Search PubMed⌕ Search

Biomedical subjects

A A Conlan

Publications and source records attributed to A A Conlan.

At least 37 records · Page 2Linked to original sources
PubMed1987

Pulmonary aspergilloma--indications for surgical intervention. An analysis of 22 cases.

Surgical resection of aspergillomas has generally been associated with excess mortality and morbidity; 22 patients who had a resection of complicated mycetomas were studied retrospectively. Indications for surgery were serious haemoptysis (14), massive haemoptysis (6), and recurrent infection (2). Extrapleural pneumonectomy was required in 9 patients and extrapleural lobectomy in 12; thoracoplasty alone was done in 1 patient. There was 1 hospital death (4.5%); 4 patients developed postoperative empyemas (18%), 2 with associated bronchopleural fistulas. Two further patients (9%) had stable postresectional spaces. Surgery for complicated aspergilloma was associated with significant postoperative morbidity.

Adult↗
PubMed1986

Avoidance of jejunostomy. A reliable method of naso-enteral tube placement after oesophageal surgery.

Nutritional maintenance after oesophageal surgery and during treatment of oesophageal disease is given high priority. A method of naso-enteral feeding tube placement suitable for these patient groups was evolved and studied prospectively. A standard nasogastric tube is used as a conduit for a guide-wire over which a soft, small-bone naso-enteral tube is threaded into position. Thirty patients underwent placement of such tubes postoperatively or during treatment of oesophageal disease. Placement and feeding was successful in all. Six patients developed controllable diarrhoea.

Enteral Nutrition↗
PubMed1986

Resectable pulmonary nephroblastoma metastases presenting as chest wall lesions on radiography. A report of 2 cases.

Two children with pulmonary metastases from nephroblastomas showed the radiological features of chest wall tumour involvement. Diagnostic surgical exploration subsequently revealed pedunculated and fully resectable peripheral lung metastases. The mechanism by which these pedunculated lesions mimicked the classic 'D sign' of an extrapulmonary (pleural or chest wall) tumour is explained.

Child, Preschool↗
PubMed1986

Pulmonary resection in the prone position for suppurative lung disease in children.

Lung resection for suppurative inflammatory disease is hazardous in children whose small airway diameter precludes the use of standard methods of bronchial separation. A prospective evaluation of the prone position for thoracotomy in 17 children referred for operation with severe inflammatory disease was done. Bronchography showed whole lung bronchiectasis eight, destroyed lung in three, and lobar bronchiectasis five. Pulmonary resections performed with the child prone included left pneumonectomy (nine), right pneumonectomy (four), lingulectomy with lower lobectomy (two), and other lobectomy (two). No endobronchial or intrapleural spillage occurred. One child required reexploration for bleeding and one child developed a postoperative empyema that ultimately caused death. The remaining 16 children were discharged within 8 days of operation, and follow-up of 1 to 18 months records favorable progress.

Bronchiectasis↗
PubMed1985

The microflora of chronic pleural empyema. An analysis of 89 patients.

Bacteriological cultures from 89 patients with chronic pleural empyema were studied. Seventy-nine patients had positive and 10 negative culture results. Forty-eight patients had a single isolate--pyogenic cocci in 32 and Gram-negative enteric bacilli in 16--and multiple organisms were grown in 31 patients. Anaerobic organisms were recovered in 6,2%. Our negative culture rate of 11,2% may reflect failure to recover anaerobes, but could represent sterilization of the empyema by prior use of antibiotics. The results of antibiotic sensitivity tests and the pathogenicity of the organisms recovered suggest that the choice of antibiotic combinations for chronic pleural empyema requires careful consideration.

Adolescent↗
PubMed1985

Bronchiectasis in urban black children.

From July 1979 to July 1982, 29 cases of childhood bronchiectasis were encountered at Leratong Hospital. They were retrospectively divided into two groups: 16 patients underwent surgical intervention and the other 13 patients received medical treatment only. Symptoms and signs were reviewed and findings on bronchography were studied. The left lower lobe was the most common site of involvement, and the lingular segment was invariably also affected by bronchiectatic changes. Ten of the surgical patients (63%) underwent pneumonectomy. In 75% of the surgical group there was an excellent or good result after surgery, while a good result was achieved in 40% of those receiving medical treatment only. We have reviewed other large series to compare surgical and medical management, and discuss factors that may influence the outcome of surgical treatment.

Adolescent↗
PubMed1985

Normovolaemic haemodilution using dextran 70 in thoracic surgery.

Normovolaemic haemodilution was undertaken in 10 patients requiring elective thoracic surgery. The resultant blood loss, cell loss, use of donor blood and acid-base changes were compared with those in 10 patients undergoing similar procedures who were anaesthetized in the standard manner. Normovolaemic haemodilution reduces the use of donor blood and provides more satisfactory acid-base status than that in controls. The known antithrombotic effect of dextran 70 (Macrodex; Saphar) did not affect the crude clotting time. The technique is a feasible alternative to use of donor blood, especially when difficulties in supply exist or there is a high risk of disease transmission.

Adolescent↗
PubMed1985

Pleural sinography in the management of thoracic empyema. A study of 52 cases.

Pleural sinography is indicated in the management of empyema thoracis. The factors influencing the successful completion and interpretation of this procedure are discussed. A retrospective study of 86 sinograms from 52 patients with pleural empyema was undertaken to identify how the information obtained influenced management decisions and affected therapy. Pleural sinography is a valuable study within the limitations of correct performance and interpretation.

Adolescent↗
PubMed1984

Empyema thoracis--a prospective study on 73 patients.

