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Biomedical subjects

A C Wicks

Publications and source records attributed to A C Wicks.

At least 73 records · Page 4Linked to original sources
PubMed1984

Cimetidine therapy does not prevent rebleeding from peptic ulceration.

One-hundred and five patients admitted to hospital with symptoms of acute upper gastrointestinal haemorrhage shown at endoscopy to be due to peptic ulceration were entered into a prospective double-blind controlled trial of cimetidine versus placebo therapy. The trial therapy was commenced within 12 hr of admission and continued for 7 days. Cimetidine therapy made no difference to the transfusion requirements, rebleeding rate or number of operations performed in patients with either gastric or duodenal ulcers, nor was it of benefit in patients aged over 65 years of age.

Aged↗
PubMed1984

Primary tuberculosis of the esophagus.

A case of primary tuberculosis of the esophagus is presented in an Asian patient. This is a rare site for tuberculosis and mimicked the appearance of a carcinoma.

Adult↗
PubMed1982

Massive bleeding from the ileum: a late complication of pelvic radiotherapy.

Recurrent massive hemorrhage from the ileum as a late complication of radiotherapy has not previously been documented. We describe two patients with a history of pelvic radiotherapy 18 months and 11 yr before, in whom the source of melena was localized to the small bowel preoperatively. Characteristic serosal appearances of ileal radiation injury were present at laparotomy and resection of the terminal ileum controlled the hemorrhage. Pathological study revealed no ulceration but multiple telangiectatic vessels in the tips of mucosal villi. This cause should be considered in patients with obscure gastrointestinal bleeding previously exposed to pelvic radiotherapy.

Aged↗
PubMed1980

Peritoneoscopy in a developing country.

Peritoneoscopy in medical cases remains largely unpopular in the USA and the UK. In many developing countries there is often a heavy demand on medical facilities and the rapid diagnosis of intra-abdominal problems is of major importance. We present a series of 193 patients in whom peritoneoscopy was carried out during a 2 1/2-year period. Eighty-six per cent (166) of examinations yielded information of positive diagnostic value. The most common diagnoses were hepatocellular carcinoma, liver cirrhosis, bilharzial fibrosis and peritoneal tuberculosis. The peritoneoscopic appearances in the various lesions are illustrated and discussed. Peritoneoscopy is a safe procedure and its value in a developing country is great, both in terms of economy of man-hours employed and, more particularly, of diagnostic yield.

Adolescent↗
PubMed1980

A follow-up of 93 newly diagnosed African diabetics for 6 years.

In 1971, 107 newly diagnosed black diabetics admitted to Harare Central Hospital, Rhodesia, were studied. Nine died before discharge. In 1977, 93 of the 98 patients discharged alive were traced but of these 38 (41%) had since died. Of 18 autopsies performed the cause of death was hypoglycaemia in 8 patients and hyperglycaemia in 4. Seven factors were associated with a poor prognosis: male sex, age, alcohol consumption, low body mass, high serum globulin in males, low serum albumin in females and referral to other than the teaching hospital diabetic clinic for follow up care.

Adult↗
PubMed1978

A simplified procedure for the analysis of cholesterol, phospholipids and bile salts in human bile.

Cholesterol, total bile salts and phospholipids have been measured on alcoholic extracts from human bile-rich duodenal contents. Folch extraction before phospholipid assay was found to be unnecessary and, unless fresh samples are used, it is liable to give misleadingly low values. Removal of bile pigment before measuring cholesterol was unnecessary because this estimation was done by gas-liquid chromatography. The methods described provide a simple, reproducible analysis of bile lipids.

1-Propanol↗
PubMed1978

Variability of colonic function in healthy subjects.

Twenty healthy subjects eating normal diets made repeated five-day stool collections, the 10 females making their collections in four to six successive weeks. In most subjects there were striking variations in transit time, measured by Hinton's method. The variability of average faecal wet and dry weight, faecal volume, and the frequency of defaecation was equally great, suggesting that the transit time variations were genuine. The size of individual stools varied even more, often tenfold or more. Faecal water content was relatively constant. There were no significant differences between males and females, and in the females there were no obvious changes related to the phases of the menstrual cycle. The normal variability of colonic function should be taken into account in planning experiments and in interpreting existing data.

Adolescent↗
PubMed1978

Bran and bile: time-course of changes in normal young men given a standard dose.

Twelve healthy young men added bran 15 g twice daily to their diet and underwent aspiration of bile-rich duodenal contents at 0, 1, 2, 4 and 6 weeks. In the 6-week sample, but not earlier, there was a significant decrease in deoxycholate and increase in chenodeoxycholate. Bile was unsaturated with cholesterol at the beginning and remained so throughout. The delay in the action of bran may be because it reduces the formation of deoxycholate in the colon and does not merely impede its absorption.

Adult↗
PubMed1977

Fluctuations of serum and bile lipid concentrations during the menstrual cycle.

