Biomedical subjects
Publications and source records attributed to M A Roberts.
A case of multiple gastric carcinoid tumours is described in an elderly man with atrophic gastritis and hypergastrinaemia. This case provides further evidence of an association between hypochlorrhydric states and some gastric endocrine tumours.
Explore the source record for details and available documents.
A consecutive series of 397 myelograms performed in 385 patients over a six month period at the Mersey Regional Neurosciences Unit is reported. The reasons for performing the myelogram were to identify the cause of a radicular lesion in 54% of patients, a chronic spinal cord lesion in 30%, an acute cord lesion in 9%, suspected disease at the level of the foramen magnum 6%, and for a variety of other conditions in 8%. For the 385 patients undergoing a myelogram in the study period, the median interval from admission to request, request to myelography and from myelography to discharge was nought, one and three days respectively. The proportion of patients submitted to myelography by individual consultants ranged from 7% to 28%. There was a two-fold variation in the delays in the time to requesting and performing myelograms. There was room for improvement in the clinical information supplied on the myelography request form. The role of ancillary investigations and their effect on myelography was unclear. Only 16 of the patients with suspected cord disease had visual evoked responses performed before myelography. Five of them had myelography after an abnormal result. The estimated annual direct cost of myelography in the unit was at least 486,000 pounds. Reorganisation might have yielded hypothetical "savings" of between 30,000 pounds (6%) and 155,000 pounds (32%), though in practical terms these "savings" represented resources which might have been freed for use in other higher priority clinical problems within the unit, rather than true reductions in monetary cost.
In an epidemiological study conducted in SWA/Namibia to document the prevalence of high-risk factors for cervical cancer 754 women belonging to a number of ethnic groups were examined. The prevalence of cervical intra-epithelial neoplasia and human papillomavirus infection was among the highest reported in the world. There was also an alarming incidence of other sexually transmitted diseases and disturbingly low usage of contraceptive methods. There is an urgent need for a comprehensive, well-organised cytological screening programme if an 'epidemic' of cervical cancer is to be prevented in SWA/Namibia. There was good evidence to suggest that an identical situation exists in the RSA.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
This prospective study investigated the common belief that pyrexia is frequently absent in elderly patients with infection. Oral temperature was closely monitored using both a mercury and an electronic thermometer in 150 ill elderly patients (mean age 81 years) of whom 80% were new admissions to this Unit. A scoring system was devised, based on investigation results and excluding temperature, to assess objectively the likelihood of infection. Seventy-one patients (47%) had 'definite' infection: 95% were pyrexial. A further eight of the nine patients with probable infection were pyrexial. There were no significant differences in mean temperature or other indices of infection between those who died of their infection and those who survived. Ten per cent of all pyrexias were detected only on the electronic thermometer, not on mercury measurement. In 12% of pyrexial patients, the pyrexia first appeared more than 12 h after temperature measurement started. With effective monitoring, pyrexia is detectable in the vast majority of infected elderly patients.
Comparative evaluation of six commercial rubella virus antibody kits is described. A set of serum samples skewed toward nonreactive and low-positive rubella antibody levels was used because the goal of an immunity screening test is the detection of susceptible individuals. The M. A. Bioproducts Rubastat and the Hynson, Westcott and Dunning Rubascan were superior in achieving high sensitivity, specificity, and reproducibility. They also were the easiest and fastest tests to perform, and they require equipment available in most laboratories.
Although senile dementia of Alzheimer type (SDAT) is the commonest cause of dementia in the elderly, it is important to recognise potentially reversible causes such as normal pressure hydrocephalus. This has been reported to occur in association with Paget's disease of the skull, but would appear to be an extremely rare complication of this disease. To date 4 cases of successful surgical intervention in normal pressure hydrocephalus complicating Paget's disease of skull have been reported. We report 3 cases which have presented to one Department of Geriatric Medicine during a 3-year period. Two cases were diagnosed prior to death and both responded well to ventriculo-peritoneal shunting.
Explore the source record for details and available documents.
Vibrio vulnificus is a halophilic marine vibrio which may produce infection in wounds exposed to seawater or raw shellfish. The Centers for Disease Control has received two isolates from wounds exposed to inland waters, a New Mexico creek and an Oklahoma reservoir. Halophilic organisms were recovered from both the creek and the reservoir, and the water in both sites was found to be brackish. Both clinical isolates of V. vulnificus grew in salt concentrations as low as those found in the creek and reservoir. These cases illustrate the potential for pathogenic halophilic Vibrio species to live in brackish inland waters and produce infections in patients living in inland areas of the United States.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
To determine antibody responses to small doses of human diploid cell rabies vaccine (HDCV), we determined rabies antibody titers in 124 volunteers who had been vaccinated with one of five primary preexposure regimens. In a sixth group of 47 persons previously vaccinated with duck embryo rabies vaccine (DEV), we evaluated the booster responses after a 0.1-mL dose of intradermal (ID) HDCV. Persons in all five groups undergoing primary immunization received three doses of vaccine, one each on days 0, 7, and 28. The dose and route of vaccination for the five groups included 1 mL intramuscular (IM), 0.1 mL ID (two subgroups), 0.1 mL subcutaneous (SC), and 0.25 mL SC. Adequate titers developed in all persons, irrespective of the route or quantity of vaccine. The geometric mean titers (IU/mL) on day 49 in those receiving primary regimens were 12.87 (1.0 mL IM), 7.44 (0.1 mL ID by syringe), 3.05 (0.1 mL by jet injector), 3.17 (0.1 mL SC), and 6.47 (0.25 mL SC). Titers on day 90, while lower, were still acceptable. Adequate antibody titers developed in all persons previously vaccinated with DEV after a single 0.1-mL ID dose of HDCV; however, higher titers developed at day 7 in those who had shown an adequate response to DEV in the past. Results of this study suggest that HDCV may be used ID or SC for primary preexposure rabies prophylaxis and ID for booster immunization.
Eighty-one elderly patients with epileptic seizures are described, of whom 60 were investigated by computed tomography. The cause was cerebrovascular disease in 44%, tumour in 12%, extracerebral in 11%, and unknown in 16%. Partial seizures were commoner in patients with tumour than with other causes. The findings are discussed in relation to other studies and to the investigation of elderly patients presenting with seizures.