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Biomedical subjects

W House

Publications and source records attributed to W House.

At least 19 recordsLinked to original sources
PubMed1999

Identifying and screening patients at high risk of colorectal cancer in general practice.

OBJECTIVES: To determine the feasibility and acceptability of selecting patients at risk of colorectal cancer by taking family histories by means of a postal questionnaire. To determine if this information could be translated into simple risk categories to guide subsequent management. SETTING: Patients aged between 30 and 69 years inclusive, registered with a mixed suburban and rural training general practice in south west England. METHOD: A postal questionnaire survey seeking demographic information and family history of colorectal cancer was sent to all eligible patients. Personal risk of colorectal cancer was stratified according to predetermined criteria. Risk assessment was modified if necessary after the general practitioner conferred with a geneticist. Patients were subsequently offered colonoscopy (high risk) or faecal occult blood testing (intermediate risk). RESULTS: Response to the questionnaire was 84.7%. 250 patients had a family history of colorectal cancer, of whom 52 were assigned to the high risk group, 104 to the intermediate group, and 94 to the low risk group. The geneticist reassigned five intermediate risk patients to the high risk group. Of 27 patients who had a colonoscopy, two were found to have an adenocarcinoma and a further two adenomatous polyps. In the group given faecal occult blood testing, two patients presented with colorectal cancer before being screened. CONCLUSIONS: A postal questionnaire is feasible and acceptable for the collection of information about a family history of colorectal cancer from patients in general practice. The personal risk of developing the disease according to standard criteria can be estimated and then managed by a simple protocol.

Adult↗
PubMed1998

Comparison of oral and intraperitoneal iron supplementation in anaemic rats: a re-evaluation of the mucosal block theory of iron absorption.

To evaluate the extent to which daily oral Fe supplements may block Fe absorption from a subsequent dose, we compared effects of oral and intraperitoneal (i.p.) Fe supplementation on Fe status in anaemic rats (haemoglobin (Hb) 90 g/l). A ligated duodenal loop technique was used to assess the effects of the Fe supplements administered either orally or i.p. at different frequencies on Fe absorption from a subsequent test dose. Anaemic Sprague-Dawley rats were assigned to seven groups of eight rats each and received either oral or i.p. Fe supplements for 3 d as follows: (1) 4 mg oral supplement daily (three doses in 3 d); (2) 4 mg oral supplement once (one dose on day 1, low-Fe dose on days 2 and 3); (3) 12 mg oral supplement once (one dose on day 1, low-Fe dose on days 2 and 3); (4) 3.2 mg i.p. supplement daily (three doses in 3 d); (5) 3.2 mg i.p. supplement once (one dose on day 1); (6) 9.6 mg i.p. supplement once (one dose on day 1); (7) low-Fe diet (control). The effectiveness of the supplements in treating Fe deficiency on each of the two test-factors, i.e. route of administration and frequency of dose, was assessed by determining Hb-Fe gain and liver-Fe stores after the 3 d test period. Oral supplementation was as effective as i.p. in improving the Fe status of the anaemic animals. However, a 15 min absorption of a radio-Fe test dose from a ligated loop in i.p.-supplemented groups was significantly higher (11.68 (SD 1.70)%, 17.49 (SD 4.59)%, 16.71 (SD 3.39)%) than in orally supplemented groups (3.24 (SD 1.35)%, 2.45 (SD 1.05)%, 1.80 (SD 0.35)%) despite equal body Fe stores. No significant difference in intestinal Fe absorption efficiency was detected within the oral groups but those supplemented only once were more effective than or as effective as the group receiving daily supplements for 3 d in improving Fe status as indicated by Hb-regeneration efficiency. We conclude that there is a mucosal block with the administration of oral Fe supplements but the extent of this blocking effect during oral Fe supplementation is not as dramatic as currently thought in the context of the poor efficacy of daily Fe supplementation programmes.

Administration, Oral↗
PubMed1997

Influence of iron supplementation frequency on absorption efficiency and mucosal ferritin in anaemic rats.

It is believed that frequent Fe doses decrease the efficiency of absorption as a consequence of the loading of intestinal mucosal cells with Fe from the previous supplemental dose. We examined this premise in thirty anaemic Sprague-Dawley rats given Fe supplements as FeSO4 in 1 g preparations of a 50:50 (w/w mixture of low-Fe diet and sucrose under one of the following regimens: one 3 mg Fe dose daily for 3d, four 0.75 mg doses daily at 6 h intervals for 3 d, and one 9 mg dose on day 1 followed by two placebo (low-Fe diet) doses on days 2 and 3. All groups were fed on two low-Fe meals daily (8.3 mg Fe/kg diet). After an overnight fast rats were dosed with 1 ml of an 59Fe-labelled ferric nitrilotriacetic acid solution (37 kBq 59Fe, 50 micrograms Fe) orally and killed 10 h later. Absorption of 59Fe was measured as the percentage of the 59Fe retained by the carcass without the gastrointestinal tract 10 h after dosing relative to the initial 59Fe dose. Haemoglobin-Fe gain, liver non-haem-Fe, and mucosal duodenal ferritin were determined after the 3 d supplementation period. Absorption of the test dose in rats supplemented once 3 d before assessment of Fe absorption was 2.6-fold greater than those supplemented with daily single doses and 1.9-fold greater than those supplemented with daily multiple doses. Our data indicate that both mucosal ferritin and liver Fe levels account for the higher absorption efficiency found in rats supplemented once to simulate intermittent regimens.

Anemia, Iron-Deficiency↗
PubMed1991

Lymphocyte-macrophage activity in the human endolymphatic sac.

