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Biomedical subjects

B G Conry

Publications and source records attributed to B G Conry.

14 recordsLinked to original sources
PubMed2005

Limited ARSAC licence acquisition for radionuclide radiology.

Radionuclide radiology faces a potentially crippling future manpower shortage. A combination of future retirement, few trainees and many currently unfilled posts threatens to limit future service delivery. The case is made for in-house modular training of existing consultants as the way forward for radionuclide radiology, allowing limited ARSAC licence acquisition. We propose this as a viable solution to the manpower problem in radionuclide radiology.

Consultants↗
PubMed2001

Radionuclide radiologist directed nuclear medicine services in district general hospitals in the South Thames Region.

The equipment, staffing levels and imaging workload of all 14 radiologist directed nuclear medicine services in district general hospitals in the South Thames Region are presented. These are generally single camera departments providing a broad range of imaging procedures, including cardiac studies and white cell labelling, as well as the more usual renal, lung, thyroid and bone examinations. All departments have a high throughput, averaging 2358 examinations per year. Departmental staffing levels are variable, with some institutions having inadequate consultant radiology sessions free of other commitments as well as inadequate physics support. Potentially, these are important quality and legal issues that departments may need to address with hospital Trusts and Commissioning Agencies. Four small departments provided a service without any formally contracted radiologist sessions for nuclear medicine in the radiologists' job plans. The three medium sized departments have a closer match between sessions contracted and those actually worked, but in only one of these did the contracted sessional commitment equal the recommendation of the Nuclear Medicine Committee of the Royal College of Physicians. There is a disparity between the number of contracted consultant sessions and those actually worked in most institutions (86%), being at least two sessions in eight hospitals. Recommendations are made regarding the adequacy of some of the elements of provision in South Thames and the legal and safety implications for hospital Trust management and Commissioning Agencies.

England↗
PubMed2000

Differential bore sheath breast biopsy--a pilot study of a new technique.

The increasing requirement for core biopsy in the diagnosis of early breast disease puts additional demands on radiologists' time and expertise. We present a new approach to percutaneous breast biopsy of impalpable lesions with core biopsy and simultaneous hook wire localization. The technique allows accurate localization of breast lesions and is unique in that it facilitates simultaneous hook wire localization. Percutaneous biopsy by this method was accurate in 9 of 11 patients.

Biopsy↗
PubMed1999

One year prospective open study of the effect of high dose inhaled steroids, fluticasone propionate, and budesonide on bone markers and bone mineral density.

BACKGROUND: Inhaled corticosteroids are recognised as the most effective agents in the treatment of asthma. However, concerns have been expressed about the effects of high doses of inhaled corticosteroids on safety in relation to bone resorption and formation. This study measures the effects of two inhaled corticosteroids on bone markers and bone mineral density (BMD) over one year. METHODS: A one year randomised, prospective, open parallel study comparing inhaled fluticasone propionate (FP), 500 micrograms twice daily in 30 patients, and budesonide (BUD), 800 micrograms twice daily in 29 patients, delivered by metered dose inhaler and large volume spacers was performed in adults with moderate to severe asthma. Biochemical markers of bone turnover (osteocalcin, procollagen type 1 C-terminal propeptide (PICP), immunoreactive free deoxypyridinoline (iFDpd), N-terminal crosslinked telopeptides of type I collagen (NTx)), BMD at the spine and femoral neck, and serum cortisol concentrations were measured at baseline and 12 months later. RESULTS: There were no significant differences between the inhaled steroids on bone markers of bone resorption and formation or bone mineral density. Bone mineral density of the spine increased slightly in both groups over the 12 month period. Serum osteocalcin levels increased from baseline in both treatment groups (FP 16.9%, p = 0.02; BUD 14.3%, p = 0.04). PICP did not differ significantly from baseline. Both markers of bone resorption (iFDpd, NTx) varied considerably with no significant changes after one year. There was a significant correlation in percentage change from baseline between BMD of the spine and osteocalcin at 12 months (r = 0.4, p = 0.017). Mean serum cortisol levels remained within the normal range in both groups following treatment. CONCLUSION: There was no evidence of a decrease in BMD during 12 months of treatment with high doses of either FP or BUD. The change in spine BMD correlated with the increase in osteocalcin. Studies extending over several years are needed to establish whether these findings persist.

Administration, Inhalation↗
PubMed1997

Local staging of prostate cancer with 0.2 T body coil MRI.

This study was undertaken to evaluate the accuracy of low field strength body coil MRI in the staging of clinically localized prostate cancer. Fifty-three patients with prostate cancer were examined on a 0.2 T body coil system before undergoing radical prostatectomy. Of the 20 cases with unconfined stage T3 disease on histology, 12 were correctly staged, whilst three cases were overstaged by MRI. (Accuracy 79.2%, sensitivity 60%, and specificity 90.9%.) The accuracy, sensitivity and specificity for the detection of capsular penetration were 77.3%, 55% and 90.9%, respectively, whilst those for seminal vesical invasion were 94.3%, 83.3% and 95.7%, respectively. It is concluded that a high level of staging accuracy, comparable to that obtained in some published studies using high field strength endorectal coil MRI, can be obtained using 0.2 T body coil MRI.

Aged↗
PubMed1996

Short communication: Prospective assessment of a new graduated hookwire for the localization of impalpable breast lesions.

The benefits of the addition of site specific variable graduations to a conventional mammographic localizing wire were assessed in a prospective multidistrict study. Six surgeons and five radiologists localized lesions in 31 patients in three District General Hospitals. The advantages of the graduated wire were shown to be greater ease and accuracy of radiological localization with easier surgical excision and a smaller resected breast specimen.

