Biomedical subjects

K A Buchan

Publications and source records attributed to K A Buchan.

15 recordsLinked to original sources

PubMed1991

Primary hepatocellular carcinoma in an area of low incidence: evidence for a viral aetiology from routinely collected data.

In recent years a strong case has been made in support of a viral aetiology for at least some primary hepatocellular carcinoma (PHC) in areas of low incidence. By pooling routinely collected cancer registration and infection data, study of the relationship between hepatitis B virus (HBV) infection and the incidence of PHC in Scotland over the period 1972-1985 has confirmed this view. Over this period the incidence of PHC in men increased, there was a relationship between the incidence of notification of HBV infection and that of hepatocellular carcinoma in different parts of the country, and an increased risk attached to those chronically infected with the virus. Given the recent introduction of lower cost yeast derived vaccines, there may now be more scope for prevention both of primary liver cancer and of other liver disease.

Adolescent↗

PubMed1990

Herpes simplex virus infection of the hand.

The first episode of herpes simplex virus (HSV) infection of the hand can occur in association with infection at another site, such as primary HSV-1 gingivostomatitis. Autoinoculation is the likely route of transmission. The attacks are usually solitary and last about 14 days. A first episode that results from exogenous inoculation may be severely inflammatory and may last up to 28 days. The majority of cases are recurrent infections and most often occur in adults with HSV-2 infection.

Adult↗

PubMed1990

Human orf. A diagnostic consideration?

We saw four unrelated cases of human orf infection over a 3-month period. Each patient had a clear-cut history of contact with sheep and developed a characteristic painful pustular lesion on the hand. There were no significant systemic symptoms. Examination of an aspirate by electron microscopy confirmed the diagnosis. The lesions resolved spontaneously within 6 weeks. Human orf infection occurs in North America, and although seldom reported, it should be considered in the diagnosis of cutaneous lesions in patients who have exposure to animals associated with it.

Adult↗

PubMed1988

Herpes simplex virus infection of the hand. Clinical features and management.

Herpes simplex virus (HSV) infection of the hand occurs predominantly in three different population groups. Young adults with a recurrent HSV II infection of the hand account for the majority of cases. A prodromal phase of up to 72 hours and a recurrence of seven to 10 days' duration occasionally associated with lymphangitis, lymphadenopathy, and lymphedema are characteristic. HSV I infection of the hand classically occurs in children with herpetic stomatitis and in health care workers infected during patient care delivery. In health care workers, the infection may last 21 to 28 days and be associated with severe pain and lymphangitis. Recurrences appear uncommon in HSV I infections. Primary infection is usually managed conservatively. Vesicle drainage for pain relief and antiviral therapy with acyclovir may be of value. For recurrent infections, acyclovir, 800 mg orally, twice daily, initiated during the prodrome in an open study of eight patients appeared effective in aborting the attack. Evaluation of long-term suppression in recurrent HSV infection of the hand is in progress.

Acyclovir↗

PubMed1987

Delta hepatitis virus infection in China.

To assess the prevalence, epidemiological features and prognostic implications of hepatitis D (Delta) in Sichuan Province, The People's Republic of China, 649 sera (515 from HBsAg positive patients and 134 from HBsAg negative subjects) were tested by radioimmunoassay (RIA) for antibody to the hepatitis D virus (anti-HD). Forty-seven sera (7.2%) showed some degree of reactivity. Serial dilutions of these sera indicated that prozoning was not responsible for the equivocal results. Thirty-four of the 47 sera were submitted under code to a second laboratory for independent analysis. According to those results anti-HD antibodies were detected in four of these sera. The overall prevalence of anti-HD in the HBsAg positive patients therefore was 0.8% (4/515). On the basis of clinical, biochemical and histological data 427 HBsAg positive sera were further divided into acute Type B hepatitis, chronic Type B hepatitis, healthy carrier state and hepatocellular carcinoma (HCC) subgroups. Two of 65 (3.1%) anti-HD positive sera belonged to the acute Type B hepatitis group; one of 104 (0.9%), the chronic Type B hepatitis group and one of 246 (0.4%), the healthy carrier group. No antibody was detected in sera from 12 HBsAg positive HCC patients. All HBsAg negative patients were negative for anti-HD antibody. The results of this study indicate that despite a high prevalence of hepatitis B virus infection, positive serology for delta virus is uncommon in Sichuan Province, The People's Republic of China.

Adolescent↗

PubMed1986

The prevalence of antibody to delta virus in western Canada.

