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Biomedical subjects

R J Robinson

Publications and source records attributed to R J Robinson.

At least 37 records · Page 2Linked to original sources
PubMed1996

Cancer surveillance in ulcerative colitis: a survey of patients' knowledge.

BACKGROUND AND STUDY AIMS: The present study aimed to investigate the level of knowledge concerning colorectal carcinoma and its screening and treatment in a group of patients with long-standing and extensive ulcerative colitis. PATIENTS AND METHODS: A postal questionnaire was sent to 61 patients with long-standing and extensive ulcerative colitis. They were asked about their risk of carcinoma, about the existence of screening facilities, and about the treatment of colorectal carcinoma. RESULTS: Forty-three completed questionnaires were returned. Eighty-six per cent of patients were aware of the increased risk of carcinoma. Only 44% knew that it was possible to screen for colorectal carcinoma. Forty-seven per cent of patients were unaware that carcinoma detected at screening would require surgical removal. CONCLUSION: Large numbers of patients are unaware of the existence of screening facilities for colorectal cancer, and are ignorant of the treatment of the disease. Increased public information is required to improve compliance with screening programmes, and to enable patients to take part in decisions about their management.

Colitis, Ulcerative↗
PubMed1996

Sigmoidoscopy and rectal biopsy: a survey of current UK practice.

OBJECTIVE: To establish the pattern of practice of sigmoidoscopy and rectal biopsy in the UK, and to estimate the rate of occurrence of important complications. DESIGN: Postal questionnaire enquiring about practice in the previous 2 years. SUBJECTS: Consultant members of the British Society of Gastroenterology. MAIN OUTCOME MEASURES: Bleeding or perforation following sigmoidoscopy and rectal biopsy. RESULTS: Completed replies were received from 277 consultants, giving a response rate of 84%. Of the sigmoidoscopies performed, 71% were rigid and the remainder fibreoptic flexible sigmoidoscopy (FOS). The complication rate after sigmoidoscopy and rectal biopsy was 0.01%. Perforation was significantly more common in FOS than in rigid sigmoidoscopy (eight in 134,482 sigmoidoscopies versus five in 328,815, chi2 = 5.18, P < 0.05). The distance from anal margin and wall of biopsy did not influence perforation rates. Significant bleeding was similar with both techniques (eight in 134,482 versus 35 in 328,815, chi2 = 2.27, NS). CONCLUSION: Rigid sigmoidoscopy is still more widely used than FOS in the UK, and is probably safer. Complications resulting from rectal biopsy are uncommon but perforation occurs more frequently with FOS than with rigid sigmoidoscopy. The site of biopsy appears to be unimportant.

Biopsy↗
PubMed1996

Does Crohn's disease need differentiation from tuberculosis?

Crohn's disease (CD) and tuberculosis (TB) of the gastrointestinal tract pose major diagnostic problems for clinicians where these conditions coexist. Clinically and radiologically, the diseases are similar. In the West, TB is considered in the differential diagnosis of all suspected cases of CD, particularly among Asian migrants. Earlier age of presentation, perianal disease and enteric fistulae favour a diagnosis of CD. Aphthoid ulceration, pseudopolyps and filiform mucosa at endoscopy are suggestive of CD and a negative tuberculin test us useful. The final diagnosis depends largely on histopathology and the presence or absence of acid fast bacilli. Tuberculosis is more common in developing countries and intestinal TB frequently coexists with pulmonary tuberculosis. TB is known to affect all age groups and fistulous communication, although uncommon, does occur. In addition to radiology and endoscopy, laparotomy may be required to establish the diagnosis. In developing countries, CD is uncommon and remains largely a diagnosis of exclusion. A trial of anti-tuberculosis therapy may often be prescribed before definitely diagnosing CD. The development of molecular biology techniques had led to a revival of interest in mycobacteria as a possible aetiological agent in CD. DNA from Mycobacterium paratuberculosis and Mycobacterium kansaii have both been identified in CD cases but the significance of this finding has not been established. However, in the near future polymerase chain reaction will become increasingly useful in differentiating CD from intestinal TB because it allows the amplification and identification of very small quantities of mycobacterium DNA.