Biopsy↗
PubMed1993

Case report: computed tomography of generalized lymphangiomatosis and chylothorax.

The diagnosis of lymphangiomatosis can often be made on clinical grounds with the aid of plain radiography. In children with intractable chylothorax computed tomography (CT) of the thorax may reveal the presence of a mediastinal mass but frequently in lymphangiomatosis will not demonstrate any specific features. Abdominal CT, on the other hand, may suggest the diagnosis by the association with intraabdominal lymphangioma.

Child↗
PubMed1989

Diagnostic and therapeutic efficacy of barium meal examination: a prospective evaluation in general practice.

OBJECTIVE: To assess the efficacy of barium meal examinations in managing patients with dyspepsia in general practice. DESIGN: Prospective study by questionnaires completed by general practitioners before and within three to six months after the barium meal examination. Information was requested about the patients' symptoms, current treatment, reason for requesting the examination, and the working diagnosis, including degree of certainty and, after the examination, about any change in diagnosis, diagnostic confidence, or management and to determine whether the examination was judged to be helpful or not. SETTING: Inner city health district. PATIENTS: 133 Patients with dyspepsia referred by general practitioners for outpatient barium meal examination, 31 of whom failed to attend for the examination, or refused it on arrival, or did not have fully completed questionnaires. Two patients were not available for follow up. MAIN OUTCOME MEASURES: Prevalence of radiological abnormalities and the influence of the examination result on management, particularly changes in drug treatment. RESULTS: Fully completed pairs of questionnaires were available for 100 patients, 58 of whom were aged below 50. Most of the barium meal reports (64) were to confirm the clinical diagnosis; only 22 were to exclude serious disease. Ninety nine patients were already receiving treatment, with 39 taking an H2 receptor antagonist. Fifty eight barium meal examinations showed abnormalities (31 major abnormalities); there were no cancers and in only 18 patients was the working diagnosis changed as a result of the findings. Although the barium meal result increased management confidence (63 patients) and allayed patients' anxiety (46), changes in management attributed directly to the examination occurred in only 22 patients. Management changes were minor, usually comprising interchange of antacids and H2 receptor antagonists. CONCLUSIONS: Young patients (aged below 50) with dyspepsia are still being overinvestigated. Although barium meal examination improves diagnostic confidence and allays patients' anxiety, fully utilising communication skills at the initial consultation might allay anxiety more economically.

Adult↗
PubMed1988

Imaging neural crest tumours with 123I-metaiodobenzylguanidine and X-ray computed tomography: a comparative study.

Iodine-123 metaiodobenzylguanidine (MIBG) has been used as a diagnostic agent for imaging neural crest tumours. In a retrospective study of 27 patients, the role of 123I MIBG scintigraphy and X-ray computed tomography (CT) for detection of disease was compared. Both imaging techniques were accurate in the identification of these tumours. Iodine-123 MIBG was slightly more accurate in detecting metastatic disease. Computed tomography of tumours was useful in planning appropriate metastatic intervention. We suggest 123I MIBG should be the primary imaging procedure followed by CT in the investigation of these patients.

3-Iodobenzylguanidine↗
PubMed1987

Cervical spine fractures and rear car seat restraints.

Two cases of potentially fatal cervical spine fractures in children who were inadequately restrained by malfunctioning car seat restraints are presented. Adequate parental maintenance of seat restraints and their readjustment when children change from wearing lightweight to thick, heavy clothing are imperative.

Cervical Vertebrae↗
PubMed1987

The effect of oral magnesium-containing bowel preparation agents on mucosal coating by barium sulphate suspensions.

Alteration in the quality of mucosal coating by barium sulphate suspension observed during double-contrast barium enema (DCBE) examinations when an oral magnesium-containing purgative (Picolax) was used as sole bowel preparation has been investigated in vivo. Small amounts of Picolax were found to produce a linear increase in apparent viscosity and thixotropy, due to flocculation. The effect of equivalent concentrations of acid was significantly less (p less than 0.01), and of magnesium chloride was significantly greater (p less than 0.05), whereas magnesium citrate was comparable to Picolax, demonstrating the deflocculating effect of citrate on the flocculating action of magnesium ions. It is suggested that colonic residue from orally ingested magnesium-containing purgatives may contain sufficient magnesium ions to increase viscosity of the barium suspension and visibly affect its coating during DCBE.

Barium Sulfate↗
PubMed1987

The clinical application of computed x ray tomography in tumour identification.

The clinical applications of computed x ray tomography (CT in tumour identification are reviewed. The advantages and limitations of the technique are highlighted in the context of tumour presentation, staging and subsequent management. Particular emphasis is laid on the ability of CT guided biopsy techniques to overcome the lack of soft tissue specificity inherent in CT scanning.

Biopsy↗
PubMed1986

General practice and teaching hospital use of barium meal examinations in the City and Hackney Health District.

The value of barium meal examination in the management of younger patients with dyspepsia has been seriously questioned as diagnostic yield is reported to be low with only minor abnormalities detected. Our 9 month survey of general practice and hospital out-patient use of barium meal examination in the City and Hackney Health District during 1983-84 shows that 51% of patients investigated were less than 50 years and 20% less than 30 years of age, suggesting that clinicians have not heeded these warnings. However, 30% of the younger patients had barium meal mucosal abnormalities. Over all age groups abnormalities were more prevalent in men and in general practice rather than hospital out-patient referrals (59% vs 45%; P less than 0.02). Previous studies may therefore have underestimated the prevalence of barium meal abnormalities in younger patients, and continued use of this examination in such patients may indicate that clinicians have found the results helpful in patient management.

Adult↗