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Biomedical subjects

G Galea

Publications and source records attributed to G Galea.

At least 19 recordsLinked to original sources
PubMed1998

Supply and demand of bone allograft for revision hip surgery in Scotland.

The Scottish National Blood Transfusion Service is the main provider of bone for grafting in Scotland. Bone is procured only from live donors, following very strict selection criteria, and we have investigated whether the amount being collected was adequate. Our current harvest of approximately 1700 femoral heads per year is shown not to be enough to meet the future demand for revision surgery of the hip. Many more of these operations are being undertaken, and impaction grafting is being used increasingly. We have calculated the predicted rates of collection and usage for the next four to five years so that we can expand our service in a controlled fashion.

Arthroplasty, Replacement, Hip↗
PubMed1996

Study on medical donor deferrals at sessions.

A 10-month audit of reasons for donor medical deferral at sessions was carried out in two Scottish regions of the SNBTS. Six thousand deferred donors were assessed. Although the deferred donor population mirrored the attending donor population in both regions, significantly more donors, both new and regular, were deferred in the Edinburgh and South East region, compared with the North East. The main differences in deferral were attributable to three clinical conditions (cervical carcinoma in situ, other gynaecological conditions and hypertension) and to donors admitting to high-risk behaviour. Although the staff in the deferral process - doctors, nurses and clerks - were involved in roughly equal proportions in both regions, the spectrum of medical conditions seen by each staff grouping appeared to be different in each region. The staff in the South East appeared to have made more correct decisions. Further analysis and audits are being undertaken in areas highlighted by this study.

Blood Donors↗
PubMed1995

A predictive score index for the outcome of associated biofeedback and vaginal electrical stimulation in the treatment of female incontinence.

A group of 64 women with stress incontinence alone (20), urgency incontinence (7) and mixed incontinence (37) were treated during 12 sessions, each 20 minutes long, during 6 weeks with combined alternating biofeedback and intravaginal electrical stimulation. Of the patients 21 had a complete recovery, 20 recovered sufficiently to avoid other forms of treatment and 23 failed to respond to the treatment. Thus, the overall success rate for this treatment was 64%. Various physiological parameters were collected from each patient before the start of the treatment sessions. Patient age, estrogen status, detrusor hyperreflexia, intravaginal pressure, percent transmission of the abdominal pressure to the urethra, degree of intrinsic sphincter deficiency and compliance with therapy were significant factors affecting the success of treatment. A statistical analysis was performed on these measurements to generate a score index model capable of predicting the outcome of a treatment consisting of associated biofeedback and electrical stimulation. We present a reliable method for distinguishing between patients who will and will not respond to this form of treatment. The most significant variables predictive of a good reduction outcome are patient age, presence of estrogen, absence of detrusor instability and intrinsic sphincter deficiency, low urethral hypermobility and, most of all, compliance with treatment.

Adult↗
PubMed1995

The sustained impact of a group and screen and maximum surgical blood ordering schedule policy on the transfusion practice in gynaecology and obstetrics.

A retrospective study was carried out to examine the durability of the impact of Group and Screen (GS) and Maximum Surgical Blood Ordering Schedule (MSBOS) policy on transfusion practices. The study involved the Gynaecology and Obstetrics wards of the three Aberdeen teaching hospitals, all of which are supplied with blood and services by the transfusion laboratory of Aberdeen and North East of Scotland Blood Transfusion Service. The transfusion laboratory and hospital records were examined and analysed for all transfusion events in Gynaecology and Obstetrics during the three periods of 6 months immediately before, immediately after and 2 1/2-3 years following the introduction of a GS and MSBOS policy in November 1986. The number of units of blood crossmatched and units transfused decreased consistently and progressively to half the pre-GS and MSBOS level in both Gynaecology wards and Obstetrics wards during the study periods. This reduction was not associated with a decrease in the clinical workload. However, the crossmatched/transfused ratio (CTR) showed an immediate but transient improvement (3.6 to 2.2 to 3.4) and only partial and delayed improvement (10.1 to 9.6 to 7.7) with regard to blood use in the Gynaecology wards and the Obstetrics wards (respectively) during the three periods of 6 months indicated above. We conclude that the introduction of a GS and MSBOS policy can have a significant and sustained impact in reducing unnecessary blood ordering. The CTR may not be as sensitive an indicator of the effect of the introduction of GS and MSBOS as the total blood usage and a more detailed examination of blood use is necessary to assess performance and long-term impact.

