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Biomedical subjects

D S Barrett

Publications and source records attributed to D S Barrett.

26 records · Page 2Linked to original sources
PubMed1985

Pulmonary mycotic aneurysms secondary to infective endocarditis in a patient with a persistent ductus arteriosus and partial anomalous pulmonary venous drainage.

Mycotic aneurysms are a rare but recognized complication of infective endocarditis. Aneurysms of the pulmonary artery are usually associated with infected congenital heart lesions and especially with persistent ductus arteriosus. This report deals with a patient with a persistent ductus who developed multiple mycotic aneurysms in the right lung following infective endocarditis, and whose management was complicated by anomalous venous drainage of most of the contralacteral lung. Surgical closure of the ductus to reduce pulmonary blood flow failed to prevent haemoptysis, and further surgery to ligate the feeder arteries to the aneurysms was required.

Adult↗
PubMed1982

Suppression of natural cell-mediated cytotoxicity in man by maternal and neonatal serum.

the natural cytotoxicity of cells prepared from the blood of human neonates and women at the time of parturition was investigated, using a 4 hr 51Cr release assay and two established cell lines as targets. Although cord cells proved to be cytotoxic, the overall level was distinctly lower than that of normal adult cells. Whereas adult cells from males gave higher levels of cytotoxicity compared with cells from females, this was not the case for cord cells. Cells from women in labour showed even lower cytotoxic values. Neonatal and maternal serum or plasma caused a profound inhibition of the cytotoxicity shown by adult cells when present during the assay or following preincubation of effector cells with serum. Cord cells were not suppressed by either autologous or allogeneic cord sera. The nature of these suppressive factors and their origin and ontogeny remain to be elucidated. It would appear that in the neonate, and possibly also in the fetus, natural cytotoxicity is largely suppressed by serum factors, both in mother and offspring. This could represent yet another example of immunological modulation in pregnancy.

Adult↗
PubMedDate not supplied

Patients' recollection of day case knee arthroscopy procedure.

A prospective study of 103 consecutive patients who underwent day case knee arthroscopy was performed. The purpose was to evaluate the information delivery system, patient comprehension, and issues of informed consent pertaining to day case arthroscopy procedures. There were 34 females and 69 males in the study group and their mean age was 38.6 years (range: 14.4 to 74.9 years). The diagnosis, procedure, and aftercare were explained to the patients in the outpatients clinic by a trained nurse and by the operating surgeon just prior to the operation. The nurse before the operation gave the patients an information booklet. Postoperatively the patients were informed about the findings and diagnosis prior to their discharge from the day care facility. Patients were requested to complete a questionnaire. Three weeks later they were given the same questionnaire, prior to consultation, in the outpatient clinic. These two forms were compared with the operative findings and diagnosis documented in the copy, of the questionnaire completed by the surgeon as well as the case notes. Most patients (38.8%; 40 patients) had no recollection; 3.9% (4 patients) had partial recollection at their consultation three weeks later; 19.4% (20 patients) found that the arthroscopic photograph was not helpful in making them understand the procedure; and 9.7% (10 patients) found the information booklet to be unhelpful. Further, 23.3% (24 patients) said that it would not help if the booklet were sent to them prior to the operation. The recollection rate was also correlated to their position on the operating list, to ascertain the effect of the anesthetic. There was a 65.9% (58 patients) recollection rate in those patients who were on the first half of the list and there was only a 33.33% recollection rate in those patients who were last or second to the last [p = 0.0225]. We recommend regular evaluation and improvement in the communication and information delivery system provided to patients.

Adolescent↗
PubMedDate not supplied

Avascular necrosis following chevron distal metatarsal osteotomy: a significant risk?

The authors have shown the chevron osteotomy to be an effective operation for hallux valgus where degenerative changes have not occurred in the metatarsophalangeal joint. Chevron osteotomy is normally restricted to younger patients, yet in this study there has been no upper limit for age and the authors have shown a high rate of patient satisfaction with good mobility and cosmesis. Results are not significantly operator-dependent, and the procedure is simple and reliable. The authors have been unable to verify previous reports in smaller studies of the serious complication of avascular necrosis of the metatarsal head on clinical or radiological grounds.

Adolescent↗