Outpatient liver biopsy: a prospective evaluation of 500 cases.
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Adult↗
Biomedical subjects
P Beddy
Publications and source records attributed to P Beddy.
Non-seminomatous testicular metastasis mimicking acute appendicitis.
This is the first report in the literature of a non-seminomatous metastasis from an occult testicular primary that presented as an acute appendicitis. The report highlights the necessity of testicular re-imaging in cases of occult malignancy and reviews the association of chromosome 12 with embryonal germ cell tumours.
Adult↗
Valsalva and gravitational variability of the internal jugular vein and common femoral vein: ultrasound assessment.
PURPOSE: Central venous cannulation via the common femoral vein is an important starting point for many interventions. The purpose of this study was to determine the optimum conditions for cannulation of the femoral vein and to compare these with the relative changes in the internal jugular vein. METHODS: High-resolution 2D ultrasound was utilised to determine variability of the calibre of the femoral and internal jugular veins in 10 healthy subjects. Venous diameter was assessed during the Valsalva manoeuvre and in different degrees of the Trendelenburg position. RESULTS: The Valsalva manoeuvre significantly increased the size of the femoral and internal jugular veins. There was a relatively greater increase in femoral vein diameter when compared with the internal jugular vein of 40 and 29%, respectively. Changes in body inclination (Trendelenburg position) did not significantly alter the luminal diameter of the femoral vein. However, it significantly increased internal jugular vein diameter. CONCLUSIONS: Femoral vein cannulation is augmented by the Valsalva manoeuvre but not significantly altered by the gravitational position of the subject.
Adult↗
Testicular varicoceles.
A testicular varicocele represents an abnormal degree of venous dilatation of the pampiniform plexus. It is a relatively common condition and may present at scrotal pain and swelling. An association with male subfertility is an area of debate. This article describes the present day radiological criteria and imaging techniques to aid accurate diagnosis of varicoceles. In addition, the role of the interventional radiologist in treating this condition is discussed.
Embolization, Therapeutic↗
A critical appraisal of the out-patient fracture clinic: is communication really the key?
The most common factor in an adversarial doctor-patient relationship is failed communication. We audited our communication skills, patient satisfaction and assessed patients' capacity for retaining information. 120 consecutive first time patients with one of 5 fracture types were assessed. Patients scored (a) the doctor's communication skills and (b) their overall fracture clinic experience. Patient satisfaction was high, mean 8.2 (range 2-10, SD 1.76) points. There was a statistically significant difference in a patient's knowledge pre and post consultation. Forty-three patients (36%) could recall a specific consequence of the fracture (p<0.005). Forty (31%) and twenty six (22%) patients could recall the name of the Registrar and Consultant respectively. Doctors scored 9.2 (range 7-10, SD 1.23) points for communication skills. Patients are concerned with a fracture's impact on daily activities, often failing to register who treats them and any serious consequences. With doctors being scored so highly, the dilemma remains of how better to deliver the message.
Ambulatory Care↗
Reduced inflammation in genetically hypertensive rat airways is associated with reduced tachykinin NK(1) receptor numbers.
The airways of the genetically hypertensive rat (GH) are hyperinnervated by substance P-containing sensory nerves and exhibit reduced inflammatory responsiveness to substance P and to capsaicin. The present study measured tracheal inflammation to resiniferatoxin (1.0 microgram/kg i.v.), a capsaicin analogue, which lacks the hypotensive action of capsaicin itself, alone or after the neuronal nitric oxide synthase inhibitor 1-(2-trifluoromethylphenyl)imidazole (TRIM) (50 mg/kg i.p.). The inflammatory response to resiniferatoxin alone was 50% lower in untreated GH than in control rats, a similar strain difference to that seen previously with capsaicin. Pre-treatment with TRIM had no effect on inflammation in either strain. Binding kinetics of the tachykinin NK(1) receptor antagonist [3H](S)-1-(2-[3-(3, 4-dichlorophenyl)-1-(3-isopropoxyphenylacetyl)piperidin-3-yl]ethyl)-4- phenyl-l-azoniabicyclo[2,2,2,]octane chloride ([3H]SR140333)(0.125-16.0 nM) showed 50% reduction of B(max) in GH versus control tracheae (74+/-13 cf.165+/-26 fmol/mg protein). Our results indicate that the reduced neurogenic inflammatory responsiveness in GH rats can be attributed entirely to reduced tachykinin NK(1) receptor numbers.
Animals↗