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Ashley M Groves

Publications and source records attributed to Ashley M Groves.

27 records · Page 2Linked to original sources

Myocardial perfusion scintigraphy: patients' perception of benefit and risk.

BACKGROUND AND AIM: Myocardial perfusion scintigraphy is a useful and safe investigation, which has now received approval by the National Institute of Clinical Excellence (NICE). However, there are common unpleasant side-effects to the drugs used and there is a risk from radiation. This study was performed to assess patients' perceptions of the benefits and risks of myocardial perfusion scintigraphy, and to determine whether the cardiac stress component influenced these perceptions. METHODS: Ninety patients attending our institution for thallium-201 myocardial perfusion study over a period of 2 months were interviewed with regard to their perception of the benefits of the study. Patients were interviewed prior to and following the stress study. RESULTS: On average, patients thought they had a good (three in four) chance of benefiting from myocardial perfusion imaging. Sixty per cent of patients were unaware that they were going to be exposed to ionizing radiation and over 80% were unaware of the side-effects. Two-thirds of the patients said they would undergo the test even if there was only a one in ten chance of benefiting. The majority of patients were uninfluenced by the stress component of the study. CONCLUSIONS: Many patients lack a knowledge of the risks of myocardial perfusion scintigraphy. Most patients would undergo myocardial perfusion studies even if they had a poor chance of benefit.

Adult↗

Antinuclear antibody positive pleural effusion in a patient with tuberculosis.

A patient with tuberculosis presented with a pleural effusion that was highly positive for antinuclear antibody (ANA). The pleural fluid autoimmune profile was positive for ANA IgG at a titre of 1 : 1280. Antibodies to double-stranded DNA were not detected in the pleural fluid or in serum. The serum autoimmune profile was positive for ANA IgG at 1 : 160 and IgM at 1 : 40. Pleural fluid was positive on culture for Mycobacterium tuberculosis after 8 weeks. Pleural biopsy for histology showed chronic inflammation and culture revealed no growth. The pleural fluid resolved with the anti-tuberculous treatment, and signs and symptoms of systemic lupus erythematosus or malignancy did not occur, which suggests that tuberculous pleural effusion is one of the causes of high ANA in pleural fluid.

Antibodies, Antinuclear↗

The role of transbronchial needle aspiration in the diagnosis of bronchogenic carcinoma.

BACKGROUND: For many years in the United States transbronchial needle aspiration (TBNA) has been used with flexible bronchoscopy to diagnosis bronchogenic carcinoma, but very few data are available from the United Kingdom. METHODS: All bronchoscopies performed for suspected bronchial carcinoma at Papworth Hospital, Cambridge, United Kingdom, over the last 3 years were reviewed retrospectively. Patients with peribronchial disease, as evidenced by submucosal infiltration or extrinsic compression on bronchoscopy, were selected for TBNA. Patients with computed tomography evidence of subcarinal lymphadenopathy were also included. In total we identified 78 patients: 67 with peribronchial disease and 21 with subcarinal lymphadenopathy. All 78 patients underwent TBNA, and in 8 of these TBNA was performed in 2 sites. RESULTS: Malignancy was confirmed in 66 of the 78 patients. TBNA was positive in 31/66 (47%) of the patients who had proven bronchogenic carcinoma. Additional staging information was obtained in 9/21 patients (42.8%) who underwent subcarinal lymph node aspiration. We also found that TBNA was diagnostic in 1 patient with tuberculosis and 1 with sarcoidosis. There was only 1 important TBNA complication, which was a small pneumothorax. CONCLUSION: In our preliminary experience with selected patients suspected to have bronchogenic carcinoma (based on peribronchial disease or subcarinal lymphadenopathy), we found TBNA a safe and useful tool.

Biopsy, Needle↗