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Biomedical subjects

M Dillon

Publications and source records attributed to M Dillon.

At least 55 records · Page 3Linked to original sources
PubMed1985

Treatment of first episode genital HSV with oral acyclovir: long term follow-up of recurrences. A preliminary report.

Systemic acyclovir (ACV) treatment has been shown to have significant effects on shortening the clinical course of first episode genital HSV infections, decreasing the quantity of HSV antibody in convalescent phase serum, without affecting the incidence of recurrences in 6 months of follow-up. In order to assess long term recurrence patterns, we prospectively studied subjects enrolled in a randomized double blind trial of oral ACV for first episode genital HSV. Sixty-three of sixty-eight subjects were followed monthly for recurrences for a mean of 36 months with 90% of subjects completing two years. There was no difference in the incidence of recurrence (90%) in (29) placebo vs (37) ACV treated HSV-2 infected subjects. Recurrences rates were similar between ACV and placebo treated subjects with nonprimary HSV-2 infection followed 2 years. The majority of these subjects were found to have HSV-2 antibody in their acute sera suggesting prior asymptomatic acquisition of HSV-2 infection and therefore established ganglionic latency at the time of first clinical disease. In subjects with true primary HSV-2 infection, however, mean recurrence rates were significantly lower in ACV treated subjects after 6 months, 0.87 ACV vs 3 placebo per 6 month period (p less than 0.01). The percentage of subjects experiencing recurrences after 1 year was also reduced by ACV treatment (70% placebo subjects vs 12.5% ACV subjects).(ABSTRACT TRUNCATED AT 250 WORDS)

Acyclovir↗
PubMed1984

Plasma methotrexate levels in patients with gestational trophoblastic neoplasia treated by two methotrexate regimens.

Plasma methotrexate levels were measured in six patients with nonmetastatic and three patients with "low-risk" metastatic gestational trophoblastic neoplasia who were treated by two different methotrexate regimens. Five patients were treated with 16 cycles consisting of methotrexate, 1 mg/kg (days 1, 3, 5, and 7) followed in 24 hours by citrovorum factor, 0.1 mg/kg (days 2, 4, 6, and 8). Cycles alternated between intravenous and intramuscular administration. Statistical differences in plasma levels were found at 1 and 48 hours between the two routes of administration but probably were not of clinical importance. The plasma levels at the time of citrovorum factor administration were below that necessitating citrovorum factor rescue. Four patients were treated with alternating cycles of intravenous or intramuscular methotrexate, 0.5 mg/kg for 5 consecutive days without citrovorum factor. A total of 15 cycles demonstrated no difference in plasma levels at 1, 12, and 24 hours between intravenous and intramuscular administration. Statistical differences in plasma methotrexate levels were noted between the two methotrexate regimens only with intramuscular administration but were not of clinical importance. The reduced toxicity of the methotrexate-citrovorum factor may be due to the scheduling of the methotrexate and not to the citrovorum factor.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

Effect of three single doses of oxmetidine administered intravenously on the volume and acidity of gastric secretion, serum prolactin and gastrin concentration in healthy volunteers.

Gastric acid secretion was measured in six healthy volunteers following the intravenous administration (over 30 min.) of oxmetidine 200 mg, 400 mg and 800 mg in a randomized double blind trial for 12 hours. Gastric aspirates were fractionated into hourly aliquots and pH, volume, gastric acidity and gastric acid output were determined. Total gastric acid output over 12 hours was significantly reduced from 24.4 mmol/12 h (median) after placebo to 13.5 mmol/12 h, 11.8 mmol/12 h and 7.7 mmol/12 h after oxmetidine 200 mg, 400 mg and 800 mg respectively. An inhibition of at least 90% was achieved with all doses of oxmetidine and this lasted dose-dependently for 4 to 6 hours. A rise in pH to greater than 5 occurred during the 2nd or 3rd hour after dosing which lasted for 2-5 hours depending on the dose administered. Mean hourly pH was dose-dependently significantly higher for 4-6 hours following oxmetidine treatment than after placebo. A significant reduction in gastric acidity after oxmetidine infusion was also observed while the reduction in volume output calculated for 12 hours was not statistically significant. No significant rises in serum gastrin levels were observed with the oxmetidine doses used. Three out of the six subjects tested showed an increase in serum prolactin levels in response to the highest dose of oxmetidine but this was not statistically significant. The results of the present study have shown that the administration of 400 mg oxmetidine did not cause a longer pH elevation greater than 5 than 200 mg, while with 800 mg side effects were observed in one of the six subjects studied.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

Treatment of first episodes of genital herpes simplex virus infection with oral acyclovir. A randomized double-blind controlled trial in normal subjects.

