Biomedical subjects

C Battersby

Publications and source records attributed to C Battersby.

At least 19 recordsLinked to original sources

PubMed1998

Association of symptoms of type 2 diabetic patients with severity of disease, obesity, and blood pressure.

OBJECTIVE: The symptoms of 430 type 2 diabetic patients were determined by a self-administered questionnaire before entry into the U.K. Prospective Diabetes Study. RESEARCH DESIGN AND METHODS: Entry into the trial followed 2 months of dietary treatment for newly diagnosed patients with type 2 diabetes. Forty symptoms with five levels of severity were included in the questionnaire. A complaint rate was computed as the sum of symptom scores divided by the number of symptom questions answered. RESULTS: The complaint rate was independently and positively related to BMI, fasting plasma glucose (FPG), and being a woman. Three symptoms--presence of dry mouth (P < 0.001), thirst (P < 0.01), and stomach pain (P = 0.02)--were related to FPG independent of sex, age, BMI, or blood pressure. Only dry mouth was related to HbA1c (P = 0.05). Complaints of shortness of breath, swollen ankles, headaches, heartburn, sweating, wheezing, nocturia, thirst, and diarrhea increased with BMI independently of other variables. A complaint of cold extremities decreased with BMI. Heartburn, weakness of limbs, and hot flushes were positively related to blood pressure, and unsteadiness was negatively related. CONCLUSIONS: The symptoms reported by patients with type 2 diabetes increased with FPG and markedly with BMI. The symptoms associated with obesity have been underestimated in the past.

Age Factors↗

PubMed1995

Quality of life in treated hypertension: a case-control community based study.

The aim of this case-control community study was to determine whether there was a difference in quality of life between hypertensive subjects and matched normotensive controls. Cases aged 40-79 years were randomly selected from a hypertensive register and matched with controls for age, sex, ethnicity and health centre. Cases had phase V diastolic blood pressure (DBP) > or = 100 mm Hg or systolic blood pressure (SBP) > or = 180 mm Hg, or were on anti-hypertensive medication. Controls had DBP < or = 90 mm Hg and no record of raised BP or anti-hypertensive treatment within the past year. Quality of life was measured by self-administered questionnaire. Data from 90 matched pairs, average age 62 years, with 47% men, were analysed; 80 hypertensive subjects were on anti-hypertensive medication. Hypertensive subjects showed an impairment in well-being compared with controls. They had a lower Health Status Index, had more sickness absence from work, greater symptomatic complaint and impaired psychological well-being. Relatives also reported a poorer quality of life in the hypertensive subjects. This impairment could be a result of the disease, adverse effects of drug treatment or to the effects of labelling.

Adult↗

PubMed1994

Establishment of a cell line from a hepatocellular carcinoma from a patient with hemochromatosis.

We describe the establishment and characterization of a novel hepatoma cell line. This cell line, designated RBHF-1, was established from a hepatocellular carcinoma of a 67-yr-old man with a history of genetic hemochromatosis. At this writing, the cells have been maintained in RPMI-1640 tissue-culture medium and fetal calf serum without any additional supplements for 30 mo. The cells form colonies on soft agar and are not tumorigenic in nude mice. The cell line is polymorphic and displays characteristics of mature hepatocytes by synthesizing albumin, alpha 2-macroglobulin, fibronectin and alpha-fetoprotein. Cytogenetic analysis shows multiple chromosomal aberrations, with a consistent deletion in the long arm and deletions or rearrangements in the short arm of chromosome 1. There is no evidence for hepatitis B or hepatitis C virus infection of the cell line. The cells contain no detectable intracellular iron after staining with Perls' stain. Unlike other hepatoma cell lines, there is no detectable binding of epidermal growth factor to RBHF-1 cells. This is the first cell line to be established from a patient with hemochromatosis, and it provides a potentially important model for the study of hepatocyte transformation in association with iron overload.

Aged↗

PubMed1993

Cognitive function in hypertension: a community based study.

