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Biomedical subjects

D Byrnes

Publications and source records attributed to D Byrnes.

9 recordsLinked to original sources
PubMed1995

A late, fatal complication of a high energy thermal injury to the scalp.

Marjolin's ulcer is an uncommon condition in which malignant transformation occurs in a chronic inflammatory focus. It was originally described in association with a thermal injury, however, its occurrence with protean chronic inflammatory foci has been described. We report the occurrence of and aggressive squamous carcinoma 3 decades after a high voltage electric mark injury to the scalp. This is the first such case described in the literature. The case supportively highlights the role of chronic inflammation and sepsis in epidermal scar cancer development, and it underlines the importance of appropriate wound management initially and expeditious treatment of sepsis and resistant skin ulceration because the malignant behavior of these tumors is aggressive and unpredictable.

Carcinoma, Squamous Cell↗
PubMed1994

Management of severe spasticity with intrathecal baclofen delivered by a manually operated pump.

Intrathecal baclofen abolishes spasticity in many patients with neurological diseases but there are few studies on its long-term effectiveness. Since 1986 a manually operated subcutaneous pump has been used to deliver baclofen intrathecally in 21 patients with a follow up of at least one year. Most patients had multiple sclerosis and all were wheelchair-bound. Sixteen patients had a complete and sustained benefit. In four other patients the treatment was effective in the short term but not in the long term. In the remaining patient the pump never worked. Complications included meningitis, pump failure, erosion through the skin, and baclofen overdose. Nevertheless, only three patients have asked to discontinue the treatment. We conclude that intrathecal baclofen, delivered by a manually operated implanted pump, is an effective treatment for severe spasticity in most patients.

Adult↗
PubMed1987

Methyl tertiary butyl ether cholelitholysis of calculi in the gallbladder and bile ducts.

Recent use of the cholelitholytic agent, methyl tertiary butyl ether (MTBE) has demonstrated its efficacy in the dissolution of cholesterol calculi. In three patients with retained stones in the bile duct, MTBE was instilled and aspirated through a T tube to effect dissolution. Stones dissolved completely in two patients, while in the third, partial dissolution permitted instrumental extraction through the T tube tract. In this third patient, dissolution of gallbladder stones in vitro was relatively slow. Patients tolerated the procedure well and there were no major complications. There was no evidence of duodenal inflammation in two patients who underwent duodenoscopy and biopsy before and after treatment. Four patients with cholesterol cholelithiasis underwent direct gallbladder perfusion with MTBE. The mean size of the gallstones was 0.8 cm (range 0.25-1.75 cm) and the mean number of stones per patient was four (range 1-13 stones). MTBE was instilled via a percutaneous gallbladder catheter inserted under local anesthesia with X-ray control. In three patients, the stone dissolution appeared to be complete after three to six hours of treatment. In the fourth patient, catheter displacement led to termination of dissolution therapy. Follow-up ultrasonograms in two patients demonstrated residual debris not visualised on the immediate post-dissolution films. Complications occurred in two patients and included catheter dislodgement and bile leakage after catheter withdrawal. Biliary perfusion with MTBE is a therapeutic option in patients with retained stones in whom instrumental retrieval has failed. It may also have a role in selected patients with symptomatic stones in the gallbladder.

Adult↗
PubMed1987

Enprostil and ranitidine: comparative efficacy and safety in patients with duodenal ulcer.

This randomised, double-blind, double-dummy, multiclinic study of duodenal ulcer healing compared the efficacy and safety of enprostil with ranitidine. The six week trial admitted 164 patients with endoscopically demonstrated duodenal ulcer. Ratings of symptoms and adverse events were collated from patients' daily diaries, and endoscopy was repeated to verify healing after four weeks and, if appropriate, after six weeks. Medication used was enprostil (35 micrograms capsule) or ranitidine hydrochloride (150 mg tablet) with matching placebos twice daily. After six weeks, 81% of patients treated with enprostil and 95% of those treated with ranitidine had healed ulcers, a statistically significant difference (p = 0.007). There were no differences between treatment groups for the number of days until the daytime ulcer pain completely ceased. Night-time ulcer pain ceased significantly earlier in the group receiving ranitidine (p = 0.019) and was less severe during the week before the last visit (p = 0.001); daytime pain for ranitidine users was also less severe (p = 0.020) during this week. Mild to moderate adverse experiences were reported by 44% of enprostil and 35% of ranitidine patients. There were no severe adverse events. In conclusion, both enprostil and ranitidine were found to be safe and effective in the treatment of duodenal ulcer. However, the ranitidine regimen used in this trial produced better results than the enprostil regimen.

Clinical Trials as Topic↗