Search PubMed⌕ Search

Biomedical subjects

E Giles

Publications and source records attributed to E Giles.

At least 19 recordsLinked to original sources
PubMed2006

Routine coagulation screening in children undergoing gastrointestinal endoscopy does not predict those at risk of bleeding.

BACKGROUND AND STUDY AIMS: Routine coagulation screening prior to gastrointestinal endoscopy is performed in many centres in the UK, despite the lack of any evidence to support the practice. The aim of this study was to assess the benefits of routine pre-endoscopy coagulation screening in children and to assess how widespread this practice is in the UK. PATIENTS AND METHODS: We performed a retrospective analysis of the case notes of 250 consecutive patients who had undergone routine coagulation screening prior to endoscopy and biopsy, in accordance with our unit's protocol, looking for evidence of abnormal results or episodes of bleeding. We also performed a telephone survey of the protocols for coagulation screening at other paediatric units in the UK which are known to perform gastrointestinal endoscopy on a routine basis. RESULTS: According to our hospital's laboratory reference ranges, 16.8 % of the children who underwent endoscopy and biopsy had abnormal clotting. This was neither clinically significant nor associated with an increased bleeding risk in any patient. Of the 23 UK paediatric gastroenterology centres surveyed, including our own, five (21.7 %) perform routine coagulation screening before endoscopy. CONCLUSIONS: This study suggests that, although it is a relatively common practice, routine coagulation screening is not indicated in children who are undergoing gastrointestinal endoscopy and biopsy, and that it does not predict those at risk of significant bleeding. We would therefore suggest that if pre-endoscopy screening is to be performed, it should be reserved for those who are potentially at high risk of bleeding.

Blood Coagulation Disorders↗
PubMed2005

Response to long-term lamivudine treatment (up to 5 years) in patients with severe chronic hepatitis B, role of genotype and drug resistance.

Lamivudine is effective in suppressing viral replication, normalizing alanine aminotransferase (ALT), and improving histological appearance in HBe positive and negative hepatitis. It is unclear whether hepatitis B virus (HBV) genotype influences the response to lamivudine. We report the long-term response of patients with chronic hepatitis B with and without cirrhosis at baseline treated with lamivudine according to HBV genotype. Retrospective review of charts of all patients treated with lamivudine monotherapy between 1993 and 2002. Response to therapy defined as ALT in the normal range, undetectable HBV DNA, and in the HBeAg positive group loss of HBeAg and/or the development of anti-HBe. HBV DNA measured by the Digene Hybrid capture assay (sensitivity 1.4 x 10(6) copies/mL). YMDD mutation at rtL180M and rtM204V/I measured by restriction digest of amplified products. Genotyping performed by sequencing and phylogenetic tree analysis of the preS region of the virus genome. Seventy-one patients treated with lamivudine for 6 months or more, 53 (75%) were male, average age 47 years, 38 (54%) were HBeAg+ and 33 (46%) HBeAg-. Mean baseline HBV DNA viral titre was 1280.2 copies/mL and 518 copies/mL respectively. Cirrhosis was present in 30 (42%). Sera were examined for YMDD mutations at last patient visit in 61 (86%), and were detected in 45 (74%), there being no association with a particular genotype. Data from up to 5 years on lamivudine indicated no difference in biochemical or virological response between genotypes. Cirrhosis was more prevalent with specific genotypes. We found no influence of HBV genotype on the development of resistance to lamivudine, however liver disease severity was influenced by genotype.

Alanine Transaminase↗
PubMed1998

Vestibular stimulation by multichannel cochlear implants.

The recipient of a Nucleus 22 multichannel cochlear implant began to experience severe vestibular stimulation related to the implant. This patient's experience initiated a study with the objective of determining the frequency of implant-related vestibulo-ocular stimulation. Subjects consisted of 17 randomly selected patients who use cochlear implants. Included in the study were 14 Nucleus 22 and three Med-El Combi 40-devices. Stimulation of the implants was performed both by individual channel and with sound field broad-band 80-dB noise using the users' normal device settings. Eye movements were monitored with infrared videonystagmography. Only one subject, who used a Med-El Combi 40, showed a consistent and strong ocular response to cochlear stimulation but had no subjective symptoms. The authors conclude that vestibulo-ocular activation is possible with multichannel cochlear implants but is infrequent and may not be clinically significant.

Cochlear Implants↗
PubMed1997

Cochlear implantation in otosclerosis: a unique positioning and programming problem.

A case is reported in which a Nucleus 22 channel cochlear implant was inserted into the basal turn of the cochlea of a patient with advanced otosclerosis. It then passed out of the anterior end of the basal turn into an otospongiotic cavity related to the cochlea. Seven electrodes were located in the basal turn and it was possible to map them sufficiently well for the patient to derive considerable benefit from the implant. The problem of implant induced facial nerve stimulation in otospongiosis is also discussed.

Cochlear Implants↗
PubMed1996

Neuropsychological performance, disease severity, and depression in progressive supranuclear palsy.

