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Biomedical subjects

S T Green

Publications and source records attributed to S T Green.

At least 19 recordsLinked to original sources
PubMed2002

Liver abscess in adults: ten years experience in a UK centre.

BACKGROUND: The epidemiology and management of liver abscess (LA) have evolved over time. AIM: To examine our experience over 10 years in a UK teaching centre. DESIGN: Retrospective review of patient records. METHODS: We reviewed the records of all patients aged >16 years discharged from Royal Hallamshire Hospital with a diagnosis of LA between April 1988 and December 1999. RESULTS: There were 69 patients with LA (65 pyogenic, 4 amoebic), giving a crude annual incidence rate of 2.3/100,000/year (18.15/100,000 hospital admissions). Median age was 64 years. Single lesions were found in 41 patients, multiple lesions in 28. Pre-admission, patients were symptomatic for a median 14 days, with the most common symptoms and signs being fever and abdominal pain/tenderness. Pathogens were identified in 74% and predisposing aetiology in 92% of those undergoing investigation. Spread of infection to the liver via the portal venous system was the commonest route of infection (46%), most frequently in patients aged >/=60 years (p=0.019). Abdominal ultrasound (US) was diagnostic for LA in >90% of cases. Treatment with anti-microbial therapy plus interventional radiology was optimal. The case fatality rate was 12.3%, mainly from associated underlying pathology. DISCUSSION: LA is commonly associated with underlying gastrointestinal pathology. Seeking out this underlying aetiology is an integral part of management. We recommend US as the first-line diagnostic tool with guided intervention plus antibiotic(s) as first-line treatment. Prognosis depends chiefly on the underlying pathology.

Adolescent↗
PubMed2001

Successful treatment of molluscum contagiosum with topical imiquimod in a severely immunocompromised HIV-positive patient.

Molluscum contagiosum is a common viral infection in the immuno-compromised HIV-positive patient where it is often severe and affecting the face and neck. It is frequently resistant to conventional, locally destructive therapies. Anecdotal evidence suggests that the immunomodulatory drug imiquimod might be a valid therapeutic option in this group of patients. We report the case of a severely immunocompromised HIV-positive patient with resistant facial molluscum contagiosum lesions that responded to topical imiquimod. The response to therapy and the possible implications for pathogenesis are discussed.

AIDS-Related Opportunistic Infections↗
PubMed2001

Potential for hepatitis C transmission among non-needle/syringe sharing Sheffield drug injectors through the sharing of drug preparation paraphernalia.

This study aimed to investigate possible means by which hepatitis C virus (HCV) might be transmitted between drug injecting individuals without the sharing of needles and syringes. A questionnaire-based survey of 143 (out of 287) attendees was conducted at an Infectious Diseases Unit-based HCV clinic. Those patients (all of whom were positive for antibodies to HCV) who asked about risk activities and those that admitted to a history of recreational drug injecting were questioned in detail about their past and current drug preparation practices. Ten per cent denied any history of needle and/or syringe sharing and had no other apparent source of their HCV infection, but instead admitted to having shared drug preparation eqiupment. The existence among drug injectors of such practices with the potential to transmit blood borne viruses is important as it may explain how HCV, which is capable of being spread via very small quantities of blood, can be passed between drug injecting individuals who might otherwise never come into contact with another drug injector's blood. Clinical and public health messages regarding the prevention of the spread of HCV may need to be revised and strengthened.

Communicable Disease Control↗
PubMed2000

Two simultaneous cases of Cyclospora cayatensis enteritis returning from the Dominican Republic.

According to the "International Passenger Survey," published in 1996 by the Office of Trading Standards, 534,000 British people traveled to the Caribbean area (personal communication, ABTA, 1998). The Dominican Republic, the eastern end of a large Caribbean island, has become in recent years one of the most popular destinations for UK holidaymakers as well as for travelers from many other countries. Cyclospora cayatensis has been firmly identified as a cause of gastroenteritis among international travelers,1 including human immunodeficiency virus (HIV)-positive individuals,2 but it has not been previously reported in the literature in British individuals returning from this increasingly popular vacation destination.

Aged↗
PubMed1999

Automated exchange transfusion for life-threatening plasmodium falciparum malaria--lessons relating to prophylaxis and treatment.

We report a case of traveller to Kenya who contracted severe plasmodium falciparum malaria complicated by disseminated intravascular coagulation and acute renal failure. She had taken no antimalarial prophylaxis in view of concerns in the media regarding the adverse effects of mefloquine. There was a protracted delay before the diagnosis of malaria was made. Clinical recovery occurred following treatment with intravenous quinine, haemofiltration and manual/automated red-cell exchange transfusions. Automated red-cell exchange transfusion resulted in a marked decrease in the parasitaemia, before a response to quinine therapy would have been anticipated, leading to a successful outcome thereafter. In conjunction with other groups we therefore feel that exchange transfusions should be considered in seriously ill patients with falciparum malaria, multiorgan complications and parasitaemias greater than 10%.

Adult↗