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Biomedical subjects

W B James

Publications and source records attributed to W B James.

At least 19 recordsLinked to original sources
PubMed1994

A database on dyspepsia.

A prospective study of dyspepsia was carried out in a primary referral hospital between 1974-1987 including 1540 patients of whom 1433 were seen as outpatients. The study protocol was agreed in advance and a structured questionnaire was used to elicit relevant clinical information: up to three diagnoses were permitted for each patient. The commonest principal diagnoses were duodenal ulcer (26%), functional dyspepsia (22%), and irritable bowel syndrome (IBS) (15%); alcohol related dyspepsia (4%) was as common as gastric carcinoma or symptomatic gall stones. Multiple diagnoses were common (31% given two diagnoses, and 6% given three) so that in all 2111 diagnoses were given to 1540 patients; the functional disorders (IBS and functional dyspepsia) considered together accounted for 39% of all diagnoses made. Whereas organic conditions were diagnosed by clinicians with confidence (63-98% considered 'certain'), even when given as the principal or first diagnosis IBS was considered 'certain' in only 61% and functional dyspepsia 48%. The demographic symptom data, together with information on tobacco and alcohol use, and work lost are described in detail.

Adult↗
PubMed1982

Double-contrast examination of the oesophagus: the radiological changes of peptic oesophagitis.

A simple method for obtaining double-contrast views of the oesophagus as part of the routine double contrast examination of the upper gastrointestinal tract using high-density low-viscosity barium is described. The typical radiological changes of early peptic oesophagitis (confirmed by endoscopy) which can be readily demonstrated with this technique are illustrated as an example of its practical value. These consist of 'smudged' or 'cobble-stone' mucosa with thickened and distorted longitudinal folds. Superficial erosions and deep ulcers may also be seen. It is suggested that endoscopic confirmation of these characteristic radiological signs of peptic oesophagitis is unnecessary.

Barium↗
PubMed1982

Duodeno-gastric reflux in normal and dyspeptic subjects.

A simple radiological technique is described for detecting the presence, or absence, of duodeno-gastric reflux (DGR) at barium meal examination. The incidence of DGR was found to be approximately the same in both normal volunteers and dyspeptic patients. Although there was a slight trend towards an increased incidence in gastric ulcer, this did not reach statistical significance. The severity of reflux did not correlate with the presence of peptic ulceration. DGR appears to be more common with increasing age. Our results cast doubt on the hypothesis that reflux of duodenal content plays a primary role in the pathogenesis of gastric ulcer.

Adolescent↗
PubMed1981

Successful treatment of Raynaud's Syndrome with prostacyclin.

There is evidence to suggest that platelet activation occurs in Raynaud's syndrome. We evaluated the effect of prostacyclin (PGI2) a potent antiplatelet and vasodilator agent in 5 female patients with Raynaud's syndrome. Outpatient visits were made at weekly intervals for 4 weeks. At the first visit buffer solution (Wellcome Laboratories) was infused intravenously for 5 hrs, thereafter three five hr infusions of PGI2 at a peak dose of 10 ng/Kg/min were given. Six weeks after the infusions patients were reviewed. Symptomatic improvement, including healing of ischaemic ulcers, occurred in 4 out of 5 patients. Thermography confirmed an increase in hand temperature after PCI2. Subjective and objective improvement has persisted for at least 6 weeks after the last treatment.

Ambulatory Care↗
PubMed1981

Intravenous cholangiography by bolus injection of meglumine iotroxamate and meglumine iodoxamate: a comparative trial of two new contrast media.

The meglumine salts of iodoxamic and iotroxamic acids are recently developed intravenous cholangiographic media. In several studies these two media have been shown to be significantly better than meglumine iodipamide and meglumine ioglycamate for opacification of the biliary tree and incidence of adverse effects. As part of a multi-centre double-blind trial 100 patients were given iodoxamate or iotroxamate. Comparisons of opacification, side effects and renal excretion of contrast were made. The results showed no statistically significant difference in biliary tree opacification; more frequent renal excretion of contrast with iodoxamate; and contrary to previous reports a slightly higher incidence of side effects with iotroxamate.

