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Biomedical subjects

R Astley

Publications and source records attributed to R Astley.

At least 19 recordsLinked to original sources

Metaphyseal fractures in osteogenesis imperfecta.

Forty-one children with osteogenesis imperfecta have been reviewed. A minority (7/41) showed small metaphyseal fractures, resembling those seen in non-accidental injury, but in all of these there was obvious generalized bone disease so that confusion with non-accidental injury did not occur.

Battered Child Syndrome↗

Demonstration of pulmonary arteries by contrast injection into pulmonary vein.

Pulmonary venous injection of contrast medium in the near-wedge position produced a flow into the pulmonary arterial tree in 15 out of 21 children with cyanotic congenital heart disease. In 5 there was good opacification of both sides from a single injection. The technique provides an additional method of demonstrating the anatomy of the pulmonary arteries where surgical treatment is contemplated.

Adolescent↗

A 20-year prospective follow-up of childhood hiatal hernia.

A long-term prospective follow-up of 113 children with vomiting due to a small hiatal hernia is described. When reviewed by the same clinical and radiological observers 20 or more years later, over 90% of unoperated non-stricture patients were asymptomatic whereas only 44% of the stricture and/or surgically treated group were without symptoms. Half or possibly more of the asymptomatic patients still had a hernia and it is possible that these may suffer a recurrence of symptoms later in adult life. The loculus of thoracic stomach tended to retain the same shape; there was a slightly better prognosis for the locular type of hernia compared with the tubular type. Complicating oesophageal strictures can decrease or disappear without surgery other than dilatation; the results of treatment by radical surgery were disappointing. There is need for an even more prolonged follow-up into later adult life.

Adult↗

A form of metatropic dwarfism in two brothers.

Two brothers are described with identical features of short-limbed dwarfism, normal face, hands and feet, respiratory difficulties and mild scoliosis. It proved impossible to offer a definitive diagnosis, though radiological features as a whole bore similarities to those of metatropic dwarfism, with the most notable feature the narrowing of the ossified components of the vertebral bodies.

Dwarfism↗

Lead intoxication in children in Birmingham.

Of 38 children investigated between 1966 and 1971 who had a blood lead concentration greater than 37 mug/100 ml eight had encephalopathy and one died; all these eight had a blood lead concentration of 99 mug/100 ml or above. Blood lead levels are related to haemoglobin concentrations and anaemia is common in children with blood lead concentrations of 37-60 mug/100 ml, levels previously accepted as harmless.Children with blood lead concentrations greater than 60 mug/100 ml show radiological evidence of lead intoxication, and treatment for this should be considered when blood lead concentration exceeds 37 mug/100 ml. Children presenting with unexplained encephalopathy should be radiographed for evidence of lead intoxication.

Anemia↗