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Biomedical subjects

H J Thomson

Publications and source records attributed to H J Thomson.

At least 19 recordsLinked to original sources
PubMed1997

The effect of breakfast on minor anal complaints: a matched case-control study.

With the objective of exploring the association between breakfast and minor anal complaints, an age, sex and pregnancy matched case-control study was carried out in the out-patient clinics at Birmingham Heartlands Hospital. Patients were selected after personal interviews using a structured questionnaire in out-patient clinics. Information on age, sex, occupation and breakfast habits, as well as on haemorrhoids and anal fissure, was obtained. Patients who had haemorrhoids or anal fissure were placed in the case group; the remainder were controls. Any patient with diverticulosis, inflammatory bowel disease, colon cancer or bowel resection for any reason was excluded from the study. The main outcome measures were the odds of developing haemorrhoids or fissure in patients who did not eat breakfast. The results are based on 47 cases that were age, sex and pregnancy matched. Of the case group, 36% did not eat breakfast, compared with 11% in the control group. The analysis demonstrated a 7.5-fold increase in the odds of suffering from haemorrhoids or anal fissures in matched subjects who did not eat breakfast, with a very high level of significance (P = 0.0036). This indicates that there is a very strong association between failure to eat breakfast and haemorrhoids or anal fissure. It is anticipated that educating the public to eat breakfast would lead to a long-term fall in the incidence of anal complaints, in the attendant morbidity for the patients and in the cost to the health service.

Adolescent↗
PubMed1993

Exogenous neuropeptide Y blocks myoelectric activity in the upper gastrointestinal tract of starved dogs. Brain neuropeptide Y converts a fasting pattern of myoelectric activity to a fed pattern.

The effect of intracerebroventricular (ICV) neuropeptide Y (NPY) on the migrating motor complex (MMC) was examined in five starved dogs. Myoelectric activity was recorded using gastric, duodenal, and jejunal electrodes. Intragastric pressure was monitored via a gastric fistula, and ICV injections were given through a cerebroventricular guide. Recordings were made with no ICV injection and before and after 250-microliters bolus injections of vehicle as control (0.1% dog serum albumin in saline) or 500 pmol/kg NPY. The mean interval between MMCs was 98 +/- 10 min without ICV injection and 96 +/- 7 min after control solution. After ICV injection of NPY no further MMCs were recorded in any dog, even though the study was continued for a minimum of 3.5 h. Instead, the myoelectric pattern became indistinguishable from that in fed dogs. We conclude that central NPY plays a role in modulation of upper gastrointestinal myoelectric activity. This may reflect a central regulatory role for NPY in the coordination of feeding.

Animals↗
PubMed1993

Informed consent: a case for more education of the surgical team.

A questionnaire was given to 37 members of staff of the Department of Surgery, Addenbrooke's Hospital, Cambridge, in order to determine whether their knowledge was adequate to give accurate information to patients regarding operations and thus to obtain properly informed consent for that operation. Each participant was asked to estimate the 24-h and 30-day mortality for five common elective operations. A wide range of answers was given for operations by all groups. Estimates of 24-h mortality after unilateral inguinal herniorrhaphy differed between staff grades by a factor of 3, but estimates of 24-h mortality after thyroidectomy differed by a factor of 100 between consultant surgeons and staff nurses. Our findings suggest that some members of the surgical team have insufficient knowledge about common operations to obtain properly informed consent from patients.

General Surgery↗
PubMed1992

CT-guided drainage of pelvic abscesses: the peranal transrectal approach.

Five patients with deep pelvic abscesses underwent computed tomography (CT)-guided catheter drainage using a transrectal approach. The use of an outer removable plastic sheath over the catheter to facilitate positioning and prevent inadvertent damage to the mucosal wall is described. This new approach using CT guidance is discussed and the alternative routes reviewed.

Abscess↗
PubMed1992

Intracerebroventricular neuropeptide Y stimulates bile secretion via a vagal mechanism.

