Biomedical subjects
Publications and source records attributed to K D Foord.
We describe a case of primary antiphospholipid syndrome presenting with varied arterial abnormalities. Patients with antiphospholipid syndrome commonly present with thrombotic problems, but there is a subgroup of patients who develop aneurysms with no evidence of vasculitis. This may represent part of the spectrum of the syndrome itself rather than an associated disease such as polyarteritis nodosa.
This paper is based on 4 years of practical experience with a developmental pre- Digital Imaging and Communications in Medicine (DICOM) picture archiving and communication system (PACS) plus analysis from the respecification study data for a DICOM/HTML PACS replacement. High-performance, but economic, workstations are required within PACS for radiologists to rapidly and accurately report images. For economic reasons such workstations should utilise standard landscape orientation monitors. They must have full Radiology Information System (RIS) integrated reporting functionality to optimise radiologists' work. The workstations must also be capable of displaying request data and both new and associated old images and image reports from multiple modalities. All images should be imported as "folders" according to semi-intelligent "knowledge table" based DICOM 3.0 standard Worklist control exerted by image management servers. This information can be obtained by relevant image lists and decision charts. A description of an optimal standard monitor workstation environment and related issues based on experience and literature review is given.
Almost equivalent, intravenous iodine doses of the three new low-osmolar contrast media, ioxaglate (Hexabrix), iopamidol (Niopam) and iohexol (Omnipaque) have been compared for image quality on the intravenous urogram. Generally good radiographic images were obtained. Iohexol gave better results for the nephrogram and pelvicalyceal distension compared with the other contrast media, but only the nephrogram results were statistically significant. Pyelographic density and ureteric distension and density were similar with all three contrast media. In patients where low-osmolality contrast media need to be used for intravenous urography, we suggest that iohexol gives the best radiographic images. Other factors, such as cost and the relative incidence of side-effects of the low-osmolar contrast media also need to be taken into consideration.
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The subjective side-effects of almost equivalent intravenous iodine doses of the three new low-osmolar contrast media, ioxaglate (Hexabrix), iopamidol (Niopam) and iohexol (Omnipaque) have been recorded and are found to be generally comparable. Urticaria occurred more frequently with ioxaglate than with the other contrast media and there was a tendency for ioxaglate to cause more nausea. Pain at the injection site occurred less often with ioxaglate than with iohexol. If low-osmolar contrast media are to be used in intravenous urography the relative cost of each is important, there being as yet insufficient data concerning the relative incidences of major reactions.
Three preparations, two based on magnesium citrate and one an optimised oral mannitol regime, have been compared for their effectiveness in clearing the large bowel prior to double-contrast barium enema and for effects on barium mucosal coating. If excellent clearance alone is taken as the criterion of acceptability, the preparations based on magnesium citrate are shown to be equal to each other, but better than mannitol. No significant difference in coating performance is seen between the three preparations. Magnesium citrate regimes cause significantly less nausea and vomiting than mannitol. No differences are noted in the frequency of abdominal or rectal pain between the preparations. It is concluded that mannitol should be abandoned as a barium enema preparation.
A oral mannitol purgative which is used prior to colonoscopy proved disappointing for barium enema preparation. A number of ways of improving bowel clearance with mannitol in divided dosage, preliminary oral metoclopramide and a clear fluid diet have been assessed. Divided dosage and a clear fluid diet were both beneficial, whereas oral metoclopramide was ineffective. Using the best regime, 38% of patients had a totally clear bowel compared with 33% using an established lavage technique. It is concluded that oral mannitol, with a clear fluid diet, is a satisfactory preparation for double contrast barium enema, and a regime is recommended.