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Biomedical subjects

G E Thomas

Publications and source records attributed to G E Thomas.

At least 37 records · Page 2Linked to original sources
PubMed1980

Survey of management in acute upper gastrointestinal haemorrhage.

The answers to a questionnaire concerning attitudes of members of the British Society of Gastroenterology to the management of acute upper gastrointestinal bleeding are analysed. In the majority of cases patients were admitted to general wards under the care of physicians. Use of intensive therapy units and venous pressure monitoring varied widely. Emergency endoscopy appeared readily available and was usually the first diagnostic procedure. Double contrast radiology and emergency angiography were available in relatively few centres. Specific nonoperative treatments (angiographic and endoscopic) were scarcely employed. Most respondents agreed that elderly patients fared badly, but there was little agreement concerning other factors which influence re-bleeding or outcome. There was a wide divergence of opinion concerning the need for surgical intervention in certain hypothetical clinical situations. Despite the difficulties involved, we believe that controlled trials are necessary to improve the management of bleeding patients.

Acute Disease↗
PubMed1977

Cirrhosis of the liver in Rhodesian Blacks.

Thirty-five Black patients with cirrhosis of the liver were admitted to the professorial unit over a 1-year period and were included in a carefully planned prospective study. Men predominated over women in a ratio of 3:1. Alcohol consumption in the form of African beer was significantly higher in cirrhotic patients than in a control population. The clinical picture was neither predominantly that of alcoholic nor of cryptogenic cirrhosis. Hepatomegaly, porphyria cutanea tarda, ascites, splenomegaly and oesophageal varices were common. There was a complete absence of gynaecomastia, spider naevi and liver palms. Histologically, the majority of patients had macronodular cirrhosis, and only 1 patient had micronodular cirrhosis and minimal fatty change. Hepatitis B surface antigen (HbsAg) was not detected in any patient, despite a positive HbAg rate of 4% in Black African blood donors, determined by means of the same laboratory technique.

Adult↗
PubMed1977

Advantages of the plasma uptake method for measuring vitamin B12 absorption.

The plasma uptake method for determining vitamin B12 absorption is reassessed. The results of this study demonstrate the ease with which normal controls can be separated from patients with intestinal malabsorption of vitamin B12 and from those with pernicious anaemia. This method is also shown to be a sensitive index of improved vitamin B12 absorption after treatment of small-intestinal disease and with the addition of intrinsic factor in pernicious anaemia. The advantages, particularly for developing countries, over the more commonly used Schilling test are discussed. It is emphasized that, because of the lack of a universally accepted normal value, healthy controls should be studied to define the normal range for the community under investigation.

Anemia, Pernicious↗
PubMed1977

Small bowel ischaemia and infarction in young women taking oral contraceptives and progestational agents.

Case histories of three young women who suffered small bowel infarction associated with oral contraceptives and progestational agents are presented. Two infarctions were due to superior mesenteric artery thrombosis and one to superior mesenteric vein thrombosis. All of these patients were of blood group A and smokers, factors which are known to predispose to vascular thrombosis. A study was made of 18 additional cases reported in the literature. It was found that many of these cases presented with a history of symptoms of 2 weeks of more and at operation some of the cases appeared to be reversible. One case was reported where apparent reversion of the process of vascular thrombosis occurred after cessation of the oral contraceptive.

Adult↗
PubMed1977

Hepatocellular carcinoma in the Rhodesian African.

We have carried out a prospective survey of 28 primary liver carcinomas over one year. Hepatocellular carcinoma is the commonest malignancy seen in Rhodesian blacks, which results in a high index of suspicion and accounts for the 96.4% positive diagnosis before death in this study. The age distribution was evenly spread through adult life with no definite peak incidence. Some were young and without evidence of chronic liver disease, but many had the stigmata of established hepatic disease. This contrasts with the common assertion that in areas of high incidence for primary liver cancer those affected are mainly young and lack signs of chronic liver disease. The commonest presenting symptoms were abdominal pain and swelling and weight loss. Hepatomegaly, often tender and nodular, was present in all but one. The incidence of alpha-feto protein, 46.5%, is low compared with other countries where primary liver cancer is common. Hepatitis B antigen was absent in all 28, suggesting that there is no association between the persistence of the antigen and hepatocellular carcinoma in Rhodesia. Liver function tests, although abnormal, were never diagnostic of primary liver cancer. We have confirmed the association of high alcohol consumption and cirrhosis with hepatocellular carcinoma.

