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Biomedical subjects

A E Cameron

Publications and source records attributed to A E Cameron.

At least 37 records · Page 2Linked to original sources
PubMed1988

Surgeons' attitudes to the operative management of duodenal ulcer perforation and haemorrhage.

The currently preferred operative management of duodenal ulcer haemorrhage and perforation was assessed by means of a questionnaire sent to 274 consultant general surgeons in England. A 70% response rate was achieved. Simple closure, with or without H2 antagonist treatment, was the most popular management of a perforated acute duodenal ulcer. For perforation of a chronic duodenal ulcer occurring during H2 antagonist therapy, truncal vagotomy and drainage was the definitive procedure of choice. There was no consensus about the operative management of perforation complicating non-steroidal anti-inflammatory drug treatment in the elderly patient. Proximal gastric vagotomy appears to have few advocates in the definitive management of either duodenal ulcer perforation or haemorrhage. Of our sample 70% selected truncal vagotomy and drainage with underrunning of the ulcer as the operative treatment of choice for bleeding. Endoscopic coagulation appears to be used only rarely.

Acute Disease↗
PubMed1988

A standardised approach to the insertion of Hickman catheters.

A standardised technique for the insertion of Hickman catheters under local anaesthetic is described. The external jugular vein is to be preferred, but if this proves too small the catheter may be introduced via the internal jugular vein using a Seldinger technique. A total of 44 Hickman catheters were inserted into 44 patients using this approach without major complication.

Anesthesia, Local↗
PubMed1987

Gastric volvulus in childhood.

Gastric volvulus is a rare surgical emergency in infancy and childhood. Only 51 cases have been reported. We describe four new cases. The classical features of the condition are discussed.

Barium Sulfate↗
PubMed1987

A randomised comparison of polydioxanone (PDS) and polypropylene (Prolene) for abdominal wound closure.

Two hundred and eighty four patients undergoing laparotomy by vertical incision were randomly allocated to closure with interrupted mass sutures of No. 1 polydioxanone (PDS) or No. 1 polypropylene (Prolene). Dehiscence occurred in 0.7% of the PDS group but in 6.4% of the Prolene group (P = 0.018). Wound infection occurred in 8.6% of the PDS group and 15.4% of the Prolene group (P = 0.1). One hundred and ninety patients attended for review at a minimum of one year. Incisional herniation, usually asymptomatic, was present in 11% of each group. Knots were palpable in 2% of the PDS patients but in 12% of the Prolene: wound pain occurred in 12% of the PDS group but in 23% of the Prolene group (P = 0.06). These results suggest that PDS may be useful for abdominal closure.

Abdomen↗
PubMed1986

The surgical treatment of upper limb hyperhidrosis.

Primary hyperhidrosis is a common and poorly understood condition. Surgical thoracic sympathectomy, either by the cervical or transaxillary route, entails major surgery, so there is a tendency to offer this only to those most severely affected. Endoscopic thoracic sympathectomy is a simple, safe and effective procedure. The technique and results are described and it is recommended as the appropriate procedure for treating upper limb hyperhidrosis, including localized axillary sweating.

Adult↗
PubMed1985

Pain and mobility after inguinal herniorrhaphy: ineffectiveness of subcutaneous bupivacaine.

We studied pain and mobility in 101 men undergoing elective unilateral inguinal herniorrhaphy. Subcutaneous infusion of 0.5 per cent bupivacaine via a fine catheter was used as an adjunct to conventional analgesia in half of the patients. This had no effect on the perception of pain measured at 8 and 24 h by visual linear analogue, nor on the analgesics requested by the patients. The walking ability of all patients was significantly impaired 24 h postoperatively, but again bupivacaine conferred no benefit. Organisms were cultured from 12.5 per cent of the catheters.

Bupivacaine↗
PubMed1985

Carbon-fibre versus Marlex mesh in the repair of experimental abdominal wall defects in rats.

Large abdominal wall defects were created in Porton-Wistar rats and either left unrepaired (9 rats), or repaired with polypropylene (Marlex) mesh (11 rats), or with an open darn of filamentous carbon (11 rats). A further ten animals had a simple midline skin incision. At 5 months there were gross hernias in the unrepaired animals. Neither repair had resulted in gross recurrence although four of the carbon-repaired animals had bulges through the open weave. Tensiometry of the excised abdominal wall showed no difference in the strength of the two repairs. However, microscopy showed a striking difference-the Marlex had induced a chronic inflammatory response with disorganized collagen, whereas the carbon was not only well-tolerated but acted as a scaffold for well-organized and orientated collagen.

Abdominal Muscles↗
PubMed1985

Successful Whipple's operation for pancreatic injury.

A case is presented of severe pancreatic injury in a 30-year-old man following a road traffic accident. A Whipple's operation was performed successfully. Despite some postoperative complications, the patient is well and back at work 1 year after the operation.

Adult↗
PubMed1985

Patient flow patterns in a recovery room and implications for staffing.

A detailed analysis of the occupancy of a new recovery room in a small district general hospital was undertaken during the initial three months of its use. The main problems were found to be irregular workload, consistently high patient occupancy over lunchtime, and difficulty in matching traditional nursing shifts to periods of heavy workload.

Bed Occupancy↗
PubMed1984

The effect of cyclophosphamide on immunological control mechanisms.

Cyclophosphamide (CY) given three days before immunization with a range of antigens increases the intensity of cell-mediated immune responses. CY given around the time of immunization also reverses immunological tolerance, blocks antigenic competition and modifies desensitization. The effect on antibody production is not so predictable. However, it may increase the IgE response without affecting IgG1 or IgG2 response to the same antigen and may abolish immunological memory. The action of CY is on rapidly-turning-over cell populations. Lymphocytes are maximally at risk 48 hours before they transform into large pyroninophilic cells, that is just before the S phase of cell division. CY has a preferential effect on both T- and B- suppressor cells. The application of these findings to experimental cancer models is discussed. These findings are not restricted to CY, as a wide range of cytotoxic drugs with different actions at the cellular level may have similar profound effects on the regulation of the immune response.

Animals↗
PubMed1983

Axillofemoral and femorofemoral grafts: a 6-year experience with emphasis on the relationship of peroperative flow measurement to graft survival.

Over a 6-year period 64 axillofemoral bypass and femorofemoral crossover grafts have been performed in 58 patients, most of whom were considered unfit for intra-abdominal surgery. Indications were peripheral ischaemia in 78 per cent and disabling claudication in 22 per cent. The limb salvage rate at 3 years was 75 per cent. No claudicants lost limbs, but only one-third of patients presenting with forefoot gangrene or ulceration avoided amputation. Most patients presenting with ischaemic symptoms at rest had associated femoropopliteal and distal disease, confirmed by the ankle pressure index measurements, and this influenced graft patency. Although the cumulative patency at 3 years for all grafts combined was 57 per cent with similar patencies for both the axillofemoral and femorofemoral grafts, early occlusion was more common in axillofemoral grafts and this may be reduced in bifemoral grafts by the increased flow rate in the vertical limbs. Peroperative electromagnetic flowmeter measurements were made after reconstruction on 55 femoral arteries in 46 of the patients and graft flow velocities were derived from these measurements. Comparison between velocities from those grafts remaining patent and those subsequently occluding showed a high incidence of occlusion in grafts with a maximal velocity after distal vasodilatation of less than 8 cm/s. Graft occlusion after the first postoperative month was more commonly associated with other factors such as continued smoking, severity of distal disease and perigraft infection.

Aged↗