proteins and showed that intact microsomes isolated from unfrozen liver samples can be used to study glucose-6-phosphatase in cases of SIDS that were presumably due to the low concentrations of liver lipid peroxidation. More recently we have used a combination of techniques to demonstrate the abnormalities of glucose-6-phosphatase in cases of SIDS. Classic gross pathology and histology have now clearly defined the various subgroups of sudden and unexpected deaths of infancy. This now enables us to develop new molecular approaches to predict and prevent hypoglycaemia in infants who are at risk of SIDS.

Blood Glucose↗
PubMed1991

Two deaths from intravenous nifedipine abuse.

An incident is reported in which 2 intravenous drug abusers died as the result of uncontrolled experimentation with intravenous injection of the common anti-hypertensive and anti-anginal drug Nifedipine (Adalat t.m. Bayer), probably in mistake for the commonly abused short-acting benzodiazepine drug Temazepam. Large quantities of Nifedipine were identified in the blood of both decreased men by gas chromatography. Apart from intense gastric mucosal congestion, pulmonary oedema and general visceral congestion, the autopsy findings were entirely nonspecific. The similarity in colour, shape and texture between capsules of Nifedipine and those of Temazepam is likely to have prompted the mistake.

Adult↗
PubMed1991

Adrenal atrophy at autopsy in two asthmatic children.

In two children dying in status asthmaticus, adrenocortical atrophy was demonstrable at autopsy. Both children had been treated since infancy with pulsed steroidal inhalers, short courses of oral or parenteral steroids, and steroidal skin preparations (for associated eczema). Adrenocortical atrophy has not been described previously in this clinical context. The increasing administration of steroids to asthmatic children may lead to the production of overt--or more frequently, subclinical--atrophy of the adrenal cortices with important consequences to mortality and morbidity.

Adolescent↗
PubMed1991

Elderly suicides in the Lothian and borders region of Scotland, 1983-1988.

This study examined all the suicides in the over 60 age group in the Lothian and Borders region of Scotland during the period 1983-1988. The data was analysed according to a number of variables, primarily with the intention of identifying the characteristics of the elderly suicide population. With the exception of those persons who exhibit a history of previous attempts, it is concluded that no characteristics unique to that cohort exist. Hence the problem of an accurate and precise diagnosis and assessment of suicide risk is difficult and complex. Cases exhibiting recent contact with the medical profession illustrate the problems of preventive procedures once a valid initial assessment has been made. Medico-legal issues raised by these cases are noted. It is suggested that prevention must be considered as a general function of the care of the elderly rather than as a process appropriate to a 'high-risk' group.

Aged↗
PubMed1991

Rape and sexually transmitted diseases: patterns of referral and incidence in a department of genitourinary medicine.

A retrospective study was carried out of all women attending a Department of Genitourinary Medicine over a 3-year period. Note was taken of referring source, presenting symptoms, infection detected at STD screening and follow-up attendance. Comparison was also made between the number of women referred by the police surgeon and the number who actually attended. We observed an overall incidence of STD of 35% and noted that many infections had a similar prevalence to that of our normal clinic population over the same time period. Only 13% of the women referred by the police attended although after the initial visit attendance was similar regardless of referral source. A number of asymptomatic women were noted to have infection with Neisseria gonorrhoeae and Chlamydia trachomatis. Although, the risk of significant STD following sexual assault is low greater efforts should be made to encourage women to attend for screening whether or not they are symptomatic.

Adolescent↗
PubMed1991

Cyanide ingestion. Case studies of four suicides.

Deliberate ingestion of cyanides is relatively rare, as reflected in the Registrar General's figures. There are no pathognomonic specific autopsy findings and even the distinctive smell may be missed by some individuals. We present four cases of cyanide ingestion, one of which appears to be the first reported case of magnesium cyanide poisoning in humans. The problems involved in investigating deaths from cyanide ingestion are discussed.

Adult↗
PubMed1990

Medication in police custody.

Police Officers have an obligation to look after the welfare of the persons detained by them. As such persons may require to be given medication on a regular basis during their period of custody which may last a few days, the Police are also responsible for ensuring that this takes place. To identify the extent of this requirement, a survey was carried out by questionnaire in Edinburgh over a period of one month. Thirty-five per cent [corrected] of the 127 detainees were carrying with them a variety of drugs or required to be given medication on a regular basis. The problems associated with this practice are discussed.

Adolescent↗
PubMed1989

Hepatic microsomal glucose-6-phosphatase system and sudden infant death syndrome.