Crohn Disease↗
PubMed1996

Pedal manifestations of Milroy's disease.

A pedal complication of Milroy's disease has been presented. With a history of multiple debridement procedures as in this case, there is the risk of recurrent infections and the possibility of permanent vascular compromise, particularly with respect to the thin pedal skin on the dorsal aspect. When the toes are recurrently involved with infection, a patient may be best served with a transmetatarsal amputation using a skin flap on the plantar aspect.

Adult↗
PubMed1993

Comparison of monoclonal antibodies AUA1 and BER EP4 with anti-CEA for detecting carcinoma cells in serous effusions and distinguishing them from mesothelial cells.

Commercially available monoclonal antibodies AUA1, BER EP4 and carcinoembryonic antigen (CEA) were applied to cell blocks from 95 serous effusions. AUA1 and BER EP4 were reactive with 89% of effusions known to contain carcinoma cells, and anti-CEA with 71%. They also reacted with cells in two effusions from patients with malignant disease which were regarded as negative on conventional cytological examination of Papanicolaou-stained smears. They were negative in all but one of the benign effusions. Using all three antibodies, 95% of effusions containing carcinoma cells were detected. Use of these antibodies could improve the cytological diagnosis of serous effusions.

Antibodies, Monoclonal↗
PubMed1993

Myositis due to cholesterol emboli.

Myositis due to spontaneous cholesterol embolization is uncommon and usually associated with cutaneous abnormalities at presentation. A case of myositis due to cholesterol emboli is reported. The patient presented with painful weak legs, and the diagnosis was confirmed by muscle biopsy.

Aortography↗
PubMed1991

Causes and associations of severe and persistent specific speech and language disorders in children.

Eighty-two school-age children with severe and persistent specific speech and language disorders were studied. 71 had specific developmental language disorders, three had structural malformations (cleft palate) and eight had disorders acquired after a period of normal language development, including five with Landau-Kleffner syndrome. The sex ratio was 3.8 boys to one girl. Nearly half had a family history of speech-language disorder, with one in 5.2 affected siblings. Aetiological factors were found in 26 per cent: 11 per cent prenatal, 3 per cent perinatal and 12 per cent postnatal. 21 per cent had had a seizure and 7 per cent had had seizures after the age of eight. 29 per cent were left-handed, 90 per cent were clumsy and 22 per cent first walked after 18 months. The complex origins of specific speech and language disorders are discussed.

Brain Damage, Chronic↗
PubMed1987

The incidence of awareness, and amnesia for perioperative events, after cardiac surgery with lorazepam and fentanyl anesthesia.

One hundred patients (mean age 59 +/- 10 years) were premedicated with morphine, 0.15 mg/kg, and scopolamine, 0.008 mg/kg. Anesthesia was induced with lorazepam, 50 microg/kg, followed by fentanyl, 50 microg/kg, oxygen and pancuronium, 0.15 mg/kg. Isoflurane was given for short periods before and after cardiopulmonary bypass to 57 patients when hypertension was uncontrolled by addition of fentanyl and/or nitroglycerin. Morphine was used as the sole sedative postoperatively. Patients were interviewed following discharge from the surgical intensive care unit to assess the incidence of operative awareness, and to assess amnesia for events occurring during four preoperative and two postoperative periods of the patients' hospital stay. During three preoperative periods (day of admission, evening before, and morning before operation), 1%, 3%, and 2% of patients had complete amnesia, and 19%, 41%, and 31% had partial amnesia of events. Fifty-five percent of patients exhibited complete, and 34% of patients exhibited partial amnesia to events occurring in the preinduction period. Two patients reported intraoperative awareness (noises, conversation) occurring at the end of the anesthetic. In the two postoperative periods (morning of the day after surgery and intensive care stay), 9% and 15% of patients had complete, and 35% and 47% of patients exhibited partial amnesia. Amnesia was statistically significantly greater in patients over 60 years of age in the preinduction period. Duration of cardiopulmonary bypass did not affect the incidence of amnesia.

Aged↗