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Hwang J, McDowell S, Cole B, Huber AR, Reyes C. Cytologic Analysis of a Glomus Tumor in the Left Second Toe: Case Report. Am J Clin Pathol 2021. [DOI: 10.1093/ajcp/aqab191.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction/Objective
Glomus bodies reside in the stratum reticularis of the dermis as well as in visceral organs. Their functions involve temperature and blood pressure regulation. The incidence of glomus tumors is approximately 1.5%, occur more frequently in women, and generally manifest during the third to fifth decade of life. A majority of glomus tumors are diagnosed by biopsy and excision. At least 19 case reports exist in the literature where glomus tumors are diagnosed by fine-needle aspiration (FNA). We add to this growing literature by discussing a case report involving the cytologic findings of an FNA-diagnosed glomus tumor.
Methods/Case Report
A 66-year-old female presented with left second toe pain for 41 years but worsening in the past several months. Physical exam revealed 5/5 muscle strength in her toes without loss of sensation. There was no edema, erythema, nor ecchymosis. Pain was notably out of proportion when palpating her second nailbed. Magnetic resonance imaging (MRI) with contrast was performed revealing a 1.1 x 1.0 x 0.9 cm circumscribed, ovoid mass involving the dorsal aspect of the second toe distal phalanx along its dorsal margin (Figure 1). The patient underwent fine needle aspiration and biopsy. Cytologic findings included clusters of uniform cells with round to oval nuclei and scant cytoplasm. There was spindling of cells noted in some of the clusters. Cells were surrounded by thick wisps of magenta colored myxoid material reminiscent of a pleomorphic adenoma (Figure 2). Biopsy showed uniform cells surrounding capillaries. Immunohistochemistry performed on the biopsy showed that lesional cells were positive for alpha-smooth muscle actin (SMA). A diagnosis of glomus tumor was made. Amputation was performed with clear margins.
Results (if a Case Study enter NA)
NA
Conclusion
Glomus tumor is a rare tumor that is usually diagnosed on biopsy; however, it has distinct cytologic features that can aid in its diagnosis on fine needle aspirations.
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Affiliation(s)
- J Hwang
- Pathology, Brooke Army Medical Center, San Antonio, Texas, UNITED STATES
| | - S McDowell
- Department of Orthopaedics, University of Rochester School of Medicine & Dentistry, Rochester, New York, UNITED STATES
| | - B Cole
- Diagnostic Radiology, Ide Imaging Partners, Rochester, New York, UNITED STATES
| | - A R Huber
- Pathology & Laboratory Medicine, University of Rochester School of Medicine & Dentistry, Rochester, New York, UNITED STATES
| | - C Reyes
- Pathology & Laboratory Medicine, University of Rochester School of Medicine & Dentistry, Rochester, New York, UNITED STATES
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O’Hare A, Balaz D, Wright DM, McCormick C, McDowell S, Trewby H, Skuce RA, Kao RR. A new phylodynamic model of Mycobacterium bovis transmission in a multi-host system uncovers the role of the unobserved reservoir. PLoS Comput Biol 2021; 17:e1009005. [PMID: 34170901 PMCID: PMC8266114 DOI: 10.1371/journal.pcbi.1009005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 07/08/2021] [Accepted: 04/25/2021] [Indexed: 11/18/2022] Open
Abstract
Multi-host pathogens are particularly difficult to control, especially when at least one of the hosts acts as a hidden reservoir. Deep sequencing of densely sampled pathogens has the potential to transform this understanding, but requires analytical approaches that jointly consider epidemiological and genetic data to best address this problem. While there has been considerable success in analyses of single species systems, the hidden reservoir problem is relatively under-studied. A well-known exemplar of this problem is bovine Tuberculosis, a disease found in British and Irish cattle caused by Mycobacterium bovis, where the Eurasian badger has long been believed to act as a reservoir but remains of poorly quantified importance except in very specific locations. As a result, the effort that should be directed at controlling disease in badgers is unclear. Here, we analyse densely collected epidemiological and genetic data from a cattle population but do not explicitly consider any data from badgers. We use a simulation modelling approach to show that, in our system, a model that exploits available cattle demographic and herd-to-herd movement data, but only considers the ability of a hidden reservoir to generate pathogen diversity, can be used to choose between different epidemiological scenarios. In our analysis, a model where the reservoir does not generate any diversity but contributes to new infections at a local farm scale are significantly preferred over models which generate diversity and/or spread disease at broader spatial scales. While we cannot directly attribute the role of the reservoir to badgers based on this analysis alone, the result supports the hypothesis that under current cattle control regimes, infected cattle alone cannot sustain M. bovis circulation. Given the observed close phylogenetic relationship for the bacteria taken from cattle and badgers sampled near to each other, the most parsimonious hypothesis is that the reservoir is the infected badger population. More broadly, our approach demonstrates that carefully constructed bespoke models can exploit the combination of genetic and epidemiological data to overcome issues of extreme data bias, and uncover important general characteristics of transmission in multi-host pathogen systems.
