Biomedical subjects
Publications and source records attributed to C J Smart.
A retrospective review was made of the effect of early post-operative total parenteral nutrition on recovery from total cystectomy with formation of an ileal conduit. No difference in mortality or time spent in hospital after operation was noted between 2 groups receiving either total parenteral nutrition or isotonic dextrose-saline solutions.
5 young male patients with all the symptoms and signs of genito-urinary tuberculosis but in whom no organism could be cultured from the urine are described. 4 of them rapidly responded to a course of tetracycline. Various organisms are suggested as a cause of this condition, and careful bacteriological investigation in the future might discover the cause.
The surgical technique of synchronous bilateral nephrectomy or nephrolithotomy is described. The operative details, the indications, advantages and complications are reported in this series of ten patients. These bilateral posterior vertical incisions with minimal cutting of abdominal musculature, together with rapid mobilisation of the patient and the absence of prolonged post-operative pain, provide a distinct advantage over conventional renal incisions.
A clinical diagnosis of chronic prostatitis was made on 105 adult males who were subsequently admitted and investigated by Stamey localisation techniques, psychological questionnaires, urine flow studies, cysto-urethroscopy and prostatic biopsy or transurethral prostatectomy. From the Stamey localisation studies and cultures of the tissue obtained at transurethral prostatectomy a diagnosis of bacterial prostatitis was made in 50%, of which half were Staphylococcus albus and half were well recognised urinary pathogens. Other significant pathology was found in 25% and, particularly of note, were 2 patients who presented with chronic cystitis (biopsy negative) and subsequently developed carcinoma of the bladder. Also in this group were 5 unsuspected strictures and 5 patients with poor flow rates but normal endoscopy. Investigations in the remaining 25% were all negative except for a significantly higher incidence of neuroticism when compared with the other groups and controls.
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