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Biomedical subjects

H Adams

Publications and source records attributed to H Adams.

At least 73 records · Page 4Linked 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

The sonographic features and implications of fetal pleural effusions.

Pleural fluid was detected by ultrasound in three fetuses as an anechoic area surrounding the echogenic fetal lung. In one fetus the underlying lung was small, immobile and of abnormal contour; death occurred in the neonatal period and the lung was found to be hypoplastic. In two other fetuses the lungs appeared sonographically normal, being mobile with normal contours. Both survived, one following spontaneous intra-uterine resolution of the effusion and the other after early neonatal intervention prompted by the antenatal diagnosis. Sonography can detect pleural fluid in utero and may permit differentiation between normal underlying lung and pulmonary hypoplasia. We recommend serial scanning to detect early adverse effects of pleural effusion upon the fetus and to plan management changes.

Adult↗
PubMed1986

Clinical and pathological aspects of human African trypanosomiasis (T. b. gambiense) with particular reference to reactive arsenical encephalopathy.

Fourteen of 330 patients treated with melarsoprol (Mel B) for human African trypanosomiasis (HAT) developed a severe reactive arsenical encephalopathy (RAE). Six of these cases were fatal and postmortem examination was performed on 5 patients. Symptoms of "sleeping sickness" were compared with symptoms after treatment with arsenicals and the subsequent onset of RAE. There are 3 characteristic syndromes of RAE: convulsive status associated with acute cerebral edema, rapidly progressive coma without convulsions, and acute nonlethal mental disturbances without neurological signs. Three subjects revealed hypoxic brain damage with acute cerebral edema, and multiple hemorrhages of brain stem in those comatose. The pathology of the underlying HAT (chronic perivascular inflammation and plasma cytic infiltration of the brain) and the pathology of the RAE (characterized by acute vasculitis) are distinct. RAE occurs in the first as well as in the second stage (CNS involvement) of trypanosomiasis but the reason for this is unclear; an exclusive toxicity of the drug, or a Herxheimer reaction are possible but seem unlikely. Both clinical and laboratory findings point rather to a drug-related, delayed immune response.

Animals↗
PubMed1984

Fatal self-poisoning with benoxaprofen.

A report of the first fatal self-poisoning due to primary toxicity of benoxaprofen. Benoxaprofen is toxic in acute overdosage to the central nervous system, myocardium and kidneys, but appears to spare the liver.

Anti-Inflammatory Agents↗
PubMed1981

An interactive graphic database microcomputer for clinical control in data intensive therapies.

Experiments showed a small computer could improve access to large concentrations of clinical data in renal dialysis and transplantation and enhance the clinical feedback loop which controls substitute renal function. Interactive access adds a sub-loop which allows close adaptation to clinical use. Prototype software was transferred to an LSI-11 microcomputer with 20 Mbyte cartridge discs, multiple remote VDUs and video graphic displays and printer-plotter. Data capture is both manual and by automatic transfer from laboratory computers. Push-button interaction displays clusters of data, including computed functions, as graphs and tables on variable time scales. programmed scans generate data-base analyses. The system reconfigures for individual sites. The microcomputer version has run routinely for a year and proved a practical tool at acceptable cost. Down-time has been small but strongly resented by medical and nursing staff. The system can accommodate 750 patients, but has also been 'stretched' for an oncology laboratory and configured for other specialities.

Computers↗
PubMed1978

A survey of admissions and deaths in a black paediatric department.

Patterns of paediatric illness in hospital were surveyed with a view to planning for improved community health services. High morbidity and early mortality from neonatal, nutritional, gastro-intestinal and respiratory disease reflected late referral to hospital of seriously ill children. Combined preventive, promotive and primary care clinics, health education and improved transport facilities for the sick are a high priority for the area.

Black or African American↗
PubMed1978

Neonatal Listeria monocytogenes meningitis. A case report.

The clinical presentation, bacteriological results, treatment, and outcome of Listeria monocytogenes meningitis in a newborn infant are described. The neonatal listeriosis was of the late-onset variety, and the infant survived the infection, but hydrocephalus, which necessitated operative relief, developed. Although 2 cases of Listeria meningitis have previously been described in South Africa, and opportunistic listeriosis is known to occur here, this is apparently the first documented case of neonatal listeriosis in this country.

Child, Preschool↗
PubMed1977

Spectinomycin versus tetracycline for the treatment of gonorrhea.

Spectinomycin and tetracycline are alternative drugs to penicillin in the treatment of gonorrhea. To compare the efficacy of these agents and their propensity to select resistant gonococci, we treated 4043 patients randomly with either 2 or 4 g of spectinomycin once or 9 g of oral tetracycline for four days. Minimum cure rate for anogenital gonorrhea was 94 per cent with either drug. Oropharyngeal infection responded poorly to spectinomycin in men, with failure of therapy in six of 11. Postgonococcal urethritis in men was less common after tetracycline than after spectinomycin (P less than 0.005). Spectinomycin failure was not related to drug resistance. Tetracycline failure correlated with resistance (P less than 0.0002); one fifth of the isolates resistant to 1.0 mug per milliter of tetracycline were not eradicated. For several reasons, including the appearance of beta-lactamase-producing gonococci, it is no longer clear that penicillin G is the "drug of choice" for gonorrhea. Spectinomycin and tetracycline are equally acceptable alternatives, each with distinct advantages and disadvantages.

Administration, Oral↗
PubMed1977

Diffuse brain damage of immediate impact type. Its relationship to 'primary brain-stem damage' in head injury.

In a neuropathological analysis of 151 fatal non-missile head injuries, there were 19 cases with focal lesions in the dorsolateral quadrant of the brain-stem in the corpus callosum, and histological evidence of diffuse damage to white matter. Eight of these cases had not experienced a high intracranial pressure during life. All 19 cases had been rendered unconscious at the moment of impact and had remained so or in the persistent vegetative state until death. It is therefore concluded that diffuse damage to white matter may occur as a primary event at the moment of impact, that is, it is one type of immediate impact damage to the brain. It is also concluded that this type of damage is the pathological basis of 'primary brain-stem injury' since in no patient thought clinically to have sustained 'primary brain-stem injury' were abnormalities confined to the brain-stem. Since no patient with this type of brain damage recovered consciousness after injury, it is probable that diffuse damage to white matter is the most important single factor governing the outcome in a patient who sustains a non-missile head injury.

Adolescent↗