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Affiliation(s)
- Anthony O’Hare
- Computing Science and Mathematics, Faculty of Natural Sciences, University of Stirling, Stirling, United Kingdom
| | - Daniel Balaz
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - David M. Wright
- Veterinary Sciences Division, Agri-Food and Biosciences Institute, Stormont, Belfast, Northern Ireland, United Kingdom
- School of Biological Sciences, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Carl McCormick
- Veterinary Sciences Division, Agri-Food and Biosciences Institute, Stormont, Belfast, Northern Ireland, United Kingdom
| | - Stanley McDowell
- Veterinary Sciences Division, Agri-Food and Biosciences Institute, Stormont, Belfast, Northern Ireland, United Kingdom
| | | | - Robin A. Skuce
- Veterinary Sciences Division, Agri-Food and Biosciences Institute, Stormont, Belfast, Northern Ireland, United Kingdom
| | - Rowland R. Kao
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
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Byrne AW, Graham J, McConville J, Milne G, Guelbenzu-Gonzalo M, McDowell S. Liver fluke (Fasciola hepatica) co-infection with bovine tuberculosis in cattle: A prospective herd-level assessment of herd bTB risk in dairy enterprises. Transbound Emerg Dis 2019; 66:1727-1736. [PMID: 31012527 DOI: 10.1111/tbed.13209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 04/04/2019] [Accepted: 04/10/2019] [Indexed: 11/28/2022]
Abstract
Co-infection of tuberculosis (TB) and helminths is recognized as a significant problem in regions where such pathogens are endemic and chronic cases exist. Co-infection can modulate the immune system leading to interference with diagnostic tests, increased pathological impacts and pathogen persistence. However, research has found that such interactions between pathogens can be context and species specific. Recent studies have suggested that liver fluke, Fasciola hepatica, infection may impact on immunological responses and diagnostics for bovine tuberculosis (bTB; caused by Mycobacterium bovis) in cattle. Where evidence of such interaction exists, there would be an onus on policy makers to adjust eradication programs to minimize impacts. We assessed the association between herd-level bTB breakdown risk and seasonal variation in liver fluke exposure based on 5,753 bulk tank milk (BTM) samples from 1,494 dairy herds across Northern Ireland. BTM was tested by an IDEXX antibody specific enzyme-linked immunosorbent assay (ELISA) using the 'f2' antigen as a detection agent. The ELISA determined the result based on a sample to (known) positive ratio (S/P%) from which binary status and categories of exposure were derived. Associations were tested using multivariable random effects models. Models predicting bTB risk were not improved with the inclusion of liver fluke exposure levels. Variations in modelling liver fluke exposure (S/P%, binary, categories of exposure) and bTB risk (skin test breakdowns, post-mortem confirmed breakdowns, breakdown size and lag effects) also failed to support associations (neither positive nor negative) between the pathogens at herd-level. These results, along with previously published animal-level data from Northern Ireland, suggest that the nexus between bTB and F. hepatica may have small size effects at the population-level. However, our results also highlight the high prevalence of F. hepatica in cattle in our study population, and therefore we cannot fully discount the potential hypothesis of population-level depression of immune response to M. bovis due to co-infection.
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Affiliation(s)
- Andrew W Byrne
- Veterinary Science Division, Agri-food and Biosciences Institute, Belfast, UK.,School of Biological Sciences, Queen's University Belfast, Belfast, UK
| | - Jordon Graham
- Veterinary Science Division, Agri-food and Biosciences Institute, Belfast, UK
| | - James McConville
- Veterinary Science Division, Agri-food and Biosciences Institute, Belfast, UK
| | - Georgina Milne
- Veterinary Science Division, Agri-food and Biosciences Institute, Belfast, UK
| | - Maria Guelbenzu-Gonzalo
- Veterinary Science Division, Agri-food and Biosciences Institute, Belfast, UK.,Animal Health Ireland, Carrick on Shannon, Co. Leitrim, Ireland
| | - Stanley McDowell
- Veterinary Science Division, Agri-food and Biosciences Institute, Belfast, UK
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Byrne AW, Graham J, McConville J, Milne G, McDowell S, Hanna REB, Guelbenzu-Gonzalo M. Seasonal variation of Fasciola hepatica antibodies in dairy herds in Northern Ireland measured by bulk tank milk ELISA. Parasitol Res 2018; 117:2725-2733. [PMID: 29948207 DOI: 10.1007/s00436-018-5961-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 06/05/2018] [Indexed: 11/28/2022]
Abstract
Bovine fasciolosis, caused by the infection of the trematode parasite Fasciola hepatica, remains a problem in dairy herds causing significant production losses. In this study, bulk milk tank samples were utilised to generate a comprehensive survey of the variation in liver fluke exposure over the four seasons of 2016 in Northern Ireland (NI). Samples were tested using an antibody ELISA test; within-herd prevalence levels were categorised relative to sample-to-positive ratio (S/P%). Overall, 1494 herds (~ 50% of all active dairy farms in NI) were sampled. In total, 5750 samples were tested with 91% of herds having a sample result for each season. The proportion of herds with evidence of liver fluke exposure was very high across the year, with 93.03% of all bulk milk samples having some indication of liver fluke antibody presence. A high proportion of samples (2187/5750; 38.03%) fell within the highest infection class (indicating high within-herd prevalence). There was significant seasonal variation in the mean S/P%. A multivariable random effect ordinal logit model suggested that the greatest probability of being in a higher infection class was in winter, whilst the lowest was recorded during summer. There was a significant negative association between increasing herd liver fluke infection class and herd size. Furthermore, there was significant variation in infection levels across regions of Northern Ireland, with higher infection levels in northern administrative areas. This study demonstrates the very high liver fluke exposure in this region of Europe, and that risk is not equally distributed spatially or across seasons in dairy herds.