The human endolymphatic sac was analysed electron microscopically in patients undergoing acoustic Schwannoma surgery or vestibular nerve section. In addition, endolymphatic sacs from cadavers were analysed light microscopically. The results show that the human sac is endowed with a variable number of leucocytes and that there is a continuous recirculation of immuno-competent cells in this area of the inner ear that may be of importance for clearance of the inner ear from foreign substances and microorganisms derived from nearby located infection-prone areas. The possibility in Meniere's disease of a disturbed immunological activity in the sac is discussed.

Ear, Inner↗
PubMed1990

Normal nasal airway resistance in noses of different sizes and shapes.

Measurement of nasal airway resistance is becoming a common clinical technique. Accurate definition of the normal range of airflow is critical for maximal usefulness of this technique. Since typical nasal size and shape vary greatly with ethnic background, different norms for different ethnic groups may be appropriate. Nasal airway flow and resistance and external nasal size and shape were measured in 130 asymptomatic subjects (52 black, 56 white, and 22 Hispanic). Nasal length, width, columellar length, and nasolabial angle were similar for whites and Hispanics, but both groups differed significantly from blacks--even when changes attributable to biologic aging were factored out. In spite of these differences, there was no significant difference in any nasal airflow or resistance parameter among groups, suggesting that currently used airflow and resistance standards are valid for these three different ethnic groups.

Airway Resistance↗
PubMed1990

[Cochlear implants].

William House gives in the address the essential of his philosophy about cochlear implant: "My 30 years of experience with cochlear implants has gone by very quickly. It is only during the past 10 years that cochlear implants have been widely used throughout the world. During that 10 years we have seen a change in the attitudes of scepticism and outright feeling of opposition to this technology to general acceptance and widespread interest. Implants are still in their infancy, and my present feeling is that it will take at least 20 years for this technology to reach maturity. I feel that we will only reach the ultimate maturity of cochlear implant technology if we keep a very open mind as to different types of devices and processing schemes, and if we try to keep our technology as simplified as possible in order to minimize our clinical time in working with these patients, and also minimize the cost of the manufacturing and maintenance of complex systems".

Adult↗
PubMed1987

Comparison of outcome of low-risk labour in an isolated general practice maternity unit and a specialist maternity hospital.

The outcome of labour of 185 low-risk pregnancies at an isolated general practitioner maternity unit was compared with that for 185 comparable low-risk pregnancies at a specialist maternity hospital. No difference was found in mode of delivery or in the proportion of women requiring no analgesia, although significantly more women in the general practice group received analgesia beyond nitrous oxide. There was a significantly higher level of intervention in labour in the maternity hospital group in the form of fetal monitoring and augmentation of labour. The duration of first stage of labour was longer and meconium staining less frequent in the general practice group. Fourteen (7.6%) of the general practice group were transferred in labour to the specialist unit.The results suggest that where considerations for selection of low-risk pregnancy permit, the general practice maternity unit can provide a distinctive style of intrapartum care with minimum intervention.

Delivery Rooms↗
PubMed1987

Outcome of women booked into an isolated general practice maternity unit over eight years.

The outcome of pregnancy of 1303 women admitted for delivery (including those transferred after admission) at an isolated general practitioner maternity unit over the period 1978-85 was studied. The outcome following change of booking before admission was also assessed for the years 1982-85. The crude perinatal mortality rate was 1.5 per 1000 for all admissions between 1978 and 1985. Of the women admitted in 1978-85 7.4% were transferred after admission while for those booked at the unit in 1982-85 11.3% had their place of booking changed. A higher proportion of nulliparous women than multiparous women were transferred or had their place of booking changed. The main reasons for transfer after admission were delay in the first stage of labour (21.9%), spontaneous rupture of membranes not in labour (16.7%) and hypertension (15.6%), and for change of booking postmaturity (26.9%) and hypertension (16.4%).Sufficient information concerning risk of transfer and change of booking may now be available from studies of isolated general practice maternity units for pregnant women at low risk to make an informed choice of place for delivery.

Delivery Rooms↗
PubMed1984

Hearing preservation in patients with acoustic neuromas via the middle fossa approach.

Twenty patients with acoustic neuromas were operated on in an attempt to preserve hearing. These patients were selected from a series of approximately 300 patients seen from May 1975 to March 1979. All patients were operated on via the middle fossa approach. Hearing was preserved in approximately 35% of the patients. Preoperative and postoperative audiograms were performed on all patients. Tumor size ranged from 5 to 15 mm. These current cases are compared and added to our previous series of 17 cases (10 with hearing preserved) from a series of 500 acoustic neuromas reported elsewhere. Selection of patients, audiogram results, details of the middle fossa procedure, and work by other investigators are discussed.

Hearing Loss↗
PubMed1980

Vestibular neuronitis. Electron microscopy of Scarpa's ganglion.

Scarpa's ganglion and the superior vestibular nerve of a patient with vestibular neuronitis examined under the electron microscope displayed degenerative neuronal changes and axonal lesions considered to be the cause of the clinical features of vestibular neuronitis.

Female↗
PubMed1980

Pressure sensation in Meniere's disease.

This article reports a case of Meniere's disease accompanied by a persistent feeling of pressure in the ear. The patient had undergone a series of surgical procedures to alleviate his symptoms. The pressure sensation was relieved only by translabyrinthine cochlear nerve section. The relationships of the result of translabyrinthine cochlear nerve section with the mechanism and pathway of the pressure sensation are discussed. Cochlear nerve section is recommended at the same time as vestibular nerve section for patients with unilateral Meniere's disease with severe pressure sensation in the ear.

Adult↗