To assess the prevalence and pathological role of hepatitis D virus (HDV) infection in western Canada, we tested a total of 310 sera from the province of Alberta, Yukon and Northwest Territories for antibody to HD (anti-HDV) by commercial solid phase radioimmunoassay. Two hundred and forty-five sera were hepatitis B surface antigen (HBsAg) positive. These were classified on the basis of clinical and biochemical data as either acute hepatitis, chronic hepatitis or in the healthy carrier phase of infection Sixty-five HBsAg negative sera from patients with other forms of chronic liver diseases served as controls. Anti-HDV was detected in only four of the HBsAg positive sera (1.6%) and in none of the controls. The prevalence of anti-HDV was significantly higher in patients with chronic hepatitis, three of twenty-two (13.6%) than in patients with acute hepatitis (0%) (p less than 0.05) or healthy carriers (0%) (p less than 0.005). Two of the four anti-HDV positive sera were obtained from patients with a history of parenteral drug abuse. These results indicate that HDV infection is uncommon in western Canada but, when it does occur, is more likely to be associated with chronic inflammatory liver disease. Parenteral drug abuse appears to be the major risk factor for HDV infection in western Canada at this time.

Acute Disease↗

PubMed1986

Benefits of orotracheal and nasotracheal intubation in neonates requiring ventilatory assistance.

To investigate differences in orotracheal (OT) and nasotracheal (NT) intubation for ventilatory assistance, we randomly assigned 91 neonates to be intubated via either of the two routes: 46 infants were assigned to the OT group and 45 infants were assigned to the NT group. Inability to intubate the nostril in three neonates, and respiratory or cardiac instability during attempted NT intubation in three neonates, resulted in the assignment of 52 infants to the OT group and 39 infants to the NT group; patients in both groups were of comparable size, sex, and clinical problems. Initial malposition of the endotracheal tube and need to retape, reposition, or replace the tube during the mean duration of intubation of 247 +/- 42 hours for the OT group and 273 +/- 57 hours for the NT group were similar. Daily Gram stains of tracheal aspirates showed that inflammation (greater than or equal to ten polymorphonuclear cells per 400 power fields) was common (51% OT group, 53% NT group). Cultures grew potential pathogens in 37% of the patients from the OT group and 31% of the NT group. There was no difference in the clinical or radiologic incidence of pneumonia. Postextubation problems were comparable: atelectasis, 48% OT and 59% NT; stridor, 15% OT and 26% NT. OT intubation may be preferred for prolonged ventilatory assistance in neonates because of the relative ease of initial intubation.

Female↗

PubMed1974

Aetiology and epidemiology of viral croup in Glasgow, 1966-72.

A retrospective study of 258 children admitted to Ruchill Hospital, Glasgow, with croup between 1966 and 1972 indicated that the viruses most frequently associated with the syndrome were parainfluenza types 1 and 3 and influenza A. Most cases were admitted in the late autumn and winter months, with a small peak in May and June. This seasonal distribution mirrored the circulation of the main causative agents in the community, parainfluenza 1 being principally associated with the autumn cases, influenza A the winter cases and parainfluenza 3 the summer cases. Two of these ;croup associated' viruses showed regular periodicity, parainfluenza 1 occurring biennially in even years and influenza A in most years. The periodicity of parainfluenza 3 is as yet undetermined.

Adenoviridae↗

PubMed1974

The effect of vagotomy and drainage on the small bowel flora.

The incidence of small intestinal colonization in unoperated duodenal ulcer patients was low and similar to that in the normal population. The majority of patients seven to 10 days following truncal vagotomy and drainage were colonized whereas none of a control group of patients following simple closure of a perforated duodenal ulcer was colonized. In patients with pyloroplasty, this high incidence fell to control levels on average 18 months postoperatively, but in patients with a gastro-jejunostomy, the incidence remained raised probably due to the presence of the afferent loop. Only two patients developed episodic diarrhoea and there was no obvious association with small bowel colonization.

Adult↗

PubMed1974

Clinical and laboratory study of postvagotomy diarrhoea.

Thirty-two patients with diarrhoea, on average four years following truncal vagotomy and drainage, were studied. A comparison was made with 24 patients without postvagotomy diarrhoea. The incidence of bacterial colonization of the upper small intestine was no different in the two groups, though patients with a gastroenterostomy had a significantly higher incidence than those with a pyloroplasty. There was a higher incidence of ;anaerobic colonization' in patients with diarrhoea, but statistical significance was not reached. Colonization was associated with significantly lower levels of gastric acid secretion. Though 13 patients with diarrhoea had an abnormal faecal fat excretion, no correlation could be found between this and the severity of the diarrhoea or bacterial colonization, either with an anaerobic or a coliform type flora.In patients with diarrhoea, no small intestinal mucosal abnormality was detected, the mean haematological and serum biochemistry values were within normal limits, and the body weight was similar to that before operation. Two patients with diarrhoea had abnormal haematological values five years following vagotomy and gastroenterostomy in association with ;anaerobic colonization' of the upper small intestine. As the incidence of haematological abnormalities after gastric surgery increases with time, colonized patients might merit particularly close clinical observation.

Adult↗

PubMed1972