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Biomedical subjects

R Railton

Publications and source records attributed to R Railton.

At least 19 recordsLinked to original sources
PubMed1994

Death of a classified worker probably caused by overexposure to gamma radiation.

This paper describes the case of an industrial radiographer who was seriously overexposed to gamma radiation. The exact circumstances of this exposure were not established but it was concluded that he was repeatedly irradiated probably to a total average whole body dose of at least 10 Gy over several years. Also, a much larger dose to a hand required its partial amputation. He developed myelodysplasia, which progressed to acute myeloid leukaemia from which he died. Karyotypic examination of the leukaemic blasts showed changes very similar to those associated with secondary leukaemia that may develop after radio or chemotherapy. The paper describes his medical case history, the investigation of his workplace, and the attempts to estimate his radiation dose by chromosomal analysis of blood lymphocytes and electron spin resonance of dental enamel and bone.

Acute Disease↗
PubMed1993

Malfunction of medical equipment as a result of mains borne interference.

Medical equipment has become more intelligent as the manufacturers have incorporated the latest microprocessor based technology. Equipment malfunction can be caused at any time by inherent errors in the control program but it is particularly important that this is designed to cope with the effects of electrical interference which, in addition, may cause corruption of the software. We have considered interference found in the mains supply in the hospital environment. Using a test protocol with appropriate interference simulators, a wide range of medical equipment was removed temporarily from use and its immunity to electrical mains borne interference tested. Battery operated mains rechargeable devices were unaffected by mains voltage variations including drop-outs and sags whereas mains powered devices were affected to varying degrees of severity. In particular, repetitive drop-outs caused loss of power due to fuse blowing in some life support equipment. Impulses affected 25% and pulse bursts 50% of the equipment tested with some evidence that the more recent designs coped better. The EEC Directive on electro-medical compatibility compliance may cause the design of equipment to be improved but hospitals will have to cope with the above problems in their existing equipment for many years to come.

Electricity↗
PubMed1993

The value of thallium scintigraphy in a district general hospital.

The usefulness of exercise Tl scintigraphy (combined with electrocardiography) in a district general hospital has been assessed in 80 patients in whom a previous exercise electrocardiogram (ECG) had not been definitive. Seventy-five of the patients presented with chest pain and five with no pain but an abnormal ECG. Case notes and test results were examined to establish the clinicians' judgment of the likelihood of having coronary heart disease (CHD) and the patient's outcome. The mean time of follow-up was 27 months. In the majority of patients the test was found to help the clinician come to a decision on the presence or absence of CHD. It was found to be particularly useful in patients with abnormal resting ECGs. There was a shorter time to discharge for patients classified as highly unlikely of having CHD. Only four patients were re-referred following discharge from the outpatient clinic. Nine patients were referred for coronary angiography with five being found to have significant stenosis. None of the 16 patients in whom the exercise ECG was normal had ischaemic myocardial segments in the Tl scintigraphy.

Coronary Disease↗
PubMed1989

Lymphoscintigraphy in the detection of cervical metastases from oral carcinoma: a pilot study.

This paper reports the findings of a pilot study in which a radioisotope technique was used in the detection of cervical metastases in patients with histologically proven oral squamous cell carcinomata. Sixteen patients were assessed with the technique after diagnosis and then examined after an interval of not less than 6 months for evidence of palpable cervical-lymph nodes. Eight of the patients subsequently underwent radical neck dissection. Comparing the radioisotope technique to the clinical findings and surgery revealed a high incidence of false-positives. However, since 11 of the patients received chemotherapy, it may be that the false-positive results reflect regression of disease caused by chemotherapy. The 11 patients did not show evidence of any other pathology in the neck. This technique, with further refinement, could be a useful diagnostic tool to screen cervical metastases that are below the threshold of manual palpation, since early identification of neck cervical nodes is crucial to the treatment plan and management.

Aged↗
PubMed1988

Long-term performance of Tec vaporizers. Basis for a rational maintenance policy.

We reviewed the maintenance records of Tec vaporizers which had been in clinical use for up to 4 years. Tec 4s and Enfluratec 3s were found to be extremely reliable, but Fluotec 3s suffered progressively from mechanical and calibration problems. Their most recurrent fault was sticking valves caused probably by thymol crystallizing on the valve faces. This fault did not occur with Fluotec 4s, which are designed to prevent liquid agent reaching the valve surfaces. We found, in a study of the effects of thymol accumulation, that only occasional draining of a Fluotec vaporizer is required to keep thymol concentration below the level at which its output is reduced. We conclude that, if regular field calibration checks are carried out as a safety measure, the service interval for Tec vaporizers could be extended beyond Ohmeda's present recommendation of one year.

Anesthesia, Inhalation↗
PubMed1987

Myocardial scintigraphy with I-123 heptadecanoic acid as a test for coronary heart disease.

We have evaluated 123I-heptadecanoic acid for myocardial scintigraphy in the diagnosis of coronary heart disease by comparing the results obtained with it in subject groups with high and low probabilities of disease. We conclude that although some patients in the former group can be identified, the test is neither sufficiently sensitive nor specific for routine clinical use.

Adult↗
PubMed1987

Comparison of electrical measurements on constant voltage and constant current ECT machines.

Electrical measurements were made during treatment of two groups of patients, one group receiving treatment from a constant current ECT machine and the other from a constant voltage machine. The electrical impedance and energy were calculated and compared for the two groups. More energy was delivered by the constant voltage than by the constant current machine, but the spread of energy delivered was comparable. With a consistent technique for applying the electrodes there is little to choose between these machines, but the constant current machine may be preferred where consistency cannot be achieved.

Acute Disease↗
PubMed1986

Exposure of midwives to nitrous oxide in four hospitals.

The exposure of midwives to nitrous oxide in four hospitals was measured with personal samplers. In three of the four hospitals the average exposure was not significantly less than 100 parts per million (ppm). In one hospital the average exposure was 360 ppm; this was reduced by a factor of about 2.5 when a trial scavenging system was used. Differences in working practices and in the layout, size, and ventilation of the labour suites contributed to the observed differences in average exposure. Midwives and other staff working in the labour room are potentially at risk from excessive occupational exposure to nitrous oxide.

Anesthesia, Obstetrical↗
PubMed1986

Variability of left ventricular function at diagnosis and after treatment in insulin-dependent diabetes.

Measurements of left ventricular ejection fraction (LVEF) were made using nuclear angiography in 9 newly-diagnosed insulin-dependent diabetic patients at diagnosis and after a period of stable control. Similar measurements were made in a control group of 10 insulin-dependent patients whose control was stable. While mean LVEF did not change significantly in either group, 5 of the newly-diagnosed patients had a significant change in LVEF (both positive and negative). None of the stable diabetic patients had any significant change in LVEF. Analysis of variance of the changes in LVEF in both groups showed a significant difference (p less than 0.002). Abnormal left ventricular function in diabetic patients may be transient, reversible and related to change in diabetic control and need not indicate structural myocardial disease such as cardiomyopathy.

Adolescent↗