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Biomedical subjects

K R Hunt

Publications and source records attributed to K R Hunt.

36 records · Page 2Linked to original sources
PubMed1993

Sonographic image degradation after barium enema.

RATIONALE AND OBJECTIVES: The authors previously showed that barium does not interfere with abdominal sonography performed after a biphasic upper gastrointestinal tract examination. This study was designed to assess the impact of a barium enema (BE) examination on the quality of abdominal sonography performed immediately after the barium enema. METHODS: Forty patients scheduled for routine barium enemas (22 air contrast and 18 solid column) were prospectively examined with abdominal sonography before and after their BEs. The resulting 80 sonograms were randomized; three radiologists blindly assessed the quality of images of each of six anatomic areas (aorta, pancreas, porta hepatis, gallbladder, and the right and left lobes of the liver). RESULTS: There was no statistically significant degradation of the images for the right and left lobes of the liver and the pancreas. However, the images for the gallbladder, porta hepatis, and aorta had a statistically significant (P < .05) degradation of their ultrasound quality following barium enema. CONCLUSIONS: Unlike upper gastrointestinal tract examination, BE examination does interfere with the quality of a subsequent abdominal ultrasonography. Thus, when both studies are required, sonography should be performed first.

Abdomen↗
PubMed1993

Mammographic surveillance of breast cancer patients: should the mastectomy site be imaged?

OBJECTIVE: This study evaluated the usefulness of routine mammography of the mastectomy site in women who have been treated for breast carcinoma. MATERIALS AND METHODS: From a retrospective review of medical records and mammographic examinations of 827 patients who had mastectomies, the following information was obtained: demographic data, type of breast reconstruction (if any), length of follow-up after mastectomy, evidence of local recurrence, and results of physical examination of the breast and mammography immediately before diagnosis of local recurrence. RESULTS: Local recurrences of breast cancer were seen in 39 (4.5%) of the 859 breasts in the study group. All patients had a physical examination of the breast and mammography within 3 months of the diagnosis of recurrent breast carcinoma. Mammography of the mastectomy site did not show any recurrences that were not suspected on the basis of physical examination. For two of 20 patients, spot-compression views of palpable abnormalities showed thickening of the surgical scar. In four patients with pain in the chest wall, no abnormalities were found on physical examination or mammograms, but bone scintigrams showed metastasis to the ribs. CONCLUSION: Our results indicate that mammographic imaging of the mastectomy site does not increase the detection of locally recurrent breast cancer.

Adult↗
PubMed1992

Moonlighting during the radiology residency.

RATIONALE AND OBJECTIVES: The authors surveyed current residents and practicing radiologists to assess motivations for and attitudes about radiology moonlighting during residency. METHODS: One thousand one hundred current fourth-year radiology residents and 1,100 practicing radiologists who finished training within the past 10 years were surveyed. Information was solicited concerning motivations for and attitudes toward moonlighting and the effects of moonlighting on residents' training. Current residents were compared with former residents to assess changes in attitudes about moonlighting. RESULTS: There were no important differences in the practicing and training cohorts. Of each group, 52% moonlighted. Debt was the main motivating factor influencing a resident's decision to moonlight. Moonlighters owed significantly more money (average debt, $25,804) at the beginning of their residency than did non-moonlighters (average debt, $19,554). In addition, 72% of moonlighters had to begin loan repayments during training with average monthly payments of $284. Departmental policy was less of an influencing factor. There was no statistical difference in the way moonlighters and non-moonlighters spent their time with respect to clinical work, reading radiology, or participating in research. CONCLUSIONS: Residents moonlight primarily for financial reasons but also perceive a positive educational benefit. Although no significant negative effects on the residency were found in this study, rising debt, decreased forbearance of repayment, and possible resultant increases in the amount of time spent moonlighting, might eventually affect resident's productivity in more traditional residency activities.

Employment↗
PubMed1991

Effectiveness of strategic anthelmintic dosing in controlling Haemonchus contortus infections in sheep in the United Kingdom.

The strategic use of anthelmintics in the control of infections of Haemonchus contortus in ewes and lambs, was investigated in a series of paddock trials. The levels of infection and clinical signs associated with the presence of either benzimidazole-resistant or benzimidazole-susceptible strains of H contortus in lambs were controlled by regular drenching with levamisole or mebendazole, respectively, or by the strategic use of closantel in combination with mebendazole. In the latter case, control was achieved by dosing either the ewes in the early part of the grazing season, or the lambs from June onwards. It was concluded that worm control strategies based on closantel could provide effective control of both benzimidazole-susceptible and benzimidazole-resistant strains of H contortus on farms in the United Kingdom.

Animals↗
PubMed1991

Effectiveness of clean grazing strategies in controlling Haemonchus contortus infections in sheep in the United Kingdom.

The effectiveness of clean grazing systems for controlling the sheep abomasal parasite Haemonchus contortus under experimental conditions was monitored for a grazing season in ewes and lambs carrying either benzimidazole-susceptible or resistant populations of the parasite. Both preventive and evasive strategies failed to give effective control of H contortus. Lambs grazing with ewes that had received no anthelmintic showed clinical signs of haemonchosis by early July. Lambs from ewes dosed with a benzimidazole (mebendazole) before turn out, developed clinical signs of haemonchosis later in the season. The presence of anthelmintic resistant genotypes had a significant effect on the appearance of clinical signs, and on the epidemiology and control of disease. It was concluded that alternative worm control strategies will be required for the effective control of H contortus in the United Kingdom.

