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Biomedical subjects

D S Watson

Publications and source records attributed to D S Watson.

At least 19 recordsLinked to original sources
PubMed1999

Pain control after thoracotomy: bupivacaine versus lidocaine in continuous extrapleural intercostal nerve blockade.

BACKGROUND: The use of a continuous bupivacaine extrapleural intercostal nerve block after posterolateral thoracotomy has been shown in randomized controlled studies to be effective in reducing postoperative pain and restoring pulmonary function. It is our hypothesis that when using a continuous infusion for nerve block, a long-acting agent (bupivacaine) is unnecessary and a shorter-acting agent (lidocaine) would offer equivalent results with less systemic toxicity. This study was designed to determine whether lidocaine was as effective as bupivacaine in a continuous extrapleural intercostal nerve block after posterolateral thoracotomy because lidocaine is a less toxic analgesic agent. The study was prospectively randomized and double-blinded. METHODS: Forty-six patients undergoing elective posterolateral thoracotomy were randomized to blindly receive bupivacaine (n = 23) or lidocaine (n = 23) by continuous infusion pump through an intraoperatively placed indwelling extrapleural catheter. Postoperative pain was assessed for 48 hours by patient-controlled morphine consumption and by linear visual analog scale. There was no statistically significant difference in age, sex, or type of operation between the two groups. RESULTS: There was no statistically significant difference between the bupivacaine and lidocaine groups in patient-controlled morphine use or in visual analog scale scores. CONCLUSIONS: Lidocaine offers equivalent pain control to bupivacaine when administered for continuous extrapleural intercostal nerve block after posterolateral thoracotomy, with less risk of systemic toxicity.

Aged↗
PubMed1999

Growth dysregulation and p53 accumulation in human primary colorectal cancer.

p53 accumulation is common in colorectal cancer, but effects on growth homeostasis are unclear. In this study, DNA content, cell cycle phase fractions and DNA strand-breaks consistent with apoptosis were assessed by flow cytometry in 42 fresh primary colorectal tumours and matched normal mucosa. p53 accumulation was assessed in 37 fixed tumour sections, by immunohistochemistry. In normal mucosa, 10.3 +/- 6.6% (mean +/- s.d.) cells were in DNA synthesis phase while 28.7 +/- 17.9% showed apoptosis. A relationship suggestive of growth homeostasis, was observed between these parameters (r = 0.8; P < 0.05). In cancers, a greater number of cells were in DNA synthesis phase (15.6 +/- 12.9% tumour vs mucosa 10.3 +/- 6.6%; P < 0.02) while fewer showed apoptosis than normal mucosa (18.5 +/- 17.0% tumour vs mucosa 28.7 +/- 17.9%; P < 0.01). DNA synthesis and apoptosis fractions were unrelated in cancers, suggesting growth dysequilibrium. p53 accumulation was detected in 59% (22/37) tumours and was associated with reduced apoptosis compared to p53-negative tumours or mucosa (14.8 +/- 15% p53 accumulation vs 26.3 +/- 18% p53-negative; P < 0.05; vs 28.7 +/- 17.9% mucosa; P < 0.05). p53 accumulation was unrelated to DNA synthesis phase fractions. p53 accumulation is accompanied by reduced apoptosis which may accentuate growth dysequilibrium in colorectal cancer.

Aged↗
PubMed1999

Cyclin D3 expression, cell proliferation and pathological stage of human primary colorectal cancer.

Cyclin D3 promotes cell cycle progression but its expression and prognostic significance in human colorectal cancer is unknown. This study assayed cyclin D3 expression against cell cycle phase fraction and Duke's stage in 35 fresh human primary colorectal cancers. DNA content, cell cycle phase fraction and cyclin D3 expression were assessed by flow cytometry in disaggregated tumors. Cyclin D3 expression and S-phase fraction were independently related to Duke's stage. In Duke's stage C tumors, a higher proportion of cells expressed cyclin D3 (14.4 vs. 8.8%, mean; p < 0.05 by Mann-Whitney U test) and were in DNA synthesis (S) phase (21.1 vs. 9.7%, mean; p < 0.05 by Mann-Whitney U test). Neoplastic deregulation of cyclin D3 expression may provide a selective growth advantage which is related to stage in human colorectal cancer.

Aged↗
PubMed1994

Incidence of inguinal hernias diagnosed during laparoscopy.

This prospective study was done to identify the incidence of asymptomatic hernias diagnosed during laparoscopic surgery. Previously unidentified inguinal hernias were discovered in 13 of 100 consecutive patients undergoing laparoscopic procedures (13%). Nine of the patients were male, four were female. The average age was 43.3 years. Four defects were direct and nine were indirect (patent processus vaginalis). Eleven defects were small (< 3 cm) but two were large (> 3 cm). All four direct defects occurred in male patients. We conclude that asymptomatic defects are surprisingly common in our surgical population (13%) and that laparoscopic examination of the pelvis is a sensitive technique for identifying these defects. To date, no patient with laparoscopically diagnosed hernia has had symptoms or complications related to the hernia. We recommend that the surgeon should note in the medical record the presence of a defect, but not proceed with prophylactic repair of asymptomatic defects.

Adult↗
PubMed1992

Ear health of aboriginal primary school children in the Eastern Goldfields Region of Western Australia.

The ear health and state of hearing of 642 Aboriginal children living in the Eastern Goldfields of Western Australia in 1989 was assessed by audiometry, otoscopy and tympanometry in order to establish the efficacy of the existing ear health program. A heavy burden of ear disease and hearing loss is reported and the findings are compared with previous surveys. A conclusion is drawn that the ear health of this population has not improved in the last decade.

Adolescent↗
PubMed1992

Developing a competency-based education program for nurse-monitored sedation.

Because of technological innovations and changes in the methods of health care delivery in the ambulatory setting, a new role for the perioperative nurse has emerged, that of monitoring patients who receive intravenous (IV)-conscious sedation during surgery and other invasive procedures. This article describes how to develop a competency-based education program for an ambulatory surgery center advocating the role of both a circulating nurse and monitoring nurse for the care of patients receiving IV-conscious sedation.

Competency-Based Education↗
PubMed1989

Telemedicine.

Ideally, health care is a communication-intensive process and information that relates to problem-solving and treatment regimens is exchanged constantly among health workers and between patients and their health-care providers. The primary health-care teams in a remote area of Queensland were linked with their base hospital, regional hospitals, a teaching hospital and an aerial retrieval team by means of AUSSAT 1. This article describes the changes in the health workers' consultations and in their patient-management practices when they used the satellite communications network. These changes resulted in improved health care and reduced some health-care costs.

Allied Health Personnel↗