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Biomedical subjects

A T Axon

Publications and source records attributed to A T Axon.

At least 235 records · Page 13Linked to original sources
PubMed1983

Bacteraemia with upper gastrointestinal endoscopy--a reappraisal.

To assess the risk of infective endocarditis for susceptible patients having upper gastrointestinal (GI) endoscopy, we have prospectively studied the incidence, level, duration and source of endoscopy-related bacteraemia and the microorganisms involved. Blood was drawn for aerobic and anaerobic culture and pour plate estimation from 50 patients undergoing upper GI endoscopy. Blood cultures were positive in two patients with the isolation of Streptococci and other oropharyngeal organisms during and 5 min after endoscopy. Pre-endoscopy salivary cultures in both patients grew Streptococci identical to those isolated from the blood; pour plates were negative. We conclude that though the risk of infective endocarditis after upper GI endoscopy is probably very low, the finding of a 4% incidence of transient low-level bacteraemia of oropharyngeal origin argues for antibiotic prophylaxis for susceptible patients.

Adolescent↗
PubMed1983

Disinfection of gastrointestinal fibrescopes--evaluation of the disinfectants Dettox and Gigasept.

The disinfectant solutions Dettox (based on a quaternary ammonium compound) and Gigasept (based on succine dialdehyde) were evaluated during disinfection procedures with a new disinfecting apparatus for gastrointestinal fibrescopes. Thorough disinfection was achieved after 2 minutes using Dettox 8% or Gigasept 10%; persistent fibrescope contamination with Gram-negative organisms was found after disinfection with Dettox 4% or Gigasep 5%. No adverse effects in endoscopy staff or damage to fibrescopes were seen. Adequate disinfection of endoscopic equipment prevents endoscopy-related infection and can be readily achieved by trained endoscopy staff using rapidly bactericidal disinfectants.

Aldehydes↗
PubMed1983

Gastrointestinal endoscopy: infection and disinfection.

The past decade has seen the development of an array of complex flexible fibreoptic instruments for gastrointestinal (GI) endoscopy, and an increasing use of these for diagnostic and therapeutic purposes. It has been recognised more recently that the use of contaminated endoscopic equipment can lead to serious and occasionally fatal infections. Infection with a wide variety of micro-organisms has been reported following oesophago-gastroduodenoscopy (OGD) and endoscopic retrograde cholangio-pancreatography (ERCP).

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1983

Effects of tripotassium dicitrato bismuthate (TDB) tablets or cimetidine in the treatment of duodenal ulcer.

Forty patients with duodenal ulcer were randomly allocated to treatment with either tripotassium dicitrato bismuthate tablets or cimetidine for six weeks. Endoscopically confirmed healing of the ulcer occurred in 80% treated with tripotassium dicitrato bismuthate tablets and in 85% treated with cimetidine. Symptomatic improvement was also similar in the two groups. Treatment with cimetidine was associated with an increase in pH of gastric aspirate during treatment and increased numbers of bacteria were isolated from the gastric aspirate during treatment, while the pH and bacterial flora of gastric aspirate did not change during tripotassium dicitrato bismuthate treatment. Serum and urinary bismuth levels rose during treatment with tripotassium dicitrato bismuthate and urinary excretion remained raised two weeks after cessation of treatment. Tripotassium dicitrato bismuthate tablets appear to be as effective as cimetidine in the treatment of duodenal ulcer without the potentially undesirable effects of a reduction in gastric acid secretion.

Adult↗
PubMed1983

Gastrointestinal transit of liquids.

A simple, non-invasive technique has been established for the simultaneous measurement of stomach emptying and the small bowel transit of a liquid meal. The rate of gastric emptying (T1/2) was measured in 21 normal subjects by using a gamma camera and computer to observe emptying of 200 ml of water to which 200 muCi 99Tcm - diethylene tetramene pentacetic acid chelate was added. By adding lactulose to the drink and measuring breath hydrogen (H2) concentration, small bowel transit time (Ta) was simultaneously estimated. There was no significant correlation (r = 0.26, P greater than 0.2) between T1/2 and Ta or between T1/2 and the shape of the breath H2 evolution curve. However, the shape of the breath H2 curve did seem to be affected by Ta. The technique should prove useful for the study of gastrointestinal motility in disease states.

Disaccharides↗
PubMed1982

Metrizamide as contrast medium in endoscopic retrograde cholangio-pancreatography.

Endoscopic retrograde cholangio-pancreatography (ERCP) has been performed in 17 patients using metrizamide (Amipaque) as contrast medium, and in 33 using meglumine diatrizoate (Urografin). The quality of pancreatograms obtained has been compared, using a specially developed scoring system, an any clinical and biochemical evidence of (acute) pancreatitis following ERCP observed. The mean pancreatogram score was slightly higher when Amipaque was used but there was no difference in the frequency or extent of hyperamylasaemia between the two groups. The slight advantage of Amipaque is not sufficient to overcome the disadvantages of its relatively high cost and inconvenience in use.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1982

Endoscopic retrograde cholangiograms of the normal and post-cholecystectomy biliary tree.

