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S Nussey

Publications and source records attributed to S Nussey.

6 recordsLinked to original sources
PubMed1993

The long-term efficacy of conservative surgery and radiotherapy in the control of pituitary adenomas.

OBJECTIVES: We assessed the long-term efficacy and toxicity of conservative surgery and radiotherapy in the control of pituitary adenomas. DESIGN: Retrospective study of patients treated at the Royal Marsden Hospital. PATIENTS: Four hundred and eleven patients with pituitary adenomas treated with conventional external beam radiotherapy at the Royal Marsden Hospital between 1962 and 1986. Two hundred and fifty-two patients had clinically non-functioning pituitary adenomas, 131 had hormone secreting tumours and in 28 patients the secretory status was not known. Three hundred and thirty-eight patients had surgical intervention of whom only 11 had complete tumour excision. All patients received conventional fractionated external beam radiotherapy to a dose of 45-50Gy in 25-30 fractions. MEASUREMENTS: Actuarial progression free survival and overall survival and assessment of toxicity, particularly in terms of vision, requirement for hormone replacement therapy and incidence of second tumours. RESULTS: The actuarial progression free survival was 94% at 10 years and 88% at 20 years for all patients and 97% at 10 years and 92% at 20 years for patients with clinically non-functioning adenomas. Only secretory status was an independent prognostic factor for disease control. The 10 and 20-year survivals for all patients were 77 and 58% respectively. When compared with the normal population the relative risk of death was 1.76 (P < 0.001) and no prognostic factors for survival were identified. The morbidity of radiotherapy was low. Visual deterioration, assumed to be radiation induced, occurred in 1.5% of patients and the risk of second brain tumour was 1.9% at 20 years. Fifty per cent of patients received hormone replacement therapy by 19 years. CONCLUSION: Conventional external beam radiotherapy as described here combined with conservative surgery is safe and effective in the control of pituitary adenomas. These results should form a baseline for comparison with new treatment strategies.

Adenoma↗
PubMed1990

Ultrasound in the diagnosis of granulomatous liver disease.

Ultrasound is a widely used method of assessing the liver for space occupying lesions and, more recently, parenchymal liver disease. We have reviewed the ultrasound scans and reports of 11 patients with biopsy proven granulomatous liver disease. Multiple echogenic lesions 3-5 mm in diameter, each surrounded by an hypoechoic halo, were seen in the liver of all the patients and in the spleens of three patients. A specific diagnosis of granulomatous hepatitis was suggested at the time of scanning in seven patients. An abnormal liver was noted in the other four patients but no specific diagnosis was suggested. We believe that granulomata in the liver can be detected using ultrasound and, if the above appearances are seen during an ultrasound scan, a diagnosis of granulomatous hepatitis should be considered.

Adult↗
PubMed1986

Assessment of non-mydriatic fundus photography in detection of diabetic retinopathy.

Non-mydriatic retinal photography with later interpretation of the photographs was assessed as a screening method for the detection of diabetic retinopathy; when compared with an ophthalmologist's clinical assessment in a random group of 62 diabetic patients it was accurate (false negative 6.8%, false positive 2%) and sensitive (sensitivity 96%, specificity 98%). The assessment of further management required based on analysis of the photographs was 96.5% in agreement with the further management suggested by the ophthalmologist after direct clinical assessment of the patient. If this technique were used to screen patients in a typical diabetic clinic the predicted positive accuracy rate would be 84% and the predicted negative accuracy rate 99.5%.

Diabetic Retinopathy↗