UNLABELLED: The effect of intracerebroventricular injection of neuropeptide Y on biliary secretion was studied in conscious dogs, prepared with gastric and duodenal fistulas and cerebroventricular guides. Bile secretion was increased in a dose-dependent fashion by intracerebroventricular neuropeptide Y. The peak increase was seen after 500 pM/kg of neuropeptide Y which resulted in a 30 x 2% increase in bile flow over the period 30-150 minutes after injection. ( CONTROL: 23 x 2 (1 x 2) ml/2 hours; neuropeptide Y 500 pM/kg: 30 x 5 (1 x 1) ml/2 hours). Biliary lipid composition was not altered significantly but bicarbonate output was increased at all doses tested. Intravenous infusion of neuropeptide Y (1000 pM) for 1 hour had no significant effect. Intracerebroventricular neuropeptide Y (1000 pM/250-300 mg body weight) also increased bile flow in urethane-anaesthetised rats. This effect was abolished by cervical vagotomy. The demonstration of a central stimulation of alkaline bile flow suggests that bile secretion may be subject to central modulation.

Animals↗
PubMed1987

Submucosal collagen changes in the normal colon and in diverticular disease.

Full thickness specimens of normal colon (n = 15), and colon from patients with diverticular disease (n = 5) were obtained at operation or autopsy. In the isolated submucosa the ultrastructure of the constituent collagen fibres was examined by transmission electron microscopy. Collagen fibrils in the left colon become smaller (p less than 0.001) and more tightly packed (p less than 0.001) than those in the right colon with increasing age. This difference is accentuated in diverticular disease (p less than 0.01). Factors which contribute to the development of colonic diverticulosis, such as raised intraluminal pressure, may be responsible for premature change in submucosal structure.

Adolescent↗
PubMed1987

Diagnosis of acute pancreatitis: a proposed sequence of biochemical investigations.

In 60 controls and 108 patients admitted with acute abdominal pain, Rapignost urinary amylase correctly identified (++) 18 of the 23 patients with acute pancreatitis (AP), with 8 results being equivocal (+), and 1 false negative. This is a suitable screening test for AP, but an equivocal result requires further investigation. In 14 patients with AP the serum amylase was over 1000 U/l with no false-positive results, whereas when 316 U/l was used as the diagnostic threshold, 22 cases were identified (but with 2 false positives). Serum lipase was 100% sensitive in the diagnosis of AP, but there were three false-positive results.

Acute Disease↗
PubMed1986

Active observation in acute abdominal pain.

Only a minority of patients admitted with acute abdominal pain require urgent operation, but the identification of those who need an operation may be difficult. Many surgeons adopt a radical approach and operate when the diagnosis is doubtful, which often leads to 20 percent rate of negative findings on laparotomy. In this study, 220 patients of all ages admitted with acute abdominal pain were studied prospectively, and when the diagnosis on admission was uncertain, a policy of active observation was employed. In all, 39 percent of the patients underwent operation and only 5 percent had negative findings on laparotomy. No patient suffered as a result of this policy, which is recommended as a safe and effective approach to the management of acute abdominal pain.

Abdomen↗
PubMed1986

Endoscopic pancreatography in cystadenoma of the pancreas.

A case of mucinous cystadenoma of the tail of the pancreas is reported in which endoscopic retrograde cholangiopancreatography was used to define the surgical anatomy prior to operation. The demonstration of a normal proximal main duct allowed simple ligation of the body of the gland when the tail was excised.

Adult↗
PubMed1985

Surgical aspects of intestinal injury due to pelvic radiotherapy.

Seventy-one patients with intestinal injury secondary to pelvic irradiation had predominantly large bowel lesions. Seventeen cases were treated conservatively and 54 came to surgery, 28 patients having more than one operation. Following this essentially salvage surgery there were more ileal than colonic anastomotic leaks. Thirty-four patients died during the follow-up period (2-12 years), 19 from recurrent malignancy, and nine as a result of continuing radiation effects. Seventy per cent of the patients who had a radiation fistula died as a result of malignancy. Of 42000 cases of pelvic malignancy treated by irradiation over the decade 1972-1982, surgical referrals for complications constituted 1.7%, with an overall radiation-related mortality of 0.2%. It is our opinion that colostomy alone has little part to play in this condition, and a policy based on excisional surgery is suggested.

Adult↗