The diameter of extrahepatic and intrahepatic bile ducts was measured on 50 normal retrograde cholangiograms and on the cholangiograms of 109 post-cholecystectomy patients undergoing endoscopic retrograde cholangiopancreatography: 70 of the post-cholecystectomy patients had a normal cholangiogram and 39 had retained stone or biliary stricture, of whom 17 were jaundiced. Biliary diameter at all points measured was greater in the post-cholecystectomy patients with no biliary lesion than in normals, and further increased in the presence of pathology (e.g. retained stone). The extent of overlap in biliary diameter between all these three groups is so great that measurement of bile duct calibre cannot separate patients with retained stone from post-cholecystectomy patients without retained stone, or from patients with an entirely normal biliary tree, even in the presence of obstructive jaundice. Methods of evaluating the biliary tract which rely on the measurement of bile duct diameter (e.g. ultrasound) are therefore of limited value in the investigation of post-cholecystectomy patients.

Adolescent↗
PubMed1982

Plasma protein profiles and prognosis in gastric cancer.

In 104 patients with gastric cancer the serum proteins carcinoembryonic antigen (CEA), C-reactive protein (CRP), alpha 1-acid glycoprotein (AGP) (orosomucoid) and alpha 1-antichymotrypsin (ACT) were measured pre-operatively. The estimated median survival of patients with both raised CEA and ACT was only 5 weeks in contrast to 64 weeks for those with both proteins normal. An intermediary group with one of these proteins raised and the other normal had an estimated median survival of 15 weeks. Similar results were obtained by considering a combination of CEA with either AGP or CRP. For these data the results were not explicable in terms of associations between survival time and patient's age, stage, operative procedure, histological classification or site of primary tumour.

Adult↗
PubMed1982

Simultaneous culture of saliva and jejunal aspirate in the investigation of small bowel bacterial overgrowth.

Both saliva and jejunal aspirate were cultured from 22 patients with suspected small bowel bacterial overgrowth and from eight controls. Large numbers of organisms (greater than 10(6)/ml) were recovered from the jejunal aspirate of 16 subjects, in five of whom the same organisms were present in similar relative proportions in the saliva, suggesting contamination of the sample with saliva, while in 11 the jejunal organisms differed from those in saliva. In eight of these the jejunal flora was a typical 'faecal' flora usually associated with small bowel bacterial overgrowth but, in three, the jejunal floral was superficially similar to that of saliva. Distinct subpopulations of bacteria, typically Gram-positive non-sporing rods, were, however, evident in the jejunum of these patients, and were also recovered, in smaller numbers, from the jejunum of controls, suggesting that they form a distinct jejunal microflora. Culture of saliva in addition to jejunal aspirate may be useful in the recognition of contamination of the proximal small bowel with saliva, and in the diagnosis of small bowel bacterial overgrowth.

Bacteria↗
PubMed1982

Intestinal permeability in coeliac disease: the response to gluten withdrawal and single-dose gluten challenge.

Intestinal permeability has been studied in 21 patients with coeliac disease in relapse and after gluten withdrawal using an oral test of intestinal permeability based on the simultaneous oral administration of two probe molecules. The increased absorption of the larger molecule (cellobiose) and the decreased absorption of the smaller (mannitol) found in untreated coeliac disease both returned to normal within five months of starting treatment, the abnormality in cellobiose absorption correcting more rapidly than that of mannitol. After exposure to a single oral dose of gluten, the intestinal permeability of six patients with treated coeliac disease became transiently abnormal with an increased absorption of cellobiose, returning to normal within one week. The possible structural and functional implications of these findings are discussed. The cellobiose/mannitol ratio appears to be of value in assessing the response to gluten withdrawal in coeliac disease, and also in monitoring patients who are already established on a gluten free diet by detecting dietary lapses and 'non-responding coeliac disease'. It may also offer an alternative to jejunal biopsy in patients subjected to gluten challenge.

Adolescent↗
PubMed1982

New disinfecting apparatus for gastrointestinal fibre-endoscopes.

Bacterial contamination of gastrointestinal fibre-endoscopes is a potential source of clinically significant infection. Aqueous 2% alkaline glutaraldehyde adequately disinfects fibre-endoscopes but may cause serious sensitivity reactions among endoscopy staff. A new 'closed-system' disinfecting apparatus is described that disinfects with glutaraldehyde for 30 minutes before an endoscopy session, for two minutes between patient procedures, and for 10 minutes before storage. Bacteriological cultures of the endoscope after disinfection were virtually sterile. Extremely low glutaraldehyde vapour levels were detected by gas chromatography in endoscopy room air during disinfection procedures. This relatively simple apparatus offers rapid, effective, and safe disinfection of fibre-endoscopes.

Disinfection↗
PubMed1982

Buscopan or glucagon for endoscopic cannulation of ampulla of vater?

The number of intravenous injections of hyoscine-N-butylbromide (Buscopan) or glucagon required to maintain relaxation of the duodenum during endoscopic retrograde cholangiopancreatography (ERCP) were compared in a double blind trial of 55 patients. There was no significant difference in the number of injections. Serum amylase levels after the use of both relaxants were compared in 50 patients undergoing ERCP. No significant difference in the levels of hyperamylasaemia were found.

Ampulla of Vater↗
PubMed1981

Serum beta 2-microglobulin in hepato-biliary diseases.

The levels of serum beta 2-m in hepato-biliary disease have been examined. Significant increase has been observed in various benign and malignant diseases of the liver, but not in jaundice due to acute pancreatitis. The age-dependent relationship of beta 2-m is present in controls, weaker in the malignant diseases and absent in the benign diseases. The level of beta 2-m is not influenced by jaundice. Serum beta 2-m levels have no role as a discriminant in liver disease.

Adolescent↗