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Affiliation(s)
- Andrew W Byrne
- Agri-food and Biosciences Institute, Veterinary Science Division, Stormont, Belfast, UK. .,School of Biological Sciences, Queens University Belfast, Belfast, UK.
| | - Jordon Graham
- Agri-food and Biosciences Institute, Veterinary Science Division, Stormont, Belfast, UK
| | - James McConville
- Agri-food and Biosciences Institute, Veterinary Science Division, Stormont, Belfast, UK
| | - Georgina Milne
- Agri-food and Biosciences Institute, Veterinary Science Division, Stormont, Belfast, UK
| | - Stanley McDowell
- Agri-food and Biosciences Institute, Veterinary Science Division, Stormont, Belfast, UK
| | - Robert E B Hanna
- Agri-food and Biosciences Institute, Veterinary Science Division, Stormont, Belfast, UK
| | - Maria Guelbenzu-Gonzalo
- Agri-food and Biosciences Institute, Veterinary Science Division, Stormont, Belfast, UK. .,Animal Health Ireland, Carrick-on-Shannon, Leitrim, Ireland.
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Byrne AW, Graham J, Brown C, Donaghy A, Guelbenzu-Gonzalo M, McNair J, Skuce R, Allen A, McDowell S. Bovine tuberculosis visible lesions in cattle culled during herd breakdowns: the effects of individual characteristics, trade movement and co-infection. BMC Vet Res 2017; 13:400. [PMID: 29284483 PMCID: PMC5747088 DOI: 10.1186/s12917-017-1321-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 12/14/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bovine tuberculosis (bTB), caused by Mycobacterium bovis, remains a significant problem for livestock industries in many countries worldwide including Northern Ireland, where a test and slaughter regime has utilised the Single Intradermal Comparative Cervical Tuberculin (SICCT) test since 1959. We investigated the variation in post-mortem confirmation based on bTB visible lesion (VL) presence during herd breakdowns using two model suites. We investigated animal-level characteristics, while controlling for herd-level factors and clustering. We were interested in potential impacts of concurrent infection, and therefore we assessed whether animals with evidence of liver fluke infection (Fasciola hepatica; post-mortem inspection), M. avium reactors (animals with negative M. bovis-avium (b-a) tuberculin reactions) or Bovine Viral Diarrhoea Virus (BVDV; RT-PCR tested) were associated with bTB confirmation. RESULTS The dataset included 6242 animals removed during the 14 month study period (2013-2015). bTB-VL presence was significantly increased in animals with greater b-a reaction size at the disclosing SICCT test (e.g. b-a = 5-9 mm vs. b-a = 0 mm, adjusted Odds ratio (aOR): 14.57; p < 0.001). M. avium reactor animals (b-a < 0) were also significantly more likely to disclose VL than non-reactor animals (b-a = 0; aOR: 2.29; p = 0.023). Animals had a greater probability of exhibiting lesions with the increasing number of herds it had resided within (movement; log-herds: aOR: 2.27-2.42; p < 0.001), if it had an inconclusive penultimate test result (aOR: 2.84-3.89; p < 0.001), and with increasing time between tests (log-time; aOR: 1.23; p = 0.003). Animals were less likely to have VL if they were a dairy breed (aOR: 0.79; p = 0.015) or in an older age-class (e.g. age-quartile 2 vs. 4; aOR: 0.65; p < 0.001). Liver fluke or BVDV variables were not retained in either multivariable model as they were non-significantly associated with bTB-VL status (p > 0.1). CONCLUSIONS Our results suggest that neither co-infection of liver fluke nor BVDV had a significant effect on the presence of VLs in this high-risk cohort. M. avium tuberculin reactors had a significantly increased risk of disclosing with a bTB lesion, which could be related to the impact of co-infection with M. avium subsp. paratuberculosis (MAP) affecting the performance of the SICCT however further research in this area is required. Movements, test history, breed and age were important factors influencing confirmation in high-risk animals.
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Affiliation(s)
- Andrew W Byrne
- Agri-food and Biosciences Institute, Veterinary Science Division, Stormont, Belfast, Northern Ireland, BT43SD, UK. .,School of Biological Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK.
