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Biomedical subjects

R B Stephens

Publications and source records attributed to R B Stephens.

29 records · Page 2Linked to original sources
PubMed1982

An assessment of dynamic gastric scanning with 99Tcm-pertechnetate.

Following intravenous injection, technetium-99m (99Tcm) is selectively taken up by the stomach, and this uptake, which is stimulated by pentagastrin, may be quantified using a gamma camera. Using this property of 99Tcm as a means of assessing gastric function, we found that the mean rate of 99Tcm uptake was significantly greater in 24 duodenal ulcer patients than in 10 healthy controls (P less than 0.01). Scanning values did not correlate with BAO of MAO which were measured on a separate day. Both vagotomy (n = 10) and cimetidine infusion (n = 5) significantly reduced the rate of uptake of 99Tcm (P less than 0.01). Thus, although 99Tcm reflects a function of the stomach which is similar to acid secretion, scanning did not give a good estimate of acid secretion in this group of subjects.

Adult↗
PubMed1982

The role of estrogen receptor status in predicting the response of carcinoma of the breast to adjuvant chemotherapy.

This study was undertaken to determine if there was any correlation between the estrogen receptor status and the response of patients with operable carcinoma of the breast to adjuvant chemotherapy. Seventy-seven patients with metastases to the axillary lymph nodes who were receiving adjuvant chemotherapy following a modified radical mastectomy were studied. During the period of study, 12 of 34 estrogen receptor-positive tumors recurred, with a mean disease-free interval of 17.8 months, and 19 of 43 estrogen receptor-negative tumors recurred, with a disease-free interval of 15.2 months. Statistical analysis of recurrence at two years showed no difference between these two groups. Only one patient of 18 in the premenopausal group of women with estrogen receptor-positive tumors, however, had a recurrence compared with 11 of 24 patients with estrogen receptor-negative tumors. This difference was highly statistically significant, p greater than 0.0005. We have concluded that the estrogen receptor status is not a reliable indicator of response to adjuvant chemotherapy for all patients. Our data do indicate a positive correlation between response to adjuvant chemotherapy and estrogen receptor status in the premenopausal group of patients and suggest that adjuvant chemotherapy in the premenopausal group of patients may be exerting some of its effect by ovarian suppression rather than by solely cytotoxic effect on cancer cells of the breast.

Adenocarcinoma, Scirrhous↗
PubMed1982

Acute and chronic management of esophageal varices by injection sclerotherapy.

Of 29 consecutive patients with acute bleeding from esophageal varices, 27 were treated by injection sclerotherapy. Bleeding was controlled by injection in 25 patients. Long term injection therapy was undertaken in these 25 patients. Obliteration of the varices was achieved in five, two of whom had re-canalization and rebleeding. Patent varices remained in 20 patients, with 11 instances of rebleeding and seven deaths due to hemorrhage. All patients with alcoholic cirrhosis had rebled while receiving long term injection sclerotherapy.

Adolescent↗
PubMedDate not supplied

Effect of a betadine connection shield on central venous catheter sepsis.

The effect on the rate of central venous catheter sepsis of incorporating the catheter hub in a povidone-iodine (Betadine) connection shield was evaluated in a randomized controlled clinical trial involving 47 Silastic catheters inserted in 35 patients solely for the administration of parenteral nutrition. All catheters were tunneled subcutaneously and once inserted were randomized to one of two subsequent management groups. Group 1 (n = 25) were managed in a standard fashion whereas Group 2 catheters (n = 22) in addition were managed by incorporating the catheter hub in a Betadine connection shield (Connection Shield 3; Travenol/Baxter). The catheter lifespans in the two groups were similar (Group 1 mean 10.8 days; range 3-28: Group 2 mean 13.3 days: range 5-31). There was a significant difference in the rates of both clinical sepsis (Group 1, 8 cases; 32%; Group 2, 1 case; 4.5%; p less than 0.05) and bacteriologic sepsis (Group 1, 6 cases; 24%; Group 2, 0 cases; p less than 0.05) in the two groups. Incorporating the catheter hub in a Betadine connection shield confers significant benefit in terms of reducing the incidence of catheter sepsis in patients receiving total parenteral nutrition.

Catheterization, Central Venous↗
PubMedDate not supplied

Review of 210 autogenous vein by-pass operations.

This is a retrospective review, using the life table method, of 210 vein by-pass operations. Sixtythree percent of the operations were performed for limb salvage. Eightyeight percent of the operations were performed with the distal anastomosis below the knee joint. The longerm patency rates for those grafts with good run-off was significantly better (p = .036) than for those with poor run-off and the addition of a lumbar sympathectomy was found not to significantly alter the longterm patency rates. Re-operation for graft failure in the first 448 hours after operation was found to be worthwhile procedure giving a cumulative patency rate of 59.9% at five years. A five year cumulative patency rate of 57% is reported and autogenous vein bypass is considered a worthwhile procedure for limb salvage and some selected claudicants with femoro-popliteal arterial disease.

Adult↗
PubMedDate not supplied

Simple closure and follow up H2 receptor antagonists for perforated peptic ulcer--immediate survival and symptomatic outcome.

There is controversy over the optimum treatment of perforated peptic ulcer. Non-operative management is associated with a high incidence of subsequent operation while immediate definitive surgery is associated with a high initial peri-operative mortality. We have a policy of simple closure and follow up H2-receptor antagonists. This study reviews 100 consecutive patients to identify immediate survival and subsequent symptomatic results of this surgical policy. The mean age was 49 years with 24 patients over 70 years. Sixteen were taking H2-receptor antagonists and 20 taking non-steroidal anti-inflammatory drugs on admission. Simple closure was performed in 94 and six had definitive surgery as their first procedure. The 30 day mortality was 6% (1% for < 70 yrs n = 76, 20% for > 70 yrs n = 24). Complete follow up was achieved in 90%, (range 2-80 months). Seventy-four percent were asymptomatic, 13% intermittently symptomatic and 7% had continuous symptoms. Only five patients (6%) required subsequent definitive surgery. The policy of simple closure and follow up H2 receptor antagonists for perforated peptic ulcer is safe and effective in the long term.

Adolescent↗