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Biomedical subjects

D B Russell

Publications and source records attributed to D B Russell.

13 recordsLinked to original sources
PubMed2001

Urinary tract infections in men in a primary care population.

OBJECTIVE: There have been few studies on urinary tract infections (UTIs) in adult males. This study aimed to look at the clinical features of males presenting with urinary tract infections in a predominantly gay general practice population. METHOD: A retrospective audit and analysis was carried out of all male patients presenting with symptoms suggestive of a UTI and in whom a pathogen was cultured from urine. The subjects were drawn from two urban general practices in Melbourne. Subjects with known pre-existing urinary tract abnormalities, or in whom recent urinary tract instrumentation had been performed, were excluded, as were subjects in whom Neisseria gonorrhoeae was cultured from urine. RESULTS: Thirty-three subjects were identified, with a total of 47 presentations. Six subjects were excluded on the basis of pre-existing known factors which would predispose to UTIs, leaving 27 subjects, with 37 episodes of UTI. The mean age was 43 (range = 28-62) and 25 of the 27 identified as gay. Nine out of the 27 (33%) were HIV positive with a mean CD4 of 574/mm3 (range = 41-1812). The main presenting symptoms were dysuria/burning on micturition, urinary frequency, fever/sweats and haematuria. Urethral discharge occurred in two episodes. Multiple symptoms on presentation were common. The main organism cultured was E. coli. Fourteen subjects underwent further radiological investigation and two abnormalities were detected. CONCLUSION: Uncomplicated UTIs are uncommon in males presenting to general practice. The symptoms are similar to those in females with UTIs, though fever may be more common. Treatment with oral antibiotics in a primary care setting is generally curative. Further investigation of males with UTIs may be appropriate, but more studies are needed as to the cost-benefit of this.

Adult↗
PubMed2000

Intraoperative heparin in addition to postoperative low-molecular-weight heparin for thromboprophylaxis in total knee replacement.

The administration of heparin during operation has been reported to enhance the efficacy of thromboprophylaxis in patients undergoing total hip replacement. We have performed a small pilot study in which intraoperative doses of heparin were given in addition to the usual postoperative thromboprophylaxis with enoxaparin in 32 patients undergoing total knee replacement. The primary endpoint was deep-vein thrombosis (DVT) as demonstrated by bilateral venography on 6 +/- 2 days after operation. Sixteen patients developed DVT; in two the thrombosis was proximal as well as distal and in one the occurrence was bilateral. There was one major haemorrhage. These results are similar to those obtained with the use of postoperative thromboprophylaxis with enoxaparin alone. They do not provide support for the initiation of a larger randomised trial of this approach to management.

Anticoagulants↗
PubMed1998

Mastoid pneumocele causing atlantooccipital pneumatization.

A 49-year-old woman had a palpable mass in her occipital region. Plain radiographs and CT examination revealed extensive atlantooccipital pneumatization with findings consistent with the diagnosis of mastoid pneumocele. Decompression was achieved with placement of a myringotomy tube, resulting in prompt symptomatic relief. On a follow-up CT examination, the pneumatized areas had become opacified and new bone formation was present.

Air↗
PubMed1982

Radiation and nitroimidazoles in supratentorial high grade gliomas: a second clinical trial.

As a continuation of a previous controlled trial using "high-dose" metronidazole as a specific sensitizer of hypoxic cells, we used a more efficient nitroimidazole derivative (misonidazole, MISO) in combination with higher doses of radiation in patients with supratentorial high-grade astrocytomas. Sixty-six patients were stratified according to functional level and histological grading, and randomly allocated within 2 weeks of operation of 1 of 3 therapeutic groups: 1, conventional radiation alone; 2, large fractions of radiation with high-dose metronidazole; and 3, radiation as in Group 2 but with equitoxic doses of MISO. We examined survival as the principal end-point of the study. Neither by increasing the dose of radiation over the previous study, nor by using a more efficient sensitizer, were we able to improve survival over the current conventional daily fractionated radiation.

Adult↗
PubMed1981

Diagnostic leg scanning for deep venous thrombosis in the recently heparinized patient.

Leg scanning with fibrinogen I 125, either alone on in combination with other procedures, has been proposed as an alternative to venography for diagnosis of deep venous thrombi. Clinical circumstances may necessitate anticoagulation before scanning can be performed, which could alter its reliability. We have compared the results of scanning with venographic findings in heparinized patients with venous thromboembolism. Different criteria for an abnormal leg scan gave different sensitivities and specificities. During the first four days of scanning with a requirement for a persistently abnormal result, five of eight criteria had high specificity (greater than 92%). However, sensitivities did not exceed 55%. With the use of transiently abnormal results and six days of scanning, higher sensitivities were obtained but specificities were reduced. No criterion gave results considered acceptable for a diagnostic test for deep venous thrombosis. Leg scanning should therefore not be used for this purpose in patients who have received anticoagulants. Our results also suggest that duration of symptoms has little effect on the sensitivity of leg scanning and that the test is more reliable for establishing the presence of thrombus than at defining its location.

Clinical Trials as Topic↗
PubMed1980

Fortuitously discovered intracranial aneurysms.

A series of ten patients had 12 intracranial aneurysms fortuitously discovered during roentgenographic investigation for unrelated symptomatology. The benign course of these lesions during a two-year to 7 1/2-year period of observation is of interest.

Adult↗
PubMed1977

Complications of cerebral angiography and pneumography.

There were incidences of 0.7% severe and 5.5% mild complications in 1,971 direct puncture carotid angiograms done over a 5-year period. In 1,035 retrograde branchial angiograms, there was a 0.6% incidence of severe, and a 4.7% incidence of mild, complications. Complications tended to increase with increasing age of the patient. Brachial angiography is virtually free of life-threatening complications, and the incidence of neurological sequelae was markedly less than that shown by a comparable analysis of catheter angiography. Of patients undergoing 1,542 fractional pneumoencephalograms, 2 had severe complications.

Adolescent↗
PubMedDate not supplied

Clinical experience with Hexabrix in cerebral angiography.

Sixty patients from the University of British Columbia, Vancouver General Hospital, and University of Alberta Hospitals Edmonton participated in an open-labelled clinical study on the safety, tolerability and efficacy of ioxaglic acid (Hexabrix) in cerebral angiography. Only 4% of patients experienced significant pain during carotid and brachiocephalic injections of Hexabrix. No increased incidence of side effects or adverse effects were encountered. In addition, radiographic film quality overall was excellent and comparable to that obtained using conventional contrast agents. Hexabrix is a safe and effective contrast agent for cerebral angiography.

Adolescent↗