Biomedical subjects
Publications and source records attributed to E R Littlewood.
The Trucut and Surecut liver biopsy needles have been compared in a prospective randomised study. Although the Surecut specimens were longer and heavier they tended to fragment during processing. Trucut specimens were subject to less artefact and were rated more highly by the histopathologist. However, the majority of biopsies obtained by both needles were satisfactory for diagnostic purposes.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Fifty-eight patients with uncomplicated diverticular disease of the colon took bran crispbread, ispaghula drink, and placebo for four months each in a randomised, cross-over, double-blind controlled trial. Assessments were made subjectively, using a monthly self-administered questionnaire, and objectively, by examining a seven-day stool collection at the end of each treatment period. In terms of a pain score, lower bowel symptom score (the pain score and sensation of incomplete emptying, straining, stool consistency, flatus, and aperients taken), and total symptom score (belching, nausea, vomiting, dyspepsia, and abdominal distension) fibre supplementation conferred no benefit. Symptoms of constipation, however, when assessed alone, were significantly relieved. Both fibre regimens produced the expected changes in stool weight, consistency, and frequency. It is concluded that dietary fibre supplements in the commonly used doses do no more than relieve constipation. Perhaps the impression that fibre helps diverticular disease is simply a manifestation of Western civilisation's obsession with the need for regular frequent defecation.
Stools have been tested for occult gastrointestinal bleeding in 278 outpatients and 170 hospital inpatients using the Haemoccult and Haemastix methods. Seventeen outpatients (6.1%) and 42 inpatients (24%) were positive with the Haemoccult technique. Thirty-three outpatients (11.9%) and 93 inpatients (54.7%) were positive with the Haemastix test. Following investigation of the Haemoccult-positive patients, only 2 cases (3.4%) were considered false positive. However, the false positive rate with Haemastix was 22.9% which is unacceptable in a screening test. Haemoccult may be useful as a screening test for asymptomatic general practice patients, but a test of greater sensitivity is needed for hospital patients.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Fifty obese patients were givena 1.34 MJ (320 kcal) formula diet (containing 44 g/day carbohydrate, milk protein supplying 24--29 g protein/day in a total of 31 g/day, fat 2 g/day and the RDA of minerals and vitamins) for four to 12 weeks, either as inpatients (22) or outpatients (28). This regime was followed by a 3.35 MJ (800 kcal) conventional diet as outpatients. All but six outpatients completed the trial. Substantial weight losses were achieved in all patients with a total mean loss of 8.4 kg at four weeks and 11.0 kg at eight weeks. At four weeks the mean weight loss was 9.6 kg for inpatients and 7.2 kg for outpatients (P less than 0.05). There was no statistical difference in weight between the groups at eight weeks. Patients who continued on the 1.34 MJ formula diet for 12 weeks continued to lose weight but those on the 3.35 MJ conventional diet did not. Nitrogen-balance studies were carried out on the inpatients. During the first four weeks there was a small net loss of nitrogen (56 g, equivalent to 350 g protein) but equilibrium was achieved by the fifth or sixth week. There was no evidence of protein deficiency as judged by unchanged serum total protein, albumin, haemoglobin, RBC and PCV. Equilibrium between intake and excretion of sodium and potassium was also achieved throughout, and serum electrolytes were unchanged. A large number of other routine clinical and laboratory tests showed the treatment was safe. Serum bilirubin was elevated (18--48 per cent) and increased slightly above normal in two outpatients. Serum cholesterol was decreased by 21 per cent and triglycerides by 45 per cent after three weeks. Serum lipids in hyperlipaemic patients were normalised. It is concluded that the very-low-calorie formula diet provides a safe and very effective method of weight reduction, and the advantages of hospital compared with outpatient treatment are small.