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Biomedical subjects

A J Crisp

Publications and source records attributed to A J Crisp.

At least 37 records · Page 2Linked to original sources
PubMed1994

Case report: benign urachal neoplasm.

Benign urachal neoplasms have been rarely reported. We describe a case of a large benign mesenchymal neoplasm (21 x 19 x 14 cm) arising from the urachus, with imaging by computed tomography and ultrasound.

Abdomen↗
PubMed1994

Ultrasound assessment of the efficacy of wound drains.

We report the use of ultrasound in the assessment of the efficacy of wound drains in preventing wound haematoma. 171 patients with proximal femoral fractures who underwent AO dynamic hip screw or hemiarthroplasty were randomized as to whether or not they should receive wound drainage. Patients then underwent ultrasound examination on the 5th postoperative day to localize and quantify any wound haematomas. Results show that drains are effective in preventing wound collections, but only while in situ; following the removal of drains the size of resulting wound collections is the same whether the wound has been drained or not (Student's t-test; t = 0.19, NS). This study questions current theories on the mechanisms by which wound drainage is thought to influence wound healing.

Drainage↗
PubMed1993

Arthro-osteitis--a clinical spectrum.

Arthro-osteitis is an uncommon condition which can be associated with palmoplantar pustulosis. It forms part of a group of conditions which include the synovitis, acne, pustulosis, hyperostosis, osteitis syndrome (SAPHO) and sternocostoclavicular hyperostosis. We report four cases illustrating the clinical spectrum of this condition which occurred in the absence of concomitant skin lesions. One patient had extensive aortic calcification a feature not previously reported in this condition, which may represent a low grade inflammatory aortitis.

Adult↗
PubMed1993

Treatment of Paget's disease of bone with single dose intravenous pamidronate.

OBJECTIVES: To assess the efficacy of a single intravenous infusion of pamidronate in Paget's disease of bone. METHODS: Fourteen patients with active Paget's disease (raised serum alkaline phosphatase, bone pain or neurological involvement) were treated with a single intravenous infusion of 105 mg pamidronate. Patients were assessed for biochemical and clinical improvement for up to two years following treatment. A further infusion was given following symptomatic relapse (pain at a known site of pagetic involvement). RESULTS: Serum alkaline phosphatase fell following treatment, with a nadir 5.9 months after treatment. Bone pain was improved in nine of 12 patients after six months. Retreatment of four patients resulted in a similar response. CONCLUSION: Single dose intravenous pamidronate (105 mg) is a convenient and effective treatment for Paget's disease.

Aged↗
PubMed1993

Pulmonary infections caused by Mycobacterium malmoense and Mycobacterium tuberculosis: comparison of radiographic features.

OBJECTIVE: The purpose of this study was to compare the radiographic features seen at presentation of pulmonary infections caused by Mycobacterium malmoense and Mycobacterium tuberculosis. The correct differential diagnosis has important therapeutic implications. MATERIALS AND METHODS: The initial radiographs of 16 patients who had proved pulmonary M. malmoense infection were compared with those of 32 age-, sex-, and race-matched patients who had M. tuberculosis infection. The radiographs were analyzed by two radiologists who had no knowledge of the infecting organism. For statistical comparisons, chi 2 and Fisher's exact tests were used. RESULTS: Radiographic findings seen more often in patients who had M. malmoense infection than in those who had tuberculosis were as follows: cavities larger than 6 cm in diameter were found in six (37%) of 16 vs two (6%) of 32 (p < .01); air-fluid levels within cavities were seen in four (25%) of 16 vs one (3%) of 32 (p < .05); loss of lung volume was observed in 12 (75%) of 16 vs 11 (34%) of 32 (p < .01); and coexistent pneumoconiosis was present in four (25%) of 16 vs none of 32 (p < .01). Air-space shadowing involving more than one bronchopulmonary segment was less common in the M. malmoense group, seen in three (19%) of 16 patients, than in the M. tuberculosis group, seen in 16 (50%) of 32 patients (p < .05). CONCLUSION: The radiographic appearances of pulmonary infection caused by M. malmoense differ from those of pulmonary tuberculosis. These differences do not appear to be sufficient to allow a specific diagnosis on the basis of radiographic findings alone.

Adult↗
PubMed1992

Giant cell tumours in mandible and spine: a rare complication of Paget's disease of bone.

The case of a man who was diagnosed as having polyostotic Paget's disease at the age of 52 years is described. He developed a rare neoplastic complication of Paget's disease--a giant cell tumour in his mandible, which was excised. Nine years after the diagnosis of this tumour he developed a new giant cell tumour arising from the L3 vertebral body. He was born in Avellino in Italy, from where five other cases of giant cell tumours arising from Pagetic bone disease have been reported. No family relationship between our patient and the other cases was established. His Paget's disease was particularly aggressive and resistant to treatment with two single high dose infusions of pamidronate almost two years apart.