| | - Jordon Graham
- Agri-food and Biosciences Institute, Veterinary Science Division, Stormont, Belfast, Northern Ireland, BT43SD, UK
| | - Craig Brown
- Agri-food and Biosciences Institute, Veterinary Science Division, Stormont, Belfast, Northern Ireland, BT43SD, UK
| | - Aoibheann Donaghy
- Agri-food and Biosciences Institute, Veterinary Science Division, Stormont, Belfast, Northern Ireland, BT43SD, UK
| | - Maria Guelbenzu-Gonzalo
- Agri-food and Biosciences Institute, Veterinary Science Division, Stormont, Belfast, Northern Ireland, BT43SD, UK
| | - Jim McNair
- Agri-food and Biosciences Institute, Veterinary Science Division, Stormont, Belfast, Northern Ireland, BT43SD, UK
| | - Robin Skuce
- Agri-food and Biosciences Institute, Veterinary Science Division, Stormont, Belfast, Northern Ireland, BT43SD, UK
| | - Adrian Allen
- Agri-food and Biosciences Institute, Veterinary Science Division, Stormont, Belfast, Northern Ireland, BT43SD, UK
| | - Stanley McDowell
- Agri-food and Biosciences Institute, Veterinary Science Division, Stormont, Belfast, Northern Ireland, BT43SD, UK
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Byrne AW, Guelbenzu-Gonzalo M, Strain SAJ, McBride S, Graham J, Lahuerta-Marin A, Harwood R, Graham DA, McDowell S. Assessment of concurrent infection with bovine viral diarrhoea virus (BVDV) and Mycobacterium bovis: A herd-level risk factor analysis from Northern Ireland. Prev Vet Med 2017; 141:38-47. [PMID: 28532992 DOI: 10.1016/j.prevetmed.2017.04.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 03/20/2017] [Accepted: 04/25/2017] [Indexed: 11/26/2022]
Abstract
Bovine viral diarrhoea virus (BVDV) is a significant pathogen of cattle, leading to severe economic and animal-welfare impacts. Furthermore, the pathogen has been associated with impacting the progression or spread of other pathogens (e.g. Mycobacterium bovis, the causative agent of bovine tuberculosis (bTB)). During this study we investigated (i) risk factors for BVDV at a herd-level and (ii) whether there was any association between BVDV and herd-level bTB risk. The data for this study were gathered from a voluntary BVDV control programme in Northern Ireland (2013-2015) based on the identification of virus positive animals through tissue tag testing of calves. We assigned a herd-level BVDV status to 2827 participating herds, where a herd was assumed "infected" if one or more animals tested positive for BVDV. Two model suites were developed. Firstly, we assessed risk factors for BVDV herd status using multivariable logit random-effects modelling, aggregating to the calendar year level (2013-2015; n=4828; model 1). Secondly, we aggregated data across the three years of the study to give an overall status for the whole study period (n=2827; logistic model 2). Risk factors included year, herd-type, herd size, number of births, inward trade moves, calf mortality, and region. Furthermore, the herd-level bovine tuberculosis status (based on the single intradermal comparative cervical tuberculin (SICCT) test outcomes, or confirmation at post-mortem), or the size of bTB breakdowns (number of SICCT test positive animals), of herds was also investigated to assess whether there was an association (co-infection) with herd BVDV status. The final models suggested that BVDV herd status was positively associated with increased levels of calf mortality, herd size, number of births, the number of BVDV tests undertaken and the number of animals introduced to the herd. There was a significant univariable positive association between BVDV status, and SICCT breakdown risk, breakdown size and confirmed bTB status in model 2. However, there was no evidence of significant associations between bTB status (using SICTT status, confirmed status or herd breakdown size) and BVDV status in final multivariable models when controlling for other significant confounders. These results provide information for action for the future control and eradication of BVDV in Northern Ireland, though these data provide little support for the hypothesised association between BVDV and bTB status at herd-level. Further animal-level analyses are necessary to investigate whether there is support for a BVD-bTB co-infection association, including the impact of co-infection on the severity of infection.
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Affiliation(s)
- A W Byrne
- Agri-Food and Biosciences Institute, Veterinary Science Division, Stormont, Belfast BT43SD, United Kingdom; School of Biological Sciences, Queen's University Belfast, Belfast, United Kingdom.
| | - M Guelbenzu-Gonzalo
- Agri-Food and Biosciences Institute, Veterinary Science Division, Stormont, Belfast BT43SD, United Kingdom
| | - S A J Strain
- Animal Health and Welfare Northern Ireland, Dungannon Business Cube, 5 Coalisland Rd., Dungannon, Co., Tyrone, BT71 6JT, United Kingdom
| | - S McBride
- Agri-Food and Biosciences Institute, Veterinary Science Division, Stormont, Belfast BT43SD, United Kingdom
| | - J Graham
- Agri-Food and Biosciences Institute, Veterinary Science Division, Stormont, Belfast BT43SD, United Kingdom
| | - A Lahuerta-Marin
- Agri-Food and Biosciences Institute, Veterinary Science Division, Stormont, Belfast BT43SD, United Kingdom
| | - R Harwood
- Department of Agriculture, Environment, and Rural Affairs, Dundonald House, Belfast, BT43SB, United Kingdom
| | - D A Graham
- Animal Health Ireland, 4-5 The Archways, Carrick on Shannon, Co., Leitrim, Ireland
| | - S McDowell
- Agri-Food and Biosciences Institute, Veterinary Science Division, Stormont, Belfast BT43SD, United Kingdom
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Basson S, Zani A, McDowell S, Athanasakos E, Cleeve S, Phelps S, Charlesworth P. Antegrade continence enema (ACE): predictors of outcome in 111 patients. Pediatr Surg Int 2014; 30:1135-41. [PMID: 25287377 DOI: 10.1007/s00383-014-3602-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/25/2014] [Indexed: 02/07/2023]
Abstract
PURPOSE The antegrade continence enema (ACE) is used as a means of managing faecal incontinence and constipation with varying outcomes. We aim to evaluate our outcomes of ACEs and identify predictors of outcome. METHODS A retrospective case-note review of patients ≤16 years of age undergoing an ACE (March 2000-September 2013) was carried out. Data collected included: patient demographics, functional outcomes and complications. Data are quoted as median (range) and compared using Mann-Whitney and Fisher's exact test. Univariate analysis was performed to identify predictors of successful outcomes. P < 0.05 is significant. Successful outcome = total continence/occasional leakage and failed outcome = regular soiling and/or constipation. RESULTS 111 patients with complete data sets underwent an ACE [59% male, median age = 9.5 years (3.4-16 years)] and median follow-up = 48 months (4 months-11 years 4 months). Underlying diagnoses were idiopathic constipation (n = 68), anorectal malformation (n = 27), neuropathic bowel (n = 7), Hirschsprung disease (n = 5) and gastrointestinal dysmotility (n = 4). Social continence was achieved in 87/111 (78%). Fifteen percent of patients underwent reversal of ACE due to resolution of symptoms. There was no difference in outcomes related to diagnosis, gender, age or follow-up duration. Complication rate was 20.7% (23/111). CONCLUSIONS The ACE is safe and effective in the management of intractable constipation and soiling. No predictors of outcome were identified.
