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Biomedical subjects

J H Grieve

Publications and source records attributed to J H Grieve.

9 recordsLinked to original sources

Drug-related deaths in Grampian, Scotland.

AIMS: To analyse the demographic data from fatalities arising directly from illicit drug abuse in the Grampian area and compare the findings with trends in drug seizures in Grampian to ascertain if these reflect the recorded deaths, and to attempt to identify a subgroup of the abusing population which might be at greater danger from overdose of controlled substances. METHODS: Cases in which the cause of death was directly attributed to illicit drugs from the beginning of January 1995 until the end of December 1999 were identified, and their epidemiological and toxicological data were analysed. The information regarding drug seizures was gained from Home Office publications for the same time period. RESULTS: One hundred and thirteen cases were retrieved consisting of 93 males and 20 females, aged 16 to 43 years (Median 25). The most commonly isolated substance was morphine followed by benzodiazepines. In 97 cases two or more drugs were involved with five cases showing positive toxicology for four or more drugs. Of the female deaths 75% fell into the 16-25 year age range. Drug seizures rose by 49% from 1995 to 1998 with both heroin and benzodiazepine seizures increasing by more than five fold in the same period. CONCLUSIONS: Deaths directly due to illicit drugs showed a significant increase over the study period and were concentrated in the young male population. The drug seizures increased but the extent of this was not mirrored in the deaths. A shift in emphasis to an older age group is also indicated; drug misuse educational programmes should continue to be targeted at all populations but information may also be targeted at the older age groups and at females under 25 years of age.

Adolescent↗

Quality assurance of histopathologic diagnosis in the British Army: role of the Army Histopathology Registry in completed case review.

The purpose of this study was to assess the clinical and pathological value of reports resulting from review of all completed surgical pathology cases submitted to the Army Histopathology Registry (AHR). All histopathological cases completed in the British Army are sent to the AHR for archiving; prior to placing cases in the archive both microscopic material and submitted reports are reviewed by staff of the AHR. A "nonagreed" report is produced for those cases in which the reviewing pathologist has a dissenting opinion or for which he thinks other comments may be helpful. All nonagreed reports produced over a 19 month period were subjected to a further pathological and clinical review. The original surgical pathology reports were compared with AHR reports and the significance of the differences in diagnosis assessed. During the study interval, 4.0% of total cases reviewed were identified as nonagreed record cases. The clinical and pathological reviews placed the nonagreed cases into significant categories in 2.1% and 1.9% of instances respectively. These findings suggest that nonselected review of completed surgical pathology cases identifies a significant proportion of cases for which dissenting opinions may have important clinical and pathological consequences.

Hospitals, Military↗

A new life-long hemorrhagic disorder due to excess plasminogen activator.

A life-long bleeding disorder is described, characterized by hemorrhage occurring after surgery, injury, or dental extraction, and finally by spontaneous intracerebral bleeding. No abnormality of platelet function or plasma coagulation was demonstrable, but grossly enhanced overall fibrinolytic activity was present. The patient had, additionally, a hyperlipidemia with gross arterial atheroma and a family history of myocardial infarction but not of any hemorrhagic disorder. Laboratory studies led to the conclusion that the enhanced fibrinolysis was due to consistently greatly raised levels of a plasma plasminogen activator physically and immunologically related to that in human tissues and blood vessel endothelium. No deficiency of any known inhibitor of fibrinolysis was detected. Free plasmin was not detectable in functional assays but continuous intravascular plasmin generation clearly occurred as evidenced by presence of plasmin-alpha 2-antiplasmin complexes and of fibrin/fibrinogen-related antigens. Excessive production of plasminogen activator appeared to have occurred throughout life and to be independent of the hyperlipidemia. The pathologically increased fibrinolytic activity may have accounted for the complete absence of detectable thrombotic vascular occlusion at autopsy despite extensive arterial disease with severe narrowing of coronary and cerebral arteries.

Blood Coagulation Tests↗