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Biomedical subjects

J M Duggan

Publications and source records attributed to J M Duggan.

At least 19 recordsLinked to original sources
PubMed1992

Aluminium beverage cans as a dietary source of aluminium.

OBJECTIVE: To examine the possibility that aluminium beverage cans contribute to the dietary level of aluminium. METHOD: The aluminium content of a variety of beverages from aluminium cans and glass containers was measured. RESULTS: The contents of 106 aluminium cans and bottles representing 52 different beverages all had a higher aluminium content than Newcastle tap water at 1.4 mumol/L, ranging as high as 385 mumol/L. Non-cola soft drinks averaged 33.4 mumol/L from cans and 5.6 mumol/L from bottles. Cola drinks averaged 24.4 mumol/L from cans and 8.9 mumol/L from bottles, whereas beer in cans or bottles averaged about 6 mumol/L. CONCLUSIONS: In general, the aluminium content of beverages from aluminium cans was higher than that from glass containers, and it rose with decreasing pH. Within a given category there was a wide variation in aluminium content. If the speculative link between aluminium intake and Alzheimer's disease is established then beverages from aluminium cans, particularly soft drinks, may be a risk factor.

Aluminum↗
PubMed1992

Changing trends in perforated peptic ulcer during the past 45 years.

Since 1944 there has been a dramatic change in the pattern of admissions for perforated peptic ulcer (PPU) to the Royal Newcastle Hospital, the main teaching hospital of the Hunter Region, Australia. Between 1944 and 1950, females accounted for 6% of all perforations; since then the proportion of females admitted with this complication has risen to 32%. Simultaneously, the modal age for PPU has shifted from the fifth to the seventh decade and the ratio of gastric to pyloroduodenal perforations has fallen from 1.1:1 to 0.6:1. No good explanation for this change in the natural history of PPU, also noted elsewhere, is evident.

Adult↗
PubMed1992

Perforated peptic ulcer in the Hunter region: a review of 174 cases.

A review of 174 consecutive patients admitted with a diagnosis of perforated peptic ulcer to eight Hunter Region hospitals during 1979-86 is presented. Among the female admissions, the proportion of patients greater than 70 years of age was twice that in males. One-third of all perforations were in females who accounted for two-thirds of all perforated gastric ulcers. Multivariate analysis revealed that perforations located in the stomach and older age were both significant independent variables adversely affecting outcome following surgery. In contrast, shock at presentation and delay in operating were not statistically significant independent risk factors.

Adolescent↗
PubMed1989

Audit of the activity of a same day ward.

OBJECTIVE: To assess the utilization of a 16-bed same day ward with particular reference to preadmission, discharge and after-care planning, and complication and delayed discharge rates. METHOD: Three audits, each of 200 consecutive patients, were carried out during 1987 with a questionnaire suitable for desk-top data processing. RESULTS: The same day ward was capable of being used by a wide variety of disciplines, with one in five patients aged more than 70 years. Significant falls in complication and delayed discharge rates occurred, with increasing use of discharge notes and follow up arrangements by medical staff. Preadmission visits by a community nurse may facilitate the appropriate use of the ward by elderly patients.

Aged↗
PubMed1988

Pulmonary vascular efflux of norepinephrine in Dahl rats susceptible or resistant to salt-induced hypertension.

The purpose of these studies was to determine whether the accumulation of norepinephrine by the pulmonary circulation is altered in the Dahl model of genetic hypertension. Pulmonary norepinephrine accumulation was evaluated by performing a compartmental analysis of the efflux of L-[3H]norepinephrine from perfused lungs after inhibition of the norepinephrine-metabolizing enzymes. The lungs were isolated from Dahl salt-hypertension-susceptible (S) and salt-hypertension-resistant (R) rats that had been on a high sodium diet for 3 weeks. In both S and R rats, norepinephrine was accumulated into a single compartment with an efflux half-time of approximately 23 min, in addition to its distribution in the extracellular space. The size of the extracellular space was significantly increased in the S rats, but there was no difference in the size of the compartment of L-[3H]norepinephrine efflux between S (6.4 +/- 1.2 ml/g) and R (3.7 +/- 0.7 ml/g) rats. These data indicate that impaired accumulation and efflux of norepinephrine by the lungs does not contribute to the pathogenesis of hypertension in Dahl S rats.

Animals↗
PubMed1986

Haematemesis patients should be managed in special units.