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Affiliation(s)
- S Basson
- Department of Paediatric Surgery, The Royal London Hospital, Whitechapel, London, E1 1BB, UK,
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Adam S, Almeida MF, Assoun M, Baruteau J, Bernabei SM, Bigot S, Champion H, Daly A, Dassy M, Dawson S, Dixon M, Dokoupil K, Dubois S, Dunlop C, Evans S, Eyskens F, Faria A, Favre E, Ferguson C, Goncalves C, Gribben J, Heddrich-Ellerbrok M, Jankowski C, Janssen-Regelink R, Jouault C, Laguerre C, Le Verge S, Link R, Lowry S, Luyten K, Macdonald A, Maritz C, McDowell S, Meyer U, Micciche A, Robert M, Robertson LV, Rocha JC, Rohde C, Saruggia I, Sjoqvist E, Stafford J, Terry A, Thom R, Vande Kerckhove K, van Rijn M, van Teeffelen-Heithoff A, Wegberg AV, van Wyk K, Vasconcelos C, Vestergaard H, Webster D, White FJ, Wildgoose J, Zweers H. Dietary management of urea cycle disorders: European practice. Mol Genet Metab 2013; 110:439-45. [PMID: 24113687 DOI: 10.1016/j.ymgme.2013.09.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 09/04/2013] [Accepted: 09/06/2013] [Indexed: 12/30/2022]
Abstract
BACKGROUND There is no published data comparing dietary management of urea cycle disorders (UCD) in different countries. METHODS Cross-sectional data from 41 European Inherited Metabolic Disorder (IMD) centres (17 UK, 6 France, 5 Germany, 4 Belgium, 4 Portugal, 2 Netherlands, 1 Denmark, 1 Italy, 1 Sweden) was collected by questionnaire describing management of patients with UCD on prescribed protein restricted diets. RESULTS Data for 464 patients: N-acetylglutamate synthase (NAGS) deficiency, n=10; carbamoyl phosphate synthetase (CPS1) deficiency, n=29; ornithine transcarbamoylase (OTC) deficiency, n=214; citrullinaemia, n=108; argininosuccinic aciduria (ASA), n=80; arginase deficiency, n=23 was reported. The majority of patients (70%; n=327) were aged 0-16y and 30% (n=137) >16y. Prescribed median protein intake/kg body weight decreased with age with little variation between disorders. The UK tended to give more total protein than other European countries particularly in infancy. Supplements of essential amino acids (EAA) were prescribed for 38% [n=174] of the patients overall, but were given more commonly in arginase deficiency (74%), CPS (48%) and citrullinaemia (46%). Patients in Germany (64%), Portugal (67%) and Sweden (100%) were the most frequent users of EAA. Only 18% [n=84] of patients were prescribed tube feeds, most commonly for CPS (41%); and 21% [n=97] were prescribed oral energy supplements. CONCLUSIONS Dietary treatment for UCD varies significantly between different conditions, and between and within European IMD centres. Further studies examining the outcome of treatment compared with the type of dietary therapy and nutritional support received are required.
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Affiliation(s)
- S Adam
- Royal Hospital for Sick Children, Glasgow Royal Infirmary, Glasgow, UK
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Welsh MD, Baird PM, Guelbenzu-Gonzalo MP, Hanna A, Reid SM, Essen S, Russell C, Thomas S, Barrass L, McNeilly F, McKillen J, Todd D, Harkin V, McDowell S, Choudhury B, Irvine RM, Borobia J, Grant J, Brown IH. Initial incursion of pandemic (H1N1) 2009 influenza A virus into European pigs. Vet Rec 2010; 166:642-5. [PMID: 20495164 DOI: 10.1136/vr.4851] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The initial incursion of pandemic (H1N1) 2009 influenza A virus (pH1N1) into a European pig population is reported. Diagnosis of swine influenza caused by pandemic virus was made during September 2009 following routine submission of samples for differential diagnosis of causative agents of respiratory disease, including influenza A virus. All four pigs (aged six weeks) submitted for investigation from a pig herd of approximately 5000 animals in Northern Ireland, experiencing acute-onset respiratory signs in finishing and growing pigs, were positive by immunofluorescence for influenza A. Follow-up analysis of lung tissue homogenates by real-time RT-PCR confirmed the presence of pH1N1. The virus was subsequently detected on two other premises in Northern Ireland; on one premises, detection followed the pre-export health certification testing of samples from pigs presumed to be subclinically infected as no clinical signs were apparent. None of the premises was linked to another epidemiologically. Sequencing of the haemagglutinin and neuraminidase genes revealed high nucleotide identity (>99.4 per cent) with other pH1N1s isolated from human beings. Genotypic analyses revealed all gene segments to be most closely related to those of contemporary pH1N1 viruses in human beings. It is concluded that all three outbreaks occurred independently, potentially as a result of transmission of the virus from human beings to pigs.
