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Biomedical subjects

S Dilly

Publications and source records attributed to S Dilly.

7 recordsLinked to original sources
PubMed2000

Amiodarone-induced bone marrow granulomas.

Amiodarone hydrochloride, a class III antiarrhythmic agent used to treat supraventricular and ventricular cardiac dysrhythmias. In this report we describe two patients receiving amiodarone for atrial fibrillation who underwent bone marrow biopsies to investigate paraproteinaemia (case 1) or severe thrombocytopenia (case 2). Multiple bone marrow granulomas were found in both patients, without evidence of any other cause. In both patients the granulomas disappeared after amiodarone withdrawal, suggesting a direct association.

Aged↗
PubMed1994

Splenic sepsis in sickle cell disease.

We describe two patients with sickle cell disease (SCD) who developed infections situated in the spleen. One patient had a splenic abscess and there was strong clinical evidence for an infected splenic infarct in the second patient. SCD predisposes to splenic infection because of functional hyposplenism, defective phagocyte function and splenic infarction. Splenic infections can occur in patients who might be considered to have an absent spleen and the diagnosis of splenic abscess should be considered in individuals with SCD who present with fever and abdominal pain.

Abscess↗
PubMed1993

Physicians' attitudes to the autopsy.

The overall autopsy rate (excluding coroner's autopsies) at a large teaching district general hospital over a four year period was 16.5%, but individual rates for ten general physicians varied from 5% to 35%. During this period, the mean autopsy rate for general medicine (14%) was significantly lower than rates for cardiology (21%), geriatrics (23%) and paediatrics (36%), but similar to general surgery (13%). Autopsies were widely perceived as being of benefit to education and research, but physicians were often unaware of their value for confirming the diagnosis and for clinical audit, and over-estimated their actual autopsy rates on average by 50%. High rates (18-30%) were associated with consultants who had a definite policy regarding autopsies and had made this clear to their junior staff. Low rates (6-10%) obtained where there was no consultant policy on autopsies, and were frequently attributed by the consultant physicians to failure by their junior staff. Physicians should be more aware of the value of autopsies, and should take responsibility for increasing and monitoring autopsy requests to improve clinical audit, quality assurance and medical education.

Attitude of Health Personnel↗
PubMed1992

Are granisetron and ondansetron equivalent in the clinic?

There are no published direct trials of granisetron vs. ondansetron. Difficulties exist in comparing reported trials because of differences in methodology, especially in response criteria. In this review, a comparison is made between ondansetron and granisetron by recalculating the complete response criterion for granisetron, standardising it against that in the ondansetron programme (i.e. no vomiting). Weighted means have been calculated for three areas of study. Against cisplatin-induced emesis the (weighted) mean percentage of complete responders were calculated at 64% (range 49-77%) for granisetron and 49% (range 40-55%) for ondansetron. Against moderately emetogenic stimuli, the response rates were 76% (range 68-80%) and 73% (range 60-87%) respectively. For fractionated chemotherapy the response rates were 57% and 27% for granisetron and ondansetron respectively. Although not shown by formal statistical analysis, these results suggest that a clinical advantage for granisetron may exist.

Antiemetics↗
PubMed1986

Potential errors in the estimation of coronary arterial stenosis from clinical arteriography with reference to the shape of the coronary arterial lumen.

Underestimation of coronary arterial stenosis at clinical arteriography has been explained by inadequate radiological views of crescentic or slit-shaped lumens. Postmortem perfusion-fixation of the coronary arteries at physiological pressures shows that most stenotic lesions result in circular, elliptical, or D-shaped lumens. Crescentic lumens in fully distended vessels are associated only with acute mural thrombus projecting into the lumen or with massive intra-intimal thrombus and plaque fissuring. Elliptical and D-shaped lumens, however, adequately explain the clinically observed phenomenon that some stenotic lesions can be seen only in one x-ray plane and not in another. It is no longer correct to postulate a crescentic or slit-like lumen. Furthermore, not only can elliptical and D-shaped lumens result in underestimation of stenosis, they may also result in serious overestimation. Lumens need only to deviate slightly from being circular for error to be introduced into the estimation of stenosis by currently used methods. The calculation of percentage stenosis from densitometric measurements or from computerised reconstruction of the arterial lumen is, however, more accurate.

Coronary Disease↗
PubMed1986

Prognostic factors in stage I non-seminomatous germ-cell testicular tumors managed by orchiectomy and surveillance: implications for adjuvant chemotherapy.

Between February 1979 and March 1985, 126 patients with clinical stage I non-seminomatous germ-cell testicular tumors were entered into a surveillance study after orchiectomy. Of this group, 36 (28%) have relapsed. The prognostic significance of 13 clinical, histopathologic, and biochemical factors has been analyzed. Vascular invasion and lymphatic invasion (LI) within the primary tumor, histology, and involvement of the epididymis and rete testis were significantly associated with an increased risk of relapse. However, multiple regression analysis showed that only histology and LI were significant, independent prognostic factors. These findings provide the basis for the consideration of adjuvant chemotherapy for patients with apparent clinical stage I testicular non-seminoma who are at high risk of harboring occult metastases.

Adult↗