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Biomedical subjects

A K Grant

Publications and source records attributed to A K Grant.

12 recordsLinked to original sources
PubMed1979

Iron deficiency anaemia--a prospective study.

A prospective study was performed over 15 months to determine the cause of iron deficiency in adult males and postmenopausal females attending a general hospital. The laboratory computer identified all subjects with a haemoglobin less than 10.6 g/dl and a mean corpuscular volume less than 86 fl. Patients becoming anaemic after trauma or recent surgery were excluded. The iron status of each patient was assessed by serum iron studies, serum ferritin or sternal marrow aspiration. Reduced red cell indices and blood film morphology were not diagnostic of iron deficiency. Of 215 patients assessed, about half (103) were found to be iron replete. This group had a variety of disorders--malignancy, chronic inflammation, chronic renal and non-malignant haematological diseases. The other group of 104 patients satisfied criteria for iron deficiency, and 100 of these were investigated further. The cause of iron deficiency was found in all but three subjects. Inadequate dietary intake was a contributing factor in over half of the patients and 40 regularly took salicylates. Investigation defined a source of chronic gastrointestinal blood loss in most instances.

Adult↗
PubMed1978

The Mallory-Weiss lesion: a five-year experience.

A retrospective survey has been made of patients with the Mallory-Weiss lesion who presented with upper gastrointestinal tract bleeding during the period 1972 to 1976. The lesion was diagnosed endoscopically in 78 cases, representing 7.7% of the total number of patients admitted with upper gastrointestinal tract bleeding. Patients ranged in age from 18 to 86 years (mean 43 years). The male-female ratio was 3:1. A history of retching and vomiting clearly preceded the bleeding in 60 patients. Significant alcohol intake within 48 hours of bleeding was reported in 53% of patients. Other upper gastrointestinal tract conditions, or migraine, may have induced vomiting in some instances. Previously known Mallory-Weiss lesions were rare (two patients), but 21% of patients had well documented past upper gastrointestinal tract bleeding from other causes. The tears were situated at the cardio-oesophageal junction in 47% of patients and were entirely gastric in 30%; 23% were oesophageal. Blood replacement was required in 31 patients (40%), and 16 of these were transfused with five or more units. Of those patients requiring transfusion, half had other significant pathological lesions. The mean hospital stay was four days and prolonged stay in hospital was usually necessary only in the presence of other disease. In no instance was surgery required primarily to control bleeding from mucosal tears. This study suggests that the Mallory-Weiss lesion is a relatively common cause of upper gastrointestinal tract bleeding, but that it is usually a benign condition, unless it complicates some other disorder.

Adolescent↗
PubMed1978

The significance of widening of the presacral space at contrast radiography in inflammatory bowel disease.

The width of the presacral space was measured prospectively at various levels in 100 persons without organic colonic or rectal disease who had barium enema X-ray examinations. A standard technique was employed. The most consistent measurement was obtained at the level opposite the S3-S4 disc space; readings varied between 2 mm and 16 mm. Using 16 mm as the upper limit of normal, and a similar technique of barium enema examination, the width of the presacral space at the S3-S4 disc level was measured in 66 patients with inflammatory bowel disease (ulcerative colitis--49; Crohn's colitis--17). The width did not correlate with the severity of the disease process as indicated by sigmoidoscopic examination in proximity in time to the radiological examination. There was a relationship between increased width of the presacral space and the duration of the disease process.

Adolescent↗
PubMed1978

Gastrointestinal pitfalls.

Gastrointestinal symptoms account for 15 to 30 per cent of patients presenting to first contact doctors. The disorders causing these are many and varied--some are rare but most are common. While a considerable depth of knowledge is necessary to suspect, diagnose and treat the rarer diseases, it is the common conditions which constitute the major problems in everyday practice. These problems usually result from inadequate clinical assessment, from a lack of logical thought, from incorrect teaching in undergraduate years and from an uncritical application of therapeutic methods which are not based on scientific fact.

Cholelithiasis↗
PubMed1977

Obstruction of the gastrointestinal tract by foreign bodies in adults.

Foreign bodies may become impacted because of congenital or acquired narrowing of the gastrointestinal tract or owing to unusual physical characteristics of the ingested material. Active intervention is necessary when impaction is complicated by intestinal obstruction or perforation or when the foreign body is composed of a toxic substance.

