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Biomedical subjects

H Bradby

Publications and source records attributed to H Bradby.

4 recordsLinked to original sources
PubMed1994

Prevention of rebleeding from oesophageal varices: two-year follow up of a prospective controlled trial of propranolol in addition to sclerotherapy.

A prospective randomised trial comparing propranolol and sclerotherapy to sclerotherapy alone was conducted over a 2-year follow up in a district hospital setting of unselected patients. Rebleeding and survival were analysed. Thirty-nine patients were randomised to propranolol plus sclerotherapy and 34 to sclerotherapy alone. The two groups were clinically comparable. There was no significant difference in the cumulative percent of patients free of rebleeding; 54% of the sclerotherapy group rebled compared to 52% of the group treated with propranolol plus sclerotherapy (Hazard ratio 1.09 (0.54-2.22) and p = 0.81, NS). Two-year actuarial survival was also not significantly different, with 77% of the propanolol plus sclerotherapy group surviving, compared to 74% of sclerotherapy alone (Hazard ratio 1.08 (0.35-2.22) and p = 0.79, NS). The mean time to eradication of varices was not significantly different between the two groups (propranolol plus sclerotherapy 222 days, sclerotherapy alone 243 days), nor did the rate of variceal recurrence differ (72.7 vs 72 days). This study did not show long-term improvement in rebleeding or survival using propranolol in addition to a regular sclerotherapy programme.

Adolescent↗
PubMed1990

Rapid intravenous low-dose diazepam as sedation for upper gastrointestinal endoscopy.

One hundred patients for endoscopy, aged, between 18 and 74 years were randomly allocated to two equal groups. Group A received 10 mg diazepam intravenously rapidly over 2-4 s; Group B received diazepam intravenously over 1-2 min, titrated to provide a satisfactory level of sedation (mean dose 15.9 mg). Patient co-operation during endoscopy was similar in both groups, but one patient in Group A developed respiratory depression. Tests of psychomotor function after endoscopy showed greater impairment 30 min following injection for Group B, compared with Group A (P less than 0.02). Total or partial amnesia for endoscopy was present in 62% of Group A, and 90% in Group B (P less than 0.005). However, postal follow-up showed that endoscopy was acceptable to 96% of Group A and 98% of Group B. Delayed sedation later in the day was reported by 26% of Group A compared with 48% of Group B.

Adolescent↗
PubMed1982

Bile diversion after total gastrectomy.

A method for studying bile reflux into the oesophagus after total gastrectomy is described using 99Tcm-HIDA and an external imaging system. Two reconstructions were studied: oesophagojejunostomy with a diverting entero-anastomosis (omega reconstruction 6 studies) and Roux-en-Y reconstruction (20 studies). The incidence of reflux on scanning correlated well with the incidence of oesophagitis, and the finding of reflux was almost always associated with severe symptoms. The omega procedure was unsuccessful in diverting bile in 5 patients despite an entero-anastomosis as wide as 12 cm. The Roux-en-Y reconstruction was unsuccessful in diverting bile in 5 patients all of whom had a diverting limb 35 cm in length; none of the 9 patients with a diverting limb longer than 35 cm refluxed (range 40--50 cm).

Bile Reflux↗