Biomedical subjects
A Beale
Publications and source records attributed to A Beale.
Consultant assessment and appraisal.
Explore the source record for details and available documents.
Radiologic, endoscopic, and surgical gastrostomy: an institutional evaluation and meta-analysis of the literature.
PURPOSE: To evaluate the effectiveness and safety of radiologic, percutaneous endoscopic (PEG), and surgical gastrostomy. MATERIALS AND METHODS: This project involved 5,752 patients (837 patients underwent radiologic gastrotomy; 4,194, PEG; and 721, surgical gastrostomy). Seventy-two (47 male, 25 female; age range, 12-94 years) underwent gastrostomy within 1 year in this series (radiologic gastrostomy, n = 33; PEG, n = 35; surgical gastrostomy, n = 4). A meta-analysis of 5,680 additional cases from literature published from 1980 to the present was also performed. RESULTS: Rates of successful tube placement were higher for radiologic gastrostomy than for PEG in our series and in the meta-analysis (99.2% vs 95.7%, P < .001). Major complications occurred less frequently after radiologic gastrostomy in our series and in the meta-analysis (5.9% vs 9.4% for PEG and 19.9% for surgery, P < .001). Thirty-day procedure-related mortality rates were highest for surgery (2.5% vs 0.3% for radiologic gastrostomy and 0.53% for PEG, P < .001). CONCLUSION: Radiologic gastrostomy is associated with a higher success rate than is PEG and less morbidity than either PEG or surgery.
Clinical outcomes of patients with suspected pulmonary embolism using 99Tcm-Technegas as a ventilatory agent for lung scanning.
Clinical outcome analysis was carried out in 175 of 206 consecutive patients referred for a lung scan with clinical suspicion of pulmonary embolism (PE). The follow-up time period ranged from 4 to 18 months. High-quality ventilation images corresponding to the six standard perfusion images were obtained using Technegas as a ventilatory agent. Lung scan reports showed that 22% of the patients had a high, 14% indeterminate, 18% low and 9% very low probability for PE and 37% were normal lung scans. These reports usually supported the referring clinicians' provisional diagnosis and were confirmed by the clinical outcome analysis of these patients giving an apparent sensitivity for the lung scan of 96% and specificity 93%. A strategy for lung scanning in PE is proposed.
Interferon and respiratory syncytial virus.
Explore the source record for details and available documents.
The cost of acute asthma--how much is preventable?
Asthma is known to be widely under-treated, and unnecessary morbidity from the disease is common. This paper reports a prospective survey of hospital admissions for acute asthma and assesses the efficacy of pre-admission therapy in terms of preventing hospital admission. District and national costs were estimated for hospital admission of patients with acute asthma and, although the direct cost to the patients was not measured, a calculation was made of the number of working days lost annually. The results of this survey show the need for improved education of both doctors and patients, and in particular for improved clinical management. The findings also suggest that the cost to the patient, including those costs incurred by hospital admission, are potentially preventable.