Abomasum↗
PubMed1990

Efficacy of ivermectin against benzimidazole-resistant nematodes of sheep.

Two trials involving a total of 36 Dorset horn lambs were conducted to assess the anthelmintic efficacy of ivermectin against experimental infections of benzimidazole-resistant strains of Haemonchus contortus and Ostertagia circumcincta. Two resistant strains of each of the two species were used and in each trial the lambs were allocated to three groups. One group was given 200 micrograms ivermectin/kg bodyweight orally, the second group was given 5 mg oxfendazole/kg bodyweight orally and the third group remained untreated as controls. Fourteen days after treatment the lambs were necropsied. Ivermectin was found to be more than 99 per cent to 100 per cent effective against all four benzimidazole-resistant strains, whereas oxfendazole was 78.6 per cent and 83.8 per cent effective against the H contortus strains, and 25.6 per cent and 39.8 per cent effective against the O circumcincta strains.

Animals↗
PubMed1990

Prospective comparison of plain abdominal radiography with conventional and digital renal tomography in assessing renal extracorporeal shock wave lithotripsy patients.

Most publications citing the effectiveness of renal extracorporeal shock wave lithotripsy have used plain abdominal radiography to assess residual calculi after treatment. We compared radiologist sensitivity and specificity in the detection of calculi on plain abdominal radiographs versus conventional film-screen and digital renal tomograms in extracorporeal shock wave lithotripsy patients. Of the patients 50 were imaged before and within 24 hours after lithotripsy. Six radiologists evaluated the resultant 300 studies for the presence and location of calculi. The mean sensitivity for digital tomograms was 83% for pre-lithotripsy and post-lithotripsy studies, which was significantly higher than for plain abdominal radiography and conventional tomography after lithotripsy. However, there were significantly more false positive stone diagnoses associated with digital tomogram interpretation. Signal detection analysis verified the over-all superiority of digital tomography for post-extracorporeal shock wave lithotripsy imaging. Calculus detection by conventional and digital tomography is superior to detection by plain abdominal radiography. However, because we did not perform delayed imaging, it is not possible to say what impact digital tomography might have on the management of extracorporeal shock wave lithotripsy patients.

Humans↗
PubMed1990

Comparison of breast consistency at palpation with breast density at mammography.

Palpable breast consistency on physical examination was compared with the breast density on mammography for 909 consecutive patients. One of two experienced nurse practitioners palpated each patient's breasts and assigned a consistency value of 1 (little palpable breast consistency) to 4 (maximal palpable breast consistency). Seven mammographers rated the breast density on mammography as either fatty, mild, moderate, or marked parenchymal density for each breast. A low statistical correlation between the two parameters was shown. Thirty-seven percent of markedly dense breasts on mammography was rated only 1 or 2 on palpation. Thus, breast consistency judged by palpation cannot be directly correlated with the density shown on mammography and cannot be used to predict optimal radiographic technique.

Adult↗
PubMed1989

Anthelmintic drug resistance in the UK.

The term 'anthelmintic drug resistance' describes the heritable ability of some nematode parasites to survive treatment with anthelmintic drugs at the recommended therapeutic dose levels. Genes for resistance appear to be present in many of the important pathogenic nematodes of ruminants and horses. Under intensive management systems, where heavy reliance is placed on anthelmintic drugs for worm control, the selection of resistant genotypes may result in increased reports of the drugs failing to control the nematode populations against which they are aimed. Anthelmintic resistance has been reported from many parts of the world, and in some countries multiple drug-resistant strains have emerged. In the UK, recent investigations indicate an increasing level of resistance to benzimidazoles among nematodes of sheep and horses. The incidence, diagnosis, epidemiology and implications of anthelmintic resistance are discussed.

Animals↗
PubMed1989

The lack of sonographic image degradation after barium upper gastrointestinal examination.

The presence of barium in the gastrointestinal tract after barium studies of the stomach and colon is thought to interfere with the performance of abdominal sonography. This notion results in delays in diagnosis and scheduling inconveniences when both studies are indicated at the same time. To determine if this belief is true, we prospectively obtained sonograms before and after biphasic upper gastrointestinal examinations in 40 patients. The 80 sonograms were randomized and blindly interpreted by two radiologists who used a scale from 0 to 4 to rate the appearance of six anatomic areas (gallbladder, pancreas, aorta, porta hepatis, and right and left lobes of the liver). The results showed no degradation of the image of these structures on the sonograms obtained after the barium meal compared with the prebarium sonograms. We conclude that barium does not interfere with sonography performed immediately after an upper gastrointestinal examination. Consequently, when both studies are needed, a sonogram can be scheduled after an upper gastrointestinal exam.

Abdomen↗
PubMed1988

Field observations on the control of ovine parasitic gastroenteritis in south-east England.

Three worm control strategies, on a commercial farm in south east England, were monitored parasitologically for a grazing season. Three peaks of larval infection in June, late August and late October/early November occurred on paddocks grazed by dosed ewes and lambs on a new ley (preventive strategy). Lambs dosed and moved on to a hay aftermath in July (evasive strategy), had a mean egg count of 2090 by late August, attributable to infection with Haemonchus contortus. Three weekly drenching of lambs (suppressive strategy), suppressed faecal egg counts until September when the treatment interval was extended due to other on-farm commitments. In addition to these observations, autoinfection, with Haemonchus contortus, was seen to occur in lambs grazing summer turnips. An in vitro egg hatch assay, and critical efficacy trial, confirmed the presence of a benzimidazole resistant strain of Haemonchus contortus on this farm. The implications of these findings are discussed.

Animals↗