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Biomedical subjects

B Cady

Publications and source records attributed to B Cady.

At least 127 records · Page 7Linked to original sources
PubMed1983

Cost of smoking.

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Costs and Cost Analysis↗
PubMed1983

Carotid body tumor. The Lahey Clinic experience.

We believe that paragangliomas of the carotid body should be excised in all patients unless formidable medical conditions prohibit the use of general anesthesia. If these tumors are left unresected, they will eventually grow to invade the skull and kill the patient. With definitive diagnostic modalities available, in addition to comparatively low-risk anesthesia, autotransfusion, and replacement of the carotid artery, there are few patients who cannot be surgically treated. The important point is that although such a tumor is rare, its presence must always be considered when dealing with a lateral neck mass. Carotid arteriography should be performed when a carotid body tumor is suspected.

Carotid Arteries↗
PubMed1983

The effect of thyroid hormone administration upon survival in patients with differentiated thyroid carcinoma.

Seven hundred sixty-one patients with operable differentiated thyroid carcinoma were treated between 1931 and 1970. Median follow-up time was 18 years and ranged from 5 to 40 years. Sixty-three percent of the patients were followed more than 15 years, and 46% were followed more than 20 years. Because resections usually spared sufficient thyroid tissue for homeostasis, thyroid hormone was not routinely prescribed after operations performed before 1960. Altogether 244 patients with papillary carcinoma and 76 patients with follicular carcinoma received thyroid hormone, while 296 patients with papillary carcinoma and 45 patients with follicular carcinoma did not receive thyroid hormone after operation. With papillary carcinoma, 14% of men greater than 40 and women greater than 50 years of age (high risk) but only 2% of men less than or equal to 40 years of age and women less than or equal to 50 years of age (low risk) died of disease (P 0.0001). Twenty-six percent of high-risk but only 4% of patients with low-risk follicular cancer died (P 0.0001). However, there was no statistically significant improvement in survival times with use of thyroid hormone when patients were categorized by risk group and pathology. These data support the importance of age and sex in previously described risk groups; these factors supersede the effects of adjuvant treatment. This absence of effect on survival times calls into question current recommendations for routine use of thyroid hormone after surgical therapy. Conceptually, such absence of adjunctive hormone effect on survival time after operation is similar to hormonal effects in other endocrine cancers, which may nevertheless provide good palliation in some cases.

Adenocarcinoma↗
PubMed1982

Ultrasound-guided catheter localization of intrahepatic abscesses--an aid in open surgical drainage.

A catheter placed by the radiologist in a hepatic abscess before operation affords many luxuries to the surgeon. Percutaneous aspiration of the abscess provides material for Gram stain and culture, thereby allowing appropriate perioperative selection of antibiotics. The decompression provided gives the surgeon time to prepare the patient adequately for operation. Most important, use of the catheter as a guide to the abscess allows the surgeon to select the optimal approach to the liver and then proceed directly to the involved area. In this way operating time, blood loss, damage to uninvolved areas of the liver, and unnecessary contamination are kept to a minimum.

Adult↗
PubMed1981

Changes in clinical presentation and management of malignant melanoma.

Records of 147 patients with primary cutaneous malignant melanoma treated at the Lahey Clinic from 1955--1979 were reviewed. Complete clinical follow-up data were obtained, and all pathologic material was reviewed. Proposed new risk categories based on a modification of the Clark and Breslow categorizations are outlined. The incidence of low-risk melanoma has dramatically increased (from 23--53%) and that of high-risk melanoma has decreased (from 34--10%) over the period of this study. Dermal punch biopsy gives accurate staging information and carries no increased risk of local recurrence, nodal metastases, or death from disease. Resection of a margin of clinically uninvolved skin measuring twice the diameter of the primary melanoma minimizes local recurrence (2.5% or less), does not adversely affect survival, and reduces the need for skin grafting. Arbitrary wide margins are not justified. Regional lymphadenectomy offers no improvement in survival in patients with low-risk and moderate-risk melanoma and can play only a minor role at most in improving survival for patients with high-risk melanoma.

Biopsy↗
PubMed1981

Parietal cell vagotomy for intractable and obstructing duodenal ulcer.

Parietal cell vagotomy can be accomplished with minimal morbidity and mortality. Symptoms and signs of delayed gastric emptying early after operation are common and occur more frequently in patients with preoperative gastric outlet obstruction than in those without, a difference that is statistically significant. These symptoms are generally mild and transient. Dumping and diarrhea were not problems in our series. In patients with preoperative gastric outlet obstruction, parietal cell vagotomy with pyloroduodenal dilatation achieved good or excellent results in 79 percent of patients; however, the possibility of a higher recurrence rate requires further evaluation and suggests caution and selectivity in the use of this procedure. The recurrence rate of 3 percent of these patients without gastric outlet obstruction and a very good or excellent clinical result in 91 percent of these patients appear acceptable and encourage us to continue to use parietal cell vagotomy as the procedure of choice in patients with intractable duodenal ulcer. Most patients with recurrent ulcer have been treated medically with success. Close long-term clinical follow-up studies will be required to assess better the success of this procedure.

Adolescent↗
PubMed1980

Hepatic resection.

A thorough understanding of the detailed anatomy of the liver and of its anatomic variations is necessary for planning elective hepatic resection and surgical management of patients with hepatic trauma. Techniques for anatomic resections are outlined.

Bile Ducts, Intrahepatic↗
PubMed1980

Staging laparotomy in Hodgkin's disease.

Staging laparotomy is a useful procedure as long as regional radiotherapy continues to be the primary modality of treatment for early Hodgkin's disease. However, many oncologists have extended the indications for systemic chemotherapeutic agents. Studies are in progress to evaluate the effectiveness of chemotherapy alone for all patients with B symptoms as well as for those with stages I and II disease associated with large mediastinal masses or lymphocyte depletion histology. If therapeutic practices change significantly in the future, there may be fewer indications for careful staging. The natural history of treatment of cancers in a sophisticated therapeutic environment is that more careful staging is required to utilize the vast array of therapies being developed to improve prognosis. In all likelihood staging laparotomy in some form will continue to be a part of the management scheme for patients with Hodgkin's disease.

Biopsy↗
PubMed1980

Thyroid neoplasms.

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Adenocarcinoma↗
PubMed1980

Surgical anatomy.

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Blood Vessels↗