PubMed Health⌕ Search

Biomedical subjects

N A Buckell

Publications and source records attributed to N A Buckell.

9 recordsLinked to original sources
PubMed1982

Correlations between defined sigmoidoscopic appearances and other measures of disease activity in ulcerative colitis.

It has been widely assumed that the activity of ulcerative colitis is related to differences in mucosal appearances seen at sigmoidoscopic examination. We have tested this assumption by making comparisons of the symptoms and clinical signs associated with three reproducible appearances of the rectal mucosa. By cross-tabulating 222 observations of each of 10 symptoms and signs with these sigmoidoscopic appearances it has been shown that the subdivision of hemorrhagic mucosae into those which bleed spontaneously and those which bleed only on light touching or scraping is meaningful clinically. Sigmoidoscopic appearances seemed to correlate better with clinical disease activity than histological assessment, even when quantitative, of mucosal biopsies. On the basis of this study, four variables have been suggested which, in addition to the sigmoidoscopic appearances, could form the basis of regular clinical assessment or scoring.

Biopsy↗
PubMed1980

Depth of ulceration in acute colitis: correlation with outcome and clinical and radiologic features.

The depth of colonic ulceration has been graded histologically in 40 patients treated by urgent colectomy for acute colitis. Dilatation of the colon occurred in only 2 of 16 patients with ulceration limited to the submucosa, but in 18 of 24 patients with ulceration which extended into the muscle layer. Perforation occurred in 4 of the 6 patients in whom ulceration was seen to penetrate the muscle completely; the only two deaths occurred among these 4 patients. Complications of colitis thus correlated with the depth of ulceration. The clinical, laboratory, and radiologic features just before operation have been correlated with the depth of ulceration. While there was tendency for anorexia, abdominal tenderness on palpation, fever, tachycardia, leucocytosis, and hypoproteinemia to occur more commonly as the depth of ulceration increased, no single feature or combination of these features correlated well with ulcer depth. A colonic segment exceeding 5 cm in diameter with an irregular mucosal edge, outlined by gas on a plain abdominal radiograph, correlated strongly with ulceration involving the colonic muscle.

Acute Disease↗
PubMed1979

Chlamydia, cytomegalovirus, and Yersinia in inflammatory bowel disease.

The relationship of three infectious agents, Chlamydia, cytomegalovirus, and Yersinia enterocolitica, to the aetiology, clinical course, and diagnosis of Crohn's disease was studied. There was no evidence of chlamydial infection in Crohn's disease and no indication either that cytomegalovirus alters the outcome of acute attacks or that infection with Y. enterocolitica is being misdiagnosed as Crohn's disease.

Acute Disease↗
PubMed1979

How district hospitals see acute colitis.

Acute colitis was an uncommon cause of admission to twenty-two district hospitals in 1975--77. The overall mortality in this series of 130 patients was 5.2%, 1.8% during medical treatment and 20% after urgent surgical treatment. A third of the patients were admitted without previous diagnosis. Four-fifths responded to medical treatment and the rest were treated by urgent colectomy. Four of the six related deaths and half the urgent operations occurred among 18 patients iwth colonic dilatation. This complication was often detected within two days of admission by abdominal X-ray; symptoms and signs were unhelpful in its recognition. Early admission to hospital of patients with severe unexplained diarrhoea or a sharp attack of colitis, rapid investigation to exclude infection, and energetic treatment of colitis, monitored by abdominal X-rays to detect colonic dilatation at its earliest stage, might reduce the frequency and danger of this complication.

Acute Disease↗
PubMed1979

Measurement of serum proteins during attacks of ulcerative colitis as a guide to patient management.

Serial measurements of 11 serum proteins have been made throughout 39 admissions of 36 patients to hospital for the treatment of acute attacks of ulcerative colitis. There was a striking correlation between rapid changes in C-reactive protein and pre-albumin concentrations and the clinical response to medical treatment. Measurements of the alpha1-acid glycoprotein, albumin, and total serum protein concentrations at the time of admission were found to correlate with the outcome of the attack. Measurement of these proteins provides a useful guide to the management of patients with attacks of ulcerative colitis.

Adult↗
PubMed1978

Controlled trial of disodium cromoglycate in chronic persistent ulcerative colitis.

Oral disodium cromoglycate (200 mg qds) has been tested in 26 patients with ulcerative colitis that was resistant to medical treatment. In a double-blind crossover trial disodium cromoglycate and placebo were added to conventional treatment in random order, each for four weeks. There was no significant difference in therapeutic effect between disodium cromoglycate and placebo.

Adolescent↗
PubMed1978

Nonspecific inflammatory bowel disease in two general hospitals.

During 1976, 50 patients were admitted to two general hospitals for the investigation or treatment of nonspecific inflammatory bowel disease. There were more patients admitted with Crohn's disease (23) than proctocolitis (11). Half of those patients admitted with Crohn's disease required surgical treatment, the majority for small bowel obstruction. Five patients were admitted for the treatment of an acute attack of proctocolitis; these patients were all previously undiagnosed, were all admitted urgently and all responded to medical treatment.

Colitis↗
PubMed1977

A controlled comparison of corticotropin and hydrocortisone in the treatment of severe proctocolitis.

A randomized controlled trial has been made of corticotropin (ACTH) 80 units given intramuscularly daily and hydrocortisone 400 mg infused intravenously over 24 hours, in the treatment of in-patients with severe proctocolitis. Seven patients were treated with ACTH and nine with hydrocortisone over an initial seven days. Three patients in the ACTH group and six in the hydrocortisone group improved and were discharged on medical treatment. Four patients treated with ACTH and two with hydrocortisone required urgent colectomy during this admission. Plasma cortisol levels were measured, but there was no correlation between these and the observed therapeutic response. Sideeffects were troublesome in both groups but were more marked in those treated with hydrocortisone. It is concluded that ACTH is not intrinsically superior to hydrocortisone in these doses, in the treatment of severe proctocolitis.

Adrenocorticotropic Hormone↗