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Biomedical subjects

S Bentley

Publications and source records attributed to S Bentley.

At least 37 records · Page 2Linked to original sources
PubMed1982

Changes in Doppler ultrasound sonagrams at varying distances from stenoses.

The effect of different degrees of arterial stenosis on Doppler ultrasound sonagrams recorded from various distances downstream has been investigated in a canine model. It has been found that even mild stenoses give rise to considerable disturbances close to the stenosis, and that more severe stenoses give rise to greater disturbances which propagate further downstream. The distance the disturbances travelled was not related to stroke volume, and it was only for stenoses of 88% area reduction and greater that such disturbances ever propagated beyond one stroke-length. Quantitative assessment of moderate degrees of proximal stenosis using continuous wave Doppler ultrasound will not be reliable unless the distance between the major stenosis and the recording site is known.

Animals↗
PubMed1982

The effect of lodoxamide tromethamine on the immediate asthmatic response to allergen provocation.

The inhibition of immediate allergen-induced airflow obstruction by lodoxamide tromethamine (LT), a new drug with properties considered to be similar to those of sodium cromoglycate, was studied in twelve young asthmatic volunteers. Single aerosolized doses of 0 X 01 mg LT, 0 X 1 mg LT or placebo were administered by inhalation 15 min prior to allergen provocation at weekly intervals, in a double-blind random order study. Following inhalation of both doses of LT a significantly greater amount of allergen had to be administered to cause a 20% fall in the forced expiratory volume in one second (FEV1) from control levels than was the case following placebo pre-treatment (P less than 0 X 001). After single-dose inhalation of LT only minor unwanted effects were recorded; in particular a transient feeling of heat in the upper respiratory tract after inhalation of the higher dose of drug.

Administration, Intranasal↗
PubMed1982

University of Manchester sports injury clinic.

This paper reviews the work of the sports injury clinic based at the Student Health Centre, University of Manchester during its first eighteen months. A total of 852 patients including 46 Centre of Excellence athletes were treated. The results indicate that the establishment of such a specialised clinic is worthwhile, that the injured sportsmen should be treated by individuals trained and interested in the treatment of injured patients in general and that the commonest injuries are soft tissue injuries to the knee of ankle joint. A record card, designed for future computer analysis, is illustrated. It includes details of the sport, training, mechanism of injury, pathology and treatment.

Athletic Injuries↗
PubMed1981

A controlled trial to compare systemic and intra-incisional cefuroxime prophylaxis in high risk gastric surgery.

A prospective randomized controlled trial has compared single dose systemic cefuroxime (n = 27) or intra-incisional cefuroxime (n = 26) with a control group (n = 28) in 81 patients undergoing gastric resection, revision gastric surgery or operation for gastro-oesophageal malignancy. In the controls the incidence of sepsis was: 35 per cent wound infection, 29 per cent abscess, 21 per cent septicaemia. After intra-incisional cefuroxime the incidence was: 4 per cent wound sepsis, 19 per cent abscess and 4 per cent septicaemia. After systemic cefuroxime only 2 patients developed wound sepsis (7 per cent) with no cases of abscess or septicaemia. Excluded from this high risk group were 36 patients who had a vagotomy with or without drainage during the trial where antibiotics were not given, 4 of whom developed wound sepsis only (11 per cent). There was a poor correlation between the individual species isolated from the gastric aspirate and the organisms responsible for postoperative infection in the controls, but there was a good correlation between fasting gastric pH and the risk of sepsis in the controls.

Bacteria↗
PubMed1981

Influence of oral mannitol bowel preparation on colonic microflora and the risk of explosion during endoscopic diathermy.

