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D Sutherland

Publications and source records attributed to D Sutherland.

18 recordsLinked to original sources
PubMed1992

Presence and implications of chemical contaminants in the freshwaters of the Canadian Arctic.

Hydrocarbons, stable organochlorines, metals and radionuclides are widespread in the freshwaters of the Canadian Arctic. Petroleum-associated hydrocarbon sources include natural seepage, wastes and effluents from exploration, production and refining at Norman Wells and spills. Hydrocarbons also originate from combustion of carbon-based fuels, generally at lower latitudes and then reach the Arctic with air movements. Organochlorine compounds also move throughout the hemisphere by aerial pathways and have become distributed widely in Arctic fish. The organochlorine at highest concentration in Arctic freshwater is alpha-HCH, while those generally at highest concentrations in the fish are toxaphene, PCBs and chlordane. Metals are ubiquitous in Arctic freshwaters, with inputs of several metals by precipitation superimposed on natural geologic backgrounds. Mercury is found in muscle of fish from Arctic freshwaters at concentrations up to about 0.5 ppm. Radionuclides are also widespread at levels below those acceptable in food, with some local elevations near former mines. The implications of these contaminants for the northern ecosystems and the people dependent upon them are still not clear. Preliminary studies of inducible enzymes in fish suggest that the thresholds for biological damage have not been reached.

Animals↗
PubMed1992

[Simultaneous en-bloc allotransplantation of pancreas and kidney in the animal model. Comparison of separate organ and en-bloc pancreas/kidney transplantation in swine].

The high technical complication rate of pancreas transplantation requires large animal models to improve clinical transplant survival rates. The pig is a very suitable animal due to its anatomy, physiology and immunology which are similar to humans. In this study a model of en-bloc simultaneous pancreas and kidney transplantation was established which--in contrast to separate transplantation of both organs--decreases preservation time, operation time, and clamp time. Furthermore, the rates of intra- and postoperative complications were reduced compared with separate transplantation. The donor aorta (encompassing celiac axis, superior mesenteric artery, and left renal artery) is anastomosed en-bloc to the recipients aorta in a an oblique-to-side fashion. The portal vein is anastomosed end-to-side to the left common iliac vein. The exocrine pancreatic secretions are drained via duodenocystostomy to allow for monitoring of urinary amylase for rejection. The en-bloc technique is an alternative for pediatric donor organs since the risk of vascular complications is lower compared with separate implantation of the donor vessels. Based on our results in a large animal model the en-bloc technique could be used in adult uremic diabetic patients who receive a combined pancreas-kidney transplant from a pediatric cadaver donor.

Amylases↗
PubMed1991

Risk factors for second renal allografts immunosuppressed with cyclosporine.

Second renal allograft survival rates are lower than those of primary allografts. For recipients immunosuppressed with azathioprine, prednisone, and Minnesota ALG (conventional immunosuppression), risk factors associated with decreased second graft survival have been identified: age greater than 40, cadaver donor, less than 6 months between primary graft loss and retransplantation, duration of primary graft function (6 months or 1 year, depending on the study), high peak panel-reactive antibody, number of human leukocyte antigen mismatches, and delayed graft function. In this study, we used a multivariate analysis to identify risk factors associated with decreased second graft survival in patients who did or did not receive cyclosporine. Results were compared with primary graft survival rates. Risk factors for patients receiving conventional immunosuppression were: (a) primary graft loss caused by rejection greater than or equal to 6 months (P = 0.01 vs. either rejection less than 6 months or nonimmunologic loss); (b) cadaver donor (P = 0.005 vs. living related); and (c) interval between primary graft loss and retransplantation of greater than or equal to 6 months (P = 0.05 vs. less than 6 months). For CsA, risk factors that most decreased second graft survival were: (a) primary graft loss caused by rejection less than 6 months (P = 0.11 vs. nonimmunologic loss); (b) conventional immunosuppression for the primary graft (P = 0.08 vs. CsA immunosuppression); and (c) a peak PRA of greater than or equal to 21 (P = 0.14 vs. peak PRA of 1-20). For second graft recipients immunosuppressed with CsA, primary graft loss to either rejection greater than 6 months posttransplant or nonimmunologic causes was not a risk factor for second graft survival. These data extend the recent reports of other investigators by identifying risk factors for retransplant recipients treated with CsA and by demonstrating that subgroups of patients in the retransplant population can be retransplanted without additional risk (i.e., their second graft survival rates are similar to primary graft survival rates). This may become more important if, in the future, organ distribution is based on graft survival data. If so, our data would support retransplantation in patients who are immunosuppressed with CsA, especially those who lost their primary graft to either rejection greater than or equal to 6 months posttransplant or nonimmunologic causes; who receive living related grafts; and who have a peak PRA of 1-20.

Adult↗
PubMed1991

[Simultaneous removal of liver and pancreas does not have an effect on results of transplantation of these organs].

In a retrospective clinical study we compared the outcome after pancreas and liver transplantation when both organs were retrieved from the same donor to the outcome when only one or the other organ was retrieved. The results in this article demonstrate that simultaneous procurement of liver and pancreas grafts has no detrimental effect on the rate of technical failures, or allograft or patient survival after either pancreas or liver transplantation.

Adult↗
PubMed1990

Cystic central necrosis of transplanted pancreas.

The computed tomographic (CT) findings in pancreas transplant rejection have been reported to include graft swelling and inhomogeneity. We report a patient with transplant rejection in whom the preoperative CT examination and specimen radiographs revealed large cystic structures within the pancreas. Cystic central necrosis has previously been reported in patients with pancreatitis, but here it is associated with transplant rejection.

Adult↗
PubMed1977

What do family physicians see in practice?

Health care problems dealt with in their practices were recorded by seven family physicians over a period of 1 year (two others recorded for 3 months), each diagnosis being coded according to the Canuck Disease Classification Index. Problems were classified into four types: physical, psychosocial, diseases of choice (or lifestyle) and diseases of social impact. More than 85% of the 23 108 problems recorded were physical in origin and had physical manifestations. More time was spent on routine checkups and treatment of respiratory disease than on any other activity. Venereal disease and alcoholism were infrequent problems. The family physician is in a favourable position to act as health educator and counsellor and must be throughly trained in the physical aspects of disease.

British Columbia↗
PubMedDate not supplied

The open market.

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Automobiles↗