Biliary Tract↗
PubMed1980

Barium sulphate preparations for use in double contrast examination of the upper gastrointestinal tract.

Physical properties relevant to upper gastrointestinal radiology have been compared for five barium sulphate preparations and related to radiographic results. Evaluation of particles (size and stability) and whole suspension (dispersibility and fluidity) resulted in ranking of the preparations generally in accord with that based on radiological experience in double contrast examinations of the stomach. Experiments with extirpated pig stomach revealed a tendency for large particles in a low viscosity barium sulphate suspension to settle in mucosal grooves. This is believed to contribute to good radiographic definition of both the areae gastricae and small lesions. Particle size is therefore important and susceptibility to flocculation, a possible cause of random change in size during use, was assessed by measuring particle electrophoretic mobility under varying conditions; quantitative differences in suspension flow and dispersibility were also demonstrated. Fluidity and dispersibility together with rapid sedimentation of suitably sized particles resistant to flocculation underlie the successful use of low viscosity high density barium sulphate suspensions.

Animals↗
PubMed1980

Areae gastricae.

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Animals↗
PubMed1979

The use of information theory in evaluating the contribution of radiological and laboratory investigations to diagnosis and management.

Using information theory, the value of radiological and laboratory investigations has been assessed in the diagnosis and management of 67 patients suspected of having inflammatory polyarthritis. There were only three changes in diagnosis made as a result of the investigations. Both the radiological and laboratory tests supplied a small but significant amount of information in improving the physician's confidence in diagnosis. Changes in management occurred more frequently but the final management decision differed from the pre-investigation decision in only 17 of the 67 patients (25%). Radiological examination failed to decrease uncertainty using a simple 'change in uncertainty' measure. Both types of investigation supplied a limited bu significant amount of information towards the final management decision, although the contribution from radiology was only significant when view before the receipt of the results of the laboratory tests. In view of the limited value of the investigations - particularly radiology - in this study, it is important to fully asses present and future diagnostic procedures especially in relation to patient management.

Arthritis↗
PubMed1978

Assessment of rheumatoid inflammation in the knee joint. A reappraisal.

Subjective pain score, clinical assessment, 99m technetium joint uptake, infrared thermography, and thermistor skin temperature measurements were evaluated and compared in patients with rheumatoid knee treated with intra-articular hydrocortisone. In 11 patients with definite and classical rheumatoid arthritis, 10 of whom had unilateral knee involvement, the affected knee joints were assessed by the above techniques before and at intervals after treatment of up to 14 days. The anti-inflammatory property of the steroid therapy was shown by all the assessment parameters, values having decreased significantly from the pretreatment values. However, the only parameter still showing a statistically significant decrease on the 14th post-treatment day was 99mTc joint uptake. Correlations were obtained between the two clinical measurements assessed by a physician i.e. pain score and index of joint inflammation. Both of these also correlated with the 99mTc joint uptake but not with skin temperature measurements. Using the clinical assessments as a yardstick, 99mTc joint uptake seemed to provide a useful index of changes in disease activity in the group as a whole. However, skin temperature measurements by infrared thermography and by the thermistor were of considerably less value.

Arthritis, Rheumatoid↗
PubMed1976

The relationship between thermographic findings and size and depth of tumour in carcinoma of the breast.

Fifty thermograms of histologically proved breast carcinomas have been analysed without knowledge of the clinical or mammographic findings. Thermographic asymmetry between the breasts was found in 76 percent of the patients, but in only 64 per cent of the patients was the correct side indicated. Poor correlations has also been found between the thermographic findings and the size of a tumour and its distance from the skin.

Body Temperature↗