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R G Dalton

Publications and source records attributed to R G Dalton.

At least 19 recordsLinked to original sources

Acute oliguria.

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Acute Kidney Injury

Autologous predonation, haemodilution and intraoperative blood salvage in elective abdominal aortic aneurysm repair.

The feasibility of predonated autologous blood transfusion and intraoperative blood salvage in elective abdominal aortic aneurysm repair was studied. Twenty consecutive patients were evaluated, of whom five were excluded according to protocol criteria. Patients each donated 1 unit blood 14 and 7 days before operation. A third unit was withdrawn in the anaesthetic room and replaced with Hartmann's solution, producing a haemodiluted state. Intraoperative losses were minimized using the Haemonetics Cell Saver III Plus autotransfusion system. Predonated blood from two patients passed its expiry date owing to repeated operation postponements, leaving 13 patients for study. The mean(s.d.) intraoperative blood loss was 700(300) ml with a mean(s.d.) intraoperative salvage of 420(300) ml. Two patients were transfused intraoperative salvage of 420(300) ml. Two patients were transfused according to clinical need. Thus nine patients safely avoided homologous transfusion. With autologous predonation, haemodilution and intraoperative blood salvage, elective aortic aneurysm repair can be performed safely with minimal need for homologous blood.

Aorta, Abdominal

Familial MDS with 5q- abnormality.

Abnormalities of chromosome 5 and 7 are frequently found in primary MDS. Cases with familial monosomy 7 are well recognized, but there are no reports of familial MDS with deletion of 5q. We describe two sisters, aged 38 and 36 years, both of whom had MDS and interstitial deletion of 5q. The occurrence of this chromosomal abnormality reinforces the concept of tumour suppressor gene hypothesis in some cases with familial MDS.

Adult

Comparison of the in vitro characteristics of von Willebrand factor in British and commercial factor VIII concentrates.

Qualitative/quantitative analysis of von Willebrand factor antigen (vWf:Ag) in either heat or solvent/detergent treated factor VIII concentrates, used for haemophilia replacement therapy, was undertaken to assess their suitability for the treatment of vWD. For the first time immunoaffinity purified vWf:Ag (Monoclate by-product) was also evaluated by in vitro assessment. Potencies of vWf:Ag varied considerably but were consistently higher (28.9-420.5 iu/ml) than factor VIII:C (one-stage) activity (8.13-42.44 iu/ml). The functional activity of vWf was assessed by either Ristocetin Cofactor (vWf:RCo) or collagen binding methods (vWf:CBA) with typical vWf:RCo/vWf:Ag ratios ranging from 0.08 to 0.94. Multimeric analysis confirmed that in vitro biological activity was dependent on the presence of the high molecular weight forms of vWf:Ag. A significant correlation (r = 0.95) between vWf:RCo activity and collagen binding was observed in all of the concentrates with the exception of the immunopurified product. The data suggest that either NHS 8Y (mean vWfRCo/vWf:Ag = 0.94), Haemate P (mean vWf:RCo/vWf:Ag = 0.69) and high purity Octapharma V.I (vWf:RCo/vWf:Ag = 0.82) which contain medium/high MW vWf:Ag multimers are likely to be most cost-effective in the treatment of symptomatic severe vWD patients than other currently available concentrates.

Chemical Phenomena

Hypothyroidism as a cause of acquired von Willebrand's disease.

Three patients with bleeding tendency who met the criteria for type 1 von Willebrand's disease are described. In two patients, hypothyroidism was suspected and confirmed at presentation, and in the third hypothyroidism became apparent 4 years later. In all three, the history and clinical course after treatment with thyroxine indicated acquired von Willebrand's disease secondary to hypothyroidism. The possibility of hypothyroidism should be considered in patients presenting with von Willebrand's disease.

Adolescent

Effect of packed cell volume on blood glucose estimations.

The effect of changes in packed cell volume was studied in two commonly used reagent strip methods (Dextrostix and Reflotest) of measuring blood glucose and in a filter paper blood spot method. It was found that the results with both the reagent strip methods were greatly haematocrit-dependent. Attention is drawn to the possibility of false diagnoses of hypoglycaemia in haemoconcentrated patients and of normoglycaemia in anaemic patients.

Blood Glucose

Growth and hormonal status of children treated for acute lymphoblastic leukaemia.

Growth and hypothalamic-pituitary function have been studied in children in long-term remission from acute lymphoblastic leukaemia (ALL). All 14 children are growing and developing normally; in the 8 children in whom the hypothalamic pituitary axis was investigated endocrine function is normal. Continuing long-term review of these children is essential, but hypothalamic-pituitary investigation is required only when there is a decrease in growth velocity or delay in the onset of puberty.

Adolescent