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Affiliation(s)
- M D Welsh
- Agri-Food and Biosciences Institute, Veterinary Sciences Division, Stoney Road, Omagh, 43 Beltany Road, Omagh BT78 5NF, UK.
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Ackerman P, Morrison SA, McDowell S, Vazquez L. Using the Spinal Cord Independence Measure III to measure functional recovery in a post-acute spinal cord injury program. Spinal Cord 2009; 48:380-7. [DOI: 10.1038/sc.2009.140] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Jordan E, Egan J, Dullea C, Ward J, McGillicuddy K, Murray G, Murphy A, Bradshaw B, Leonard N, Rafter P, McDowell S. Salmonella surveillance in raw and cooked meat and meat products in the Republic of Ireland from 2002 to 2004. Int J Food Microbiol 2006; 112:66-70. [PMID: 16860420 DOI: 10.1016/j.ijfoodmicro.2006.05.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2005] [Revised: 02/08/2006] [Accepted: 05/24/2006] [Indexed: 11/19/2022]
Abstract
The food industry, under the regulation of the Department of Agriculture and Food (DAF) in the Republic of Ireland, is required to undertake all microbiological testing in relation to zoonoses control, in laboratories approved by DAF. These laboratories submit a monthly report of all tests undertaken, together with all presumptive Salmonella isolates for confirmation, typing and storage to the Central Veterinary Research Laboratory (CVRL). Details of Salmonella tests on 110,229 raw and 25,189 cooked meat samples from 25 laboratories were recorded over the 3-year period 2002-2004. Salmonella spp. were isolated from 1.0% of the 110,229 raw meat samples and 0.1% of the 25,189 cooked meat samples tested. The percentage of raw meat samples contaminated with Salmonella decreased over the three-year period from 1.2% to 0.9%. There was no seasonal trend in the isolation of Salmonella from any of the meats or meat products. Recoveries of the organism were highest for turkey and chicken meats at 3.1% and 2.8%, respectively, followed by porcine meats at 2.1%. The recoveries were much lower for ovine meats and meat products at 0.2% and bovine meat and meat products at 0.16%.
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Affiliation(s)
- E Jordan
- Central Veterinary Research Laboratory, Backweston Laboratory Complex, Celbridge, Co.Kildare, Ireland
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12
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Jeffreys M, Rachet B, McDowell S, Habib AG, Lepage C, Coleman MP. Survival from rectal and anal cancers in England and Wales, 1986–2001. Eur J Cancer 2006; 42:1434-40. [PMID: 16600590 DOI: 10.1016/j.ejca.2006.01.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2005] [Revised: 01/03/2006] [Accepted: 01/23/2006] [Indexed: 11/29/2022]
Abstract
The aim of this study was to investigate the effects of tumour and patient characteristics on trends in the survival of patients with cancer of the anus or rectum in England and Wales. A total of 132,542 adults (15-99 years) who were diagnosed during the 14 years 1986-1999 were followed up to 2001 through the National Health Service Central Register. Relative survival up to 5 years after diagnosis was estimated, using deprivation-specific life tables. Generalised linear models were used to estimate relative excess risks of death, adjusted for patient and tumour characteristics. The results showed that 5-year relative survival was higher in women, younger patients and more affluent patients, and higher for anal cancer than rectal cancer. Survival improved by more than 10% from the late 1980s (around 38%) to the late 1990s (49%). This trend was not explained by changes in the distribution of age, anatomical site, morphology or deprivation. The trend was more marked in younger and more affluent patients, and for adenocarcinoma and epidermoid carcinoma than for tumours with other morphology. The inequality in survival between affluent and deprived patients widened. It is concluded that improvements in survival may reflect improvements in disease stage, diagnostic technique or treatment. Which of these factors contribute to the widening socioeconomic inequalities in survival remains to be elucidated.
