Biomedical subjects
Publications and source records attributed to R W Strachan.
A patient who presented with severe abdominal pain was found to have an intrahepatic haematoma complicating previously undiagnosed polycythaemia vera (PV). Full recovery followed treatment with bed rest, control of hypertension, daily venesection and 32P. The hazards of surgery in uncontrolled PV are discussed and re-emphasized.
Five bipsy-proven cases of giant-cell arteritis illustrate some of the lesser known, but not uncommon, masquerades of this disease. The delay in reaching the diagnosis, which is common with these presentations, was a major factor in the emergence of serious sequelae including arotic regurgitation, stroke, and death. To increase awareness of the variety of clinical presentation of giant-cell arteritis, a classification of these variants into cachectic, febrile, and other forms is suggested.
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A detailed study has been made of the five hypertensive patients who received Minoxidil in Dumfries; four have been observed for over a year. Minoxidil was found to be highly effective, free from commonly encountered side effects and capable of achieving excellent control of blood pressure when given once daily. Its use led to simpler drug regimens, improved compliance and significant reduction in the length, or even need, of admission to hospital. A prolonged and clinically useful delay in the recurrence of hypertension following withdrawal of the drug was also observed.
The detailed clinical findings of a 65-year-old woman who developed aortic regurgitation caused by giant cell aortitis are presented. The initial phase of the disease was dominated by severe non-specific constitutional symptomatology suggesting infective endocarditis or a malignancy. Aortic regurgitation as a manifestation of giant cell arteritis has hitherto recieved scant attention in the published reports. The clinical and therapeutic relevance of this masquerade is discussed.
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Two alternative methods for detecting vitamin B(12) deficiency in a psychiatric population have been compared: the ;direct' approach by microbiological assay of serum vitamin B(12) levels in all patients, and the ;indirect' approach where all patients are first screened for antigastric parietal cell antibodies and thereafter all positive reactors and other ;high-risk' patients have serum vitamin B(12) assayed. The indirect approach was found to be cheaper.
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