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Biomedical subjects

J Mathews

Publications and source records attributed to J Mathews.

At least 19 recordsLinked to original sources
PubMed1999

Immunocytoma: a retrospective analysis from St Bartholomew's Hospital-1972 to 1996.

PURPOSE: To analyze the presentation features and outcome for patients with immunocytoma (IMC) managed at St Bartholomew's Hospital (SBH), London, United Kingdom, between 1972 and 1996. Outcome was compared with that of patients with small lymphocytic lymphoma (SLL)/B-cell chronic lymphocytic leukemia (B-CLL) treated at SBH during the same period. PATIENTS AND METHODS: One hundred twenty-six patients with newly diagnosed IMC were identified. Patients were subclassified (using the Kiel classification) as having lymphoplasmacytoid (n =92), lymphoplasmacytic (n = 24), polymorphous (n = 9), or undetermined (n = 1) IMC. Six patients (5%) had stage I to IIE disease; the rest had advanced disease. Treatment was given according to disease stage. Seven patients were managed expectantly. RESULTS: Eighty-two (69%) of 119 patients responded to treatment, but complete remission was seen in only 15 (13%) of 119. Treatment failed in 29 (24%) of 119 patients. There were three treatment-related deaths; five patients were not assessable for response. When survival of patients with IMC was compared with that of patients with B-CLL/SLL, a significant difference was found (P <. 01); this difference was maintained when only patients in whom the diagnosis was based on lymph node biopsy were considered (P =.01). A comparison of the three IMC subgroups showed that there was a trend (P =.06) toward a difference between B-CLL/SLL and the lymphoplasmacytoid subtype. CONCLUSION: Patients diagnosed with IMC are generally older and present with advanced disease. Conventional therapies usually result in incomplete responses of short duration. Overall, these results support the proposed World Health Organization reclassification of IMC to include lymphoplasmacytoid lymphoma (Kiel classification) as a variant of B-CLL/SLL.

Adult↗
PubMed1998

Distal femoral osteotomy for lateral compartment osteoarthritis of the knee.

Twenty-one patients with lateral compartment osteoarthritis and valgus deformity of the knee underwent distal femoral supracondylar osteotomy (medial closing wedge) between 1983 and 1993 with follow-up ranging from 1 to 8 years. Ten knees had plaster cast immobilization, 5 had fixation with 2 staples supplemented with a plaster cast, and 6 knees had rigid internal fixation with an AO blade plate. Thirty-three percent of patients had a satisfactory result using the HSS score, and 57% had a satisfactory result using the Knee Society Clinical Rating. Fifty-seven percent had a significant complication, including severe knee stiffness requiring manipulation under anesthesia (48%), nonunion/delayed union (19%), infection (10%), and fixation failure (5%). Five (19%) knees required total knee replacement within 5 years of surgery. Satisfactory results were obtained only in those patients who had less severe degrees of osteoarthritis confined to the lateral compartment (grades I to III), adequate correction of valgus deformity (the anatomical axis within 2 degrees from zero), and rigid internal fixation to permit postoperative early mobilization. These results indicate that distal femoral osteotomy is a satisfactory procedure in the young, active patient with osteoarthritis of the lateral compartment of the knee, but requires precise surgical technique and rigid internal fixation.

Adult↗
PubMed1997

Arterial occlusion in patients with peripheral vascular disease treated with platinum-based regimens for lung cancer.

BACKGROUND: Patients with cancer may be hypercoagulable, and smoking can cause both lung cancer and peripheral vascular disease. Cisplatin-based chemotherapy has been reported to cause a variety of vascular side effects. CASE REPORTS: Five patients with bronchogenic carcinoma and peripheral vascular disease developed acute arterial occlusion soon after receiving a combination of cisplatin or carboplatin plus etoposide. All these patients had risk factors for atherosclerosis and three of them had preexisting known peripheral vascular disease. CONCLUSIONS: The occurrence of acute arterial occlusion soon after initiation of chemotherapy suggests that it might have been a complication of this therapy. Hence, caution should be exercised when using platinum-based (and other?) chemotherapy in patients with known moderate or severe peripheral vascular disease.

Aged↗
PubMed1996

Body position, age and mass effect of adiposity on adipose tissue red cell flux in morbid obesity.