Aged↗
PubMed1992

Differential involvement of the dorsal and lumbar spine in osteoporosis.

The presence of normal bone density values in the lumbar spine is often assumed to exclude osteoporosis. Eleven cases are reported in which normal lumbar spine bone density and radiology were associated with one or more dorsal spine fractures; the diagnosis was postmenopausal osteoporosis in eight patients and corticosteroid induced osteoporosis in three. These findings suggest that spinal osteoporosis may sometimes be a focal disorder and emphasise the need for dorsal spine radiology in addition to bone densitometry in patients with strong risk factors for osteoporosis or with clinical evidence of the dorsal spine being affected.

Absorptiometry, Photon↗
PubMed1992

Localized scleroderma and hemiatrophy in association with antibodies to double-stranded DNA.

Localized scleroderma involves primarily skin but also muscle, bone and synovium. Further associations and transitional forms have been reported. We report here two cases showing associations between localized scleroderma and vasculitis, mononeuritis multiplex, juvenile chronic arthritis and hemiatrophy. In particular our cases both possess antibodies to double-stranded DNA, a finding not previously reported.

Adolescent↗
PubMed1992

Comparison of the effect of different reference data on Lunar DPX and Hologic QDR-1000 dual-energy X-ray absorptiometers.

We have investigated whether the Lunar DPX (software 3.4) and Hologic QDR-1000 dual-energy X-ray absorptiometers have comparable normal reference databases for the spine and femur of white UK and USA subjects. After conversion for systematic differences in absolute bone density values between the two systems, the reference databases were very similar for the spine in young subjects, but there were clear differences in the femur databases of young females and males of all ages. These differences were confirmed by comparing the percent age-matched and young values determined by the two systems for subjects scanned on both systems. Thus the diagnosis and management of a patient could differ, depending on the system used for the bone density measurements.

Absorptiometry, Photon↗
PubMed1991

Clinical profile of acute vertebral compression fractures in osteoporosis.

Thirty patients with acute, painful vertebral compression fracture were studied. Certain vertebrae, namely T8, T12, L1 and L4, were more likely to fracture. The majority occurred spontaneously (46%) or after trivial strain (36%). Of the former, 30% occurred whilst in bed. Radiation to the flanks and anteriorly was common (66%) but leg radiation was uncommon (6%). Associated symptoms noted were: nausea (26%), abdominal pain (20%), chest pain (13%). Straining exacerbated pain in only 60%. The position of comfort was lying flat (43%) or sitting (36%) but 16% found standing or walking most comfortable. The correct diagnosis was made at the first visit in only 43% of patients. In the remainder there was a mean delay of 4.5 days before diagnosis. This poor diagnostic rate may be improved if other clinical features of osteoporosis such as kyphosis and a previous history of wrist and hip fractures are recorded, particularly when acute back pain occurs in bed. Full thoracic and lumbar X-rays may be required because pain and site of pathology may not coincide. Bone scanning may be necessary if immediate X-rays are normal. In early management the position of most comfort may be preferable to complete bed rest.

Acute Disease↗
PubMed1991

Comparative performance in vitro and in vivo of Lunar DPX and Hologic QDR-1000 dual energy X-ray absorptiometers.

The measured absolute bone mineral density values of spine and femur and their precision were compared on two dual energy X-ray absorptiometers, the Lunar DPX and the Hologic QDR-1000. There were systematic differences between the two systems, the Lunar DPX always giving a higher bone density value. The ratio of the mean Lunar DPX/Hologic QDR-1000 bone density measurements obtained in vivo was 1.13 g/cm2 for spine (L2-L4) and 1.20-1.43 g/cm2 for femur measurements. For both systems, short- and long-term precision (coefficient of variation) was below 0.5% for spine in vitro measurements and below 1.5% for neck of femur in vitro measurements. Precision of in vivo measurements was less good, especially for femur measurements. The coefficient of variation of spine measurements was dependent on bone density and deteriorated with decreased bone mineral density and increased body thickness.

Absorptiometry, Photon↗
PubMed1991

Astemizole, an H1 antagonist, has no additional therapeutic effect in rheumatoid arthritis.

Mast cells are found in increased numbers in the synovium of patients with rheumatoid arthritis (RA) and may play a role in synovitis. They produce proinflammatory substances including histamine. A double blind placebo controlled study was undertaken in 60 patients with active RA using the H1 receptor blocker, astemizole, as an adjuvant to usual therapies. After 3 months of treatment there were no significant differences in clinical and laboratory variables between the groups. We conclude that H1 antagonist treatment with astemizole has no additional therapeutic effect in RA.

Aged↗