This report outlines the results of 568 episodes of acute upper gastrointestinal haemorrhage managed in the Gastroenterology Unit of The Royal Newcastle Hospital during 1964-1974. In this Unit a conservative regimen of blood transfusion and surgery was used with the aim of operating immediately on the recurrence of bleeding for patients with chronic gastric ulcers. In comparison with the 523 patients who were bleeding who were treated in other medical units in the same hospital during 1964-1969, the mortality rate was lower for all peptic ulcers (4.9% compared with 10.6%; P less than 0.025) and for gastric ulcers (8.9% compared with 23.1%; P less than 0.01), but differences for duodenal ulcers (3.6% compared with 5.8%) and in the other diagnostic sub-groups were not significant. The results are also compared with those from units that manage all admissions for upper gastrointestinal bleeding at Prince Henry's Hospital, Melbourne (which has an aggressive transfusion and surgical policy), and The Royal North Shore Hospital of Sydney (which has a "standard" approach). In spite of radically different policies, all three gastrointestinal units obtained rather similar results, with the Newcastle mortality rate from bleeding ulcers of 4.9% being the lowest of all. It is suggested that all large hospitals should have haematemesis and melaena units, as they do coronary care units, but that there is no advantage to be gained by a policy of aggressive treatment.

Adolescent↗
PubMed1986

Ten year follow-up of gastrointestinal hemorrhage patients.

The mortality and morbidity of the 241 survivors of an acute gastrointestinal hemorrhage treated between 1958 and 1964 are reported. The major purpose of this study was to assess the subsequent risk to life and health of patients presenting with acute upper gastrointestinal bleeding. Patients without dyspepsia and with a negative single contrast barium meal study had an excellent prognosis. Life Table analysis showed that the gastric ulcer patients had a mortality not significantly different from that of the Australian population, with the higher risk of death from ulcer balanced by a lower risk of fatal vascular disease. Duodenal ulcer patients had an increased mortality attributable to a 290% increase in deaths from vascular disease, but only one of the 84 died of an ulcer complication. The association between duodenal ulcer and vascular disease has been present for decades. It is unlikely to be associated with hypertension, diabetes mellitus, diet, stress, or smoking and deserves further study.

Acute Disease↗
PubMed1986

Peptic ulcer and non-steroidal anti-inflammatory agents.

Aspirin is generally regarded as a cause of gastric ulcer but the role of non-steroidal anti-inflammatory agents and paracetamol in the aetiology of peptic ulcer is unclear. To investigate this we conducted a case control study of 180 matched pairs of peptic ulcer patients and controls obtained from surgical and dermatology outpatient clinics. There were 95 gastric ulcer and 85 duodenal ulcer patients. A statistically and clinically association (relative risk = 5) was found between the regular use of non-steroidal anti-inflammatory agents and gastric ulcer. There was also evidence of positive associations between gastric ulcer and aspirin containing preparations with or without non-steroidal anti-inflammatory agents. By contrast, duodenal ulcer was unrelated to these drugs. Too few patients used paracetamol for any conclusion to be drawn on its role.

Acetaminophen↗
PubMed1985

Septicaemia as a hospital hazard.

In 1 year there were 135 episodes of septicaemia in a large referral hospital serving a population of 400,000 people. Of these, 52 were hospital-acquired giving a nosocomial septicaemia rate of 2.08 per 1000 admissions. The mortality rate rose with the number of antibiotics used; from 15% in those receiving one drug to 50% in those receiving three. A wide variety of organisms were encountered, the largest group being Staphylococcus aureus, 12 episodes; and Escherichia coli, nine episodes. Staphylococcus epidermis was pathogenic in seven patients with one death. A review of possible aetiological factors showed that 28 episodes occurred postoperatively with surgery considered directly responsible in 20. Intravenous cannulae were in place in 39 patients at the time of development of infection; they were causal in at least five; with two deaths. Urinary catheters were in situ in 14 patients and causal in at least six, with two deaths. Immunosuppression by drugs carried a worse prognosis than when infection occurred in patients with immunosuppressive disease.

Adolescent↗
PubMed1985

Conservative treatment of gastrointestinal haemorrhage.

The Gastroenterology Unit of the Royal Newcastle Hospital treats all acute bleeders in the hospital and has followed a policy of conservative blood transfusion and early surgery directed to gastric ulcer upon rebleeding. A prospective study of 201 consecutive episodes is presented and compared with recent series treated more conventionally. Our patients were transfused less, and operated upon less often with a lower mortality rate in those with chronic peptic ulcers. The data suggest that a reversion to the less aggressive treatment policies of several decades ago, combined with early limited surgery directed to endoscopically proven gastric ulcer is worthy of trial.

Acute Disease↗