Cognitive function was investigated in a random sample of subjects on the general practitioners' registry of hypertensive patients in an inner city area and matched with normotensive controls. The response rate was 66% giving 90 matched pairs, average age 63 yrs, with 47% men. There was no difference in educational background or measures of reading ability between the two groups. Cognitive function tests showed a consistent trend of poorer performance in hypertensives, with significant differences in Verbal Learning (immediate recall and retention). Age was inversely related to cognitive function, but no additional deterioration with increasing age was shown in hypertensives.

Adult↗

PubMed1992

Operative cholangiography: a perspective.

Two hundred and eighty-seven patients having operative cholangiograms were identified from a prospective study of 346 patients undergoing surgery for gallstones. Forty-two patients (14.6%) had filling defects and bile duct (BD) exploration. The false-positive exploration rate was 2.8%. Eight patients (2.8%) had unexpected BD calculi with no abnormality in pre-operative liver function tests or ultrasound. If a policy of selective operative cholangiography is pursued, then failure to detect a small number of duct stones must be expected, although unnecessary duct exploration is likely to be eliminated. The clinical significance of undetected BD calculi remains debatable.

Adult↗

PubMed1992

Quality of life on antihypertensive therapy: a double-blind trial comparing quality of life on pinacidil and nifedipine in combination with a thiazide diuretic. European Pinacidil Study Group.

The quality of life (QL) was evaluated in a 6 month double-blind trial in six European countries. Patients with a sustained supine diastolic blood pressure (SDBP), phase V, of 95 mm Hg or more on bendrofluazide, 5 mg daily (or an equivalent dose of a thiazide diuretic) were randomised to additional pinacidil (n = 127), 25 mg up to 100 mg daily, or nifedipine (n = 130), 20 mg up to 80 mg daily. The treatment groups were similar at entry for QL scores, average DBP of 103 +/- 6 (SD) mm Hg, and average age of 56 +/- 10 (SD) years. Eighteen patients on pinacidil and 12 on nifedipine withdrew due to side effects, such as oedema (both drugs) and flushing (nifedipine). The maximum antihypertensive effect was achieved within 6 weeks and maintained, resulting in a significant fall in SDBP of 13.7 mm Hg on pinacidil and 15.5 mm Hg on nifedipine at the end of the trial. There was no significant difference in the antihypertensive effect. The target SDBP was achieved in 57% of pinacidil-and 63% of nifedipine-treated patients. The average number of symptomatic complaints fell in both groups, with significant decreases in the reporting of blurred vision and headaches on nifedipine. Complaints of growth of body and facial hair increased on pinacidil but there were no significant between-drug comparisons with respect to side effects. In measures of psychological well being, patients on pinacidil showed a significant (p less than 0.05) improvement in total and cognitive function scores compared to nifedipine.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1991

Experience with biliary audit.

Experience with an audit of surgery for gallstones is discussed. Three hundred and forty-six patients were treated in a three and a half year period. There was no mortality. There was a duct exploration rate of 17%, an infection rate of 8.6%, and a re-operation rate for retained bile duct stone of 1.6%. Bile was cultured from 278 gall-bladders and culture was positive in 66 cases (23.7%). The most common organisms grown were coliforms and streptococci. Our antibiotic policy has changed as a result of this study. Audit is becoming increasingly necessary in surgical practice, not only for research purposes, but also to monitor performance. The design can be broad, to identify groups of patients for further study, or narrow, to concentrate on a particular problem. Someone must be responsible for checking the completed forms for accuracy before the data are entered into the computer. It is important that the form be as simple as possible. Forms which are too detailed will be filled in inaccurately or not at all.

Adult↗

PubMed1989

The needle glucose electrode: in vitro performance and optimisation for implantation.

