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Biomedical subjects

G M Roberts

Publications and source records attributed to G M Roberts.

At least 37 records · Page 2Linked to original sources
PubMed1989

Oesophageal tears during pneumatic balloon dilatation for the treatment of achalasia.

Fifty-eight contrast studies of the oesophagus, performed in patients shortly after balloon dilatation for the treatment of achalasia, were reviewed for evidence of perforation. Forty-nine examinations (85%) were normal and nine studies (15%) were abnormal. Three main radiological patterns were observed. Complete rupture of the oesophagus occurred in two cases. Incomplete tears of the oesophageal wall were present in seven cases: in one patient there was a linear mucosal tear while in six patients there was a localised outpouch or diverticulum. All patients with abnormal contrast studies were successfully managed conservatively. The range of radiological appearances of the distal oesophagus following balloon dilatation should be recognised to avoid unnecessary surgical intervention.

Adolescent↗
PubMed1989

Radiologists and endoscopy: a survey of the attitudes and intentions of radiologists in training.

A postal survey of senior registrars in radiology in this country was carried out to assess attitudes towards radiologists taking part in endoscopy services. One hundred and ninety-six senior registrars from 37 training centres recognised by the Royal College of Radiologists completed the questionnaire (a response of 74%). Thirty-nine per cent of respondents had some practical experience of endoscopy before commencing training in radiology. Twenty-eight per cent of respondents declared a major interest in gastrointestinal radiology. Sixty four per cent felt that radiologists should perform endoscopy (87% in the case of those with a major interest in gastrointestinal radiology). Thirty-seven per cent were interested in providing, or participating in, an endoscopy service after obtaining a consultant post. Despite this level of interest, only 18% of respondents felt that they had adequate access to endoscopy training and only 3% were aware of the training recommendations of the British Society, of Gastroenterology.

Attitude of Health Personnel↗
PubMed1988

Clinical outcome of fetal uropathy.

Thirty seven infants (27 boys and 10 girls) whose uropathy had been diagnosed antenatally were reviewed at a mean age of 24.4 months. Antenatal ultrasonography was found to be an accurate detector of renal disease, as uropathy was subsequently confirmed in 33 of the 37 infants (89%). A smaller proportion of patients required operations than in other series reported. Shortly after birth the kidney undergoes physiological adjustments and investigation may be carried out too soon. It should be delayed, especially if the infant is well. The timing of postnatal ultrasonography is important and the advice of a paediatric urologist should be sought before investigations are carried out.

Female↗
PubMed1988

Cardiff Crohn's disease jubilee: the incidence over 50 years.

The incidence of Crohn's disease in Cardiff between 1931 and 1985 has been examined using hospital diagnostic indices supplemented in recent years by records from clinicians, and the departments of pathology and radiology. Four hundred and seven new patients were confirmed after all notes had been reviewed. There has been a large increase from 0.18 cases/10(5) of the population per year in the 1930s to current values of 8.3/10(5)/year. The incidence continues to rise and shows an increasing proportion of patients with colorectal disease. Peak age specific incidences occur in the third and eighth decades of life.

Age Factors↗
PubMed1987

Out-of-hours radiology: a suitable case for audit?

An outline of radiological activity outside normal working hours over a 2-month period in a teaching hospital is presented. A 100-fold variation between specialties in the number of requests per 100 discharges and deaths is shown. Specialties with a high out-of-hours radiology demand also tended to have a high overall demand. Chest and abdomen radiographs accounted for approximately 82% of all investigations undertaken during the period of observation. Six radiological investigations--chest and abdomen radiographs, computed tomography, skull radiographs, intravenous urography and cardiac catheterisation--accounted for approximately 94% of all out-of-hours investigations. There was a 5.6-fold variation between investigations in the time taken to carry out one standard unit of work. In the health authority studied, it was estimated that pounds 93,000 was spent on radiographers' out-of-hours payments in 1984/85, of which almost 90% was directly related to the number of radiological procedures undertaken. It is suggested that the wide variation in rates of out-of-hours radiology usage between specialties requires more detailed examination. The limited range of procedures accounting for the great majority of the out-of-hours work makes a study feasible. The very marked variation in the time taken for one unit of work may result in important financial distortions if clinical budgeting becomes more widespread. The large excess cost of out-of-hours radiological investigations, which may be as much as pounds 16,000,000 per annum in England and Wales, offers the possibility of substantial savings if some of the investigations are shown to be of little clinical value outside normal working hours.