We performed a double-blind placebo-controlled trial of oral acyclovir in the treatment of first episodes of genital herpes simplex virus infections in 48 young adults (31 women and 17 men). Subjects were randomized to receive either placebo or acyclovir (200 mg per dose) five times daily for 10 days; they were examined on at least eight visits until healed and at monthly visits thereafter. Acyclovir treatment, as compared with placebo, significantly reduced virus shedding, new lesion formation after 48 hours, and the duration of genital lesions in both men and women. The total duration and severity of clinical symptoms (such as pain, adenopathy, dysuria, and malaise) were significantly reduced by acyclovir in both men and women by the third and fourth day, respectively (P less than or equal to 0.025), as compared with placebo. No toxicity was observed. Recurrence rates have so far been similar in placebo and acyclovir recipients. Oral acyclovir treatment of first-episode genital herpes simplex virus infections is clinically effective, but it does not seem to prevent virus latency or associated recurrent disease.

Acyclovir↗
PubMed1983

Carcinoma arising in the neovagina: case report and review of the literature.

Carcinoma arising in the neovagina is unusual. A case of squamous cell cancer arising in a neovagina constructed by split-thickness dermal graft is reported. This is the fifth reported case of primary cancer of the neovagina; 2 adenocarcinomas and 2 squamous cell carcinomas were reported previously. Primary carcinoma of the neovagina is a distinct clinical entity because of the younger age of occurrence and the histopathologic type.

Adult↗
PubMed1983

Radionuclide diagnosis of diaphragmatic rupture with hepatic herniation.

Seven surgically proven cases of a traumatic rupture of the right hemidiaphragm with a hepatic herniation were preoperatively diagnosed by radionuclide liver-spleen imagings, and they were retrospectively analyzed. All injuries resulted from blunt traumatic injury including automobile accidents, and there were associated pelvic and rib fractures in five cases. All patients developed some degree of dyspnea in the relatively immediate phase. All chest radiographs showed an apparent elevation of right hemidiaphragm. Radionuclide liver-spleen imaging with 99mTc sulfur colloid characteristically demonstrated a distortion of liver configuration with superior and posterior displacement of the right lobe. Four patients had a large tear in the central tendon of the right hemidiaphragm, and none had a tear in the anterior part or in left lobe of the liver. The differential diagnosis of elevated right hemidiaphragm is briefly discussed. It is concluded that the correct preoperative diagnosis of the diaphragmatic rupture with liver hernia could be made with an awareness of this condition following trauma and radionuclide liver-spleen imaging.

Accidents, Traffic↗
PubMed1982

Mixed Mullerian tumors of the uterus: clinical and pathologic correlations.

The 10-year experience at The Johns Hopkins Hospital with 61 cases of mixed Mullerian tumors were reviewed. The patients had a mean age of 63.7 years and the similar constitutional factors of diabetes mellitus, hypertension and nulliparity of endometrial adenocarcinoma. Only one patient had estrogen exposure. Eighteen percent had had prior exposure to pelvic radiation. The life table survival of the 61 patients was 41.1% at 5 years. The 2-year life table survival was 76% for disease confined to the uterus and 16.5% for extrauterine disease. There was no difference in survival between homologous and heterologous tumors. The surgical staging and the autopsies reviewed documented widely disseminated disease even when the tumor appeared to be confined to the uterus. It thus appears essential in order to improve survival these patients require aggressive staging and consideration of systemic adjuvant chemotherapy.

Adult↗
PubMed1982

The role of bougienage in the management of achalasia--the need for reappraisal.

Passive dilatation, advocated in the past by a number of gastroenterologists as the initial therapy for achalasia, has fallen into disrepute in the last 15 years. Our recent experience with five achalasia patients, four of whom were judged too fragile for esophageal myotomy or forcible dilatation, indicates the need for reappraisal of bougienage therapy.

Adult↗
PubMed1982

Peritoneal venous shunting for ascites: a 15-year perspective.

Intractable ascites is an incapacitating condition for the patient and a difficult management problem for the physician. Three different shunts have been evaluated in 26 patients over a 15-year period and, on the basis of this experience, recommendations are made to avoid some of the technical problems with peritoneal venous shunts. Nine patients had a Hyde shunt, 12 had a LeVeen shunt, and five patients had a Denver shunt. Operation was performed only after failure of medical management during a 2-24-week period of hospitalization. Four patients had malignant ascites, two nephrogenic ascites, and the remaining 24 patients had ascites secondary to alcoholic liver disease. The type of shunt used did not appear to be critical, as the results were similar in the three groups. The morbidity rate of 57% (operative deaths and need for revision) and the fact that only 27% were alive after one year emphasize that improvements are desirable. Methods to avoid technical problems influencing malfunction of the device are stressed.

Ascites↗