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Biomedical subjects

A M Jenkins

Publications and source records attributed to A M Jenkins.

At least 55 records · Page 3Linked to original sources
PubMed1987

Deep electrical burns to the scalp.

Full skin thickness burns to the scalp involving bone damage are not uncommon. These are mainly caused by electricity, but there are some flame injuries. Investigation of the extent of bone damage by technetium bone scan and the use of CT head scan are recommended. Early closure of the defect using a flap is also recommended, even if wound contamination is present. The results can be very gratifying.

Adult↗
PubMed1987

Skin necrosis secondary to meningococcal septicaemia in an adult.

A case of skin loss after meningococcal septicaemia is presented. This is a rare condition in adults and occurs after very severe infections. The skin loss is due to vasculitis, resulting from a combination of direct infection of the skin by Neisseria meningitidis, and an immunological reaction. Secondary infection frequently occurs under the eschar. Skin loss is treated by debridement and delayed split skin grafting.

Adolescent↗
PubMed1986

Ruptured abdominal aortic aneurysm.

Between 1974 and 1984, 174 patients with ruptured abdominal aneurysms have been treated by three vascular surgeons. The 11-year period showed a dramatic increase in the number of patients presenting with ruptured aneurysms. The overall operative survival, including patients who died before a graft could be inserted, was 67 per cent with improvement from 60 per cent in the first half of the period to 69 per cent in the second. The overall survival rate for the 162 who had a completed graft was 72 per cent. Reference to data from the Lothian area surgical audit showed that there has been a transfer of responsibility from general to vascular surgeons with an increase in the proportion of patients treated by operation. Concentration of care within a single specialized unit appears to have had a favourable effect on survival.

Aged↗
PubMed1986

Vascular access: experience with the brachiocephalic fistula.

Eight years' experience with the brachiocephalic fistula for vascular access are reported. Eighty one fistulae were created in 77 patients. Forty one fistulae were created by an end to side anastomosis and 40 using a side to side technique. Overall patency was 70% at 1 year; 57% at 2 years; 50% at 3 years, which compares well with other secondary access procedures. Anastomotic configuration did not significantly affect fistula survival. Cardiac failure and arterial steal syndrome were significant problems with the side to side fistula. Two patients died from fistula complications; one exsanguinated at home from a cannulation site and another succumbed to high output cardiac failure. Infection was rare. The end to side brachiocephalic fistula is recommended as the secondary vascular access procedure of choice. It is a simple, reliable procedure which does not require graft implantation and preserves the saphenous vein, should tertiary access be required.

Adolescent↗
PubMed1982

Sequential grafts for limb salvage in the presence of widespread occlusive vascular disease. A review of twenty patients.

Twenty patients with widespread occlusive vascular disease received sequential bypass grafts for lower-limb salvage. In 16 patients an isolated common femoral or profunda segment was perfused by a proximal graft and run-off was augmented by femoropopliteal bypass. In 4 a femoropopliteal bypass constituted the proximal component perfusing an isolated popliteal segment, run-off being increased by a popliteal-to-tibial graft. Dacron, expanded polytetrafluoroethylene (PTFE) (Gore-Tex), and autogenous vein grafts were used. The mean period of follow-up was 10.6 +/- 7 months and 70% of the limbs were salvaged. Thirteen graft systems remain currently patent, 4 have thrombosed, 2 patients died with patent grafts, and 1 required amputation despite graft patency.

Aged↗
PubMed1980

Medium-term follow-up of forty autogenous vein and forty polytetrafluoroethylene (Gore-Tex) grafts for vascular access.

Patency of 40 polytetrafluoroethylene (PTFE) and 40 autogenous vein arteriovenous grafts for vascular access among 56 patients is compared. Most patients required access for hemodialysis, but six grafts were for other reasons including hyperalimentation and drug administration. Cumulative patency at 3 years for both PTFE grafts and vein grafts was 64%. The complication rate necessitating secondary operation was more than three times greater in the PTFE group in which 35 secondary procedures were needed. No grafts became infected as a result of the initial operation, but eight serious complications were associated with subsequent infection of PTFE grafts and three with vein grafts, including postcannulation bleeding, abscess, and aneurysm. Twenty-six PTFE grafts developed associated stenosis in the runoff vein. This was demonstrated with angiography in 10 and the stenoses were excised and grafted, one being dilated by intravascular balloon. In 16 thrombosis was the first indication of stenosis. Histologically narrowed runoff veins showed intimal hyperplasia. Runoff stenosis did not occur among vein grafts, but in eight vein grafts themselves became stenotic. These results indicate that owing to a higher complication rate with PTFE grafts, vein grafts should be used when possible.

Blood Vessel Prosthesis↗
PubMed1980

Renal fibromuscular hyperplasia associated with subarachnoid hemorrhage from a berry aneurysm: a case report.

An 11-year-old girl with renal artery fibromuscular hyperplasia and a berry aneurysm of the anterior communicating artery with subarachnoid haemorrhage is reported. She presented with subarachnoid hemorrhage and was shown to have hypertension attributable to unilateral renal artery fibromuscular hyperplasia. Cerebral angiography showed an aneurysm of the anterior communicating artery. The aneurysm was not treated surgically, but control of the hypertension was obtained by renal revascularisation with an aortorenal graft of saphenous vein. The patient remained well subsequently, and follow-up angiography demonstrated virtual disappearance of the aneurysm and also a functioning aortorenal graft.

Cerebral Angiography↗
PubMed1976

Causes of failure to harvest cadaver kidneys for transplantation.

Fifty-two possible donors of cadaver kidneys were referred to the Nuffield Transplantation Surgery Unit, Edinburgh, in 12 months. Only 12 (23%) yielded kidneys, while a further 12 were medically unsuitable as donors. Refusal by relatives to allow cadaver nephrectomy was the largest avoidable loss of potentially transplantable kidneys. A similar but unavoidable loss occurred through sudden death of the possible donor.

Cadaver↗
PubMed1976

Long survival after renal transplantation in man.

The indications for transplantation, complications, management and results in 127 consecutive patients who had received renal transplants between October 1960 and December 1974 are presented. In 2 cases the donor was an identical twin, in 22 a living relative other than a twin, in 2 an unrelated individual in whom nephrectomy was performed for therapeutic reasons and in 101 a cadaver. At the end of the period under review there were 37 patients alive with grafts which had functioned for 6 months or more; of these, 28 had survived for more than 2 years, 13 for more than 5 years, 6 for more than 8 years and 2 for more than 12 years. Thirty-four patients were employed or doing routine housework or receiving full-time education. One patient fathered a child 4 years after transplantation; another gave birth to a healthy infant 3 years after transplantation.

Adolescent↗
PubMed1976

Peripheral aneurysms in Behĉet's disease.

Two patients with Behĉet's disease are reported, both of whom had aneurysms of peripheral arteries. In one the aneurysms were multiple. The aneurysm was replaced with a Terylene prosthesis in one patient, and in the other an autogenous vein bypass was used. In each case a further aneurysm developed adjacent to the vascular anastomosis. Severe ischaemia of the affected limbs subsequently developed in both patients.

Adult↗