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Biomedical subjects

C V Ruckley

Publications and source records attributed to C V Ruckley.

At least 181 records · Page 10Linked to original sources
PubMed1987

A controlled trial of weekly ultrasound therapy in chronic leg ulceration.

In a controlled trial to ascertain whether ultrasound given weekly in conjunction with a standard treatment for chronic leg ulcers improves the rate of healing 56 patients were randomised to standard treatment (paste impregnated bandage and a self-adhesive elastic bandage) and 52 to standard treatment plus pulsed ultrasound given weekly. After 12 weeks the proportion of ulcers healed was 20% greater in the ultrasound than in the control group.

Aged↗
PubMed1987

Chronic ulcer of the leg: clinical history.

Six hundred patients with chronic leg ulcers were studied by detailed history and examination as part of a population survey. In 22% ulceration began before the age of 40, and in this group the sex incidence was equal. Over age 40 there was an increasing preponderance of women. Ulcers were significantly more common in the left leg in women but not in men. The site of 26% of ulcers did not include the classical medial goiter area. The median duration of the ulceration at the time of the survey was nine months and 20% had not healed in over two years. The great majority of patients had had recurrence, 66% having had episodes of ulceration for more than five years. Healing of ulcers is a serious problem, but preventing recurrence is the greater challenge.

Adult↗
PubMed1987

Arterial disease in chronic leg ulceration: an underestimated hazard? Lothian and Forth Valley leg ulcer study.

Six hundred patients with chronic leg ulcers were interviewed and examined for evidence of arterial impairment. There were 827 ulcerated legs. Pedal pulses could not be felt in 94 (11%). A Doppler resting pressure index of 0.9 or less was found in 176 legs (21%). Risk factors for arterial impairment included age, ulceration affecting the foot, and a history of claudication, ischaemic heart disease, or cerebrovascular disease. Roughly half the patients with arterial impairment also showed the clinical features of chronic venous insufficiency. Careful assessment for arterial disease is mandatory before patients with chronic leg ulcers are treated with elastic compression.

Age Factors↗
PubMed1987

The treatment of venous thrombosis of the upper and lower limbs with "APSAC" (p-anisoylated streptokinase-plasminogen complex).

APSAC, administered by bolus injection, has been used to treat 28 patients: 14 with ilio-femoral venous thrombosis, 6 with "spontaneous" axillary-subclavian thrombosis and eight with superior vena-caval thrombosis associated with parenteral nutrition catheter. Four of the patients with lower limb deep vein thrombosis (DVT) showed partial lysis whereas the remaining 10 showed no change. Of the patients with upper limb and/or superior caval DVT seven showed complete lysis three showed partial lysis and four showed no benefit. APSAC is an effective treatment of venous thrombosis of the upper limbs.

Adult↗
PubMed1986

Audit of surgical audit.

A clinical audit, run by surgeons with modest clerical assistance, has been incorporated into the routine clinical practice of all hospitals in a large health authority. Data on operations and deaths are integrated into routine clinical recording, and feedback is by annual report containing statistical analyses and critical commentaries and by discussions with colleagues. The results of the first five years show statistically significant falls in the number of reoperations for intra-abdominal complications, retained gallstones, arterial grafts, and amputations and in operative mortality following surgery for benign biliary and pancreatic disease, resection of large bowel for benign disease, operations on aortic aneurysms, and arterial grafts except for aneurysms. Although the audit was designed originally for monitoring and improving quality of care, other uses include monitoring of increasing specialisation and changes in clinical practice, planning surgical services and postgraduate training, and showing the effects of changes in the availability of resources.

Clinical Competence↗
PubMed1986

Controlled environment unit in the care of the below-knee amputation stump.

A controlled environment unit has been compared with plaster dressings in the management of the below knee stump in 60 patients undergoing amputation for advanced vascular disease. The main criteria were stump healing and the speed of rehabilitation. There were 30 patients in each group. Three patients died within 10 days of operation. Primary healing was obtained in 65 per cent, secondary healing in 22 per cent and revision to above knee was required in 13 per cent. There were no statistically significant differences between the two groups. Neither did they differ in the times taken to reach the various stages of rehabilitation from bed exercises to independent walking with final prosthesis. While the controlled environment unit was as effective as the plaster dressing it tended to impede the patients' early mobility and to hinder nursing care. In particular it is not recommended for patients who may be confused or restless in the early postoperative period.

Aged↗
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↗
PubMed1985

Chronic ulceration of the leg: extent of the problem and provision of care.

A postal survey in two health board areas in Scotland, encompassing a population of about one million, identified 1477 patients with chronic ulcers of the leg. Women outnumbered men by a ratio of 2.8:1. The median age of the women was 74 and of the men 67. Seventy two (5%) were hospital inpatients, 174 (12%) were managed jointly by the primary care team and outpatient departments, and 1201 (83%) were managed entirely in the community. Efforts to improve the management of chronic ulcers of the leg should focus on primary health care.

Adult↗
PubMed1982

A comparison of acylated streptokinase-plasminogen complex and streptokinase in healthy volunteers.

The in vivo effects on the fibrinolytic and coagulation system of infusion acylated streptokinase-plasminogen complex (BRL 26921; 5, 7 and 12 mg) or streptokinase (250,000 u) were determined in healthy male volunteers. While this dose of streptokinase resulted in depletion of plasminogen and antiplasmin, and in some cases of fibrinogen and coagulation factors V and VIII, the equivalent 7 mg dose of BRL 26921 had little effect on these parameters. 12 mg BRL 26921 had some systemic effects on the fibrinolytic system. For initial clinical studies a dose of 10 mg BRL 26021 would seem appropriate. Both drugs induced an anamnestic rise in streptokinase antibody, whereas no change in liver function tests were observed. A delayed mild febrile reaction was observed in some subjects following infusion of streptokinase or BRL 26921. Clinical, laboratory, and subjective monitoring revealed no other adverse effects with either drug.

Adult↗