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Biomedical subjects

C Heron

Publications and source records attributed to C Heron.

At least 19 recordsLinked to original sources
PubMed2006

A comparison of clinical vs ultrasound determined synovitis in rheumatoid arthritis utilizing gray-scale, power Doppler and the intravenous microbubble contrast agent 'Sono-Vue'.

OBJECTIVES: Synovitis in rheumatoid arthritis (RA) is assessed clinically by the presence of joint tenderness and swelling. Synovial thickening and increased vascularity may also be detected by high-resolution ultrasonography (US) and power Doppler (PD). This study investigated the relationship between clinical and sonographic features of synovial disease utilizing US, PD and the contrast agent Sono-Vue. METHODS: Forty RA patients were recruited. One proximal inter-phalangeal or metacarpophalangeal joint was selected per patient, as being unambiguously either: swollen and tender, just swollen, just tender or neither swollen nor tender (Nil). Ten joints were selected per clinical group. On US, the mean synovial thickness was measured and synovial hypertrophy and erosions were graded subjectively. Synovial vascularity demonstrated by PD was scored subjectively pre- and post-contrast. RESULTS: All grades of synovial vascularity were found in each clinical group including the Nil group. There were significant differences between the four clinical groups for both synovial hypertrophy (P = 0.024) and PD scores pre- (P = 0.022) and post- (P = 0.039) contrast. Tender-only joints showed significantly less vascularity than other groups. Post-contrast, the median PD scores increased in all but the Nil group, in some cases from the normal to abnormal range. CONCLUSION: Synovitis demonstrated by US and PD is not predicted by patterns of disease as described by joint swelling and tenderness despite unambiguous selection of joints. Synovial vascularity was the least in tender-only joints and was heterogeneous in all other groups, including Nil joints. These findings question the reliability of traditional clinical signs in RA synovitis assessment.

Adult↗
PubMed2003

The diagnostic contribution of the frontal lumbar spine radiograph in community referred low back pain--a prospective study of 1030 patients.

AIM: The diagnostic contribution of the anteroposterior (AP) view was studied to assess whether this view could be omitted safely, thus reducing the radiation burden received by patients undergoing lumbar spine radiography. MATERIALS AND METHODS: Prospective analysis of 1030 consecutive referrals for lumbar spine radiography from general practice. RESULTS: In the majority of cases (90.5%) the AP view was non-contributory. In 4.2% the diagnosis was strengthened and it was altered in 4.6%. However, in the latter group only 1.3% of the total were considered significant alterations. These were cases of possible, but not definite, pars defects and sacroiliitis. Specific important conditions such as infection, malignancy and benign tumours were not missed on the lateral view alone, in our study population. The radiation burden is reduced by 75% by omitting the AP view. CONCLUSION: A single lateral view is an adequate examination, with the proviso that sacroiliac joint disease is not assessed on this view and some pars defects and facet joint degenerative changes may be overlooked. The radiation protection gains are considerable. A single lateral lumbar view is now our routine practice unless sacroiliitis is a specific clinical concern.

Adolescent↗
PubMed2001

Sensitivity of quantitative (1)H magnetic resonance spectroscopy of the brain in detecting early neuronal damage in systemic lupus erythematosus.

OBJECTIVE: To quantify N-acetylaspartate (NAA), total creatines (tCr), total cholines (tCho), and myo-inositol (mI) levels in normal and abnormal appearing white matter of patients with neuropsychiatric systemic lupus erythematosus (NPSLE) in order to determine the specific changes in metabolite concentrations. METHODS: Axial proton density and T(2) weighted magnetic resonance images, and short echo time (TE 30 ms) (1)H spectra were acquired with a GE SIGNA 1.5 T magnetic resonance system. Concentrations of NAA, tCr, tCho, and mI were determined, using brain tissue water as a reference, from nine patients (seven female, mean age 40.3 years, range 16-65) with NPSLE and eight healthy women (mean age 43 years, range 31-65). RESULTS: A significant rise of tCho (12.4%, p<0.05) and mI (31.4%, p<0.005) and a significant reduction in NAA (-12%, p<0.05) was found in normal appearing white matter compared with controls. Analysis according to severity of the clinical NPSLE features (subgrouped as major or minor) showed that SLE major had reduced NAA compared with SLE minor (-18.4%, p<0.05) and controls (-20%, p<0.005). The SLE major group showed a significant rise of mI (32%, p<0.01) and the SLE minor group a significant increase in tCho (18.6%, p<0.05) compared with controls. Longitudinal analysis of brain metabolites in normal appearing white matter showed consistent abnormalities in NAA, tCho, and mI in a patient with stable clinical features and a constant rise of tCho, but transient rise of mI was seen during a flare of disease in another patient. CONCLUSION: Quantitative (1)H magnetic resonance spectroscopy (MRS) suggests a particular course of neurometabolite changes that precedes irreversible reductions in NAA and permanent neuronal loss. Initially, in patients with SLE minor, there is a significant rise in tCho and a trend (reversible) for mI also to be raised. In patients with SLE major the NAA is significantly and permanently reduced and mI is significantly raised, whereas the tCho levels are near normal. Further investigations are needed to determine how specific MRS is as a clinical marker for brain disturbance in SLE.

