Search PubMed⌕ Search

Biomedical subjects

J R Bennett

Publications and source records attributed to J R Bennett.

At least 37 records · Page 2Linked to original sources
PubMed1993

Oesophagitis is as important as oesophageal stricture diameter in determining dysphagia.

It is a common observation that stricture patients with severe dysphagia may have a wide lumen, while others with a narrow stricture have few swallowing complaints. In 64 patients with benign oesophageal stricture the dysphagia score (determined by questionnaire and by a test meal both based on nine different items of food scored according to their solidity) was compared with the diameter of the stricture measured radiologically by premeasured barium spheres. There was evidence of an association, but the correlation coefficient (r) was 0.544 (p = 0.0001), suggesting that the diameter of the stricture is an important, although not the sole, determinant of dysphagia. Stricture diameter explains 29.6% (r2) of variation in dysphagia score. The patients (mean dysphagia score 71 of a maximum possible 90) were divided into three groups according to the severity of oesophagitis (19 patients had minimal, 22 moderate and 23 severe oesophagitis). Analysis revealed the mean dysphagia score to be 83, 73, 59 in each group respectively. Dysphagia score of each group was significantly different from the others (Kruskal-Wallis test). Relating the dysphagia score to stricture diameter for each group gives correlation coefficient r = 0.379 (p = 0.110) in the minimal oesophagitis group, r = 0.651 (p = 0.001) in the moderate group, r = 0.583 (p = 0.004) in the severe group. If both diameter and severity of oesophagitis are included then 66.0% of the variation can be explained. It is concluded that the degree of oesophagitis is as important as luminal diameter in determining swallowing ability.

Adult↗
PubMed1993

The effect of propofol anaesthesia on free radical-induced lipid peroxidation in rat liver microsomes.

In order to assess the in vivo significance of the free radical scavenging properties of propofol the effect of propofol anaesthesia on the sensitivity of rat liver microsomes to radical-induced lipid peroxidation has been examined. Microsome peroxidation was initiated with a combination of reduced nicotinamide adenine dinucleotide phosphate and ferric ions, and assessed by measuring the changes in oxygen tension in the microsome suspension. In comparison to animals receiving 10% intralipid, saline or midazolam, microsomes prepared from animals anaesthetized with propofol demonstrated a significantly increased resistance to lipid peroxidation. Thus, the median delay in onset of the maximum rate of oxygen consumption in animals receiving a bolus of propofol was 23.1 min (range 14.4-32.3), in comparison to delays in the animals receiving intralipid, saline or midazolam of 1.9 (0.5-4.1), 2.4 (2.0-3.7) and 3.0 (1.8-6.1) min respectively (P < 0.01 in each case, Mann Whitney U-test). More prolonged anaesthesia with either repeated boluses or an infusion of propofol also delayed the onset of lipid peroxidation (45.6 (27.2-60) and 18.3 (9.2-60) min respectively). We conclude that the free radical scavenging properties of propofol are biologically significant at anaesthetic doses.

Anesthesia, Intravenous↗
PubMed1992

Esophageal involvement in Behçet's disease. Is endoscopy necessary?

Twenty patients who were diagnosed as having Behçet's Disease between 1976 and 1990 were asked to attend the dermatology department so that their diagnosis could be reviewed in the light of recently established criteria for the diagnosis of Behçet's disease. Ten patients fulfilled the diagnostic criteria, nine of whom agreed to participate in this endoscopic study. Nine patients underwent upper gastrointestinal endoscopy, three of whom had dyspepsia alone, two had dysphagia and dyspepsia, one had symptoms of acid regurgitation, and the remainder were asymptomatic at the time of endoscopy. One patient had evidence of grade 1 reflux esophagitis, one had an incidental pyloric canal ulcer, and one patient who had severe dysphagia on presentation was found to have a high esophageal stricture with accompanying ulceration. Behçet's disease rarely affects the esophagus but when present can cause marked esophagitis with consequent stricture formation. Since the incidence of esophageal involvement was low (11%), we conclude that unless the patient had marked esophageal symptoms there is no indication for routine endoscopy of patients with Behçet's disease.

Adult↗
PubMed1992

A new dysphagia score with objective validation.

Patients' accounts of their eating capacity correlate reasonably well with their observed performance, but they do not exactly match each other. This can be attributed to patients' inaccurate estimation of eating ability and the inconstant nature of dysphagia. Therefore, we advocate a combined score in clinical trials. However, for clinical practice, a quantitative assessment of the patient's account is quicker, more convenient, and sufficiently accurate. The advantage of a numerical score is obvious in clinical trials because of its statistical versatility, and may also be desirable in certain cases in clinical practice.

Deglutition↗
PubMed1992

Short report: comparison of two orally administered bowel preparations for colonoscopy--polyethylene glycol and sodium picosulphate.

