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Biomedical subjects

C J Newland

Publications and source records attributed to C J Newland.

9 recordsLinked to original sources
PubMed1999

Cholecystostomy: an unusual approach to stenting of a distal common bile duct stricture.

Strictures, both benign and malignant, of the distal common bile duct (CBD) are reasonably common, and if stented are usually approached endoscopically via the duodenum, or transhepatically via an intrahepatic and then common hepatic duct. We describe a case of endoscopic stenting of a distal CBD stricture over a wire passed percutaneously through the gallbladder, cystic duct and into the duodenum. To our knowledge, this has not been previously described.

Cholecystostomy↗
PubMed1996

Ambulatory venous pressure: correlation with skin condition and role in identifying surgically correctible disease.

OBJECTIVES: (1) To evaluate the full spectrum of venous skin damage with respect to ambulatory venous pressure. (2) To determine whether the ambulatory venous pressure/tourniquet test can be used to select patients for superficial venous surgery (eg. long or short saphenous stripping). DESIGN: Prospective study. SETTING: Vascular studies unit. MATERIALS AND METHODS: Ambulatory venous pressure was measured in a larger sample of limbs (360) with a wide spectrum of venous disease. In addition the effect of a tourniquet placed below the knee on ambulatory venous pressure and venous refilling time was assessed in 234 limbs. This was compared with Duplex assessment of deep and superficial venous reflux at this site. RESULTS: There was a linear trend towards more severe skin damage with increasing ambulatory venous pressure. Ulceration was associated with more severe calf muscle pump dysfunction (higher ambulatory venous pressure) than were lipodermatosclerosis, eczema or pigmentation. The tourniquet test was not able to distinguish between deep and superficial reflux as determined by Duplex scanning. CONCLUSIONS: Ambulatory venous pressure should be used to quantify venous insufficiency and remains the reference standard test of the venous calf muscle pump. The tourniquet test should not be used to select patients for surgery since it cannot distinguish deep from superficial venous incompetence. Venous reflux is best localised using Duplex ultrasound.

Blood Pressure Monitoring, Ambulatory↗
PubMed1994

Clinical significance of venous reflux detected by duplex scanning.

Duplex scanning was used to determine the presence of valvular incompetence in the major veins of 274 legs with venous disease. Using multivariate logistic regression analysis the significance of valvular function in each vein in relation to the clinical condition of the limb was calculated. Superficial femoral, profunda femoris and short saphenous vein function did not correlate with the clinical state of the limb; common femoral, popliteal and long saphenous vein function did. A table was constructed from the statistical model such that the relative contribution made by each vein could be estimated for limbs with different patterns of venous insufficiency. This model should now be tested in a prospective study and, if validated, could be used to improve decision making in venous surgery.

Femoral Vein↗
PubMed1993

Percutaneous nephrostomies.

A review was made of 127 percutaneous nephrostomies (PCN) in 106 patients with benign (74 patients) and malignant (32 patients) urinary tract obstruction. Data on underlying aetiology, complications, subsequent management and long-term management are presented. The study confirms that PCN is an effective and safe method of providing temporary or prolonged urinary diversion in obstruction. Its use in pelvic malignancy should be determined by the likelihood of obtaining worthwhile prolonged palliation in individual patients.

Adolescent↗
PubMed1993

Investigation and significance of short saphenous vein incompetence.

In this study, 186 limbs with varicose veins or venous skin changes were examined using duplex ultrasonography. Limbs were classified on the basis of short saphenous or popliteal venous incompetence and the number of limbs with venous ulceration (active or healed) recorded. Short saphenous incompetence did not produce a significant increase in the incidence of ulceration, whereas popliteal reflux produced an increase in the risk of ulceration which was statistically significant when compared with limbs without reflux in these two veins (chi 2 = 4.55, P = 0.003). There was no significant difference in the proportion of limbs with concomitant long saphenous reflux between these two groups. Short saphenous reflux is not important in the pathogenesis of venous ulceration. Popliteal reflux is an important factor in the pathogenesis of venous ulceration. More attention should be paid to the surgical correction of popliteal reflux when present in limbs with venous ulceration that fail to heal by conservative measures.

Adult↗
PubMed1991

Technical report: oxygen saturation monitoring during sedation for chemonucleolysis.

Pulse oximetry is widely used during anaesthetic practice to monitor heart rate and oxygenation and has been recommended as a monitor when sedative techniques are used. We monitored 25 patients receiving sedation for chemonucleolysis and showed that 17 became hypoxaemic at some stage of the procedure, none of whom had clinically detectable signs of respiratory depression. We recommend that monitoring with pulse oximetry is used in all patients receiving sedation for radiological procedures and that all radiologists administering sedation be trained in airway management.

Adult↗
PubMed1991

Congenital hypothyroidism--correlation between radiographic appearances of the knee epiphyses and biochemical data.

Plain knee radiographs of 20 neonates with congenital hypothyroidism, were reviewed. The size and appearances of the epiphyses were compared with the biochemical data at the time of referral. Fifteen infants had unequivocal evidence of delayed bone maturation based on absence of the distal femoral epiphysis or small epiphyseal size. Seven cases had fragmentation of at least one epiphysis. A positive correlation was found, at diagnosis, between the thyroxine and triiodothyronine levels and the size of the knee epiphyses. All 14 infants with thyroxine levels of less than 70 nmol/l had small epiphyses with a combined mean diameter of the proximal tibial plus distal femoral epiphyses of 7 mm or less. Conversely, of the 6 infants with thyroxine levels of 70 nmol/l or above, 5 had combined epiphyseal diameters of greater than 10 mm. We suggest that in infants with no clinical symptoms and only moderately raised raised screening thyroid stimulating hormone, a knee radiograph showing the described radiological changes should prompt institution of thyroxine treatment before awaiting biochemical confirmation of the diagnosis.

Congenital Hypothyroidism↗