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Biomedical subjects

A F Evans

Publications and source records attributed to A F Evans.

7 recordsLinked to original sources
PubMed1989

Spread of local anaesthetic solutions following sacral extradural (caudal) block: influence of posture.

Extradural sacral (caudal) block was performed in 17 cases (14 patients) of chronic low back pain. In each case 22 ml of a bupivacaine/methylprednisolone solution incorporating a radioopaque dye was injected over a 2-min period. Patients were randomly assigned to receive the injection in the horizontal position or with 15 degrees head-up or head-down tilt applied to the operating table. Results indicate that analgesia is usually more localised than spread of solution determined by x-ray evidence and that higher levels of analgesia are achieved in patients in the head-up position. Possible causes are the differing distribution characteristics of the constituents of the solution and the gravitational effects of posture on cerebrospinal fluid mechanics. Technical problems associated with obesity, congenital abnormalities, vascular uptake of solution, and delayed spread of the injectant due to adhesions are discussed.

Anesthetics, Local↗
PubMed1979

Initial experiences with a formalised teaching programme in diagnostic radiology during the clinical undergraduate course.

The initial experiences of a four-week clinical undergraduate attachment in diagnostic radiology are described. The course is divided into (1) a series of prepared lecture programmes which cover aspects of diagnostic radiology in a systematic manner, (2) experience in hospital X-ray departments, observing special investigations and routine reporting, attending clinicoradiological conferences and receiving informal and formal tuition from radiologists, and (3) visits to specialised radiological and other imaging departments, namely ultrasound, nuclear medicine, neuroradiology and paediatrics. The aims of the courses are: (i) to provide a means of teaching clinical subjects and pathology in a dimension which crosses the tightly compartmentalised undergraduate curriculum; (ii) to instil basic principles of radiological interpretation, (iii) to teach undergraduates how to use the facilities of diagnostic imaging departments effectively and efficiently when they have qualified; (iv) to increase interest in the specialty, and insight into student opinion. There are difficulties involved in this large teaching commitment, for instance, understaffing, and the development of the course has been geared to counteracting these problems.

Curriculum↗
PubMed1979

The effect of glucagon on infusion cholangiography.

The study was undertaken to assess the effects of glucagon on biliary tract opacification during intravenous cholangiography. Two series of infusion cholangiograms were obtained at two investigating centres designated A and B. In series A, 41 patients had ioglycamide infusions at a rate of 0.2833 g min-1 over 1 h. In series B, 31 patients had ioglycamide infusions at a rate of 0.3886 g min-1 over 30 min. Radiographs were taken in both series, immediately at the end of the infusion, 10 min later and 30 min after the infusion. Two mg of intravenous glucagon was injected into alternate cases in both series A and B immediately after the first radiograph was taken at the completion of the ioglycamide infusion. Two observers in each series than assessed the radiographic opacification of the biliary system without prior knowledge of which patients had received the glucagon. Delineation of the biliary system was considered better in both series in those patients who received glucagon when compared with the controls. Gallbladder opacification was definitely increased in series A in those receiving glucagon, and a similar tendency was shown in series B. The amount of contrast in the upper intestine was increased in series A in the glucagon group, but not in series B. It is concluded that glucagon improves visualisation of the biliary tract, especially the gallbladder at infusion cholangiography.

Bile↗
PubMed1979

Venous aortography--a forgotten technique.

A simple technique of venous aortography is described. Eleven patients were examined, 10 with suspected aortic aneurysms. The diagnosis was confirmed in six cases and the relationship of the aneurysm to the renal arteries shown in five of them. Three patients were shown to have a normal aorta. One patient with a suspected saddle embolus was shown to have a normal aorta and iliac arteries. There was one failure but there were no serious complications. The technique is a reliable and simple method of visualising arotic aneurysms, especially if subtraction prints are made.

Aorta, Abdominal↗
PubMed1979

Device for extradural monitoring of intracranial pressure: technical note.

An ICP-monitoring device utilizing an extradural method is described. Clinical and laboratory use has shown it to be easily installed, safe, accurate, and reliable. It can be used with currently available transducers and monitoring equipment. It is hoped that this simple device will encourage the increased use of ICP monitoring.

Humans↗
PubMed1978

Post-traumatic skull radiographs. Time for a reappraisal.

504 patients who had skull radiographs for head injury are included in this study. Only 9 (1.9%) had demonstrable fractures. 129 (25%) of the patients reviewed were admitted to hospital. 93 of these were admitted for up to 24 hours, and 36 for a longer period, usually for conditions unrelated to the head trauma. All but 1 of the patients with a demonstrable skull fracture were admitted to hospital, and the radiographic findings initiated active medical intervention in 2 of these cases. There was no correlation between radiographic findings and the need for hospital admission, and little correlation between radiographic findings and the presenting signs and symptoms. It is, therefore, suggested that the indications for skull radiography in the management of head injuries require reappraisal.

Craniocerebral Trauma↗