Fifty-nine consecutive patients admitted for colonoscopy were randomized to receive polyethylene glycol or sodium picosulphate. Patients expressed their opinion in a questionnaire and the endoscopists, blinded to the preparation, assessed the cleanliness of different segments of the colon. There was no statistically significant difference in the taste-acceptability of the preparations, frequency of nausea, abdominal pain, peri-anal soreness or sleep disturbance between the two groups. Polyethylene glycol caused vomiting in 13% of patients while this was absent in those who received sodium picosulphate (P less than 0.05). The average number of stools passed was 12.4 in the polyethylene glycol and 8.6 in the sodium picosulphate groups; mean difference 3.8 (95% C.I. 0.7-6.9) with P less than 0.02. The overall cleanliness of the colon was better in the polyethylene glycol group (P = 0.002) as judged by the blinded colonoscopist. There was less delay (P = 0.06) and more completed colonoscopies (P = 0.01) in this group. Polyethylene glycol was a better preparation in all segments of the colon except the rectum. We conclude that polyethylene glycol is the choice of the colonoscopist and should be given to all patients; sodium picosulphate would be a good alternative if patients are intolerant. If a limited colonoscopy or flexible sigmoidoscopy is intended, sodium picosulphate may be preferred because of its acceptable efficacy and slightly advantageous side-effect profile.

Abdominal Pain↗
PubMed1992

Advanced trauma life support. A time for reappraisal.

The experience of Advanced Trauma Life Support training received by three anaesthetists is discussed with particular reference to the teaching of airway management, the grade of staff who should attend the present courses and the relevance to the British hospital system. We conclude that these courses are useful but limited by their inflexibility and failure to recognise the difference in skill mix in the British setting.

Algorithms↗
PubMed1991

Skin and gullet.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Heartburn and gastro-oesophageal reflux.

Heartburn is a readily recognised symptom which half the British population have experienced at some time, and a fifth have frequently. It is the predominant symptom of gastro-oesophageal reflux, although less than two thirds of sufferers have endoscopically visible oesophagitis. Heartburn can also be associated with peptic ulcers or functional dyspepsia. Several changes in oesophageal function contribute to the syndrome of gastro-oesophageal reflux, the most important being inadequacy of the complex mechanism at the gastro-oesophageal junction. Understanding the various functional failures offers a better understanding of the therapeutic possibilities.

Esophagitis↗
PubMed1990

Enema or Picolax as preparation for flexible sigmoidoscopy?

Two preparations for outpatient flexible sigmoidoscopy, Picolax and Klyx enemas, have been compared in a randomized controlled trial. There was no difference in efficacy between the two preparations, but patients preferred Picolax.

Adolescent↗
PubMed1990

Clinical utility of a saliva alcohol dipstick estimate of serum ethanol concentrations in the emergency department.

Rapid determination of serum ethanol concentrations can be a useful adjunct in evaluating patients with decreased levels of consciousness. Previous reports suggest that saliva ethanol concentrations measured by a colorimetric saliva dipstick assay correlate well with serum ethanol concentrations and could be useful in the emergency department. We compared saliva dipstick assay results with concurrent serum ethanol measurements in 67 emergency department patients with altered mental status. Color changes of the stick are calibrated to reflect serum ethanol concentrations of negative (no color change), 4.3 mmol/L, 10.8 mmol/L, 21.7 mmol/L, and greater than or equal to 65.1 mmol/L. Emergency department staff were instructed to conduct the measurement according to the manufacturer's directions and round up equivocal results to the next highest concentration. Serum ethanol concentrations (mean +/- SD) grouped by dipstick results were: negative, 5.2 +/- 13.1 mmol/L; 4.3 mmol/L, 29.1 +/- 18.0 mmol/L; 10.8 mmol/L, 46.6 +/- 27.6 mmol/L; 21.7 mmol/L, 47.0 +/- 18.5 mmol/L; and 65.1 mmol/L, 62.4 +/- 24.2 mmol/L. There were 12 false-negative and 2 false-positive results. Correlation between dipstick results and serum ethanol concentrations was rho = 0.611 (p less than 0.0005). The lack of accuracy of the saliva dipstick measurements and the high number of false-negative results make it a poor choice for determining alcohol use in the emergency department patient.

Colorimetry↗
PubMed1989

The emergency department diagnosis of Trichomonas vaginitis.

Trichomonas vaginalis is a common cause of vaginitis in emergency department patient populations. While the diagnosis of this condition is usually on the basis of wet-mount microscope slide preparations, other diagnostic technology exists. We studied the accuracy of the traditional wet-mount technique as compared with detection using direct immunofluorescence and culture techniques in ED patients with the presenting complaint of vaginal discharge. Of 157 patients evaluated, the wet-mount technique detected 27 cases of Trichomonas, compared with 35 cases diagnosed by direct immunofluorescence and 52 cases detected by culture. This represents a false-negative rate for the wet-mount technique of 51%; the false-negative rates for direct immunofluorescence and culture technique were 36% and 5%, respectively. Our study suggests that the wet-mount technique is relatively insensitive in the detection of Trichomonas vaginitis.

Animals↗