Biomedical subjects

D J Sadler

Publications and source records attributed to D J Sadler.

5 recordsLinked to original sources

PubMed1999

Predicting infection in localized intraabdominal fluid collections: value of pH and pO2 measurements.

PURPOSE: To evaluate the use of pH, pO2, and the subjective opinion of the radiologist compared with bacterial culture in accurate diagnoses of bacterial infection in intraabdominal fluid collections. MATERIALS AND METHODS: Prospectively, 79 patients who were suspected of having an intraabdominal fluid collection underwent diagnostic fluid aspiration. The aspirate was cultured and measured for pH and pO2. A pH < or = 7.1 and a PO2 < or = 49 mm Hg were threshold values used to separate infected from sterile fluid collections. RESULTS: pH alone had a 92% sensitivity and 79% specificity, whereas PO2 alone had a 51% sensitivity and 79% specificity. pH or pO2 combined yielded a 92% sensitivity and 60% specificity. The radiologist's opinion produced a 83% sensitivity and 92% specificity. pH and the radiologist's opinion combined produced a 78% sensitivity and 96% specificity. pH or the radiologist's opinion combined had a 95% sensitivity and a 63% specificity. CONCLUSION: pH is the most sensitive indicator of infection and the radiologist's opinion is the most specific. We recommend proceeding to drainage if the radiologist believes the collection to be infected and performing pH analysis if not. If the pH < or = 7.04, proceed to drainage. If neither of the above criteria are met, drainage could be delayed, pending the results of culture.

Abdominal Abscess↗

PubMed1999

Image-guided central venous catheters for apheresis.

Apheresis is an increasingly important procedure in the treatment of a variety of conditions, sometimes performed via peripheral access because of concern over major complications associated with central venous catheter (CVC) placement. This study sought to determine the safety and success for ultrasound and fluoroscopically guided, non-tunneled dual lumen CVCs placed for apheresis. Prospective data collection was made of 200 attempted CVC placements in the radiology department utilizing real time sonographic guidance. The complications relating to placement were noted in all and the number of passes required for venepuncture and whether a single wall puncture was achieved was recorded in 185 cases. Duration of catheterization and reason for line removal were recorded in all. Our study group included 71 donors providing peripheral blood stem cells for allogeneic transplant. CVCs were successfully placed in all patients, 191 lines in the internal jugular and seven in the femoral vein. 86.5% required only a single pass and 80.5% with only anterior wall puncture. Inadvertent but clinically insignificant arterial puncture occurred in six (3%) cases. In no case did this prevent line placement. There were no other procedure-related complications. 173 (87.4%) catheters were removed the same day. No catheters were removed prematurely. There was one case of prolonged venous bleeding. Our study demonstrates the safety of central venous catheters for apheresis provided that duration of catheterization is short and real-time sonographic guidance is used for the puncture, and guide wire and catheter placement are confirmed fluoroscopically.

Adolescent↗

PubMed1996

Craniocervical bone pneumatisation.

We report a case of extensive craniocervical bone pneumatisation presenting after minor trauma. The patient had neurological signs and initial radiographs showed multiple lucencies in the skull base and the atlas vertebra. CT established the true nature of this rare condition.

Athletic Injuries↗

PubMed1994

Intravenous contrast media reactions: how do radiologists react?

Following the publication of the Royal College of Radiologists guidelines for the management of reactions to intravenous contrast media we assessed radiologists' understanding of intravenous contrast media reactions and their management of specific adverse reactions. A confidential questionnaire was sent to all radiologists in the Northern Region. Responses were received from 61/101 (60%). Knowledge of minor contrast media reactions was generally good but the understanding of treatment of severe reactions was poor. Knowledge of optimal management was inversely related to radiological seniority. This study suggests a poor understanding of severe contrast media reaction management amongst radiologists. Simplified treatment guidelines based on the Royal College document and aimed at severe reactions are suggested.

Anaphylaxis↗

PubMed1983

The effects of oral administration of salts of aspartic acid on the metabolic response to prolonged exhausting exercise in man.

The effects of the oral administration of salts of aspartic acid on endurance capacity and metabolic responses to prolonged bicycle exercise have been investigated. Previous reports in man and in animals have suggested that this treatment can increase the capacity to perform muscular work by virtue of its effect on circulating ammonia levels. Eight healthy young male subjects exercised to exhaustion on a bicycle ergometer at a work load requiring approximately 75% of maximum oxygen uptake. This work test was performed after placebo administration or after ingestion of 6 g of potassium-magnesium aspartate over a 24-h period, using a double-blind protocol. Exhaustion was reached after 82.7 +/- 23.5 min (mean +/- SD) following aspartate treatment and after 85.4 +/- 26.5 min following the placebo. No differences in the blood glucose, lactate, or ammonia concentrations or in the plasma free fatty acid concentration between the two treatments were observed. The respiratory exchange ratio was the same on both occasions. These results show no beneficial effect of oral aspartate administration on work capacity in man and also suggest that the metabolic processes that occur during exercise are not influenced by this treatment.

Adult↗