Oral mannitol has been widely accepted as the bowel preparation of choice for colonoscopy and elective colorectal operation because it is well tolerated by patients. Recent concern has been expressed regarding the risk of explosion and sepsis using oral mannitol because it may provide a nutrient for certain gas-producing bacteria in the colon. Samples of colonic contents aspirated at operation were compared in patients prepared by oral mannitol, by whole bowel irrigation, mannitol preceded by 48 h of oral antibiotics (neomycin with metronidazole) and in patients who did not undergo any preparation. Significantly higher counts of gas-producing Escherichia coli were recovered from patients prepared with mannitol alone compared with whole bowel irrigation or mannitol preceded by oral antimicrobials. These data are consistent with the hypothesis that fermentation of mannitol by Escherichia coli is responsible for the production of potentially explosive gas mixtures after oral mannitol preparation and may also explain the increased incidence of sepsis when oral mannitol is used for bowel preparation.

Bacteria↗
PubMed1981

The effect of proximal stenosis on Doppler waveforms: a comparison of three methods of waveform analysis in an animal model.

Methods of quantifying changes in spectrum analysed Doppler waveforms have been assessed in an experimental canine model. Artificial stenoses of varying (0-95%) area reduction have been inserted in the iliac artery of five anaesthetised greyhounds. 133 sets of Doppler waveforms recorded distally have been subjected to principal component analysis (PCA), transfer function analysis (TFA) and pulsatility index calculation (PI). Transfer function damping factor delta and PI were only able to distinguish those stenoses of greater than 85% area reduction. PCA, however, was more reliable in this range, and was usually able to distinguish stenoses of 65% and 77% area reduction. We conclude that PCA deserves further assessment in patients with aorto-iliac disease.

Animals↗
PubMed1981

The treatment of sports injuries by local injection.

Local injections of corticosteroids are frequently employed in the management of soft-tissue injuries. Side effects and contraindications of this treatment are discussed with reference to relevant literature. Indications for steroid therapy are described.

Adrenal Cortex Hormones↗
PubMed1981

Bowel preparation and the safety of colonoscopic polypectomy.

A fatal colonic explosion has been recorded during colonoscopic polypectomy after oral mannitol bowel preparation. It has been suggested that bacterial degradation of oral mannitol allows the production of hydrogen and methane which are potentially explosive. We have analyzed the gas composition of colonic aspirates in unprepared patients (n = 11), after orthograde saline lavage (n = 11), after oral mannitol alone (n = 11), and when oral mannitol was given with oral antibiotics (n = 11). After oral mannitol bowel preparation 7 patients had potentially explosive gas mixtures compared with 4 in the unprepared group, 1 after orthograde saline lavage, and none when oral antibiotics were used before mannitol. We believe, therefore, that if oral mannitol is used for bowel preparation before colonoscopic polypectomy oral antibiotics should also be administered or insufflation should be with carbon dioxide.

Administration, Oral↗
PubMed1980

Prophylactic saline peritoneal lavage in elective colorectal operations.

The influence of a single peroperative five-liter saline peritoneal lavage has been assessed in 21 consecutive patients undergoing elective operation for colorectal cancer. The aim of the study was to investigate whether reduction in bacterial counts by saline lavage would reduce the incidence of infection and thereby avoid the need for prophylactic antimicrobials. Saline lavage was shown to reduce significantly counts in peritoneal fluid of aerobic bacteria from 2 x 10(4) to 5 x 10(1) (P less than 0.001) and to reduce the counts of anaerobes in peritoneal fluid from 8 x 10(4) to 1 x 10(2) (P less than 0.001). Despite the profound reduction in peritoneal bacterial counts the rate of postoperative sepsis was extremely high; wound infection 47 per cent, intraabdominal abscess 26 per cent and septicemia 13 per cent. These results indicate that saline peritoneal lavage alone is no substitute for short-term antimicrobial prophylaxis.

Ascitic Fluid↗
PubMed1980

Comparison of three methods of whole bowel irrigation.

Sixty-two patients undergoing colorectal surgery or colonoscopy were prepared by three methods of whole bowel irrigation: nasogastric saline solution alone, nasogastric saline irrigation with oral mannitol, and oral mannitol solution without saline. The additional of mannitol to saline irrigation reduced the risk of sodium and water retention, which was eliminated by oral mannitol alone. The best mechanical preparation was achieved by adding mannitol to saline irrigation, but oral mannitol alone was judged more acceptable by the patients and less demanding by the nursing staff and was the preparation of choice for colonoscopy.

