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Biomedical subjects

N F Coghill

Publications and source records attributed to N F Coghill.

At least 19 recordsLinked to original sources
PubMed1978

A three-year survey of viral hepatitis in West London.

During a total population survey of viral hepatitis in the London Boroughs of Hounslow, Richmond and Ealing, 784 patients were seen in three years from 1 March 1972 to 28 February 1975. A diagnosis of viral hepatitis was accepted in 489. The annual incidence was 24 per 100 000. 455 of the patients were tested for the hepatitis B surface antigen (HBsAg) by a radioimmunoassay technique and 93 (20%) of these were positive. The majority of the patients with type B hepatitis were in their third or fourth decades. None was under the age of 16. The male to female ratio among patients with hepatitis B was 2 to 1 in those under the age of 30 and 5 to 1 in those aged 30 and over. The seasonal distribution of viral hepatitis showed a peak in the spring, solely from an increased incidence of non-B hepatitis, and a second, smaller peak in the autumn. There was no appreciable clustering of patients except for one local outbreak in a housing estate during the first year affecting mainly children going to the same primary school, and their parents. Patients with hepatitis B had a longer pre-icteric illness (p less than 0.05), greater duration of jaundice (p less than 0.001) and higher peak levels of serum bilirubin (p less than 0.0005) and serum alanine amino transferase (A1T) (p less than 0.03) than patients with non-B hepatitis. The finding of the surface antigen was also associated with a higher frequency of skin rash (p less than 0.0005) and a greater duration of arthralgia (p less than 0.03). Among the HBsAg negative patients the incidence of arthralgia increased with age (p less than 0.0005). Abdominal pain (p less than 0.005) and vomiting (p less than 0.005) were more common in the young. The injection experience of patients with hepatitis B showed a high proportion of 'non-therapeutic' exposure such as drug addiction. Significantly more HBsAg positive men were single than in the local community (p less than 0.001) or among the HBsAg negative men (p less than 0.01). There was no significant difference between the proportions of single women among the antigen positive and negative patients. Many of the HBsAg positive single men were either known to be or strongly suspected of being homosexual. The ad subtype of the HBsAg was found more often in males (p less than 0.01), particularly over the age of 30. All eight drug addicts tested for subtype were ay, as were two non-addicted female consorts. The association between addiction and ay subtype was highly significant in the males (p less than 0.001). The ad subtype was found in all 11 of the admitted homosexual HBsAg positive men and in all but one of the 17 strongly suspected of being homosexual.

Adolescent↗
PubMed1976

Gastric mucosa after partial gastrectomy.

A partial gastrectomy of Billroth I or II type was performed in a series of 146 patients with peptic ulcer. Gastric biopsy was carried out two years later and the histology of the specimens compared with that of the body mucosa at the time of operation. In 138 patients without body atrophic gastritis (AG) before operation this condition was found in 74 (54%) two years after (46% of DU patients and 73% of GU patients). Those with antral or pyloric canal ulcers were particularly liable to develop AG (81%). Apart from site of ulcer various other factors possibly associated with the development of AG were examined: no positive correlations were found with the possible exception of anaemia. Gastric parietal cell antibodies were not found in any patient with AG tested. The cause of gastritis after partial gastrectomy and its possible relationship with gastric carcinoma are discussed.

Age Factors↗
PubMed1974

Hepatitis B antigen in viral hepatitis in West London.

During the first 12 months of a total population survey 249 patients were seen with viral hepatitis. A total of 215 of these were tested for hepatitis B antigen (HB Ag) by radioimmunoassay and 32 (15%) were positive.More than five times as many men (27) as women (5) were HBAg positive and 19 of the men were between the ages of 20 and 39 years. There were only four drug addicts among those tested, two of whom were positive, as were two of the four patients who were tattooed.Sixty out of 86 children (under 15 years) were tested for HBAg and none was positive.

Adolescent↗
PubMed1974

Measuring the response of the jejunal mucosa in adult coeliac disease to treatment with a gluten-free diet.

A previously described technique for measuring changes in the architecture of the small intestinal mucosa was used to measure the long-term response in six patients with adult coeliac disease to treatment with a gluten-free diet. All had flat or flat-with-mosaic jejunal mucosae before treatment and were subsequently believed to keep strictly to a gluten-free diet. They were followed for between four and 14 months from the start of treatment. The ratio of the area of surface epithelium to that of crypt epithelium (;area ratio') invariably increased following gluten withdrawal, but did not begin to do so until after several weeks of treatment. No patient attained complete histological normality within the limited period of observation, which was never more than 14 months. In one of the three patients followed for a year or more the area ratio increased to within the control range, and in two of these three the ratio was about 10 times the pretreatment ratio. There was a highly significant linear correlation between area ratio and time on the diet (r = 0.775, p < 0.005). The surface cell height measurements for these patients, by contrast, rose steeply and almost invariably during the first few weeks of treatment, but after that they fluctuated without further significant change. It is suggested that the two methods of measurement were complementary to each other, surface cell height being useful while the patient was in hospital on a rigidly strict diet, and the area ratio after return home, when minor dietary lapses were almost invariable.

Celiac Disease↗
PubMed1973

A new technique for examining intestinal biopsies.

A new technique for measuring changes in the architecture of the small intestinal mucosa is described using a modification of the technique of television image analysis to measure the areas occupied by the surface and crypt epithelium in proximal jejunal biopsies. The ratios of these two areas to each other were then calculated. In 12 control mucosae, the mean ratio (+/-SD) was 2.27 +/- 0.41. In 12 untreated flat mucosae, by contrast, the mean ratio was only 0.24 +/- 0.07. This ten-fold difference, which was highly significant (p < 0.001), was greater than that for any similar measurements previously reported. This technique is intended for the measurement of changes in the mucosa too small for existing techniques to detect reliably rather than for the diagnosis of coeliac disease.

Adult↗
PubMed1970

The effect on jejunal mucosa of withdrawing and adding dietary gluten in cases of idiopathic steatorrhoea.

Biopsy studies of the jejunal mucosa in patients with idiopathic steatorrhoea after periods on a gluten-free diet showed that the epithelium improved quickly in respect of surface cell height, mucosal thickness, and mitosis count, and more slowly in respect of villous height and width. In no case was recovery complete in every particular. Appearances seen through the dissecting microscope improved slowly and incompletely. Gluten loading after a period on a gluten-free diet partially reversed some of these mucosal changes in as short a time as five to seven days. Measuring such changes may help to hasten the diagnosis in some patients with suspected gluten-sensitive enteropathy in whom there is otherwise difficulty in assessing the clinical response to a gluten-free diet. The histological response of the jejunum to a gluten-free diet and to subsequent gluten loading may help to clarify the aetiological relationship between carcinoma and jejunal mucosal atrophy.

Adult↗