Adolescent↗
PubMed2001

Speech and language therapy for adults in Hackney: an assessment of need.

With the development of separate community and the hospital trusts in the London borough of Hackney, at a time of increasing numbers and range of referrals, a number of gaps in service became apparent. The need for community adult speech and language therapy (SLT) in Hackney was identified, based on previous studies and other relevant literature. Comparison with services locally and nationally shows clearly that Hackney, in having virtually no community SLT for adults, is significantly disadvantaged. It was intended that this work would result in the widest consultation and discussion by the relevant agencies to explore ways of meeting this need.

Adult↗
PubMed1999

[Cranial pachymeningitis].

INTRODUCTION: Pachymeningitis is a fibrous inflammatory process with non-specific symptoms, involving the dura mater. Due to MRI development, diagnosis is both easier and earlier. CURRENT KNOWLEDGE AND KEY POINTS: We report seven cases and review current literature. Clinical features are headaches and cranial nerve palsies. CSF shows inflammatory changes, while MRI evidences thickening of the dura mater. Disease etiologies in the present study were tuberculosis in two cases, sarcoidosis, Lyme disease, lymphoma and dural puncture; in one case only the disease was of unknown origin. The condition of six patients improved with specific treatment. FUTURE PROSPECTS AND PROJECTS: Further MRI development should allow detection of new forms of pachymeningitis and standardization of patients' management through the study of more important series.

Adult↗
PubMed1998

Case weighting in a speech and language therapy service.

This study present an approach designed to calculate input provided by a speech and language therapy service. A case weighting system was developed in order to evaluate the cost of services, predict the need for intervention, balance and prioritise the caseload among therapists. It is suggested that this approach can be use widely in clinical practice.

Cerebrovascular Disorders↗
PubMed1998

A case of verbal auditory agnosia: missing the word ... missing the sound....

The neuropsychological nature of verbal auditory agnosia is not fully understood. This study aims to describe the language deficits and the remediation strategies used in a person with verbal auditory agnosia. In addition, it will address the theoretical issues concerning the nature of the phenomenon and the clinical implications in the management of people with this disorder.

Aged↗
PubMed1996

Acquisition of a runway motor learning task is impaired by a beta adrenergic antagonist in F344 rats.

Performance of rats on a motor learning paradigm that has been demonstrated to be dependent upon cerebellar norepinephrine (NE) was studied in male F344 rats treated with an alpha 1 antagonist (prazosin), an alpha 2 antagonist (yohimbine) or a beta noradrenergic antagonist (propranolol). The ability of propranolol-treated rats (10 mg/kg i.p. 30 min prior to daily testing) to acquire proficiency on the novel motor task was impaired while prazosin-treated rats' (0.5 mg/kg i.p. 30 min prior to daily testing) and yohimbine-treated rats' (1 mg/kg i.p. 30 min prior to daily testing) rates of acquisition of the novel motor task were not different from controls. In an attempt to distinguish between alterations in motor coordination and motor learning, additional tests of psychomotor performance were assessed for all groups of rats. These examinations included a walking test on 2.5 and 5 cm rods and speed of running on the motor task. The data indicate that drug-treated rats show no difference from controls on the above parameters. Some differences, however, were observed between propranolol and controls in the time spent in the goal box. Overall, the data are consistent with our hypothesis that the beta noradrenergic receptor is involved in the ability to acquire novel motor tasks.

Adrenergic alpha-1 Receptor Antagonists↗
PubMed1996

[Human helminthiasis at the Gauls].