We measured fasting serum and bile lipid concentrations at three intervals during the normal menstrual cycles of 11 healthy women not taking oral contraceptives. In nine of them cholesterol saturation of bile, and therefore presumably the risk of developing gall stones, was higher nine days after midcycle than at the end of menstruation. This change in bile cholesterol saturation was preceded by a significant fall in serum lipid concentrations: during the nine days after mid-cycle serum triglyceride and cholesterol concentrations fell in nine and eight of the 11 women respectively. Changes in the composition of serum and biliary lipids during the menstrual cycle are presumably due to a direct effect of sex hormones on the liver.

Adult↗
PubMed1977

Cirrhosis of the liver in Rhodesian Blacks.

Thirty-five Black patients with cirrhosis of the liver were admitted to the professorial unit over a 1-year period and were included in a carefully planned prospective study. Men predominated over women in a ratio of 3:1. Alcohol consumption in the form of African beer was significantly higher in cirrhotic patients than in a control population. The clinical picture was neither predominantly that of alcoholic nor of cryptogenic cirrhosis. Hepatomegaly, porphyria cutanea tarda, ascites, splenomegaly and oesophageal varices were common. There was a complete absence of gynaecomastia, spider naevi and liver palms. Histologically, the majority of patients had macronodular cirrhosis, and only 1 patient had micronodular cirrhosis and minimal fatty change. Hepatitis B surface antigen (HbsAg) was not detected in any patient, despite a positive HbAg rate of 4% in Black African blood donors, determined by means of the same laboratory technique.

Adult↗
PubMed1977

Advantages of the plasma uptake method for measuring vitamin B12 absorption.

The plasma uptake method for determining vitamin B12 absorption is reassessed. The results of this study demonstrate the ease with which normal controls can be separated from patients with intestinal malabsorption of vitamin B12 and from those with pernicious anaemia. This method is also shown to be a sensitive index of improved vitamin B12 absorption after treatment of small-intestinal disease and with the addition of intrinsic factor in pernicious anaemia. The advantages, particularly for developing countries, over the more commonly used Schilling test are discussed. It is emphasized that, because of the lack of a universally accepted normal value, healthy controls should be studied to define the normal range for the community under investigation.

Anemia, Pernicious↗
PubMed1977

Hepatocellular carcinoma in the Rhodesian African.

We have carried out a prospective survey of 28 primary liver carcinomas over one year. Hepatocellular carcinoma is the commonest malignancy seen in Rhodesian blacks, which results in a high index of suspicion and accounts for the 96.4% positive diagnosis before death in this study. The age distribution was evenly spread through adult life with no definite peak incidence. Some were young and without evidence of chronic liver disease, but many had the stigmata of established hepatic disease. This contrasts with the common assertion that in areas of high incidence for primary liver cancer those affected are mainly young and lack signs of chronic liver disease. The commonest presenting symptoms were abdominal pain and swelling and weight loss. Hepatomegaly, often tender and nodular, was present in all but one. The incidence of alpha-feto protein, 46.5%, is low compared with other countries where primary liver cancer is common. Hepatitis B antigen was absent in all 28, suggesting that there is no association between the persistence of the antigen and hepatocellular carcinoma in Rhodesia. Liver function tests, although abnormal, were never diagnostic of primary liver cancer. We have confirmed the association of high alcohol consumption and cirrhosis with hepatocellular carcinoma.

Adult↗
PubMed1976

Amoebic liver abscess in Rhodesian Africans.

Eighty-eight African patients with amoebic liver abscess are described. The diagnosis was readily made in pyrexial patients who had right-sided upper abdominal pain, an enlarged, very tender liver and signs at the right base. However, in apyrexial subjects (10%) and where abdominal pain was absent (7%), the diagnosis was considerably delayed. Five children (7%) were seen under the age of five, four of whom died because the diagnosis was not suspected. It is particularly emphasized that there should be a greater awareness of this condition in this age group. Amoebae were found in only a small percentage of stool (14%) and pus specimens (11%), while biopsy of the abscess edge yielded 40%. The relative values of a positive amoebic latex test (82%) and an elevated alkaline phosphatase (71%) are noted. In only half the aspirations was the classical anchovy sauce appearance seen. Metronidazole is the drug of choice with repeated aspirations for large abscesses. Mortality was 13-5%, occurring mainly in the extremes of life.

Adolescent↗
PubMed1976

The effect on intestinal transit and the feces of raw and cooked bran in different doses.

Ten healthy male subjects on a low fiber diet were given two doses of raw wheat bran (12 and 20 g/day) and two doses of cooked bran (13.2 and 22 g/day). Both doses of raw bran increased fecal dry weight but only the higher dose decreased transit time and increased stool volume. Individual stool size was increased only by raw bran 12g/day. Neither bran influenced fecal wet weight or stool frequency. This study suggests that the cereal manufacturing process alters wheat bran so that cooked bran has less effect on the intestine than does a comparable amount of raw bran.

Adult↗