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Biomedical subjects

C Collins

Publications and source records attributed to C Collins.

At least 253 records · Page 14Linked to original sources
PubMed1976

Further studies of the acute effects of phenylbutazone, oxyphenbutazone and indomethacin on the rat kidney.

Experiments were donducted on rats to determine the lowest dose of either phenylbutazone or indomethacin capable of producing papillary necrosis and in each case it was found to be 50 mg/kg body weight. A single dose of oxyphenbutazone (444 mg/kg), a major metabolite of phenylbutazone in man, produced patchy cortical necrosis, which became more extensive during daily administration for 4 days, despite evidence of regeneration. Although papillary necrosis as such was never seen with this substance, there was evidence of damage to the lower nephron in the form of tubular necrosis and calcification.

Acute Disease↗
PubMed1971

Clinical evaluation of fibreoptic sigmoidoscopy employing the Olympus CF-SB colonoscope.

Fifty-one patients with large bowel disease were examined with the Olympus CF-SB fibreoptic colonoscope. With adequate bowel preparation and employing inhalational analgesia administered by a self-demand valve the whole sigmoid colon could be examined in the majority of patients within 30 minutes. In 23% of cases (12/51) the diagnosis was either made or confirmed by this procedure alone. Fibreoptic sigmoidoscopy is especially helpful in patients with either equivocal or failed barium enemas and is indicated in patients with unexplained rectal bleeding, extending the search for polyps and cancer, and studying patients with inflammatory bowel disease.About one quarter of biopsies taken from a flat mucosal surface with the Olympus flexible biopsy forceps may be insufficient for detailed histology due to their small size. For this reason multiple biopsies may be taken. Adequate biopsies were always obtained from projecting lesions and could be very accurately sited. Colour photography employing automatic exposure control is used to supplement the information obtained. It is concluded that fibreoptic sigmoidoscopy is a valuable additional investigation in selected patients with suspected disease of the large bowel and to date has been without complications.

Anesthesia, Inhalation↗
PubMedDate not supplied

Public sector hospitals and organizational change: an agenda for policy analysis.

An important feature of health care systems in recent years is the change in the organizational position and relations of public sector hospitals. Health sector reforms have led to increasing heterogeneity in the organizational location and status of public sector hospitals and new organizational forms of public-private relations are being developed by and for hospitals. These changes can have important implications for health and health care. They raise issues around equity, control, accountability and performance of health care. Yet the policy process in practice may be failing to develop and implement appropriate forms of policy formulation on health sector reform. This paper focuses on the organizational position and relations of hospitals within public sector health services. It firstly outlines key elements of health sector reform and relates these to two dimensions of organizational change for hospitals: increasing heterogeneity and forms of public-private relations. The paper provides a descriptive format for classifying forms of hospital organizational change and proposes a framework of six questions for analysing these organizational forms. This may be used to assess the appropriateness of specific policies to particular country situations and to develop more open debate around hospital organizational forms.

Decision Making, Organizational↗
PubMedDate not supplied

Thoracoscopic repair of instrumental perforation of the oesophagus: first report.

BACKGROUND: Perforation of the oesophagus is a life-threatening condition requiring early recognition and repair to prevent mediastinitis and death. Primary closure with mediastinal drainage is recognised as the treatment of choice for patients presenting within 24 hours. Many are frail, however, and unsuitable for major surgery. AIM: To report the first case of thoracoscopic repair of the oesophagus for oesophageal perforation following instrumentation. METHODS: Flexible endoscopy revealed a 10cm perforation in the right lower oesophagus. With the gastroscope in the oesophagus, four thoracoports were introduced. Using suction and irrigation, the pleural cavity was suctioned free of debris and a 10cm longitudinal tear of the right lateral aspect of the oesophagus was repaired using interrupted polyglactin sutures through all layers. RESULTS: The patient tolerated the procedure well and made an uncomplicated recovery. CONCLUSION: The uncomplicated recovery of this frail patient without need for blood transfusions or assisted ventilation supports the notion that the thoracoscopic approach may have significant advantages. With increased experience and technical refinements there should be less reluctance to refer these patients for earlier definitive surgical repair.

Aged↗