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Biomedical subjects

J W Millar

Publications and source records attributed to J W Millar.

7 recordsLinked to original sources
PubMed1979

Tuberculosis in immunosuppressed patients.

11 patients who developed tuberculosis while on long-term immunosuppressive-drug therapy are described. The indications for immunosuppressive therapy were varied, but all patients received high doses of corticosteroids with azathioprine in addition in 2 cases and chlorambucil in a third. The diagnosis was delayed in all cases because of suppression of symptoms, so that 4 patients died, 3 directly as a result of tuberculosis. 3 of the remaining patients were critically ill at the time of diagnosis but recovered with antituberculosis chemotherapy; whereas the other 4, although not critically ill, had advanced cavitated pulmonary tuberculosis with miliary spread in one case. A clear policy of investigation and, if indicated, chemoprophylaxis is necessary for all patients in whom long-term immunosuppressive therapy, especially with prednisolone, is contemplated. A high index of suspicion for tuberculosis must be maintained with regular clinical and radiological review.

Adult↗
PubMed1979

Vulval tuberculosis.

A patient with chronic tuberculous ulceration of the vulva is reported. Tuberculosis of the external genitalia is unusual and primary infections are rare. Venereal transmission of the infection could not be proven in this patient, but appears the most likely origin of the disease. Complete healing of the vulval ulcer, with rapid relief of symptoms, followed antituberculosis chemotherapy. The importance of biopsy in the diagnosis of chronic genital ulcers is emphasised.

Adult↗
PubMed1978

Spontaneous mid-oesophageal rupture.

The clinical presentation and management of spontaneous rupture of the middle third of the oesophagus is described in two patients. Early presentation and treatment in one case led to uncomplicated recovery. In the other patient late presentation and diagnosis resulted in delayed surgical intervention with an unsuccessful outcome. The nature of this rare lesion is discussed and nine previously described cases are reviewed.

Adult↗
PubMed1978

An evaluation of the efficacy and acceptability of 'Slender' in refractory obesity.

A formula diet 'Slender' was assessed in 55 patients with refractory obesity. During the initial 12 weeks of the study, the subjects were instructed to take a carbohydrate restricted diet designed to provide 1000 kcal (4.2 MJ) per day. They were then advised to replace up to four meals a day with a packet of Slender. Of the 42 subjects completing the study, 21 stopped taking Slender after six weeks and 21 completed 12 weeks. During the pre-Slender treatment, the mean weight gain was 1.7 kg. This contrasts with a mean weight loss during the first six weeks of treatment with Slender of 1.9 kg. Those continuing to take Slender for 12 weeks lost 3.7 kg and subjects who said that they had adhered strictly throughout the trial period had a mean loss of 4.6 kg. The overall results are relatively disappointing but are similar to that which can be achieved with other forms of therapy in comparable patients. If there is use for Slender, and other similar products, it may be the prevention of obesity rather than in the management of the morbidly obese.

Adolescent↗
PubMedDate not supplied

Comparison in leprosy patients of Fernandex and Mitsuda reactions using human and armadillo antigens. A double-blind study.

The Mitsuda and Fernandez reactions to bacilli prepared from lesions of human patients and bacilli from infected armadillos were studied in 112 leprosy patients. It was observed that there is no substantial difference when armadillo lepromin is used instead of human lepromin except that a larger induration occurs with the use of the armadillo lepromin in a majority of cases. The number of those reporting a burning sensation at the armadillo lepromin injection site was slightly higher in lepromatous patients; whereas the burning sensation was observed at the human lepromin injection site by the tuberculoid cases. With the significant information compiled in this study, it is concluded that lepromin prepared from bacilli obtained from infected armadillos is as effective as that prepared from bacilli obtained from the lesions of leprosy patients.

Adult↗