A prospective study of empyema thoracis was conducted on 73 consecutive patients. The pathogenesis and bacteriological features of the condition and its clinical course and management are recorded and analysed. Pleural cultures revealed that the predominant pathogen was Staphylococcus aureus. Fifty of 65 patients had mixed isolates on pleural culture, with a 4:1 ratio of aerobes to anaerobes. Twenty per cent of the patients had anaerobic empyemas. The underlying lesion was parenchymal lung disease in 37 cases and an infected hemopneumothorax following penetrating injury in 26. The remaining 10 patients developed empyema after pulmonary resection. The empyema resolved completely in 81% of the patients.

Adolescent↗
PubMed1984

Adult respiratory distress syndrome associated with miliary tuberculosis. A case report.

In this report we describe a patient with miliary tuberculosis who presented with the adult respiratory distress syndrome. The diagnostic problems are discussed and the value of transbronchial lung biopsy is emphasized. Our experience with this patient stresses the need for maintaining a high index of suspicion for treatable causes of adult respiratory distress syndrome.

Adult↗
PubMed1984

Pessimism concerning palliative bypass procedures for established malignant esophagorespiratory fistulas: a report of 18 patients.

Eighteen patients with established malignant esophagorespiratory fistulas due to primary esophageal cancer were managed by substernal gastric bypass and isolation of the cancerous esophageal segment. Seven fistulas were esophagotracheal and 11 were esophagobronchial. Ten patients died in the hospital between two days and six weeks after operation. Eight patients left the hospital, surviving an average of 3 1/2 months, but 2 patients lived 5 and 7 months, respectively. Unrelenting respiratory infection and clinical inanition caused 7 hospital deaths in patients reestablished on oral alimentation with their fistulas disconnected. Anastomotic leaks occurred in 5 patients; three of these leaks closed. In the other 2 patients, cervicomediastinal sepsis and bilateral pneumonia with respiratory failure caused death. One patient died of anoxic cardiac arrest 48 hours postoperatively. Fifteen of the 18 patients resumed oral alimentation, but the overall results of palliative surgical therapy achieved in this series were not observably worthwhile for the majority.

Adult↗
PubMed1984

Pharyngoesophageal barotrauma in children: a report of six cases.

Pharyngeal and pharyngoesophageal penetrating injury occurred in six children following the explosive discharge of compressed carbon dioxide into their mouths. The gas was contained in plastic, screw-cap soft-drink containers overpressurized by the addition of dry ice. Three children were managed surgically and three conservatively. All recovered fully, and at follow-up of from 3 to 52 months, swallowing is normal.

Anti-Bacterial Agents↗
PubMed1983

The operative management of post-intubation tracheal strictures. Case reports.

The presentation and treatment of 2 patients with post-intubation tracheal strictures are reported. There was one subglottic and one supracarinal stricture, and they were treated by resection and anastomosis. The surgical procedures and special techniques for the facilitation of anastomosis are discussed, as is the subsequent management.

Adult↗
PubMed1983

Nutritional status of thoracic surgical patients. A prospective evaluation.

The nutritional status of 102 thoracic surgical patients was studied prospectively. Fifty patients showed combined or single abnormalities of the parameters studied. Seventy per cent of the patients with empyema were found to have abnormal nutritional values. Thirteen of 20 patients with oesophageal obstruction (malignant or benign) were also found to be malnourished or to have pathological nutritional parameter values. The diagnosis and correction of malnourishment in patients who are to undergo surgical procedures should be undertaken early.

Adolescent↗
PubMed1983

Superior vena-caval obstruction in urban blacks. A report of 82 cases.

Eighty-two patients with superior vena-caval obstruction (SVCO) were studied retrospectively. Carcinoma of the bronchus was responsible for the syndrome in 60 patients; of the remaining 22 patients, 7 had mediastinal lymphomas, 5 retrosternal goitres, 4 oesophageal cancer, 3 vascular aneurysms, 2 thymic tumours, and 1 granulomatous mediastinitis. Rigid bronchoscopy, scalene node biopsy or aspiration, cervical mediastinoscopy, anterior mediastinotomy, transthoracic needle biopsy and median sternotomy were the procedures used to make a definitive diagnosis. It is noteworthy that in 9 of the 82 patients malignant disease was not the cause of the SVCO. Seven of the remaining 73 patients had lymphoma causing compression of the superior vena cava. A significant proportion (19.5%) of urban Blacks with SVCO had causes other than hopeless bronchogenic carcinoma as the basis for their condition.

Adolescent↗
PubMed1983

Taurolidine instillation as therapy for empyema thoracis. A prospective study of 50 patients.

Fifty patients with chronic empyema thoracis, without bronchopleural fistula, were treated by drainage and twice-daily instillations of 2% taurolidine (Taurolin; Continental Ethicals) for 14 days. No antibiotics were used. Forty-three patients completed the treatment and 7 were withdrawn from the trial, 3 because of evidence of bronchopleural fistula and 1 each because of pain during instillation, associated chest-wall cellulitis, an unexplained, acute epilepsy-like episode during instillation, and inadvertent administration of antibiotics. All 43 patients who completed the trial showed an excellent clinical response with control of the local and systemic toxic effects of sepsis. A rapid falling-off in the volume and purulence of pleural drainage fluid was noted. Twenty-four of the 43 patients (55,8%) were rendered bacteriologically sterile by the treatment. Instillation of 2% taurolidine was therefore an effective form of monotherapy in cases of chronic empyema thoracis without bronchopleural fistula.

Adolescent↗