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Biomedical subjects

F Regan

Publications and source records attributed to F Regan.

52 records · Page 3Linked to original sources
PubMed1996

Deep venous thrombosis prophylaxis with low molecular weight heparin and elastic compression in patients having total hip replacement. A randomised controlled trial.

Seventy-eight patients having elective total hip replacement were randomised into 3 groups A) control; B) low molecular weight heparin: (enoxaparin 40 mg once daily) and C) enoxaparin (40 mg once daily) plus graduated elastic compression (TEDR stockings) for 8-12 days. All patients had a preoperative perfusion lung scan and chest X-Ray and a postoperative perfusion/ventilation scan together with bilateral ascending venography on days 8-12. A blood sample was taken preoperatively, on the 1st, 3rd and 5th postoperative day and at the end of the study. The control group received placebo injections. The venograms and V/Q scans were reported blindly by an independent panel of three and one radiologists respectively. An independent panel of assessors stopped entry in the control group when a total of 45 patients were admitted according to Ethics Committee directives. The study continued with groups B and C. The incidence of DVT (including isolated asymptomatic calf thrombi) was as follows: Group A (n = 14) 93%; Group B (n = 32) 38%; Group C (n = 32) 25% (chi 2; p < 0.001 for group A versus B or C). The incidence of proximal DVT was: Group A 57%; group B 28%; group C 13% (chi 2; p = 0.057 for group A versus B and p < 0.005 for group A versus C). The incidence of silent pulmonary embolism (PE) (new defect on V/Q scan) was 28% (8 out of 29) in patients with and 5% (2 out of 43) in patients without DVT (chi 2; p < 0.02). The combination of high TAT and low anti-Xa activity on the 1st postoperative day identified a high risk group of patients who had a 56% incidence of proximal DVT on the 8th to 12th postoperative day. Further studies are needed to confirm the suggested increased efficacy in prophylaxis by the combination of LMWH and GEC as compared with LMWH alone.

Aged↗
PubMed1995

Duplex ultrasound scanning for diagnosing lower limb deep vein thrombosis.

BACKGROUND: Traditionally, venography is used to investigate deep vein thrombosis (DVT), though duplex ultrasound offers a challenging, noninvasive alternative method and previous reports have described the use of duplex ultrasound for detecting proximal lesions. OBJECTIVE: To compare duplex ultrasound imaging with venography for both proximal and distal lesions using the probe compression technique and a different protocol. METHODS: Duplex scans were done by the same operator prior and blind to venography, which was performed using a standard protocol with the films being reviewed blindly by a second radiologist at a later date. RESULTS: In 74 patients, 21 of 22 above-knee lesions present on venography were detected by duplex scanning and there was complete agreement in the 52 of 52 venogram negatives. For lesions below the knee, duplex detected 26 of 27 lesions also present on venography and agreed on 37 of 43 venogram negatives. These figures give duplex ultrasound overall accuracies of 99% and 90% (Kappa 98% and 89%) for above- and below-knee lesions, respectively. CONCLUSION: These figures suggest duplex ultrasound technique compares favorably with venography for diagnosing both proximal and distal lesions.

Female↗
PubMed1995

Spiral CT scanning of the paranasal sinuses.

Because of the interest in reducing the time and radiation required for screening sinuses with CT, we compared the quality of conventional coronal CT images with coronally reconstructed, axially acquired spiral CT images. The spiral reconstructions compared favorably with the conventional images and had significantly less motion and dental amalgam artifacts.

Adult↗
PubMed1993

The use of carbon dioxide as an insufflation agent in barium enema--does it have a role?

A double blind prospective study was undertaken to evaluate the benefit of using carbon dioxide in double contrast barium enema (DCBE). 142 consecutive patients referred for DCBE were randomly allocated to receive either air or carbon dioxide (CO2) as the insufflation agent. The use of CO2 reduced the incidence of immediate and delayed severe pain from 31% to 12.5% and from 12.9% to 4.2% respectively. There was a statistically significant higher incidence of delayed severe pain in the younger age group as found in previous studies. Post-evacuation films showed that there was less residual gas after CO2. The quality of the DCBE was unchanged. We urge the more widespread use of CO2 as insufflation agent in DCBE.

Adult↗
PubMed1990

Comparison of a calixarene-based ion-selective electrode with two automated analyzers for the clinical determination of sodium in blood plasma.

Neutral-carrier ion-selective electrodes based on methyl p-t-butylcalix[4]aryl acetate have been prepared that are responsive to sodium ions. The miniaturized catheter-type electrodes were obtained by dip-coating their porcelain tips in a PVC membrane cocktail. Examination of the general performance of the electrodes revealed excellent characteristics in terms of Nernstian response, selectivity, stability, reproducibility and response time. The results from the indirect potentiometric assessment of a large number of plasma samples with the electrodes showed a good correlation with the results from two automated analyzers (Technicon Smac 3, Hitachi 704) and with flame photometric data. Although inconsistencies were observed in the measurement of some plasma samples, the variance seemed to be method-dependent, and the overall performance of the electrodes showed promise as an alternative to the sodium glass electrode. Some factors influencing the standard potential of the measuring cell are discussed as a source of error.

Autoanalysis↗
PubMedDate not supplied

MR cholangiography in biliary obstruction using half-Fourier acquisition.