The classical glucose needle electrode based on detection of H2O2 from glucose oxidase has been studied. Dip-coating of a series of outer polyurethane layers of increasing concentration (10-50% W/V) achieved devices with extended linearity (greater than or equal to 30 mM glucose) with greater reliability than a single dip-coat. In vitro performance in unstirred whole blood was acceptable, and all devices were stir-independent. Nevertheless, signal size was affected by a high solution viscosity, and this may have implications for the use of enzyme electrodes in subcutaneous tissue.

Biosensing Techniques↗

PubMed1988

The glucose enzyme electrode: is simple peroxide detection at a needle sensor acceptable?

Needle type devices have been fabricated based on Pt anodes (to detect H2O2) mounted with stainless steel needles to act as the reference. Coating of these devices with glucose oxidase allowed glucose measurement, but with high dependence on stirring and background pO2 levels as well as a restricted glucose assay range. By wet dipcoating of microporous polyurethane or the application of preformed porous membranes, the linear range has been extended up to 70 mM glucose, to give minimal pO2 dependence and insensitivity to stirring. With incorporation of polyethersulphone membranes, blood measurement was possible with high selectivity (y = 0.954x + 0.202, r = 0.991, n = 48). This establishes that simple peroxide detection at a needle sensor is acceptable, and can now be focussed on increasing biocompatibility.

Biocompatible Materials↗

PubMed1985

Monolayer culture of parenchymal rat hepatocytes on collagen-coated microcarriers. A hepatocyte system for short- and long-term metabolic studies.

A method is described for the attachment to and monolayer culture of adult rat hepatocytes on collagen-coated or fibronectin-coated microbeads or both in a chemically defined serum-free medium. Protein synthesis measured by the incorporation of [3H]leucine into protein was four-fold higher in the hepatocyte microcarrier cultures than in isolated hepatocyte suspensions. The hepatocyte microcarrier cultures showed acute responsiveness to insulin of fatty acid synthesis, glucose incorporation into glycogen, and decarboxylation of [1-14 C]pyruvate. Microcarrier-cultured hepatocytes have the combined advantages of monolayer culture and suspension systems. They are a potential tool for the study of long-term as well as acute effects of hormones.

Animals↗

PubMed1981

Psychological implications of mastectomy.

Some recent studies on the psychological trauma endured by patients with breast disease are summarized and a number of conclusions are drawn. There appear to be a number of stages through which a patient with a breast lump passes psychologically. Breast cancer attitudes in a community are dependent upon accumulated experience and cannot be changed overnight. Delay in presentation results from unconscious factors which may not be amenable to rational public health appeals. It is possible to identity a group of patients high at risk in breast surgery, although human resilience is such that the outcome if often satisfactory. There is a great need for controlled prospective studies in many areas of breast surgery rehabilitation. Some personal observations are included to stimulate discussion and interest in the area.

Adult↗

PubMed1980

Why don't doctors understand "PSYCHOLOGISTS"?

There are various factors which cause a communication gap between doctors and other members of the health team. Some of these are simple differences in language, but others go much deeper and involve basic issues of philosophy and outlook. Some of the views presented here may be indigestible in some quarters.

Disease↗

PubMed1978

Ruptured choledochal cyst: recognition and management.

A case is described of the rupture of a choledochal cyst in a 21-year-old man involved in a motor vehicle accident. At laparotomy, a haemoperitoneum was traced to a large haematoma in the lesser omentum which extended into the mesocolon and was found to be tinged with bile. Eventually it became apparent that the primary pathological condition was a large choledochal cyst into which opened the gallbladder. This cyst had split longitudinally down its anterior surface from the porta hepatis to the duodenum. Bile leakage was controlled by inserting a Foley catheter into the common hepatic duct, and inflating the balloon. Postoperative cholangiography showed massive cystic dilation of the intrahepatic ducts. Five days after the initial operation, a Roux-en Y cystjejunostomy was performed, and the patient has been well since. Crucial points in the emergency management of this condition appear to be in its recognition, and the provision of an adequate method of primary biliary drainage, if the condition of the patient demands staged management. End-to-end cystjejunostomy provides a satisfactory method of final drainage.

