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Biomedical subjects

R Brooks

Publications and source records attributed to R Brooks.

At least 145 records · Page 8Linked to original sources

Stimulation of gastric inhibitory polypeptide in normal and duodenal ulcer patients.

To investigate the role of gastric inhibitory polypeptide (GIP), a potent inhibitor of gastric acid secretion, in the hypersecretion associated with duodenal ulcer, we compared the serum GIP concentrations in 11 healthy subjects and 16 duodenal ulcer patients after the stimulation of GIP release by a mixed meal. Fasting and postprandial serum gastrin and GIP concentrations were measured by radioimmunoassay at frequent intervals after the ingestion of a test meal. The duodenal ulcer patients showed an augmented and significantly greater release of GIP as well as of gastrin compared to normal subjects. These results indicate that a defective GIP release cannot account for the gastric hypersecretion seen in patients with duodenal ulcer. The mechanism of the increased GIP response in patients with duodenal ulcer is not clear from these studies.

Adult↗

Evolution of treatment of paralytic scoliosis at Rancho Los Amigos Hospital.

Between 1954 and 1970, 351 patients with severe paralytic scoliosis were treated at Rancho Los Amigos Hospital. During this time the treatment evolved through five stages: body cast alone, halo cast, halo cast with buttons and traction wires, Harrington instrumentation, and finally preoperative halo-femoral traction and Harrington instrumentation. Coincident with this evolution, correction improved from 20 to 57 per cent, the incidence of curve progression dropped from 38 to 0 per cent, and curve extension decreased from 25 to 0 per cent, while postoperative recumbency was reduced from one year to about three weeks. In addition, complications changed, in general decreasing except for the rate of pseudarthrosis, which remained essentially the same. Clinically significant hyperlordosis involving the thoracic and lumbar spine was seen in sixteen patients who had long fusions from the fourth cervical vertebra and above to the fourth lumbar vertebra or the sacrum.

Braces↗

Scoliosis: A prospective epidemiological study.

A two and a half-year prospective study was carried out to determine incidence rates and distributions of various parameters associated with idiopathic scoliosis. Data were also collected on the progression curves detected at the initial screening. The results showed: (1) that the incidence rate was 13.6 per cent with a female-to-male ratio of 1.2:1, (2) that the most common type of curve was thoracolumbar, and (3) that spontaneous improvement occurred in approximately 22 per cent of those patients followed for an average of one year.

Adolescent↗

A multicentre comparative evaluation of catheter valves.

Catheter valves are an alternative to leg bags for urine drainage, but no studies have yet been published which have compared the performance of different valves. This study was undertaken to evaluate the performance of the seven catheter valves available on the UK market in April 1996. The study was carried out by the Continence Products Evaluation (CPE) Network funded by the Medical Devices Agency (Department of Health). Each valve type was tested for 1 week by 19-36 cognitively unimpaired and manually dextrous subjects recruited from 11 test centres. At the end of each week, subjects completed an evaluation form (based on a three-point rating scale) to record product performance. The same catheter valves were also tested for ease of opening/closing by 33 subjects (mostly catheter users) who had some manual impairment. Performance scores varied widely between products. It was found that, to be successful, a valve needs to be easy to manipulate, leak-free, comfortable and inconspicuous. Prescribers need to be aware of the strengths and limitations of different valves for appropriate product selection.

Attitude to Health↗

The selection of female urinals: results of a multicentre evaluation.

Female urinals are designed to enable women to empty their bladders while not on the toilet and are therefore potentially useful in preventing incontinence. However, there is little published information to guide product selection. Therefore, an evaluation of these products was undertaken by the Continence Products Evaluation Network (funded by the Medical Devices Agency). All 13 reusable female urinals available in the UK in March 1997 were evaluated. Each urinal was evaluated by 28-32 community-based women. Preliminarily, each subject tested all urinals by trying to place them in one or two of their preferred positions, to establish if the urinals were suitable for full testing. Each of the urinals that were selected for full testing were then used for 1 week each. During this week the subjects kept a diary to record leakage or spillage when using the urinal. At the end of the week a product evaluation form was filled in to record product performance. The results from full testing indicate that all urinals were successful for some subjects. However, some urinals were found to be successful for all four main positions (e.g. Petal Female Urinal) while others were successful mainly in one or two positions (e.g. Bridge Saddle Pan and Subaseal). Many urinals were successful in the standing/crouching and sitting on the edge (of chair or bed) positions, while comparatively few urinals were successful in the lying position. It was found that the chances of finding a suitable urinal increased with levels of independence. This means that subjects with higher levels of dependency found fewer urinals to be suitable for their needs when used without assistance. The results of this evaluation provide guidance for product selection. However, it is recommended that continence specialists keep samples of the full range of female urinals to enable women to experiment with urinals in order to find one that best suits their needs.

Activities of Daily Living↗

Torsade de pointes ventricular tachycardia in a hypothyroid patient treated with propafenone.

A 31-year-old female had recurring palpitations and black-outs for 13 years. Hyperthyroidism was diagnosed and electrocardiogram suggested ventricular preexcitation. Despite being treated for hyperthyroidism (which rendered the patient hypothyroid) and receiving propranolol for the arrhythmia, the palpitations persisted. Electrophysiologic testing identified the patient's arrhythmia, and demonstrated that it improved with intravenous propafenone, a new type 1C antiarrhythmic medication. After two days of oral propafenone, this initially good response was followed by episodes of Torsade de pointes ventricular tachycardia with repeated cardiac arrest. Lidocaine and isoproterenol failed to control the rhythm, and the patient was stabilized by electrical cardioversions, atrial pacing and withdrawing the propafenone. Propafenone has been used to treat Torsade de pointes, but we show that it may also cause Torsade de pointes.

Adult↗