Adult↗
PubMed1977

Polyarteritis nodosa of the liver: a report of two cases.

Two patients with liver disease due to polyarteritis nodosa are described. They presented in a similar manner, with a swinging fever, a polymorphonuclear leucocytosis and high alkaline phosphatase levels, but the natural history of the illness was different, with revocery in one and death in the other.

Aged↗
PubMed1977

Vaginal vault reconstruction.

This report describes a new surgical technic for vaginal vault reconstruction performed on 116 patients either at the time of vaginal hysterectomy or in cases of post-hysterectomy vault suspension for vault prolapse. The repair maintains and restores proper vaginal vault support, preserves or increases overall vaginal length and preserves the proper angle of the vaginal canal. High extraperitoneal plication of the uterosacral ligaments is used to prevent enterocele, and provides hammock-like support of the vaginal vault. The paracervical fascia of the vaginal cuff is closed transversely in the midline rather than anterior-posteriorly.

Female↗
PubMed1975

Comparison of fibreoptic endoscopy in acute upper gastrointestinal haemorrhage in Africans and Europeans.

The results of endoscopy in acute upper gastrointestinal haemorrhage were compared in a group of 138 Africans and one of 84 Europeans. Contrary to widely held clinical opinion, the incidence of gastric and duodenal ulceration was similar in the two races. Peptic ulcers were the main source of bleeding in both groups and were surprisingly more common than varices in the Africans. Bleeding from varices, however, was far more common in the Africans than in the Europeans. Stomal ulcers were confined to Europeans. Gastric erosions, often attributed to herbal medicines, were more common in the Africans but the difference was not significant. The study was not designed to determine reduced mortality since the introduction of endoscopy, but management, especially in the Africans, was aided by early recognition of haemorrhage from oesophageal varices and acute gastric erosions.

Adolescent↗
PubMed1975

Airborne infection in a fully air-conditioned hospital. IV. Airborne dispersal of Staphylococcus aureus and its nasal acquisition by patients.

Studies in a newly built hospital furnished with complete air conditioning where most of the patients are nursed in 6-bed rooms showed that the transfer of air from one patient room to another was very small, especially when there was substantial flow of air in a consistent direction between the patient rooms and the corridor, and that the direct transfer of airborne particles was even less. There was, however, no evidence of any reduction in the rates of nasal acquisition of Staphylococcus aureus compared with those to be found in naturally ventilated hospitals. The numbers of Staph. aureus found in the air of a given room that appeared to have originated from patient carriers in other rooms were many times greater than could be accounted for by direct airborne transfer. Although there was evidence that many carriers were not detected, detailed study showed that this excess transfer to the air of other rooms was genuine. It seems probable on the basis of investigations in this hospital and elsewhere that this excess transfer occurs indirectly, through dispersal from the clothing of the nursing and medical staff into the air of another room of strains with which their outer clothes have become contaminated while dealing with patients. Reduction in direct airborne transfer of micro-organisms from one room to another, whether by ventilation or other means, can only be of clinical advantage if transfer by other routes is, or can be made, less than that by the direct airborne route.

Adult↗
PubMed1975

Gastrointestinal phytobezoars in Africans.

Fourteen gastrointestinal phytobezoars are presented. There have not been previous reports in Africans. Eleven were gastric and mimicked wither peptic ulceration or carcinoma of the stomach. The classical barium meal appearance of a mobile filing defect was present in the majority but a confident diagnois of carcinoma of the stomach was made in two cases in whom fiberoptic endoscopy established the correct diagnoisis. The bezoars were composed of vegatable material from either a tuber or rhizome. Three ileal bezoars presented with acute intestinal obstruction; two were probably the result of incompletely masticated maize porridge.

Adult↗