Accidents, Traffic↗

PubMed1978

Mastectomy in a large public hospital.

Thirty women undergoing mastectomy for carcinoma of the breast in a large teaching hospital were interviewed. All indicated a very real need to discuss their experiences, and felt that the interview had been beneficial to them. Most had found the "lump" themselves--but often described it as a "hardness", a "ridge", or a "thickening". More than half felt that the counselling afforded to them had been inadequate--especially in the realm of sexual adjustment--but, if their marriages had been stable before operation, subsequent deterioration was unlikely. The threat of malignancy, rather than that of breast loss, was uppermost in the minds of most patients. It should not be assumed that postmastectomy problems do not exist because patients do not mention them, especially in large busy follow-up clinics, where privacy may be inadequate. If doctors are unable or unwilling to afford this service to their mastectomy patients, it may be necessary to delegate it to other health professionals and mastectomy volunteers.

Adult↗

PubMed1977

An electron microscopic study of the mode of donor cell death in unmodified rejection of pig liver allografts.

The only type of cell death found in pig liver allografts 1 week after technically successful operation was apoptosis. Its extent paralleled the degree of mononuclear cell infiltration of the liver parenchyma, and mononuclear cells were found applied to the surfaces of hepatocytes showing early stages of the process. The results suggest that cellular immune attack induces apoptosis of donor cells, and that the action is a direct one. However, implication of other factors such as vascular damage in the induction of apoptosis in the grafts could not be excluded.

Animals↗

PubMed1977

Acute pancreatitis: the Queensland scene.

One hundred patients suffering from acute pancreatitis and studied in two large teaching hospitals in Brisbane between 1959 and 1973 were reviewed. Gallstones were present in 43 patients (of whom 31 were female), and a history of alcoholic excess were elicited in 23. Sixty-three patients were aged over 50 years. Characteristic clinical features included spreading epigastric pain with radiation to either of the upper quadrants of the abdomen. Left-sided upper abdominal peritonitis associated with severe repetitive vomiting was suggestive of the diagnosis. The serum level in most cases fell below the arbitrary diagnostic level of 500 Somogyi units/100 ml within 72 hours of the onset of the pain. Acute haemorrhagic necrosis of the pancreas was positively diagnosed in 15 patients, six of whom died. The overall mortality rate in the series was 9%.

Acute Disease↗

PubMed1977

The dilemma of stage III breast cancer: a study of preoperative radiotherapy.

The results of treatment of 68 patients with Stage III breast cancer treated by preoperative radiotherapy and subsequent mastectomy have been compared with those in 68 patients treated by more conventional methods, matched individually for age, stage, and year of treatment. Preoperative radiotherapy delayed the time of the first local recurrence, but did not improve overall survival. It is concluded that preoperative radiotherapy may be justified in patients with Stage III breast cancer in an attempt to control local disease, but is unlikely to improve control of systemic recurrence.

Breast Neoplasms↗

PubMed1977

What shall we teach our students about breast cancer? A personal view.

The incidence of breast cancer in Australia is as high as in most parts of the world. The usual presentation is with a breast lump. Invasive and preinvasive malignant changes may be identified in both duct and lobular epithelia. There are clinical features of malignancy, but histological proof is necessary. Aspiration of cysts and reexamination of clinically benign lumps are acceptable in certain circumstances, but a tissue diagnosis should be made by needle or open biopsy. Earlier diagnosis is possible by radiological screening of asymptomatic patients, but the cost is high. Total excision of the breast (simple mastectomy) is the minimum treatment advisable for infiltrating cancer; If there is a high chance that the draining lymph nodes will contain tumor, they should be treated by surgical excision or radiotherapy. Early chemotherapy does reduce the incidence of systemic metastases after mastectomy, but its precise place in management is not yet clear. The social impact of mastectomy is considerable and deserves more attention than has been paid to it in the past. Clinical trials of treatment should continue, as they are beginning to answer some fundamental questions.

Australia↗