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Biomedical subjects

M Neill

Publications and source records attributed to M Neill.

12 recordsLinked to original sources

Adenocarcinoma in the anal transitional zone after ileal pouch for ulcerative colitis: report of a case.

This article reports the seventh known case of adenocarcinoma arising in or adjacent to an ileal pouch after proctocolectomy for ulcerative colitis. It is the second reported case of adenocarcinoma in the anal transitional zone in this setting. A literature review is presented of the six previous cases published, and on the wider subject of how to best manage the anal transitional zone. It is concluded that this is a rare, but catastrophic, event with a potentially poor prognosis and can occur late (more than a decade) after the original surgery. All ileal pouches performed for ulcerative colitis should be followed for extended periods. The development of dysplasia necessitates close follow-up, including regular biopsies, and local excision and pouch advancement can manage persistent dysplasia. When operating for dysplasia or cancer, biopsies of the anal transitional zone should be performed or consideration given to mandatory mucosectomy.

Adenocarcinoma↗

Sclerosing encapsulating peritonitis after intraperitoneal use of povidone iodine.

BACKGROUND: The use of intraperitoneal povidone iodine as an agent for peritoneal lavage in colorectal surgery is controversial. Although it possesses a wide range of antimicrobial activity and is rapidly lethal to dissociated colorectal cancer cells in vitro, concern about its potential toxicity remains. METHODS: Two cases of sclerosing encapsulating peritonitis (SEP) following elective colorectal surgery are presented. In each case the peritoneal cavity was lavaged with an aqueous povidone iodine solution. The surgical literature on the intraperitoneal use of povidone iodine is reviewed. RESULTS: Significant morbidity resulted from the postoperative development of SEP in both of our patients. In one patient an ileo-anal pouch could not be fashioned following an initial colectomy, and in the second patient a small-bowel obstruction required a laparotomy and a period of intravenous nutrition before an oral diet could be tolerated. CONCLUSION: The use of povidone iodine for peritoneal lavage in colorectal surgery is to be cautioned against in concentrations of > 1%.

Adult↗

Atraumatic severe streptococcal axillary cellulitis.

Axillary streptococcal cellulitis is rare but has been known to clinicians for years. Usually associated with trauma, it may, however, occur in previously healthy individuals who for unknown reasons can be slowly responsive to appropriate antibiotics.

Adult↗

Blood pressure trends associated with changes in height and weight from early adolescence to young adulthood.

In children, blood pressure is more closely related to height and indices of maturation than to age. This study extends observations on the relationship between height, weight, maturation and blood pressure during early adolescence into young adulthood. Standardized measurements of blood pressure, height, and weight were initially obtained in all 14-15 year old adolescents (N = 304) in a rural Kentucky school system. Measurements were repeated 5 and 8 years later. Adolescents with relatively high blood pressures continued to have higher blood pressures as young adults. Increases in systolic and diastolic blood pressure over time were related to increases of relative weight in both sexes (p less than 0.0001 and p less than 0.005, respectively), and in males increases of systolic blood pressure were related to increases of height (p less than 0.005). However, males who attained their full height at younger ages had higher blood pressures both during adolescence and subsequently, as young adults. Thus blood pressure of young adults is related to blood pressure in adolescence, relative weight and change in relative weight since adolescence, and in males to age of maturation as determined by the age at which adult height is attained.

Adolescent↗

Parasitologic and clinical efficacy of 25 and 50 mg/kg of chloroquine for treatment of Plasmodium falciparum malaria in Rwandan children.

The standard chloroquine treatment for Plasmodium falciparum malaria is 25 mg (base)/kg (C25) given over 3 days. In Rwanda, 50 mg/kg (C50) administered over 6 days has been recommended by the Faculty of Medicine, Ministry of Health. The present study compared clinical and parasitological efficacy and side effects of C25 and C50 in children less than or equal to 5 years of age. In vitro studies with chloroquine, mefloquine, pyrimethamine, and quinine were also performed. Ninety children were given a 3-day treatment of C25 and 48 a 5-day treatment of C50. Cases were followed for a total of 15 days (D0 to D14). At day 14, 73% of the C25 and 67% of the C50 children were still parasitemic, but the mean geometric parasite density had decreased by at least 96% in both groups. Clinically, 44 C25 and 12 C50 children had fever on day 0; by day 14 only 4 (9%) C25 and 4 (33%) C50 children still had fever. Side effects were found to be minimal. The chloroquine in vitro tests corroborated the in vivo findings. P. falciparum was found to be quite sensitive to mefloquine and quinine, but showed a high (59%) resistance to pyrimethamine.

Animals↗

Swamp rice farming: possible effects on endemicity of schistosomiasis mansoni and haematobia in a population in Liberia.

To obtain a better understanding of the possible influence of swamp rice farming on the patterns of Schistosoma mansoni and Schistosoma haematobium infections, the populations of two communities in rural liberia were studied. In one village, Balama (population of 435), swamp rice farms were initiated six years before the survey; in the other nearby community, Gbarta (population of 216), swamp rice farms had not yet been initiated. The prevalence of S. mansoni infection in Balama was 87% vs. 9% in Gbarta (P less than 0.01). The geometric and arithmetic mean egg counts for all infected subjects in Balama were respectively 263 and 671/g feces. in Gbarta, the geometric and arithmetic mean egg counts were 150 and 129/g feces. S. haematobium eggs were detected in 42% of subjects in Balama vs. 11% in Gbarta (P less than 0.01). Hematuria correlated with the presence of S. haematobium eggs in urine. These data indicate that there is a significantly higher prevalence and intensity of schistosomiasis mansoni and haematobia in a community where swamp rice farming has been utilized for 6 years compared to a nearby village where this water irrigation and drainage practice has not yet been implemented.

Adult↗

Restorative proctocolectomy with ileal reservoir: a pathophysiological assessment.

A metabolic and physiological assessment was carried out in 14 patients who had undergone restorative proctocolectomy with ileal reservoir more than six months previously. The haemoglobin was normal in all but one and plasma electrolytes and serum albumin, calcium, phosphorus, and red cell folate estimations were normal in all. Five patients had low serum iron levels of whom one had an iron deficiency anaemia. The 24 hour faecal fat output was normal in all patients and there was no case of vitamin B12 malabsorption as judged by the Schilling test, although four patients had marginally low values. These were not associated with increased bacterial counts in the faeces within the reservoir and there was no evidence to support a diagnosis of stagnant loop syndrome. Inflammation of the reservoir mucosa was, however, associated with higher counts of aerobic bacteria than in cases where inflammation was absent. Subtotal villous atrophy or inflammation was seen in biopsies of the reservoir in six patients. The mean faecal output per 24 hours was 659 +/- 259 g and the mean reservoir volume was 330 +/- 78 ml. Mean resting anal canal pressure was significantly lower in patients with a mucous leakage per anum than in those without, while manometry of the reservoir showed no alteration of pressure over a period of one hour before and after a meal. A positive rectosphincteric reflex was observed in nine patients.

Adult↗

The effect of diethylcarbamazine in a murine model of Brugia malayi microfilaraemia.

The effect of diethylcarbamazine was tested in a murine model of Brugia malayi microfilaraemia. A course of therapy similar to that used to treat human infection led to more than a 90% decrease in circulating parasites. Experiments in which different amounts of diethylcarbamazine were given as a single dose indicated that its microfilaricidal activity is dose-dependent. The animal model of B. malayi microfilaraemia may be useful for studies of the mechanism of action and pharmacology of diethylcarbamazine and may be applied to the screening of new microfilaricidal drugs.

Administration, Oral↗