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Biomedical subjects

J D Waye

Publications and source records attributed to J D Waye.

At least 109 records · Page 6Linked to original sources
PubMed1985

Esophageal motility and symptoms after endoscopic injection sclerotherapy.

Endoscopic injection sclerotherapy is known to cause a variety of motility abnormalities, but the correlation between these changes and symptomatology has not been clearly defined. To assess the effects of endoscopic sclerosis of varices on esophageal function and symptoms, we prospectively studied esophageal motility in 25 patients undergoing sclerotherapy (group I). Thirteen patients underwent studies before and after sclerosis, and 12 patients were studied after completion of therapy. Acid clearance was studied in five patients (group I). Twenty-four of the 25 patients (group I) completed a course of sclerosis without the development of persistent dysphagia. We found that endoscopic sclerotherapy did not significantly alter the velocity of peristalsis or lower esophageal sphincter pressure, amplitude of contraction, or the duration of contraction. Acid clearance was diminished in three of five patients. Four patients who developed an esophageal stricture following sclerotherapy were studied manometrically (group II). Three of these four patients had a manometric pattern characterized by repetitive, nonperistaltic contractions, and all four patients experienced dysphagia which was relieved by bougienage. We conclude that esophageal motility is generally well preserved following endoscopic injection sclerotherapy and does not result in a long-lasting disturbance of swallowing. Dysphagia and disordered esophageal motility do occur after sclerotherapy when a sufficient fibrotic response has resulted in an esophageal stricture.

Esophageal Stenosis↗
PubMed1985

The relationship of bacteremia to the length of injection needle in endoscopic variceal sclerotherapy.

The authors evaluated whether depth of needle insertion as determined by needle length is an important factor in sclerotherapy-associated bacteremia. In 18 consecutive sclerotherapy sessions in which sodium morrhuate was used, blood cultures were positive in 11% when using an injector with only 3 to 4 mm of needle protruding beyond the sheath, compared with the 39% incidence of bacteremia previously observed when an injector was used which permitted 6 to 8 mm of needle to protrude (0.01 less than p less than 0.05). Twenty-five additional sclerotherapy sessions in which the shorter needle was used were performed with a different sclerosant, 1% sodium tetradecyl sulfate; only 8% of blood cultures were positive. No correlation was found between fever and bacteremia. The authors conclude that the exposed needle length of the injector must be specified in any report of endoscopic variceal sclerotherapy with the flexible endoscope since this length is critical in the incidence of associated bacteremia and possibly other complications.

Endoscopes↗
PubMed1984

Retrograde amnesia effects of intravenous diazepam in endoscopy patients.

The presence of a retrograde amnesia, when caused by medications given prior to a medical procedure, can pose the medicolegal question of informed consent. This study investigated the retrograde amnesic effects of intravenous diazepam administered prior to gastrointestinal endoscopy. No significant retrograde amnesia was found in case subjects when compared with controls.

Adult↗
PubMed1983

The role of endoscopy in suspected amebiasis.

The diagnosis of amebic colitis can be difficult and confusing. The gross endoscopic appearance as well as the results of endoscopic biopsy can be extremely helpful in differentiating amebiasis from other forms of colitis. Clinical symptoms, laboratory studies, x-ray findings, cultures, and even serological studies may not be sufficient for making an accurate diagnosis. To illustrate the potential difficulties we are reporting three patients in whom the diagnosis of amebiasis was considered but in whom endoscopy was important for arriving at the correct diagnosis.

Adolescent↗
PubMed1983

Dysplasia and ulcerative colitis--a colonoscopic study.

Cancer will be found on colonoscopic biopsy in 11% of patients with chronic ulcerative colitis for over eight years' duration. Sixteen percent of patients with dysplasia will subsequently be found to have carcinoma of the colon. A total of 3% of patients in the high-risk group will have cancer of the colon. Endoscopic biopsies should be separated into those performed for diagnostic or surveillance purposes, so that meaningful and reproducible results will be obtained. Annual total colonoscopy and biopsies are recommended for surveillance purposes.

Biopsy↗
PubMed1982

A randomized double-blind study of nalbuphine as an analgesic for colonoscopy.

Forty-five patients having ambulatory colonoscopic examinations were randomly assigned to receive premedication with meperidine or with nalbuphine. Both treatment groups received equivalent amounts of intravenous diazepam as an additional sedative. Approximately half of the patients tolerated the procedure well in either treatment arm, but a significantly greater number of patients receiving nalbuphine tolerated the procedure poorly, even with large doses of medication. Nalbuphine does not appear to be as effective as meperidine for relieving the discomfort induced by colonoscopy.

Colonoscopy↗
PubMed1982

Colonoscopic diagnosis of inflammatory bowel disease.

The indications and limitations of colonoscopy in the diagnosis of inflammatory bowel disease are well defined. The endoscopic examination is usually easily performed and well tolerated by the patient, but, since endoscopic examination of the colon is an invasive procedure (and potentially dangerous), colonoscopy should only be performed in those patients in whom the indication is clear and the benefits identifiable. Colonoscopy may provide valuable information in the diagnosis and may help outline the course of therapy in patients with inflammatory bowel disease.

Barium Sulfate↗
PubMed1982

Surveillance intervals after colonoscopic polypectomy.

Two hundred and twenty seven patients had multiple follow-up total colonoscopies after initial endoscopic polypectomy. All adenomas were removed at the initial examination ('clean colon') in those patients who had no history of colon cancer, inflammatory bowel disease or polyposis coli; when re-endoscoped within one year 56% of them were found to have further adenomas. Nine percent had adenomas over 10 mm diameter which are presumed to have been missed during the index colonoscopy. Patients with single or multiple adenomas had an equal likelihood of being found to have further lesions on a one-year follow-up colonoscopy. With an apparent chance of missing a significant-size polyp at colonoscopy of at least 10% we recommend that all patients have a follow-up colonoscopy within one year after polypectomy. 133 Patients in whom no adenomas were found at the one year colonoscopy ('negative colonoscopy') were followed up. The incidence of new adenomas occurring within four years of 'negative colonoscopy' was 35% for those with a single adenoma at the index examination and twice as high for patients with multiple adenomas. If no polyp is found at one year, we recommend that interval follow-up colonoscopies should be performed every two years if more than one adenoma was removed during the initial examination, and every three years if only one was removed.

Adenoma↗
PubMed1982

Gastric polyps.

We suggest an approach to patients with gastric polyps, based on a study of 73 patients seen at this institution over a 5-year period. There were 40 cases of adenomatous and 20 cases of hamartomatous polyps. Differentiation between these two groups of polyps was not possible on the basis of clinical presentation, laboratory data, radiological, or endoscopic appearance. Differentiation was possible only on histologic examination of a totally resected specimen. In this series, only the adenomatous polyps were associated with gastric cancers in five patients. Since the malignancy either preceded or followed the recognition of adenomatous polyps, it is important to establish an early definite histological diagnosis. Patients with known adenomatous polyps should be followed closely for the development of gastric carcinoma, even after the polyps have been removed.

Adenoma↗