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Biomedical subjects

C D Collins

Publications and source records attributed to C D Collins.

At least 55 records · Page 3Linked to original sources
PubMed1994

Relationship of computed tomography tumour volume to patient survival in carcinoma of the cervix treated by radical radiotherapy.

In this retrospective study tumour volume was calculated by two different methods from the staging computed tomographic scans obtained in 1987 of 20 patients with carcinoma of the cervix. All patients underwent treatment by radical radiotherapy and the survival figures at 5 years were analysed. The aim was to identify the nature of the relationship between the true tumour volume and tumour volume obtained by measuring the maximum dimensions in each plane ("cuboid" volume). Significant correlation between the product of height x width x depth and true tumour volume was demonstrated (r = 0.983). A multivariate analysis of survival demonstrated a significantly increased relative risk for positive nodes (p < 0.03) and tumour depth > 3.8 cm (p < 0.04) or tumour width > 5.0 cm (p < 0.03). A significant difference (p < 0.02) between the median tumour volumes for early and late stage disease was present irrespective of the method used to calculate tumour volume. This study demonstrates that cuboid tumour volume can be a good reflection of the true volume; in addition, positive nodes, tumour depth and tumour width are significant determinants of survival.

Carcinoma, Squamous Cell↗
PubMed1994

Case report: myeloma of the breast--appearances on ultrasound and colour Doppler.

Multiple myeloma may on rare occasions involve the breast. We report a case where a predominantly echo-poor solid mass was present on breast ultrasound in a patient under treatment for multiple myeloma. There was evidence of neovascularization on colour Doppler allowing a provisional diagnosis of carcinoma to be made. Fine needle aspiration cytology, however, demonstrated numerous mononuclear cells characteristic of myeloma. The appearances on ultrasound of this lesion have not been previously described.

Breast↗
PubMed1994

Case report: cachexia of the kidney--a cause of pseudo-hydronephrosis.

Various pitfalls in diagnosing early hydronephrosis on ultrasound (US) have been recognized. We present a case where the appearances on US mimicked bilateral hydronephrosis in a patient undergoing treatment for recurrent colonic carcinoma. Comparison with a previous ultrasound examination demonstrated marked loss of renal sinus fat. Doppler studies demonstrated normal venous flow within each portion of the "dilated collecting system". In oncology, renal cachexia should be remembered as one of the causes of pseudo-hydronephrosis.

Cachexia↗
PubMed1994

Analysis of a year's general surgical activity in a District General Hospital.

The activity of the surgical unit of a District General Hospital was analysed over a one-year period. The numbers of outpatients seen, admissions, operations performed, and operative workload were all higher, in terms of the available surgical personnel, than those expected of a unit of this size. Thirty-five per cent of admissions were emergencies but these occupied 58 per cent of bed days. Nonetheless, three-quarters of admitted patients were discharged within five days. Three-quarters of operations were Minor or Intermediate, one-quarter were Major or more complex. Consultants performed/supervised 48 per cent of operations. 42.5 per cent were performed by unsupervised trainees and 9.4 per cent by clinical assistants. Solo trainees performed the majority of emergency operations (73.7 per cent). With regard to operative activity, the Service Equivalent Value of consultants and trainees approximated to expectations, but clinical assistants contributed more than expected.

Elective Surgical Procedures↗
PubMed1993

Detection of pneumothorax with lateral shoot-through digital radiography.

The aim of this study was to compare the performance of digital frontal radiographs vs digital lateral shoot-through radiographs for the diagnosis of pneumothoraces in supine patients. A total of 146 pairs of radiographs were performed on 32 ventilated patients on the Intensive Care Unit. Each radiograph was independently assessed by three observers for the presence or absence of a pneumothorax. A degree of confidence was assigned to each observation and an image quality score was given to each radiograph. At least two out of three observers positively diagnosed a pneumothorax in 13/146 (8.9%) of the frontal radiographs compared to 43/146 (29.4%) of the lateral radiographs (P < 0.0001), but suboptimal images were obtained more often with lateral shoot-through radiographs than with frontal radiographs. We conclude that digital lateral shoot-through radiographs are significantly more sensitive than digital frontal radiographs for the diagnosis of pneumothoraces in supine patients.

Humans↗
PubMed1993

Cytomegalovirus colitis in AIDS: plain abdominal radiograph findings.

The findings on the plain abdominal radiographs of 15 patients with cytomegalovirus (CMV) colitis and AIDS were reviewed and compared to an age, sex, CD4 count and symptom-matched control group. The radiographs were examined for mucosal thickening, bowel dilatation, pneumatosis and perforation. Nodular mucosal lesions were the most significant abnormality in those with CMV colitis being present in seven compared to none in the control group (P = 0.006 two tailed). Differences between the CMV colitis group and the control group as regards the other features were not significant. The finding of pneumatosis is the first time this has been described in patients with CMV colitis and AIDS. No evidence of perforation was demonstrated and this is attributed to a high index of suspicion in those with characteristic signs and symptoms in addition to early sigmoidoscopy and prompt treatment.

