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Biomedical subjects

I Francis

Publications and source records attributed to I Francis.

54 records · Page 3Linked to original sources
PubMed1982

Sonographic findings in perforation of the gallbladder.

The sonographic findings in 13 patients with proven gallbladder perforation are described. Two patients were scanned immediately before and after gallbladder perforation. The sonographic findings before gallbladder perforation were gallbladder distension (one case) and gallbladder wall edema (one case). Pericholecystic collections develop after gallbladder perforation. These collections have a varied sonographic appearance ranging from anechoic to complex collections, and their internal characteristics seem to depend on the duration of the pericholecystic process. The residual gallbladder lumen or calculi can be identified within or peripheral to the pericholecystic process. The most acceptable mechanism for perforation of the gallbladder is: (1) impaction of a calculus in the cystic duct; (2) gallbladder distension due to secretion into its lumen by mucous glands located in the walls of the gallbladder; (3) vascular impairment of the gallbladder due to distension of the viscus; and (4) ischemia, necrosis, and perforation of the gallbladder wall. Gallbladder perforation is a significant complication of acute cholecystitis associated with morbidity and mortality. Detection of this complication of acute cholecystitis by clinical means is difficult since the patient's symptoms are similar to those of uncomplicated acute cholecystitis. The inherent resolution of sonography offers an excellent display of the gallbladder and surrounding tissues allowing detection of pericholecystic collection secondary to gallbladder perforation.

Abscess↗
PubMed1981

Genetic screening of newborn in Australia: results for 1979.

Since screening of newborn infants for phenylketonuria (PKU) by Guthrie bacterial inhibition assay was established in the 1960s, 2 556 498 infants have been tested in Australia. Two hundred and twenty-two cases of PKU, and five cases of the variant forms of malignant hyperphenylalaninaemia (MHPA) have been found over this period, an incidence of 1/11 516 for PKU, and 1/511 300 for MHPA. In 1979, 18 infants with PKU and one with MHPA were detected. Screening for congenital hypothyroidism was carried out in four centres, and 28 new cases were detected in 1979 (an incidence of 1/5746).

Australia↗
PubMed1979

Genetic screening of the newborn in Australia. Results for 1978.

Since screening of newborn infants for phenylketonuria (PKU) by Guthrie bacterial inhibition assay was established in the 1960s. 2 334 679 infants have been tested in Australia, and 208 cases of PKU detected (an incidence of 1/11 224). In 1978, 21 infants with PKU were detected. Screening for hypothyroidism was carried out in three States, and 29 cases of congenital hypothyroidism were detected in 1978 (an incidence of 1/5894).

Australia↗
PubMedDate not supplied

Delta-F508 cystic fibrosis mutation is not linked to intussusception: implications for rotavirus vaccine.

OBJECTIVE: To determine whether the cystic fibrosis (CF) delta-F508 gene mutation predisposes to intussusception, and so selects infants who should not receive rotavirus vaccine. METHODS: Stored neonatal screening blood spots, retrieved from 81 infants with intussusception and from 79 controls, were tested for the presence of the CF delta-F508 gene mutation. RESULTS: Prevalence of the mutation was similar in blood specimens from intussusception patients and from controls. CONCLUSION: Testing for the CF delta-F508 mutation at birth is unlikely to identify infants predisposed to intussusception, and therefore is not relevant to rotavirus vaccine programs.

Australia↗
PubMedDate not supplied

CT findings in distal radioulnar dislocation.

Dislocation of the distal radioulnar joint may occur in association with fractures of the distal radius. As an isolated entity, however, it is frequently overlooked, resulting in prolonged pain and significant disability. Our case illustrates the need for careful clinical evaluation as well as the utilization of conventional radiography and CT.

Adult↗
PubMedDate not supplied

Fine needle aspiration biopsy of azoospermic testes. Could it replace histologic biopsy?