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Affiliation(s)
- Mona Jeffreys
- Centre for Public Health Research, Massey University--Wellington Campus, Private Bag 756, Wellington, New Zealand
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13
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Millar J, McDowell S, Dillon E, McDermott U, Morrison A, Wilson R, Eatock M. A phase I study of weekly docetaxel (DTX) and biweekly oxaliplatin (Ox) in patients with advanced solid tumours. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.2098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- J. Millar
- Belfast City Hosp, Belfast, United Kingdom
| | | | - E. Dillon
- Belfast City Hosp, Belfast, United Kingdom
| | | | | | - R. Wilson
- Belfast City Hosp, Belfast, United Kingdom
| | - M. Eatock
- Belfast City Hosp, Belfast, United Kingdom
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14
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Menzies F, McDowell S, Neill S. Ciprofloxacin-resistant Campylobacter. Vet Rec 2003; 152:91; author reply 91. [PMID: 12570315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
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15
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Abstract
We examined the effects of low-dose bromocriptine, a D2 dopamine receptor agonist, on processes thought to be subserved by the prefrontal cortex, including working memory and executive function, in individuals with traumatic brain injury. A group of 24 subjects was tested using a double-blind, placebo-controlled crossover trial, counterbalanced for order. Bromocriptine was found to improve performance on some tasks thought to be subserved by prefrontal function, but not others. Specifically, there was improvement in performance on clinical measures of executive function and in dual-task performance, but not measures that tap the ability to maintain information in working memory without significant executive demands. Also, on control tasks not thought to be dependent on the prefrontal cortex, no improvement on bromocriptine was noted. These results demonstrate a selective effect of bromocriptine on cognitive processes which involve executive control, and provide a foundation for potential therapies for patients with prefrontal damage causing dysexecutive syndromes.
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Affiliation(s)
- S McDowell
- Moss Rehabilitation Research Institute, Temple University School of Medicine, Philadelphia, PA, USA
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16
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Abstract
Although many individuals with traumatic brain injury (TBI) perform well on standard neuropsychological tests, they often exhibit marked functional difficulties. The functions which are impaired seem to be analogous to the role of the central executive system (CES) in Baddeley's [Working Memory, 1986, Oxford University Press, New York] widely accepted model of working memory. The purpose of this study was to investigate CES function in individuals with TBI with a dual-task paradigm. We studied 25 non-demented persons who were at various stages in their recovery from severe TBI and compared their performance on a dual-task paradigm to a group of age-matched controls. Our dual-task paradigm measured performance on a simple visual reaction time task both alone (baseline) and during concurrent tasks of articulation or digit span. Subjects were also assessed with other neuropsychological tests of executive function. TBI patients had slower reaction times on the primary task when performed alone (P < 0.05) and greater decrements in performance during dual-task conditions (P < 0.01). They also exhibited significantly greater deficits than control subjects on other measures of executive function. Although correlations between dual-task performance and other executive measures were quite low, principle components analysis suggested that a common factor does exist between these measures. These findings support the conclusion that TBI patients have a working memory impairment that is due to dysfunction of the CES and which may be related to executive function deficits as measured by standard neuropsychological testing.
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Affiliation(s)
- S McDowell
- Moss Rehabilitation Research Institute, Philadelphia, USA
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17
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McLaren A, Donnelly C, McDowell S, Williamson R. The role of ranitidine bismuth citrate in significantly reducing the emergence of Helicobacter pylori strains resistant to antibiotics. Helicobacter 1997; 2:21-6. [PMID: 9432317 DOI: 10.1111/j.1523-5378.1997.tb00052.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND This study was carried out to investigate the clinical observation that the emergence of antibiotic resistance can be reduced in Helicobacter pylori if agents are administered in combination with bismuth salts. MATERIALS AND METHODS Two H. pylori clinical isolates were grown on chocolate Columbia agar containing either ranitidine bismuth citrate (RBC) at one-half lethal concentration (8 micrograms/ml) or no drug control for 22 subcultures. After 1, 5, 8, 14, 17, and 22 subcultures, the emergence of antibiotic resistance to metronidazole, clarithromycin, and streptomycin was calculated and statistically analyzed. RESULTS Acquisition of resistance to metronidazole was reduced significantly for both strains (p = .007 and 0.014) and for one strain against clarithromycin (p = .037). However, spontaneous emergence of resistance to streptomycin was not altered significantly. In an analysis of the effect of long-term exposure of the isolates to RBC, susceptibility to bismuth was unaltered in one strain and had risen by only twofold in the other at experiment termination. CONCLUSION RBC significantly decreased resistance acquisition in an inherently sensitive strain and also decreased resistance emergence in a strain that readily became metronidazole-resistant.