OBJECTIVE: To measure red cell flux of adipose tissue in morbidly obese patients' pannus in the upright and supine position to determine factors which would render the lower pannus susceptible to ischemic necrosis. DESIGN: A cohort study of morbidly obese subjects without ischemic necrosis. SETTING: University teaching hospital. PATIENTS: Twenty-three consecutive morbidly obese patients referred for gastroplasty. MEASUREMENTS: Red cell flux, measured as RMS voltage by a laser Doppler velocimeter. An optical fiber with a tip diameter of 250 mu was inserted into the upper and lower pannus and output recorded in the upright and supine positions. Other variables recorded were age, BMI, blood pressure and serum lipids. RESULTS: Adipose tissue red cell flux demonstrates considerable spatial and temporal heterogeneity from subject to subject and in various locations in the pannus. No differences in red cell flux were detected in response to change in position. However, regression analysis demonstrated that the gradient between the upper and lower abdomen in the supine position was increasingly positive with age and in the upright position it was increasingly positive with increasing weight or BMI. CONCLUSIONS: These data suggest that red cell flux is heterogeneously distributed in the abdominal pannus and is not greatly influenced by body position. However, with increasing age and adiposity there is a gradient for decreased red cell flux to the lower portion of the pannus. This may be a factor in rendering this part of the pannus prone to ischemic fat necrosis.

Abdomen↗
PubMed1995

Reconstruction using the saddle prosthesis following excision of primary and metastatic periacetabular tumors.

From 1988 to 1991, 17 patients with malignant periacetabular tumors underwent limb-sparing surgery and reconstruction using the saddle prosthesis. There were 8 patients with primary malignant lesions (Group 1), and 9 patients with metastatic or systemic tumor involving the periacetabular pelvis (Group 2). All resections included excision of the acetabulum. Patients ranged in age from 24 to 76 years (average, 59.8 years). Local control was achieved in all patients. Wide margins were obtained in all patients with primary pelvic tumors. Functional outcomes were rated as follows excellent (10), good (2), fair (1), and poor (4). Three patients, all of whom had pulmonary metastasis before surgery, died within 8 months of surgery. Of the remaining 14 patients, 5 patients died between 6 and 28 months after the index procedure. At the end of the followup period, 9 patients were still alive (6 in Group 1 and 3 in Group 2), with a followup period ranging from 15 to 62 months (average, 33.4 months). The overall results for surviving patients were 7 excellent and 2 good results, with no fair or poor results.

Acetabulum↗
PubMed1994

Intravenous access in the critically ill trauma patient: a multicentered, prospective, randomized trial of saphenous cutdown and percutaneous femoral access.

STUDY OBJECTIVE: To compare the speed of IV access and the rate of infusion for saphenous venous cutdown and percutaneous femoral catheterization. DESIGN: Prospective, randomized, multicentered trial. Patient enrollment occurred from September 1990 through September 1991. SETTING: Patients were enrolled at three urban Level I trauma centers. TYPE OF PARTICIPANTS: Seventy-eight critically ill trauma patients. INTERVENTIONS: Participants were randomized to one of two groups: saphenous cutdown or percutaneous femoral line. After successful cannulation of the vein, 1 L of crystalloid was infused by gravity. RESULTS: The mean procedure time for the cutdown group was 5.63 +/- 2.58 minutes compared with 3.18 +/- 1.19 minutes for the femoral line group (P < .0001). The mean infusion time for the cutdown group was 6.65 +/- 4.29 minutes compared with 4.56 +/- 2.47 minutes for the femoral line group (P < .03). The mean overall time for the cutdown group was 11.76 +/- 4.81 minutes compared with 7.67 +/- 2.78 minutes for the femoral line group (P < .0002). CONCLUSION: Percutaneous femoral catheterization can be performed more rapidly than saphenous cutdown in the critically ill trauma patient with a palpable femoral pulse and allows for more rapid fluid administration. We support the use of a percutaneous femoral line as an acceptable alternative to saphenous venous cutdown in the initial resuscitation of trauma patients.

Adult↗
PubMed1994

Streptokinase alleles and disease association in group A streptococci.

Allele-specific oligonucleotides were used for PCR-based typing of the streptokinase locus of group A streptococcal strains, including well characterized type strains, isolates from patients with acute poststreptococcal glomerulonephritis and strains from Aboriginal communities in the Northern Territory of Australia. The streptokinase SKN allele, previously thought to be associated with glomerulonephritis, was no more frequent in nephritogenic than in non-nephritogenic streptococcal strains in this collection.

Alleles↗