PURPOSE: Our goal was to evaluate biliary obstruction using a T2-weighted, turbo, SE MR sequence with half-Fourier acquisition (HASTE). METHOD: A prospective evaluation of 21 consecutive patients with clinical evidence of obstructive jaundice was carried out comparing HASTE MR cholangiography (MRC) to endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography. A control group of five normal volunteers was also evaluated. The study group was imaged with a 1.5 T MR scanner using a body coil. The HASTE sequence was applied in axial, coronal, and oblique sagittal planes. Ultrafast acquisition scanning times allowed the use of a single breath hold. Bile duct dilatation, level of obstruction, and cause of obstruction were assessed on both imaging modalities by two radiologists blinded to the clinical diagnosis and to each other's results. RESULTS: All studies were interpretable with anatomy well seen in 82% of the cases. MRCs of a normal control group were correctly interpreted. The presence of biliary dilatation was accurately depicted by HASTE MRC in 100% of patients with complete interobserver agreement. The level of obstruction was depicted correctly in 87% of patients with 93% interobserver agreement. The right main duct was seen by MRC in 80% of obstructed systems. The left main duct was seen in all obstructed patients. The gallbladder was identified in 88% of patients by MRC. Common bile duct stricture and stones could be differentiated as a cause of obstruction in all cases. CONCLUSION: MRC using the HASTE imaging sequence can safely and accurately depict the presence and level of biliary obstruction. The fast acquisition time of 13 s/scan makes the technique suitable for uncooperative and ill patients. HASTE MRC should be considered an alternative procedure to direct cholangiography in selected patients.

Aged↗
PubMedDate not supplied

MRI of bowel obstruction using the HASTE sequence.

High quality MR images of the gastrointestinal tract are now obtainable using a T2-weighted fast SE MR sequence with half-Fourier acquisition of data (the HASTE sequence). This fast sequence can acquire a set of images in a single breath hold and is insensitive to peristalsis-related artifact. It can be used with other imaging modalities in defining bowel obstruction and is accurate in determining the presence of bowel dilation and level of obstruction and in differentiating obstructing tumor from other causes of obstruction.

Humans↗
PubMedDate not supplied

The diagnostic utility of HASTE MRI in the evaluation of acute cholecystitis. Half-Fourier acquisition single-shot turbo SE.

PURPOSE: The purpose of this study was twofold: (a) to determine the significance of high signal intensity surrounding the gallbladder as seen on T2-weighted HASTE (half-Fourier acquisition single shot turbo SE) MR images in patients with acute cholecystitis and (b) to determine the sensitivity of T2-weighted HASTE MR images in detecting gallbladder and common bile duct (CBD) calculi in patients with acute cholecystitis. METHOD: Seventy-two patients with a suspicion of acute cholecystitis were referred for HASTE MRI over a 2 year period. Forty-one patients underwent MRI after sonography and the remaining 31 patients before sonography. MR images were independently evaluated for the presence of MR pericholecystic high signal and gallbladder and CBD calculi. Findings were correlated with results obtained at sonography and at surgery. RESULTS: Of the 72 patients imaged with HASTE MRI, 55 had cholecystitis based on clinical, sonographic, and/or surgical findings. Of these, 45 had acute and 10 had chronic cholecystitis. HASTE MRI demonstrated MR pericholecystic high signal in 41 of 45 (91%) of the patients with acute cholecystitis. The sensitivity of HASTE MRI in diagnosing acute cholecystitis was 91%. The specificity was 79%. The positive predictive value was 87%, the negative predictive value was 85%, and the overall accuracy of the test was 89%. Gallbladder stones were seen by HASTE MRI in 38 of 41 (93%) of patients with acute calculus cholecystitis demonstrated at sonography. CBD stones were demonstrated by HASTE MRI in seven of nine (78%) patients and by sonography in five of nine (56%) patients with documented choledocholithiasis on conventional cholangiography. CONCLUSION: HASTE MRI has a high degree of accuracy in diagnosing acute cholecystitis based on the single finding of pericholecystic MR high signal. A similar level of accuracy is demonstrated in detecting gallbladder stones. Biliary duct calculi are detected with even greater accuracy than with sonography in patients with acute cholecystitis. Invasive preoperative endoscopic retrograde cholangiography may therefore be limited to only those patients with acute cholecystitis and CBD stones demonstrated on HASTE MRI. These features make HASTE MRI and ideal imaging modality in the initial evaluation of acute biliary pain and may ultimately replace sonography in the preoperative evaluation of acute cholecystitis.

Acute Disease↗
PubMedDate not supplied

Hypereosinophilic sclerosing cholangitis: findings using half-Fourier magnetic resonance imaging.

Hypereosinophilic sclerosing cholangitis is a rare disease caused by eosinophilic infiltration of the gallbladder and biliary tract seen in the idiopathic hypereosinophilic syndrome. We report a 42-year-old woman who presented with symptoms of cholecystitis and obstructive cholangitis. Imaging with magnetic resonance cholangiography using a half-Fourier spinecho sequence, we were able to visualize rapidly and non-invasively a severely abnormal gallbladder, evidence of liver parenchymal inflammation, and biliary duct dilatation.

Adult↗