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Biomedical subjects

G M Roberts

Publications and source records attributed to G M Roberts.

15 recordsLinked to original sources

Incidence of ulcerative colitis in Cardiff over 20 years: 1968-87.

The annual incidence of ulcerative colitis in the city of Cardiff was examined over a 20 year period. In the decade 1968-77, the mean annual incidence was 6.4 per 10(5) of the population compared with 6.3 for the period 1978-87. There was no difference in the distribution or extent of the disease between decades or between sexes. This contrasts with the increased incidence of Crohn's disease during the same period. The study included a survey of family practitioners which identified a further 19 patients (11% of the total).

Adolescent

Comparison of barium swallow and left gastric angiography in the diagnosis of esophageal varices, with special reference to the management of variceal bleeding.

Seventy-five patients with portal hypertension and esophageal varices were studied by means of barium swallow and selective left gastric angiography. The relative merits and limitations of these techniques in demonstrating the presence, extent, and severity of the varices are discussed, with reference to the selection of patients for prophylactic transection of the esophagus to prevent bleeding from the varices.

Adolescent

Experience with percutaneous transhepatic cholangiography using the Japanese needle.

Percutaneous transhepatic cholangiography using a very thin needle has been performed in 885 patients with a variety of underlying hepatic, biliary, and pancreatic disorders. The procedure was successful in 99% of the patients with dilated intrahepatic bile ducts and in 85% of those with non-dilated ducts. Complications which required surgical intervention occurred only in two cases (0.2%). In patients with obstructive jaundice, external bile drainage was performed immediately after visualization of the bile duct. Percutaneous transhepatic cholangiography is an extremely useful and safe method for investigating disorders of the biliary tract, for localizing the cause of obstructive jaundice, and for reducing the degree of jaundice and improving the general status of patients with obstructive jaundice.

Bile Ducts

Neurogenic and vascular claudication.

Intermittent claudication from peripheral vascular disease is sometimes difficult to distinguish from similar claudication due to degenerative disease of the lumbar spine. In the present study 26 patients with vascular disease were compared with 23 patients with lumbar degenerative disease. Assessment was by clinical and radiological examination. In the vascular group characteristic distinguishing features were: abnormal foot pulses, arterial bruits, relief of symptoms by standing, a constant claudicating distance and stocking sensory loss. In the lumbar group typical findings were: discomfort on lifting, bending, coughing or sneezing, pain on standing, history of back injury, variable claudicating distance and segmental sensory loss.

Aged

Lumbar spinal manipulation on trial. Part I--clinical assessment.

Thirty-two patients with chronic low back pain were treated three times at weekly intervals with rotational manipulation. Patients with femoral or sciatic root pain were included provided they did not exhibit root compression signs. Background therapy of codeine phosphate was administered throughout. There was a significant increase in spinal flexion measured clinically during the three-week period of manipulation followed by a significant decrease in the three-week period after manipulation. The first week of manipulative treatment was more painful than the corresponding week in the control group but in the second and third weeks there was less pain in the manipulated group. Pain scores were reduced to a significant degree within four weeks of starting treatment only in the group manipulated in the first treatment period. Patients benefitting subjectively from manipulation were more likely to be older and to have had symptoms for a shorter period than those not deriving benefit. The age of onset of symptoms was significantly later in the responders.

Adult

Lumbar spinal manipulation on trial. Part II--radiological assessment.

In a trial of manipulation for chronic low back pain, radiographs of the lumbar spine and radiographic assessment of spinal motion were of no value in predicting or assessing the response of the patients to manipulation. Although radiography of the lumbar spine is a commonly requested investigation, it contributes little to the management of such patients except to exclude serious spinal pathology before any form of physical treatment is commenced.

Adult

The radiology of the hip joints and pelvis in cerebral palsy.

Thw radiological appearances found in the pelvis and hip joints in 79 patients with cerebral palsy, aged 5--16 years, have been studied. These findings have been recorded and correlated with the clinical severity and distribution of the disease. Subluxation of the hip joints was found in 14% and dislocation in a further 6%. Spasticity was the predominant neuromuscular handicap in 69 out of 79 cases (88%). The acetabular angle and femoral neck shaft angle were related to the degree of migration of the femoral head. The acetabular angle, iliac angle, iliac index and femoral neck shaft angle were all significantly increased in the deranged group. In the dislocated group, the mean neck-shaft angle was 154 degrees. When the degree of spasticity was asymmetrical, there was a striking relationship between the laterality of the spasticity and the laterality of the deranged hip, pelvic obliquity and increased acetabular angle. A typical teardrop-shaped femoral head was seen in 48% spina bifida occulta of the lower lumbar and sacral spine in 32% and pseudoarthrosis in 3.8%. No ectopic calcification or ossification of soft tissue was noted. An awareness that these children are at risk from subluxation and dislocation of the hip and the importance of early diagnosis and treatment are emphasised.

Adolescent

Thrombogenicity of arterial catheters and guidewires.

Thrombus formation on the surface of a variety of arterial catheters and guidewires has been studies in dogs. Heparin-bonding of catheters and guidewires greatly reduced surface thrombus deposition even in the most thrombogenic material tested, and under the conditions of these experiements heparin-bonding was more effective than systemic heparinization.

Animals

Observations on the behaviour of barium sulphate suspensions in gastric secretion.

A number of barium sulphate suspensions showed varying patterns of stability when provoked with gastric secretion. The stability of the suspensions was affected by the pH, the mucin content and the volume of secretion used. These studies indicate that flocculation of the suspension in the presence of gastric residue decreases as the amount of undiluted barium sulphate in the mixture is increased.

Adsorption

In vivo and in vitro assessment of barium sulphate suspensions.

In vitro methods of testing the efficiency of barium sulphate suspensions in delineating mucosal detail using canine cadaveric stomachs have been described in the literature. In this study a comparison is made between in vitro and in vivo tests in the stomach and small intestine of dogs, using several brands of barium sulphate. The results indicate that there is considerable variation in the behavior of these suspensions between the in vitro and in vivo tests particularly in the stomach. It is our view that in vitro tests of this sort are of little value for assessing the relative advantages and disadvantages of these suspensions in demonstrating mucosal detail.

Animals

Where do all the tablets go?

Barium sulphate tablets, identical in size and shape to those of aspirin, were given to 98 consecutive patients during routine radiological studies of the upper gastrointestinal tract. In 57 patients the tablets remained in the oesophagus for longer than five minutes. Delay in passage of the tablets was particularly likely to occur in patients with hiatus hernia and reflux and if defects of peristalsis in the oesophagus were observed.

Administration, Oral