OBJECTIVE: To evaluate the possibility of replacing histologic biopsy of azoospermic testes by fine needle aspiration (FNA) for diagnostic and management purposes. STUDY DESIGN: Twenty-seven patients were examined under general anesthesia, and 53 testes were biopsied by FNA. Fifty-four testes were biopsied for histologic examination. Histology and cytology of each testis were compared to assess the discrepancy or concordance between the diagnoses. RESULTS: Twenty-seven testes showed complete concordance of cytology and histology, and 13 testes showed a mild degree of discrepancy. A severe degree of discrepancy was seen in 13 testes. In the majority of discrepant cases, FNA biopsy diagnosis was more sensitive in detecting evidence of full or advanced maturation. In one case of discrepancy, the histologic finding was Sertoli cells only, and cytology revealed focal full maturation. In vitro fertilization using sperm from this case was successful. CONCLUSION: FNA biopsy of testes in azoospermia is a fast, reliable and minimally traumatic method. The prospects for utilizing FNA biopsy material in assisted and microassisted fertilization are promising.

Adult↗
PubMedDate not supplied

Newborn screening for congenital hypothyroidism, Victoria, Australia, 1977-1997. Part 1: The screening programme, demography, baseline perinatal data and diagnostic classification.

Clinical, demographic and laboratory data from infants with congenital hypothyroidism (CH) born in the Australian state of Victoria from the commencement of neonatal screening in mid-1977 until December 1988 are reported. These provide a baseline for a 12-year prospective longitudinal study on physical and neuro-psychological outcome until mid-1997, the subject of a second paper. Infants with CH were detected using a primary TT4 screening test. Demographic data were collected prospectively using a clinical assessment protocol. Nearly all affected infants underwent 99mTc pertechnetate scanning at the initial assessment to determine the underlying aetiology of their hypothyroidism. 704,723 infants were screened and 199 with permanent primary hypothyroidism (one in 3,541) were identified. The most common aetiologies were thyroid ectopia (46%), thyroid aplasia (33%), and 'dyshormonogenesis' (11%). The clinical abnormalities classically described in CH were more evident in infants with aplasia, and the striking female preponderance in infants with thyroid dysplasia (syn. dysgenesis) was confirmed. Other features included increased frequencies of 'dyshormonogenesis' in infants of parents of Middle-Eastern origin and of labour induction in infants with dysplasia. A closed posterior fontanelle was not found in any infant with thyroid aplasia.

Age Determination by Skeleton↗
PubMedDate not supplied

Newborn screening for congenital hypothyroidism, Victoria, Australia, 1977-1997. Part 2: Treatment, progress and outcome.

A controlled longitudinal prospective study is reported of physical and neuropsychological progress up to 12 years in 152 children with congenital hypothyroidism (CH), detected by newborn screening in the Australian state of Victoria and born between the onset of screening in mid-1977 and December 1988. Linear growth of the CH children was normal. Throughout they were slightly heavier and the median head circumference was slightly larger compared with reference data. Those with thyroid aplasia required a marginally larger dose of thyroxine to achieve euthyroidism. Assessment of cognitive outcome in the children with permanent primary CH revealed the mean scores at 2, 5 and 8 years to be from 8.5 (p<0.001) to 10.2 (p<0.001) points lower than in a group of 60 euthyroid controls. However, there was large overlap and, of the affected children, only 10.1% at 2 years, 3.9% at 5 years and 6.8% at 8 years fell more than 2 SD below the means of the euthyroid controls. On univariate analysis, variables shown to have significant correlation with cognitive outcome at 8 years in the CH children were newborn activity, baseline TT4 and FTI, initial T4 dosage, socio-economic classification, maternal age, maternal education and presence of a serious accompanying disorder. On multiple regression analysis, significant variables were baseline bone age, maternal age and education, and presence of a serious accompanying disorder. No single thyroidal or extra-thyroidal variable could be identified to account for the discrepancy between the children with CH and the controls.

Age Determination by Skeleton↗