Search PubMed⌕ Search

Biomedical subjects

J Chamberlain

Publications and source records attributed to J Chamberlain.

At least 73 records · Page 4Linked to original sources
PubMed1994

Serial investigation of balloon angioplasty induced changes in the superficial femoral artery using colour duplex ultrasonography.

Percutaneous transluminal balloon angioplasty (PTA) of superficial femoral artery lesions is associated with similar initial success rates in coronary and iliac artery angioplasty but its application is limited by a much higher incidence of restenosis. To improve understanding of the trauma caused to the vessel by balloon angioplasty and the mechanisms contributing to the subsequent processes of healing and restenosis requires serial investigations of the treated arteries in vivo. This paper describes a prospective study using colour duplex ultrasonic imaging to assess arterial changes in 51 patients with atherosclerotic disease undergoing PTA of superficial femoral artery stenoses and occlusions. Each patient was scanned prior to angioplasty and at intervals up to 6 months post-angioplasty. On each scan, measurements were made of the overall vessel and lumen diameters at each site of angioplasty. These measurements indicate that angioplasty improves vessel patency mainly by stretching of the vessel wall, with compression and/or redistribution of the atherosclerotic plaque contributing less than 25% to the improvement of lumen diameter. Serial measurements after angioplasty show complex patterns of change at the angioplasty sites indicating that several mechanisms may be contributing to the processes of vessel healing and subsequent restenosis. Possible mechanisms which could explain the measured changes in overall vessel and lumen diameters are discussed.

Adult↗
PubMed1994

European Society of Mastology Consensus Conference on breast cancer screening: report of the evaluation committee.

On 4 February 1993, the European Society of Mastology (EUSOMA) convened a meeting of experts in Paris to evaluate the current evidence on the value and hazards of breast cancer screening. The Committee consisted of individuals from different countries throughout Europe and from different disciplines. We summarise here the deliberations and conclusions of the Committee.

Adult↗
PubMed1993

Fatty acid profiles of major food sources of howler monkeys (Alouatta palliata) in the neotropics.

Wild howler monkeys (Alouatta palliata) get most of their calories from carbohydrates (65%) and fats (18%) of native tropical plants, but little is known about their intake of individual fatty acids. The fatty acid composition of several natural food sources of howler monkeys collected in Panama was determined by gas-liquid chromatography. The predominant fatty acids were palmitic (30%), linoleic (23%), alpha-linolenic (16%) and oleic (15%). Fatty acids with less than 16, and more than 18, carbon chains were uncommon (0-7%). Although total saturated fatty acids were high in some specific food sources (22-54% of total fatty acids and 8 energy %), most of the calories from fat in the animals' diets are derived from mono- and polyunsaturated fatty acids (9.75 energy %). All food sources had significant amounts of the omega-3 fatty acid, alpha-linolenic acid (2.9 energy %). In terms of human diets, the howler monkey's fat consumption would not be considered atherogenic. Unless these animals show a particular adverse susceptibility to dietary fat, it is unlikely that their fat intake is the primary cause of the low, but significant, incidence of atherosclerosis that develops in these animals in the wild state.

Alouatta↗
PubMed1993

National Health Service breast screening programme results for 1991-2.

OBJECTIVES: To report the results of the NHS breast screening programme for the year March 1991 to April 1992. DESIGN: A report of statistics was derived from Körner (K62) returns and from the radiology quality assurance programme. MAIN OUTCOME MEASURES: Detection rates for breast cancer and small (< or = 10 mm diameter) invasive cancer, benign biopsy rates, and recall and acceptance rates. RESULTS: The acceptance rate for screening across the United Kingdom was 71.3%. The referral rate for further investigation was 6.2% (regional 4.3-9.0%). The breast cancer detection rate was 6.2 cancers per 1000 women screened (5.1-9.0) and the detection rate of invasive cancers < or = 10 mm was 1.4/1000 (1.0-2.3). 72% of screening programmes reached the target 70% acceptance rate, and 95% of programmes achieved a recall rate of less than 10%. 75% of programmes had a cancer detection rate of more than 5/1000, but only 32% had a detection rate for invasive cancers < or = 10 mm of more than 1.5/1000. CONCLUSIONS: Overall, the results of the screening programme for the year 1991-2 can be regarded as extremely satisfactory, given the size and complexity of the operation.

Aged↗
PubMed1993

Eye protection for the vascular surgeon.

