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Biomedical subjects

J Large

Publications and source records attributed to J Large.

14 recordsLinked to original sources
PubMed1990

Teicoplanin compared to flucloxacillin for antibiotic treatment of neutropenic patients.

Ninety-eight neutropenic patients were randomized to receive piperacillin and gentamicin in combination with either teicoplanin or flucloxacillin. Sixty-seven of these patients, most of whom had myeloma, were given this combination as prophylaxis 5 d after high dose chemotherapy, 35 receiving flucloxacillin and 32 receiving teicoplanin. Of 31 patients with leukaemia who were febrile and neutropenic following induction chemotherapy or bone marrow transplantation, 18 received flucloxacillin and 13 received teicoplanin. For those given flucloxacillin, the mean number of days to change of antibiotics was 7.8 in the prophylaxis group and 5.1 in the treatment group. In the teicoplanin arm, the mean number of days to change antibiotics was 6.8 in the prophylaxis group and 6.1 in the treatment group. Two patients in the flucloxacillin arm developed drug rashes. Four patients developed rigors after teicoplanin administration and one asthmatic became wheezy. One patient had a progressive rise in creatinine, but overall the patients having teicoplanin did not have any appreciable increase of renal toxicity compared to the flucloxacillin arm. Blood cultures were positive prior to commencement in the treatment group in nine patients, and during treatment in six patients. Organisms grown were Gram-positive in 14 patients. Teicoplanin appears to be as effective as flucloxacillin when each is used in combination with piperacillin and gentamicin in the treatment of neutropenic patients, with similar rates of toxicity.

Anti-Bacterial Agents↗
PubMed1985

Surgical treatment of saphenous varices, with preservation of the main great saphenous trunk.

A review of the important steps required in the surgical procedure for treatment of varicose veins suggests a protocol in which all damaged veins are removed by the stab avulsion technique, only veins with incompetent proximal valves are ligated, and the long saphenous vein is never removed unless it is too damaged to use for arterial grafting. With this protocol of selective conservation it is possible to preserve valuable undamaged major leg veins and at the same time treat varicose veins efficiently. A 3-year postoperative review of 171 patients with 295 affected limbs treated in this way was done by independent observers. They found a recurrence rate of only 10.5%. There is evidence to suggest that Doppler testing for proximal valve competence will further improve results in the future.

Evaluation Studies as Topic↗
PubMed1985

A conflict in vascular surgery.

It is believed that many surgeons, by adopting 'stripping' as the routine surgical treatment of significant varicose veins may be sacrificing many major leg veins which could be potentially valuable arterial grafts. A protocol of surgery is suggested which replaces stripping by the stab-avulsion technique. Thus all varices are removed and distal incompetent perforators controlled. Freed from an inevitable 'high ligation', it enables selective ligation at proximal valves, only when they are incompetent. It is suggested that this protocol treats varices effectively whilst preserving undamaged veins. The results presented show a 3 year recurrence rate of about 10%, but evidence is offered that better results will be obtained, now that Doppler equipment is readily available.

Bioprosthesis↗
PubMed1985

Changes in capillary distribution in rat fast muscles following nerve crush and reinnervation.

The recovery of muscle weight and contraction tension was measured in rat anterior tibialis muscle following unilateral crushing of the lateral popliteal nerve. Muscle twitch and tetanic tensions and muscle weight had recovered to control values within 6-8 weeks after the nerve was crushed. Capillary supply to each of the four types of muscle fibre present in the intact muscle, and within the groups of adjacent fibres of similar histochemical reaction for succinate dehydrogenase and myofibrillar actomyosin ATPase found in the reinnervated muscle, was computed by the method of Gray & Renkin (1978). Capillary area density (capillaries/mm2) within the grouped regions of the reinnervated muscle was not significantly different from the supply to the same fibre type in intact contralateral muscles. Capillary/fibre ratio for the more glycolytic fibre types (alpha W, alpha?) was lower than in intact muscle, while the values for both alpha R and beta R oxidative fibres agreed closely with control values. It seems that selective growth and loss of capillaries occurs during reinnervation, adjusting capillary supply to meet the changed metabolic demands of the individual fibres following regrouping.

Animals↗
PubMed1984

Doppler testing as an important conservation measure in the treatment of varicose veins.

While it is rational to ligate incompetent proximal saphenous valves, when treating varicose veins, it is hard to justify ligation if they are competent. Accurate diagnosis of competence by clinical tests have proved less than satisfactory. Doppler testing, with a simple blood flow indicator, is suggested as a sound basis on which to make decisions regarding 'selective ligations' of incompetent proximal valves.

False Negative Reactions↗