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Biomedical subjects

C J Roberts

Publications and source records attributed to C J Roberts.

At least 253 records · Page 14Linked to original sources
PubMed1976

Routine preoperative chest radiography in non-cardiopulmonary surgery.

Preoperative radiography was performed on 667 consecutive patients undergoing elective non-cardiopulmonary surgery in a large hospital in Wales. Of all significant findings reported 54% were due to cardiomegaly and 19% to chronic respiratory disease, and no appreciable abnormality was found in any patient under 30. Out of a subsample of 152 examined prospectively, 38% had received a chest radiograph within the last year, and the maximum marrow dose had been exceeded in 12-5%. It is concluded that the procedure, as presently practised, is not only being considerably overused but is also exposing many recipients to the potentially harmful effects of over-irradiation. The findings provide further evidence in support of the Royal College of Radiologists' proposal that a national multicentre study of diagnostic radiology should be set up with some urgency.

Adolescent↗
PubMed1976

Implications of shortening the time spent in hospital.

The decision to shorten the time spent in most areas of hospital care is extremely complex and hinges on the balance of numerous resulting credits and debits, which are largely unknown. The length of stay in hospital can be stabilized for many categories of medical care but the likely benefits may be disappointingly small in the face of unchanged demand for health care. Furthermore, a sustained reduction in length of stay could bring with it logistic contractual and personal problems, the costs of which could outweigh the benefits of stabilization. The best delivery of health care in a closed financial system seems to depend on a joint consideration of output per unit time and a provision of a service that comes near to satisfying the true need for that service. The appropriate level of service will be decided from a study of the true prevalence of the need and the ability of the service to satisfy it. The enthusiastic pursuit of traditional efficiency without adequate information may be counterproductive--by increasing demand, by demoralizing the health personnel and by diverting some of the demand into private practice. Our first priority is the rationalization of demand; this will need the combined efforts and goodwill of the consumer and the supplier. Only when demand has been rationalized may we expect a net benefit from shortening length of stay.

Economics, Hospital↗
PubMed1976

Effect of phenobarbitone on plasma lipids in normal subjects.

1. Phenobarbitone in a dose of 180 mg daily was administered to ten normal subjects for 3 weeks. There was a significant increase in total plasma cholesterol, plasma low-density-lipoprotein cholesterol, plasma low-density-lipoprotein (LDL) triglycerides and plasma LDL protein. The increase in plasma LDL cholesterol accounted for the increase in total plasma cholesterol. There was a significant reduction in the ratio of LDL cholesterol to LDL protein. 2. No significant changes were observed in total plasma triglycerides, plasma very-low-density-lipoprotein (VLDL) triglycerides, plasma VLDL cholesterol or plasma VLDL protein. 3. Evidence that drug-metabolizing enzymes were induced by phenobarbitone was provided by an increase in antipyrine clearance. No relationship was observed between changes in plasma cholesterol and changes in antipyrine clearance. Serum gamma-glutamyl transpeptidase was also increased after phenobarbitone administration, the increase being unrelated to changes in antipyrine clearance or plasma cholesterol.

Adult↗
PubMed1976

The relationship between liver volume, antipyrine clearance and indocyanine green clearance before and after phenobarbitone administration in man.

Liver volume and the clearances of antipyrine and indocyanine green have been measured before and after administration of phenobarbitone (180 mg/day) for 3 weeks to ten healthy subjects. The measurement of liver volume by an ultrasound scanning technique yielded reproducible results which were consistent with predictions of liver size by allometric methods. Before phenobarbitone, antipyrine clearance correlated with liver volume, but there was no correlation between indocyanine green clearance and liver volume. Phenobarbitone administration increased the clearance of antipyrine significantly by 90 +/- 14% but there was no significant change in indocyanine green clearance or liver volume. After phenobarbitone the correlation between antipyrine clearance and liver volume persisted. There was no correlation between indocyanine green clearance and liver volume. These results suggest that in non-medicated subjects some of the difference in antipyrine clearance is due to difference in functional hepatic parenchymal mass and that phenobarbitone increases the drug metabolising capacity per unit of hepatic mass but not total liver size.

Adult↗
PubMed1975

Interrelation of the common congenital malformations: some aetiological implications.

Analysis of congenital defects in a population of 90 921 singleton births revealed a strong interrelation between malformations: for example, 84% of lung defects, 70% of kidney defects, 34% of eye defects, 19% of cleft palate, and 15% of spina bifida coexisted with other defects which could not be designated as subsequently derived structural changes. The strength and intimacy of these interrelations casts doubt on the notion that multiple external factors are involved in the causation of human malformations.

Abnormalities, Multiple↗
PubMed1975

Observations on the epidemiology of post partum mental illness.

This study is based on a sample of 35,486 consecutive confinements in Cardiff (1965-72) which gave rise to 67 cases of post partum mental illness. No difference was found between these cases and all resident Cardiff maternities for the same period in respect of social class, maternal parity, weight gain in pregnancy, length of gestation, birth weight, and sex of infant. A statistically significant cyclic variation in month of conception and date of birth was found with a peak frequency among conceptions in the first quarter of the year. The bearing this finding may have on the prevention of post partum mental illness and the implications of the observation that post partum mental illness and the functional psychoses have a remarkably similar temporal behaviour are discussed.

Birth Weight↗
PubMed1975

An investigation of space and space-time clustering in a large sample of infants with neural tube defects born in Cardiff.

Altogether 406 infants with neural tube defects born in Cardiff between 1956-71 were investigated for evidence of space-time clustering and 100 similarly affected infants, together with matched controls born in Cardiff between 1964-66 were investigated for evidence of spatial clustering. No evidence of excessive prevalence in either dimension was observed.

Anencephaly↗
PubMed1974

Comparison of azathioprine, cyclophosphamide, and gold in treatment of rheumatoid arthritis.

Azathioprine, cyclophosphamide, and gold have been compared under double-blind conditions in the treatment of relatively early rheumatoid arthritis. Over 18 months the two "immunosuppressive" agents produced clinical improvement comparable to that achieved with gold, and they also facilitated a reduction in the dosage of corticosteroids and retarded radiological joint deterioration. Drug management was easiest with azathioprine. Cyclophosphamide was perhaps marginally the most effective drug but it produced azoospermia in males. If the long-term hazards of malignancy and mutagenesis prove to be acceptable then the anti-proliferative agents provide a useful alternative to gold therapy and can with advantage be given relatively early in the course of rheumatoid arthritis.

Adult↗