Adult↗
PubMed1977

Endoscopic diagnosis of metastatic disease of the stomach and duodenum.

The commonest tumours which metastasise to the upper gastrointestinal tract are from malignant melanoma, carcinoma of the breast and lung. Over a period of 12 months, three persons with known malignant disease were submitted to endoscopy by reason of upper gastrointestinal symptoms which could have been due to associated non-malignant disease. Two patients had known malignant melanoma and one a carcinoma of the breast. In each instance, endoscopy and biopsy demonstrated evidence of metastatic disease.

Adult↗
PubMed1977

Alpha1-antitrypsin deficiency--a literature review and a case report of a patient with chronic obstructive airways disease and cirrhosis.

A patient who manifested both pulmonary and hepatic disease associated with alpha1-antitrypsin deficiency is described. The biological function of alpha1-antitrypsin is discussed, as well as the inheritance of deficiency states and the spectrum of disorders which may ensue. Severe deficiency of alpha1-antitrypsin has been linked with pulmonary emphysema in adult life, progressive liver disease in childhood, adult cirrhosis but rarely with both pulmonary and liver disease.

Chronic Disease↗
PubMed1977

Colonoscopy and bacteraemia.

A prospective study was performed on 35 patients undergoing colonoscopy. Aerobic and anaerobic blood cultures before, during and after the investigation failed to demonstrate bacteraemia in any instance.

Australia↗
PubMed1977

Pancreatitis and renal disease.

Pancreatitis has been described previously following renal transplantation, but not in association with chronic renal failure. Analysis of 168 patients with renal transplants revealed five who developed pancreatitis, three of whom died. All five were on treatment with prednisone and azathioprine. Four patients were seen with definite attacks of pancreatitis and chronic, stable renal failure from a variety of causes. None had received immunosuppressive agents, prednisone nor thiazide diuretics, but two were on regular frusemide. One patient was on maintenance dialysis, which could not be related directly to the pancreatitis. In either group alcohol ingestion, cholethiathiasis, or hypercalcaemia was not a factor. This diagnosis of pancreatitis was established on clinical grounds and serum amylast levels of greater than 900 iu/1. Similar serum amylast elevation was not found ina random group of patients with chronic renal failure. Hyperlipidaemia was not present in any patient with pancreatitis. Although hypercalcaemia and primary hyperparathyroidism was not found in the transplant and non-transplant subjects, elevated serum parathormone levels have been described in uraemic patients with normocalcaemia. Hyperparathyroidism may be a factor in the development of pancreatitis in reanl failure. Pancreatitis carries a significant mortality risk in renal transplantation. The four non-transplanted patients have survived, despite recurrent attacks of pancreatitis.

Acute Disease↗
PubMed1976

Gastric ulceration within hiatus hernia.

A retrospective analysis has been made of 19 persons with gastric ulceration in hiatus hernias. Eleven patients presented with acute upper gastrointestinal haemorrhage and three with chronic anaemia. Seventeen had experienced previous abdominal discomfort or heartburn. Diagnosis of ulceration was achieved by endoscopy in 16 instances and by radiography in six instances. A chronic ulcer was found in 10 patients, a discrete acute ulcer in three and multiple erosions in six. Twelve of the hernias were sliding in type and irreducible, in contrast to previous reports that gastric ulceration is most frequent in paracoesophageal hernias. Conservative management resulted in complete healing of the ulcer in the majority of patients. Continued bleeding or failure of the ulcer to heal necessitated surgical intervention in six patients.

Adult↗
PubMed1976

Bleeding mucosal lesions in the upper gastrointestinal tracts of patients with oesophageal varices and hepatic cirrhosis.

Thirty panendoscopic examinations were carried out on 24 patients with oesophageal varices and hepatic cirrhosis who presented with gastrointestinal hemorrhage. A mucosal lesion, focal or diffuse, was found in the upper gastrointestinal tract in all but three instances. The findings confirmed previous reports that hemorrhage in patients with oesophageal varices frequently occurs from a source other than variceal. This study has also demonstrated that where hemorrhage occurs from oesophageal varices, erosions of the oesophageal mucosa may play a major role in its pathogenesis.

Adult↗