Appointments and Schedules↗
PubMed1986

A rapid and reliable method for extraction and assay of tricyclic antidepressant drugs in serum or plasma.

Because of their narrow therapeutic ranges and differing patient tolerances, the monitoring of tricyclic antidepressants (TADs) commonly prescribed for control of endogenous depression is highly desirable for the satisfactory treatment of patients. The majority of methods for analysis of TADs require multiple extractions from plasma with organic solvents, accompanied by obligatory centrifugation steps. We describe a simple procedure for the rapid extraction of serum TADs, with high recovery of the analyte drugs. It involves sample preparation using Analytichem 'BOND-ELUT' C-2 reverse phase columns, and analysis by gas chromatography using a nitrogen-phosphorus detector. The method offers a quick, inexpensive and low-maintenance assay which is applicable to all the common tricyclic class drugs.

Antidepressive Agents, Tricyclic↗
PubMed1985

Increased plasma glycosidase and protease activity in uraemia: possible role in the aetiology of the anaemia of chronic renal failure.

We have measured plasma N-acetyl-beta-D-glucosaminidase (EC 3.2.1.30) and neuraminidase (EC 3.2.1.18) activities as markers of glycosidase activity and immunoreactive trypsin (EC 3.4.21.4) levels as a marker of proteolytic potential in the plasma of normal and uraemic subjects. The levels of all of these enzymes are significantly elevated in the plasma of uraemic subjects when compared to normal. We have postulated that the combined attack of glycosidases and proteases on erythropoietin will lead to fragmentation of this glycoprotein hormone with loss of activity. This may be a major contributory cause to the anaemia of chronic renal failure.

Acetylglucosaminidase↗
PubMed1985

The radiological appearances of the oesophagus after sclerotherapy for varices.

Fifteen patients, whose oesophageal varices had been obliterated by injection sclerotherapy, were examined by double-contrast barium swallow. In nine patients (60%) the oesophagram was abnormal and demonstrated sharp-edged, longitudinal tramline filling defects and an irregular, patchy nodularity with loss of the normal longitudinal folds. These appearances represent redundant epithelial folds, epithelial tags and healed ulcers produced by endoscopic sclerotherapy.

Adult↗
PubMed1984

Oral cholecystographic contrast media--a comparative study.

Three oral cholecystographic contrast media have been compared, mainly with regard to their ability to outline the gall bladder and also the frequency of undesirable side-effects that they produce. No significant differences were found between the media, and the final choice of a suitable medium for use in X-ray departments may depend on their relative cost. In times of financial restraint, such a decision might increasingly involve hospital pharmacists.

Administration, Oral↗
PubMed1983

Renal papillary necrosis in haemophilia and christmas disease.

Haematuria is common in haemophilia and Christmas disease. A variety of radiological abnormalities in the urinary tract has been described in the literature, the commonest being hydronephrosis and obstructive uropathy. The findings in 26 cases seen in this centre were reported by Beck and Evans in 1972; although urinary-tract obstruction was relatively common, it was noted that signs suggestive of renal papillary necrosis (RPN) were present in some cases. In the present study, 20 of these patients were reinvestigated up to 10 years after the original radiological studies; a total number of 46 past and present intravenous urograms were examined. There was evidence of RPN in 11 of the 20 patients, and in five of these the signs had changed over the intervening period. The relevance of these findings is discussed; none of the patients showed evidence of renal failure. It is suggested that episodes of urinary-tract obstruction could be related to papillary sloughing, in some cases, rather than clot obstruction or obstruction due to retroperitoneal bleeding.

Adult↗
PubMed1981

Gastric-juice enzymes--an aid in the diagnosis of gastric cancer?