Blood Grouping and Crossmatching↗
PubMed1993

Cytomegalovirus studies on blood donors in north-east Scotland and a review of UK data.

The epidemiology of cytomegalovirus (CMV) infection as assessed by CMV antibody testing varies significantly in different parts of the world and also in different regions of a country. A study was therefore carried out to assess the prevalence of CMV antibody in our blood donors, looking in particular at different subgroups of donors as divided by age, sex and social class, to see how we could maximise the yield of CMV-negative blood from our testing. It was shown that patterns of CMV infection in the North East of Scotland followed well-established norms. Data from other Regional Transfusion Centres within the UK were also collected for comparison.

Antibodies, Viral↗
PubMed1992

Discoid lupus erythematosus in an X-linked cytochrome-positive carrier of chronic granulomatous disease.

A 13-year-old female presented with photosensitivity, recurrent aphthous ulcers and discoid lupus erythematosus (DLE)-like skin lesions. These symptoms have been linked to the carrier status of chronic granulomatous disease (CGD). Neutrophil (PMN) function was investigated by nitroblue tetrazolium reduction test and chemiluminescence. A severe impairment of PMN oxidative burst activity was revealed in spite of supranormal levels of cytochrome b245. Glucose-6-phosphate dehydrogenase activity was deficient. Her mother and two sisters also showed reduced PMN function. These findings are consistent with a cytochrome positive X-linked form of CGD with variable lyonization. DLE in association with the carrier status of this CGD variant has not been reported previously.

Adolescent↗
PubMed1992

The incidence and consequences of cytomegalovirus transmission via blood transfusion to low birth weight, premature infants in north east Scotland.

In a 2-year study involving 133 premature low birth weight (less than 1,500 g) infants, the impact of CMV infection via blood transfusion was assessed. 8.4% (7 out of 83) of transfused infants and 10% (7 out of 70) of those exposed to seropositive blood acquired CMV. In those less than 1,250 g the infection rate rose to 13.2% (7 out of 46). Seropositive infants were at a higher risk of acquiring CMV infection than seronegative ones. CMV infection did not give rise to specific immediate morbidity, and no deaths were attributed to CMV. The only source of nosocomial CMV infection was the transfused seropositive blood. Based on these findings, it was possible to formulate a CMV transfusion policy to premature infants in our region.

Antibodies, Viral↗
PubMed1990

Biofeedback therapy for female incontinence due to low urethral resistance.

Urinary incontinence, mostly secondary to low urethral resistance, in 15 women was treated for 6 weeks by biofeedback. A new device equipped with visual and audio signals connected to an intravaginal probe was used by the patient for 15 minutes twice a day. Of the patients 12 were continent subjectively and objectively, 2 had 65 and 75% improvement and could lead a normal life, and only 1 failed to respond and was treated surgically. Besides the quality of the device, success depends largely on the quality of moral support given to the patient during the treatment.

Adult↗
PubMed1990

The immune response to cytomegalovirus infection and serological methods used in its diagnosis.

The response to cytomegalovirus (CMV) infection, both cellular and humoral, is dependent on the host's immunocompetence. Understanding of this response is particularly helpful in supporting a clinical diagnosis of CMV infection. This article briefly reviews the immune response to CMV infection in different clinical settings. Numerous test systems have been adapted for measurement of antibody to CMV. The commonly available assays are reviewed and their advantages and limitations highlighted. Based on this information it is possible to select the most appropriate test kit for particular situations.

Antibodies, Viral↗
PubMed1989

Transmission of non-A, non-B hepatitis by pH4-treated intravenous immunoglobulin.