Contamination occurring during vascular surgery was studied prospectively using a surgical mask incorporating a Splashguard visor. Over a 16-week period 78 vascular procedures were included; 44 were of < 2 h duration and 34 were of > or = 2 h. Contamination on both mask and visor from blood spots was recorded at the end of each procedure. Overall, 51 per cent of principal surgeons' visors were contaminated, with contamination of the mask itself in 32 per cent. When two surgeons were operating the contamination rate for the second was also high: 36 per cent for the visor and 42 per cent for the mask. Assistants had a contamination rate of 36 per cent for the visor and 13 per cent for the mask. The lowest rate of contamination occurred for the visor and mask of the scrub nurse, 10 and 4 per cent respectively. For emergency procedures the duration of operation had no influence on the frequency of contamination. However, for the principal surgeon elective operations of < 2 h duration were less likely to involve contamination than those of > or = 2 h (P < 0.035). Blood contamination of visors and masks is common in vascular surgery but rarely appreciated by the surgeon. Routine eye protection should be considered in vascular surgery, in particular for emergency and prolonged elective procedures.

Blood-Borne Pathogens↗
PubMed1993

Change towards earlier stage at presentation of colorectal cancer.

A study was carried out to investigate the change in stage at presentation of patients with colorectal cancer over 10 years. Cases were identified from the control group of subjects enrolled into a randomized controlled study based on Haemoccult screening for colorectal neoplasia. Of 405 subjects in the control group (presenting with symptomatic colorectal cancer, 206 presented before 1989 and 199 since then. The number of patients with Dukes' stage A carcinoma diagnosed since 1989 rose from 21 (10.4 per cent) to 35 (18.1 per cent); this change occurred for rectosigmoid tumours (9.9 per cent before 1989, 28 per cent after 1989) but not for colonic cancer (10.9 per cent before 1989, 11.5 per cent thereafter). An increase in the proportion of patients with symptomatic early-stage rectosigmoid cancer has been observed in the past 10 years. No such change occurred in those with colonic cancer. This may reflect a change in awareness of te disease and its symptoms by patients and general practitioners.

Adult↗
PubMed1993

Interval cancers and sensitivity in the screening centres of the UK trial of early detection of breast cancer.

The incidence rates of interval cancers following a negative breast screen in two screening centres which offered women aged 45-64 annual screening by mammography and/or clinical examination are examined. Sensitivity of screening is estimated by comparing the incidence rate of interval cancers with that expected in the absence of screening, and the results are compared with those from alternative methods of calculating sensitivity. The incidence rate of cancers diagnosed within 12 months of a negative screen by mammography plus clinical examination was reduced by 70% for women aged 45-54, and 84% for women aged 55+. There is no indication from this that sensitivity in the UK trial was substantially lower than in other studies which have achieved larger reductions in mortality.

Breast Neoplasms↗
PubMed1993

Long-term results of double-balloon percutaneous transluminal angioplasty of the aorta and iliac arteries.

Seventy-nine patients have been treated by double-balloon percutaneous transluminal angioplasty for aortoiliac atherosclerotic lesions within 0.5 cm of the aortic bifurcation. Seven patients had repeated angioplasties, a total of 86 procedures over an 8 year period up to December 1990. The technique is described and its merits discussed. Technically successful dilatation was achieved in 81 cases (94%) and symptomatic relief was obtained in 75 (87%), including 12 of 14 patients with critical ischaemia. Fourteen of 17 occlusions up to 6 cm long and 67 of 69 stenoses were successfully dilated. After an average follow-up of 49 months (median 51 months, range 7-93), only six patients (7%) developed late recurrence of symptoms requiring further treatment. Six patients have died and 12 have been discharged from follow-up. The cumulative success rate beyond 5 years' follow-up was 80%. Complications requiring surgical intervention occurred in four patients (5%). Double-balloon percutaneous transluminal angioplasty was seen to be an effective procedure which produced lasting improvement and is recommended as the first choice treatment for localised stenotic and occlusive disease at the aortic bifurcation.

Adult↗
PubMed1993

Breast self-examination programmes in the trial of early detection of breast cancer: ten year findings.

Programmes of education in breast self-examination with specialist clinics for self-referral were introduced in two health districts around 1980. Combining the results from the two centres showed no reduction in mortality from breast cancer over the following 10 years but the mortality was low in one of the centres whilst in the other it was higher than in four geographically separate comparison centres in which there was similar careful monitoring of breast cancer incidence and mortality. Because this was not a randomised controlled trial and lacked a uniform treatment protocol, biases may be responsible for the differences observed, but it is also possible that BSE education with annual reinforcement contributed to the breast cancer mortality reduction seen in one district. The overall conclusion however is that the value of breast self-examination remains unproven.

Age Factors↗