AIDS-Related Opportunistic Infections↗
PubMed1993

Radiological and pathological features of AIDS-related polypoid cholangitis.

A review of the radiographs obtained at ERCP from 31 patients with AIDS-related sclerosing cholangitis (ARSC) demonstrated intraluminal polypoidal defects within the common bile duct and larger intrahepatic ducts in eight cases (26%). The radiological features from this subgroup are described and correlated with the microbiological and histological findings from biopsy specimens including two patients who underwent post-mortem examination. At microscopy the polypoid lesions were demonstrated to consist of granulation tissue. The presence of these polyps did not adversely affect the prognosis nor were they associated with any particular infective agent. We propose recognizing the existence of this entity by the term AIDS-related polypoid cholangitis (ARPC).

Acquired Immunodeficiency Syndrome↗
PubMed1993

The efficacy of a single posteroanterior radiograph in the assessment of metastatic pulmonary melanoma.

Posteroanterior (PA) and lateral chest radiographs are performed as part of the routine staging and follow-up investigation of patients with malignant melanoma. We have assessed the contribution of the lateral chest radiograph in the follow-up of 227 consecutive patients with proven malignant melanoma. In only once case was an abnormality evident on the lateral radiograph which was not previously detected on the PA films. Our department, as a result of this study, has discontinued the routine use of lateral chest radiography in the follow-up of patients with malignant melanoma.

Adult↗
PubMed1993

Technical note: appearances on ultrasound of impalpable injection port in a double chamber breast prosthesis.

Breast reconstruction utilizing tissue expansion is being increasingly practised by both plastic and general surgeons. Our current experience for both immediate and delayed reconstruction is with the double chamber Becker prosthesis. The prosthesis with the resulting breast mound has on occasions rendered the injection port difficult to localize by palpation. We have found ultrasound useful in identifying impalpable ports and in facilitating needle insertion into the injection dome.

Female↗
PubMed1992

Case report: pneumatosis intestinalis occurring in association with cryptosporidiosis and HIV infection.

We report a case of pneumatosis intestinalis (PI) occurring in association with cryptosporidiosis in a patient documented as being HIV-seropositive. Chest and abdominal radiographs taken 2 months previously were normal and the patient did not have any evidence of gastrointestinal infection at that time. The case was complicated by cyst rupture resulting in a pneumoretroperitoneum and pneumomediastinum. The association of pneumatosis and cryptosporidiosis has not been previously reported.

Adult↗
PubMed1992

Need to measure outcome after discharge in surgical audit.

OBJECTIVE: To assess the accuracy of outcome data on appendicectomy routinely collected as part of a surgical audit and to investigate outcome in the non-audited period after discharge. DESIGN: Retrospective analysis of audit data recorded by the Medical Data Index (MDI) computer system for all patients undergoing emergency appendicectomy in one year; subsequent analysis of their hospital notes and notes held by their general practitioners for patients identified by a questionnaire who had consulted their general practitioner for a wound complication. SETTING: One district general hospital with four consultant general surgeons serving a population of 250,000. PATIENTS: 230 patients undergoing emergency appendicectomy during 1989. MAIN MEASURES: Comparison of postoperative complications recorded in hospital notes with those recorded by the MDI system and with those recorded by patients' general practitioners after discharge. RESULTS: Of the 230 patients, 29 (13%) had a postoperative complication recorded in their hospital notes, but only 14 (6%) patients had these recorded by the MDI system. 189 (82%) of the patients completed the outcome questionnaire after discharge. The number of wound infections as recorded by the MDI system, the hospital notes, and notes held by targeted patients' general practitioners were three (1%), eight (3%), and 18 (8%) respectively. None of 12 readmissions with complications identified by the hospital notes were identified by the MDI system. CONCLUSIONS: Accurate audit of postoperative complications must be extended to the period after discharge. Computerised audit systems must be able to relate readmissions to specific previous admissions.

Appendectomy↗
PubMed1992

A successful transport scenario for the health sector in developing countries.

The role and operation of transport in the health sector in developing countries is important, costly but often taken for granted. This article suggests the need for a fresh look at the policy, planning and management of transport through the analysis of the essential components of a successful transport scenario for health services in developing countries i.e. transport and health planning; transport and organisational responsibility; the role of health sector donors; decision-making and procurement of transport and spares; transport and human resources; monitoring and control of transport and information; maintenance and repair; the budget. The article concludes with a checklist of key questions that may be used in assessing the contribution of transport to the health services.

Decision Making, Organizational↗