Lactic dehydrogenase (LDH) and beta-glucuronidase concentrations were measured in the resting gastric juice of 113 patients presenting with dyspepsia. All patients were investigated by double-contrast barium meal, endoscopy with biopsy, and, when appropriate, by laparotomy. In all patients tested there was a positive correlation between LDH and beta-glucuronidase concentrations. An index derived from the two enzyme activities correctly predicted the presence of gastric carcinoma in 41 out of 42 cases, and identified the only 2 cases of early gastric cancer in the series. There were 13 (11.5%) false-positive results, all in cases with extensive intestinal metaplasia, a change which may be associated with an increased risk of gastric malignancy. The measurement of gastric-juice enzymes is useful in the diagnosis of gastric cancer and may be of value in the identification of high-risk groups. The test is easily performed, inexpensive, and reproducible.

Clinical Enzyme Tests↗
PubMed1981

Diazepam interaction with antituberculosis drugs.

The influence of antituberculosis drugs on diazepam disposition was assessed in a series of volunteers and patients who received single intravenous doses of diazepam. In study 1, nine healthy subjects received diazepam in the drug-free control state and again during treatment with isoniazid (INH), 180 mg/day. INH did not alter diazepam volume of distribution (Vd) or protein binding, but prolonged mean elimination half-life (t1/2) from 34 to 45 hr (p less than 0.02), and reduced total clearance from 0.54 to 0.40 ml/min/kg (p less than 0.02). In study 2, diazepam disposition in a group of seven tuberculous patients on triple therapy with INH, ethambutol (EMB), and rifampin (RIF) was compared with that in healty drug-free controls matched for age and sex. Diazepam Vd and protein binding were nearly identical between groups, but mean t1/2 among patients (14 hr) was significantly shorter than in controls (58 hr, p less than 0.01) and total clearance correspondingly increased (to 1.50 from 0.37 ml/min/kg, p less than 0.01). Study 3 compared six newly diagnoses tuberculous patients receiving initial therapy with EMB alone with age- and sex-matched controls. Diazepam unbound fraction in patients tended to be higher than in controls, and diazepam Vd and clearance tended to be lower but the differences were not statistically significant. Thus, diazepam clearance is impaired and t1/2 prolonged by administration of INH alone. Markedly increased clearance and shortened t1/2 in triple-therapy patients is probably due to enzyme-inducing effects of RIF. Dosage of diazepam may require adjustment in patients with tuberculosis on chemotherapy.

Adult↗
PubMed1980

Gastroduodenal erosions in Crohn's disease.

Gastroduodenal erosions were observed endoscopically and shown by double-contrast radiology in nine of 38 patients who had established Crohn's disease elsewhere in the intestinal tract. One of the nine patients was known to have duodenal involvement by Crohn's disease, but in the other eight there was no clinical suspicion of upper gastrointestinal disease. The possible significance of this finding is discussed.

Adolescent↗
PubMed1980

Radiology of the pelvis and hips in adults with Down's syndrome.

In a radiological study of the pelvis in 66 adult subjects with Down's syndrome, 25 (38%) were found to have the classical pelvic sharpe associated with Down's syndrome in infancy and childhood. The appearance of the pelvis and hip joints was very variable and matched the variety of appearances seen in normal subjects, except that generally the pelvis was smaller than normal. The discriminating value of the iliac index (which is abnormal in up to 80% of affected infants) was lost in this group of affected adults. Subluxation and osteoarthrosis of the hips were very uncommon features. In addition to the primary morphological abnormalities in the pelvis in Down's syndrome that are described in the literature, posture probably plays a part in producing the variable radiological appearances of the pelvis.

Adult↗
PubMed1978

Comparison of barium swallow and left gastric angiography in the diagnosis of esophageal varices, with special reference to the management of variceal bleeding.

Seventy-five patients with portal hypertension and esophageal varices were studied by means of barium swallow and selective left gastric angiography. The relative merits and limitations of these techniques in demonstrating the presence, extent, and severity of the varices are discussed, with reference to the selection of patients for prophylactic transection of the esophagus to prevent bleeding from the varices.

Adolescent↗