To investigate the relationship between disease severity, cognitive impairment and depression in progressive supranuclear palsy (PSP) we studied a group of 25 patients who fulfilled strict research criteria and 25 matched controls. Disease severity was judged from the duration of symptoms, level of physical disability using the Columbia Rating Scale (CRS), and the degree of eye movement abnormality. The neuropsychological battery was designed to assess attention and executive function, visual and auditory perception, semantic memory and language production. Although the PSP group were significantly impaired on almost all of these measures, the most profound deficits were on tests of sustained and divided attention. There was no correlation between cognitive impairment and either disease duration or scores on the CRS, but performance on tests of attention correlated significantly with the degree of ocular motor impairment. Depression was found to be common in PSP but did not correlate with any other parameters. It is concluded that the cognitive deficit in PSP is widespread and independent of depression. The association between the severity of eye movement disorder and deficits in sustained and divided attention leads us to postulate that pathology involving the midbrain periaqueductal region may be critical for breakdown in these fundamental processes.

Aged↗
PubMed1996

Progressive supranuclear palsy presenting with dynamic aphasia.

BACKGROUND: Progressive supranuclear palsy (PSP) is an akinetic-rigid syndrome of unknown aetiology which usually presents with a combination of unsteadiness, bradykinesia, and disordered eye movement. Speech often becomes dysarthric but language disorders are not well recognised. METHODS: Three patients with PSP (pathologically confirmed in two) are reported in which the presenting symptoms were those of difficulty with language output. RESULTS: Neuropsychological testing showed considerable impairment on a range of single word tasks which require active initiation and search strategies (letter and category fluency, sentence completion), and on tests of narrative language production. By contrast, naming from pictures and from verbal descriptions, and word and sentence comprehension were largely intact. The degree of semantic memory impairment was also slight. CONCLUSIONS: Relatively selective involvement of cognitive processes critical for planning and initiating language output may occur in some patients with PSP. This presentation resembles the phenomenon of "verbal adynamia" or "dynamic aphasia" seen in patients with frontal lobe damage. Although definite cortical changes were present at postmortem examination, it is likely that the neuropsychological deficits reflect functional frontal deafferentation secondary to interruption of frontostriatal feedback loops.

Aged↗
PubMed1993

A review of patients attending a preliminary cochlear implant assessment clinic.

The Cochlear Implant Programme at Manchester Royal Infirmary was established in 1988 and so far (January, 1992) 38 patients have been implanted with the Nucleus 22 channel intracochlear device and one with the Ineraid device. All patients who are referred for consideration for an implant are initially seen at a preliminary cochlear implant assessment clinic conducted by an ENT surgeon. One hundred and seventy three patients attended the initial outpatient screening clinic between 1987 and January 1992. Of these 112 patients (67.6 per cent) went on for further investigation regarding suitability for implantation. This paper details the aetiology and severity of deafness in these patients and explains how suitability for admission to the next stage of assessment was decided.

Adolescent↗
PubMed1991

Stature- and age-related bias in self-reported stature.

The use of reported stature, especially self-reported stature such as on a driver's license, as a proxy for measured stature is necessary when measured stature is unavailable, for example, in matching data calculated from skeletal remains with data for missing persons. The accuracy of self-reported stature for older persons and especially for tall and short people is not well ascertained. Examination of published reports provides evidence that beginning at age 45, people compound their stature overestimation by an additional amount related to age (women by twice the amount of men). Analysis of anthropometric data from 8000 U.S. Army personnel indicates that the amount of general overestimation of stature by men is 2 1/2 times greater than that by women. Neither tall men nor tall women underestimate their stature, but men in the upper third of the stature range, and women in the upper 10%, self-report their stature with greater accuracy. No trends in accuracy are apparent in the remainder of the stature spectrum for men or women.

Adult↗
PubMed1991

Corrections for age in estimating older adults' stature from long bones.

Stature estimates based on long bone measurements require a correction factor to compensate for stature decrease in older people. Such a correction should exclude the effect of any secular trend in stature and reflect the age at which stature begins to decrease, sex differences, and the increasing rate of change with age. Stature correction which meet these requirements for ages 46 through 85, based upon two recent large-scale longitudinal anthropometric studies, are provided in tabular form.

Age Factors↗
PubMed1991

Height estimation from foot and shoeprint length.

Foot length displays a biological correlation with height that suggests the latter might be estimated from foot- or shoeprints when such evidence provides an investigator the best or only opportunity to gauge that aspect of a suspect's physical description. Previous utilization of percentages and linear regressions of foot length to make height estimates is reviewed and appraised, as is such use of shoeprints. Newly determined percentages and linear regressions for determining height from foot length for young adult males and females based upon very large U.S. Army anthropometric databases are presented and evaluated. Suggestions are made for the practical employment of shoeprint length, preferably as a direct measurement but also indirectly as a shoe size indicator, for height assessment.

Adult↗
PubMed1988

Confidence intervals for estimates based on linear regression in forensic anthropology.

Forensic anthropologists commonly use simple linear regression to estimate the value of a dependent variable, such as stature, for a single specimen where the value of the independent variable, such as humerus length, is known. Published studies providing regression equations for such use almost invariably include the standard error of estimate. Unfortunately, it is exceptional for forensic anthropologists to use the standard error to calculate correctly the confidence limits for their single predicted value. We attempt to show why this may be and provide explicit guidelines for the proper construction of confidence interval in such circumstances.

Anthropology, Physical↗