Colon↗
PubMed1980

The relationship between ultrasonic pulsatility index and proximal arterial stenosis in a canine model.

Although the ultrasonic pulsatility index (PI) is used as a test of arterial inflow, the relationship between proximal arterial stenosis and PI has not been fully evaluated. In a series of experiments on dogs, over 200 measurements of pressure, flow (using an indwelling electromagnetic flowmeter), and PI were made distal to implanted arterial stenoses of varying length (0.5--9 mm) and cross-sectional area (36--94% reduction in area). It was shown that, whereas the reduction of PI correlates broadly with stenosis severity, the scatter of results is wide for all but the tightest stenoses. This scatter is due at least in part to the variability of the vascular bed distal to the site of measurement.

Animals↗
PubMed1980

Therapeutic trials of antibiotic associated colitis.

Since September 1977 we have seen 63 patients with Clostridium difficile and a faecal toxin, but only 33 had histological evidence of pseudomembranous colitis. We have conducted separate double blind trials of an antibiotic, vancomycin and an anion-exchange resin, colestipol, in patients with post-operative diarrhoea. Vancomycin was extremely effective at eradicating the organism and its faecal toxin. These changes were associated with a marked symptomatic improvement. Colestipol proved ineffective in absorbing the faecal toxin and caused no change in numbers of Clostridial difficile. There was no associated symptomatic response. Neither drug had any effect on diarrhoea not related to Clostridium difficile. A carrier state was created by those patients who continued to excrete the organism after Colestipol or placebo treatment. This was eradicated by subsequent treatment with vancomycin. Our brief experience with metronidazole is discussed and a rational basis for treatment advocated.

Anti-Bacterial Agents↗
PubMed1979

Antibiotic-associated colitis--a review of 66 cases.

We have reviewed 66 cases of antibiotic-associated colitis since March 1975, which have been associated with a 27 per cent mortality. We believe antibiotics may predispose patients to this condition which is caused by a toxin produced by Clostridium difficile. Although the disease is rare, it is more common than previously reported. The presentation, methods of diagnosis and treatment are discussed.

Adolescent↗
PubMed1978

Randomised controlled trial of vancomycin for pseudomembranous colitis and postoperative diarrhoea.

The efficacy of vancomycin in pseudomembranous colitis was assessed in a prospective randomised controlled trial. Forty-four patients with postoperative diarrhoea were allocated to five days' treatment with either 125 mg vancomycin six-hourly or a placebo. Sixteen patients had high titres of the neutralised faecal toxin characteristic of pseudomembranous colitis; nine received vancomycin and seven placebo. At the end of treatment faecal toxins were present in one patient given vancomycin compared with five of the controls. Vancomycin caused the disappearance of Clostridum difficile from the stool in all except one patient, whereas toxicogenic strains of Cl difficile persisted in all but one of the controls. Histological evidence of psuedomembranous colitis had disappeared by the end of treatment in six out of seven patients given vancomycin compared with only one out of seven patients given vancomycin compared with only one out of five patients given placebo. In patients with faecal toxins bowel habit had returned to normal in seven of the vancomycin group compared with only one of the controls, but there was no significant difference in clinical response among patients without faecaal toxins. The results suggest that vancomycin eliminates toxin-producing Cl difficile from the colon and is associated with rapid clinical and histological improvement in patients with pseudomembranous colitis.

Bacterial Toxins↗
PubMed1978

Diarrhoea and pseudomembranous colitis after gastrointestinal operations. A prospective study.

241 patients who had gastrointestinal operations were studied prospectively. Postoperative diarrhoea occurred in 58 patients (24%) and was significantly more common after exposure to antibiotics. 9 patients (4%) had high titres of a neutralisable faecal toxin characteristic of pseudomembranous colitis. Toxigenic Clostridium difficile strains were isolated from the stools of all patients with neutralisable faecal toxin. If pseudomembranous colitis is defined as the presence of neutralisable faecal toxin, then the diagnosis is often missed by sigmoidoscopy and rectal biopsy.

Anti-Bacterial Agents↗