Four patients (2 with X-linked, one with common variable hypogammaglobulinaemia, and 1 with ulcerative colitis) developed non-A, non-B hepatitis (NANBH) following administration of a specific batch of intravenous immunoglobulin (IV IgG) manufactured by the Scottish National Blood Transfusion Service using the pH4/mild pepsin method. Each patient had normal serum ALT levels over a preceding period of 12-67 months, with raised values developing within 4-18 weeks of first administration of the implicated batch. Two patients had very mild symptoms of hepatitis, the other 2 being asymptomatic. Over a follow-up period of 8-12 months, ALT levels returned to normal in 3 patients, but biopsy-proven chronic NANBH developed in the fourth. The level of NANBH virus in the starting plasma used to manufacture this batch may have exceeded the capacity of the process to inactivate the virus. The transmission of NANBH by one of approximately 110 batches administered demonstrates the importance of continued close surveillance of recipients of IV IgG, even if asymptomatic, by regular monitoring of liver function tests and recording of all batches received.

Adolescent↗
PubMed1987

Hematological changes associated with marathon running.

Coulter profiles with differential white cell counts, serum ferritin, and haptoglobin levels were determined in venous blood samples obtained from 90 males (M) and 25 females (F) immediately before and after completion of a competitive marathon (42.2 km) race. In an additional 20 male runners, the same measurements were performed serially during the 24 h following their completion of the race. In the pre-race samples from 90 M and 25 F, hypoferritinemia was present in 4/22 M and 1 F found to be mildly anemic. Neutropenia was detected in 4 M and 3 F and mild thrombocytopenia in 2 M. Haptoglobin levels were normal in all the female runners but reduced (less than 0.3 g/l) in 6 M. All post-race samples (88 M and 25 F) were characterized by a reactive neutrophilia and thrombocytosis including those with pre-race neutropenia or thrombocytopenia. An unexpected and incompletely explained sex difference in packed cell volume (PCV) response was observed. In males, the mean PCV increased from 0.425 +/- 0.021 to 0.444 +/- 0.028 (P less than 0.0001) whereas in females it decreased from 0.437 +/- 0.029 to 0.423 +/- 0.036 (P less than 0.05). In the post-race samples, anhaptoglobinemia was found in 13/88 M and 4/25 F. In the 20 male runners studied serially for 24 h after the race, the major changes involved a progressive increase in mean plasma volume (17.4% +/- 12.2% at 24 h) compared with the pre-race value, a progressive and significant increase in MCH and MCHC probably indicating a loss in red cell water and the gradual reversion of the reactive neutrophilia and thrombocytosis to basal levels.

Adult↗
PubMed1986

Filterability of ACD-stored red cells.

The deformability of stored erythrocytes was studied using the Myrenne filtrometer MF4. Blood was stored in ACD under usual blood banking conditions and filterability studies were done at various intervals during a 3-week period. Marked reductions in stored erythrocyte filterability were noted as early as day 5 of storage. These results show that ACD is not a good "rheological' storage medium and indicate that further studies are required, using different storage media to assess the importance and significance of this rheological lesion.

Adult↗
PubMed1985

Hemorrheology of marathon running.

The hemorheological effects of severe exertion were evaluated in eight males and six females before and after a marathon. A highly significant fall in red cell filterability (RCF) was accompanied by a significant rise in plasma osmolality. This correlation was further studied by a series of in vitro experiments to establish a cause-effect relationship. As plasma osmolality increased, RCF progressively diminished. These observations demonstrate that plasma hyperosmolality is an important etiological factor in reducing RCF during strenuous exercise.

Adult↗
PubMed1985

Haematological and haemorheological changes associated with cigarette smoking.

A prospective study was undertaken to establish the haematological and haemorheological changes associated with long standing cigarette smoking in 20 heavy smokers and to assess whether any such changes were reversible after smoking was stopped. Highly significant differences were observed in whole blood viscosity, plasma viscosity, plasma fibrinogen concentrations, packed cell volume, and carboxyhaemoglobin concentrations between smokers and non-smokers. Ten of the subjects were followed up for two weeks after stopping smoking by which time whole blood viscosity and carboxyhaemoglobin concentrations had improved significantly and indications of improvement could be seen in all other measurements. Two of these subjects were further followed up for two months when all the measured variables were comparable with those in non-smokers. No correlation could be established between carboxyhaemoglobin concentration and any of the other variables. Although patients' compliance may be difficult to obtain, further prospective studies would be required to confirm our findings.

Adult↗