Microassay techniques and monospecific antibodies were used to study the hepatic glucose-6-phosphatase system in liver samples from 55 infants who had died suddenly and unexpectedly, including 38 victims of sudden infant death syndrome (SIDS). Raised hepatic glycogen was found in 10, all of whom had a diagnosis of SIDS, and in 1 other infant who was already known to have type 1b glycogen storage disease (deficiency of transport protein T1). Of the 10 infants with raised hepatic glycogen who had a diagnosis of SIDS, 8 had glucose-6-phosphatase deficiency (type 1a glycogen storage disease), and 2 had transport protein T2 deficiency (type 1c glycogen storage disease).

Glucose-6-Phosphatase↗
PubMed1989

Flow cytometric analysis of cellular DNA in human prostate cancer: relationship to 5 alpha-reductase activity of the tissue.

Flow cytometry of 20 prostate cancer specimens was carried out and the percentage DNA content in each phase of the cell cycle was correlated to the 5 alpha-reductase activity of the tumour. A group of 20 hyperplastic specimens was also entered into this study as control. Tumours were divided into 3 groups on the basis of their 5 alpha-reductase activity. This classification made it possible to identify a group of tumours of which none formed metastases (diploid tumours with 5 alpha-reductase activity greater than 20 pmol/mg protein/30 min and with less than 10% of the cells undergoing mitosis) and a second group of which 78% had metastasised at the time of presentation (diploid tumours with 5 alpha-reductase activity less than 10 pmol/mg protein/30 min and with more than 15% of the cells undergoing mitosis). DNA content within each of the 5 alpha-reductase groups appeared also to correlate with the histological grade of the cancer but no relationship was established with the stage of the disease. Our results suggest that a multi factorial discriminant combining DNA ploidy and 5 alpha-reductase measurements offers a good prognostic index for the assessment of disease progression in prostate cancer and that this might form the basis of a new approach to the treatment of this disease.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗
PubMed1989

Epidermal growth factor receptors in human prostate cancer: correlation with histological differentiation of the tumour.

The presence of specific and high affinity epidermal growth factor receptors (EGF-R) has been demonstrated in human prostate cancer (CaP). Scatchard analysis of the binding data revealed a linear plot consistent with a single class of binding sites with a mean dissociation constant (Kd) +/- s.d. = 1.6 +/- 0.4 nmol 1-1. Additionally the binding was specific for EGF since no other competitor than EGF was able to displace the binding of the labelled ligand from its receptor. Comparison of the concentrations of EGF-R in tissues from 19 patients with CaP with those measured in a group of 18 patients with benign prostatic hyperplasia (BPH) reveal that the expression of EGF-R was significantly higher in BPH (mean +/- s.d. = 125 +/- 7 fmol mg protein-1) than in CaP (52 +/- 11 fmol mg protein-1; P less than 0.01). Furthermore, in CaP the expression of EGF-R varied according to the histological grade of the cancer: well differentiated tumours demonstrated more receptors (84 +/- 13 fmol mg protein-1) than poorly differentiated tumours (22 +/- 5 fmol mg protein-1; P less than 0.01). Clearly the depletion in the expression of EGF receptors in CaP is a function of the histological grade of the cancer and as such EGF receptors could be used as a biochemical marker for tumour differentiation.

Aged↗
PubMed1989

HLA-DR expression by high grade superficial bladder cancer treated with BCG.

The local immune response to intravesical BCG therapy for widespread carcinoma in situ and superficial bladder tumour was assessed using immunohistochemical methods on serial biopsies obtained during treatment. The main findings were the induction of a strong level of HLA-DR expression by urothelial cells which persisted for several months after completion of therapy. This coincided with a mononuclear cell infiltrate in the bladder wall consisting predominantly of activated helper T lymphocytes. Smaller numbers of macrophages, suppressor cytotoxic T lymphocytes and B lymphocytes were also found. These new findings confirm that the inflammatory response to BCG involves the urothelium in an immunological reaction and suggest that the success of immunotherapy with intravesical BCG may be due to enhanced tumour antigen recognition.

Administration, Intravesical↗
PubMed1989

An audit of trauma deaths occurring in the accident and emergency department.

A retrospective study of all patients who died following trauma in the Accident and Emergency Department of the royal Infirmary of Edinburgh over a 4-year period revealed 50 patients (0.0002% of total attendances). Injury severity scores (ISS) and probabilities of survival (Ps) were calculated for all patients. Two-thirds had a Ps of zero while 7 (14%) had a Ps of 0.5 or more. From the information in the case records and at autopsy four deaths (8%) were considered to have been potentially avoidable on the basis of inadequate or inappropriate management. There were a further eight cases (16%) whose management appeared to have been unsatisfactory but who would have been expected to die even if given optimal treatment. These cases are discussed in detail. Difficulty in diagnosing thoracic injuries and delay in giving appropriate treatment were by far the commonest errors encountered. A protocol for the treatment of patients in cardiorespiratory arrest with thoracic injuries is presented. The importance of regular audit of trauma cases and deaths is emphasized.

Accidents, Traffic↗