It was possible to realize a salvaging in urgency in a building site into the enclosure of the Hôpital Avicenne in Bobigny (seine-Saint-Denis). Into ditches, traces of a native farm from the second century AC, near miscellaneous objects (pots, hatchets, fibules, pieces) was found twelve skeletons. In the ground, extracted between the wings of ilium of an adult skeleton, with an appropriated technical, it was possible to find eggs of Trichuris trichiura and a lot of eggs of Ascaris lumbrocoides. It proves, the human manure was used very probably in the gaul gardens.

France↗
PubMed1994

Complex I inhibitors induce dose-dependent apoptosis in PC12 cells: relevance to Parkinson's disease.

The mode of cell death in Parkinson's disease (PD) substantia nigra is uncertain. However, evidence is accumulating that certain of the biochemical abnormalities present in PD nigra at the time of death may precipitate apoptosis. We have investigated the mode of death induced by complex I inhibition of dopaminergic cell cultures, and our results suggest that both 1-methyl-4-phenylpyridinium and rotenone cause apoptosis at low concentrations and necrosis at high concentrations. This dose-dependent shift in the mode of cell death induced by these mitochondrial toxins may have important implications for the mechanisms of neuronal cell death in PD.

1-Methyl-4-phenylpyridinium↗
PubMed1994

Magnetic resonance neurography of the median nerve.

A magnetic resonance imaging sequence, combining fat and flow suppression with T2 weighting, has been used to produce high conspicuity images of the median nerve within the carpal tunnel. Standard maximum intensity projection techniques were then used to produce three-dimensional (3D) reconstructions of the nerve. Comparison of 3D projections with the wrist in a neutral position and wrist flexed at 45 degrees depicted changes in the shape and course of the median nerve through the carpal tunnel of normal volunteers. In some cases of carpal tunnel syndrome evidence of a localized compression was observed. A 3D image of a nerve may help in the diagnosis of peripheral neuropathy and be an aid to surgery of or near major nerves.

Adult↗
PubMed1992

Dense bones.

Explore the source record for details and available documents.

Adult↗
PubMed1990

How many tests are required in the diagnosis of palpable breast abnormalities?

Palpable breast nodules in 143 patients attending our primary diagnosis breast clinics were assessed by clinical examination, needle cytology, mammography, ultrasonography and magnetic resonance imaging (MRI). The diagnostic accuracy of all test combinations was compared with the final diagnosis of malignant or benign disease. Two-test combinations increased the sensitivity of diagnosis over that of the individual tests to between 93% and 100% except for MRI/mammography and MRI/cytology. The combinations of three or more tests increased the sensitivity further, but at the expense of an increased false-positive rate. MRI does not appear to have an important role in the primary diagnosis of breast cancer. Mammography is necessary because of the possibility of occult or multifocal disease. Clinical examination was associated with a high false-positive rate. The combination of cytology and ultrasound was best at correctly diagnosing malignancy, but in this series only 42% of patients underwent ultrasound examination. The role of breast ultrasound together with needle aspiration cytology for the diagnosis of malignancy in palpable breast nodules deserves further evaluation.

Adult↗
PubMed1984

Intravenous urography with low-osmolality contrast agents: theoretical considerations and clinical findings.

There are theoretical reasons for expecting some aspects of image quality in intravenous urography to be modified when low-osmolality, rather than conventional, contrast agents are used. The clinical findings in urography using two of these, the non-ionic agents iohexol (Omnipaque 350, Nyegaard) and iopamidol (Niopam 370, Bracco/Merck), are compared with those using sodium iothalamate (Conray 420, May & Baker Ltd), and are discussed against this theoretical background. The best nephrogram obtained with the new agents often occurred later than with the conventional agent, but quantitative differences in its density were explicable on a total iodine dose basis. The pyelographic density obtained with the new agents was significantly greater than with the conventional agent without any evidence, when abdominal compression was used, of the predicted associated poor distension of the collecting system.

Contrast Media↗
PubMed1984

Calcific pancreatitis: calcification patterns and pancreatogram correlations.

The abdominal radiographs of 74 patients with calcific pancreatitis were reviewed to assess the distribution, density and patterns of calcification. These characteristics were compared with the results of endoscopic retrograde cholangiopancreatography and ultrasonography. There was a decreasing gradient of calcification from head to tail in most patients. Foci of calcification greater than 5 mm in diameter were almost always associated with pancreatic duct obstruction. Endoscopic retrograde cholangiopancreatography did not provide additional diagnostic information and is unnecessary in calcific pancreatitis except when a precise map is required before operation.

Adolescent↗