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Affiliation(s)
- A McLaren
- GlaxoWellcome Medicines Research Centre, Stevenage, Hertfordshire, United Kingdom
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18
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McDowell S. Marketing the ET nurse in a new community: a learning experience. J Wound Ostomy Continence Nurs 1995; 22:114-5. [PMID: 7599718 DOI: 10.1097/00152192-199505000-00006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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19
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Kearney JT, McDowell S, Litschert J, Fleck SJ, Fox S, Morris D. 670 PHYSIOLOGICAL DETERMINANTS OF PERFORMANCE IN SLALOM PADDLING. Med Sci Sports Exerc 1994. [DOI: 10.1249/00005768-199405001-00672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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20
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Brereton P, Hamer A, Lavery M, Scrofani S, McDowell S, Sadek M, Brownlee R, Hoogenraad N, Wedd A. Mutant forms of the 8Fe8S ferredoxin of Clostridium pasteurianum. J Inorg Biochem 1993. [DOI: 10.1016/0162-0134(93)85396-p] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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21
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Fleck SJ, Kearney JT, Zimmerman S, McDowell S, Davenport R, Poe C. 1094 EFFECTS OF AMINO ACID SUPPLEMENTATION ON ELITE H-11 SLIDE LIPID MATABOLISM II. Med Sci Sports Exerc 1993. [DOI: 10.1249/00005768-199305001-01097] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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22
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McDowell S. [Are we using too much betadine?]. Taehan Kanho 1991; 30:54-5. [PMID: 1779593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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23
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McDowell S. Are we using too much Betadine? RN 1991; 54:43-5. [PMID: 2057678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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24
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Housh TJ, deVries HA, Johnson GO, Evans SA, McDowell S. The effect of ammonium chloride and sodium bicarbonate ingestion on the physical working capacity at the fatigue threshold. Eur J Appl Physiol Occup Physiol 1991; 62:189-92. [PMID: 1646106 DOI: 10.1007/bf00643740] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The purpose of this investigation was to examine the effect of ammonium chloride (NH4Cl) and sodium bicarbonate (NaHCO3) ingestion on the physical working capacity at the fatigue threshold (PWCFT). Eighteen adult males (mean age, SD = 23, 2 years) volunteered for two experiments (experiment 1, n = 9; experiment 2, n = 9). In both experiments, the subjects orally ingested 0.3 g.kg-1 body weight of NH4Cl and NaHCO3 over a 3-h period in random order on days separated by 72 h or more. In experiment 1, following ingestion of the substance, the subjects performed a discontinuous incremental cycle ergometer test to the onset of PWCFT which was estimated from integrated electromyography voltages at the vastus lateralis muscle. In experiment 2, the subjects performed a continuous PWCFT test. The results of these experiments indicated that NH4Cl and NaHCO3 ingestion had no significant (P greater than 0.05) effect on PWCFT (experiment 1: NH4Cl = 257, SD 26 W; NaHCO3 = 256, SD 22 W; t = 0.06; r = 0.866; experiment 2: NH4Cl = 231, 14 W; NaHCO3 = 216, 16 W; t = 1.78; r = 0.857).
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Affiliation(s)
- T J Housh
- Center for Youth Fitness and Sports Research, University of Nebraska-Lincoln 68588-0229
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25
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Housh T, Johnson G, McDowell S, Housh D, Pepper M. 334 PHYSIOLOGICAL RESPONSES AT THE FATIGUE THRESHOLD. Med Sci Sports Exerc 1990. [DOI: 10.1249/00005768-199004000-00334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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26
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Johnson G, Housh T, McDowell S, Housh D, Pepper M. 91 VALIDITY OF A TREADMILL TEST OF ANAEROBIC CAPACITY. Med Sci Sports Exerc 1990. [DOI: 10.1249/00005768-199004000-00091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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27
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28
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Hughes R, Housh T, Thorland W, Johnson G, Cisar C, Kenney K, McDowell S. 133. Med Sci Sports Exerc 1987. [DOI: 10.1249/00005768-198704001-00133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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29
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Johnson GO, Housh TJ, Thorland WG, Cisar CJ, Hughes RA, Kenney K, McDowell S. 282. Med Sci Sports Exerc 1987. [DOI: 10.1249/00005768-198704001-00282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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30
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Bubel HC, Wander AH, McDowell S. An improved method for detection of ganglionic latency in herpes simplex virus type-1 infected guinea pigs. J Virol Methods 1986; 13:301-8. [PMID: 3018019 DOI: 10.1016/0166-0934(86)90055-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
A simple method was developed which increased the sensitivity and reliability of detecting latent herpes simplex virus type-1 (HSV-1) in trigeminal ganglia of guinea pigs. Animals were infected with the Shealey strain of HSV-1 immediately following scarification of the cornea and maintained for 30-40 days to ensure that true latency was established. Viral latency was defined as the appearance of infectious virus in ganglia only upon cultivation in vitro. Thus, ganglia from similarly infected animals, homogenized immediately upon removal, did not contain infectious virus. Excised ganglia were incubated intact in high glucose medium and yielded maximal positive results (90-100%) by the twelfth day of incubation. This method was compared with the standard cocultivation technique in which minced fragments of ganglionic tissue were explanted onto Vero cell cultures. Cocultivation yielded a considerably lower latency rate and was more variable (29-57%) than the whole ganglion culture method.
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31
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Stevenson HM, Pandit SK, Dundee JW, McDowell S, Morrison JD. Experiences with a technique of neuroleptanalgesia for bronchography. Thorax 1972; 27:334-7. [PMID: 5039449 PMCID: PMC472592 DOI: 10.1136/thx.27.3.334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The use of a mixture of 2 mg phenoperidine and 5 mg droperidol as an adjunct to topical anaesthesia for bronchography, with or without prior bronchoscopy, is reported in 100 adult patients. Given slowly over 2 to 10 minutes this produces good operating conditions in the majority of patients. However, if parenteral pethidine or diazepam are used as premedication, patients may be too drowsy to co-operate with changes in posture. In the absence of excessive sedation respiratory depression will respond to the simple expedient of asking the patient to breathe. It is recommended that atropine alone be given as premedication, perhaps with oral diazepam in apprehensive patients. Despite the good operating conditions most patients remembered the procedure and half of them found it to be unpleasant.
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