PubMed Health⌕ Search

Biomedical subjects

A T Axon

Publications and source records attributed to A T Axon.

At least 217 records · Page 12Linked to original sources
PubMed1984

Use of a long acting somatostatin analogue in controlling life threatening ileostomy diarrhoea.

A woman presented with persistent ileostomy diarrhoea unresponsive to conventional drug treatment and necessitating parenteral nutrition. Output was four to six litres of watery fluid per 24 hours while she was receiving oral nutrition and two to three litres when she was starved. Treatment with a long acting analogue of somatostatin (50 micrograms subcutaneously every 12 hours) reduced the ileostomy output to 2.0-2.5 litres/24 hours with an oral diet and the effluent became semiformed. Parenteral fluids could be stopped. Somatostatin may have a role in the treatment of secretory diarrhoea, but prospective controlled trials are necessary.

Diarrhea↗
PubMed1984

Prospective comparison of three non-invasive tests for pancreatic disease.

Ultrasonography, computed tomography (CT), and an oral pancreatic function test were evaluated prospectively in 107 consecutive patients suspected of having pancreatic disease, the final diagnosis being made independently of these tests. Seventeen patients proved to have either chronic pancreatitis or a pancreatic neoplasm. Five had an unfused ventral pancreas and 10 had "minimal change" pancreatograms. Seventy five patients did not have pancreatic disease. Among the 17 patients with pancreatic disease the sensitivities of ultrasound, CT, and the pancreatic function test were 70%, 71%, and 76% respectively; among those without disease values of specificity of the three tests were 75%, 87%, and 72%. All three tests failed to detect most of the patients with unfused ventral pancreases or minimal change pancreatograms. The predictive values of a positive result for the three tests were 43%, 67%, and 34%. The predictive value of a negative result was greater than 90% for all the tests. Results improved when CT was combined with either of the two other tests. These findings show that CT is the most accurate of the three tests in diagnosing pancreatic disease but that a combination of ultrasound and the oral pancreatic function test offers a more widely applicable and almost as accurate alternative.

4-Aminobenzoic Acid↗
PubMed1984

A comparison of prednisolone enemas with low-dose oral prednisolone in the treatment of acute distal ulcerative colitis.

The therapeutic efficacy of prednisolone metasulphobenzoate enemas in the treatment of distal colitis has been compared with that of low-dose oral prednisolone, in a single-blind, cross-over trial. Treatment with steroid enemas resulted in symptomatic and sigmoidoscopic evidence of improvement more frequently than treatment with a dosage of oral steroid calculated to achieve similar plasma prednisolone levels. In addition to demonstrating, for the first time, that prednisolone metasulphobenzoate enemas are effective in the treatment of colitis, this study suggests that their efficacy is due to a local action rather than systemic absorption.

Acute Disease↗
PubMed1984

Mutagenicity of gastric juice: the importance of controlling histidine concentration when using Salmonella tester strains.

The mutagenic activity of gastric juice has been assessed using bacterial tester strains that undergo reverse mutation (Salmonella typhimurium:his(-)----his(+)). Free histidine, a known source of inaccuracy in this mutation test system, was detected in 42 of 73 juice samples (concentration range 3.5-992.4 micrograms/ml); high histidine concentrations were significantly correlated with hypochlorhydria. The effect of histidine was controlled by using a pre-incubation modification of the Salmonella fluctuation test in which juice samples and their corresponding control cultures containing equivalent amounts of histidine were incubated with the tester bacteria prior to plating out. Significant mutagenic activity was found in a high proportion of samples (18 of 20). The histidine content in gastric juice which can affect in vitro mutagenicity testing must be adequately controlled before positive or negative results can be equated with the presence or absence of intragastric carcinogens.

Adult↗
PubMed1984

Pancreatography in chronic pancreatitis: international definitions.

Terminology in classification of pancreatograms was discussed at a recent international workshop on chronic pancreatitis. A new terminology based on morphological radiographic appearances and a new classification to describe the severity and localisation of pancreatogram changes were agreed. Pancreatograms in chronic pancreatitis are graded as normal or equivocal, or as showing mild, moderate, or marked changes, either diffuse or local. It is hoped that these definitions will help communication between centres, serve as a basis for prospective and comparative studies, and facilitate computerisation.

Chronic Disease↗
PubMed1984

Operations upon the biliary tract in patients with acute pancreatitis: aims, indications and timing.

The management of gallstones in patients with acute pancreatitis (AP) is controversial. This paper reports an analysis of 171 attacks of AP associated with gallstones. Whilst awaiting elective cholecystectomy 56% of patients had further symptoms and 1 died. Non-urgent operations during the same admission as the pancreatitis (n = 34) resulted in 2 deaths and 7 septic complications, but prediction of complications may be possible. Urgent surgery (n = 5) was followed by 3 deaths. This study suggests that in most patients, cholecystectomy should be performed as soon as the patient is adequately fit. Urgent removal of an impacted ampullary stone (preferably by endoscopic papillotomy) may be required in a small minority if severe pancreatitis fails to respond to medical treatment, or if cholangitis supervenes .

Acute Disease↗
PubMed1983

The diagnostic yield of ERCP in the investigation of unexplained abdominal pain.

One hundred and forty patients with undiagnosed severe chronic abdominal pain who had not undergone previous biliary surgery were investigated by ERCP. A diagnosis was achieved in 34 patients (24 per cent) including 8 with previously undiagnosed peptic ulceration and 5 with gallstones. Twenty-five patients (18 per cent) had an abnormal pancreatogram, including 1 with pancreatic cancer. The incidence of pancreatogram abnormalities suggestive or diagnostic of pancreatitis was particularly high (60 per cent) in patients with a history of alcohol abuse. ERCP has a valuable role in the investigation of patients with 'obscure' abdominal pain.

Abdomen↗
PubMed1983

Acute pancreatitis following endoscopic retrograde cholangiopancreatography.

An analysis of endoscopic retrograde cholangiopancreatography (ERCP) examinations suggests that repeated contrast injection into the pancreatic duct during attempts to cannulate the bile duct is of major importance in the aetiology of acute pancreatitis after ERCP, even in the absence of pancreatic acinar opacification. The technique of ERCP can easily be modified to avoid repeated pancreatic duct injection and, by doing so, an increase in the incidence of acute pancreatitis has been reversed.

Acute Disease↗
PubMed1983

The endoscopic retrograde cholangiogram and pancreatogram in chronic liver disease.

The endoscopic retrograde cholangiogram and pancreatogram of 22 patients with primary biliary cirrhosis, 33 patients with other forms of chronic liver disease and 28 'normal' controls were compared. The incidence of radiological intrahepatic duct abnormality is similar in patients with primary biliary cirrhosis and in other forms of liver disease, but is present in only a minority of both groups. A 'notch' or smooth indentation on the extrahepatic bile ducts at the porta hepatis was present in 58% of patients with primary biliary cirrhosis but in none in either of the other two groups. Three out of seven patients with sclerosing cholangitis showed minimal-change pancreatitis. Pancreatic abnormalities were otherwise infrequent.

Cholangiopancreatography, Endoscopic Retrograde↗