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Biomedical subjects

E Pennington

Publications and source records attributed to E Pennington.

9 recordsLinked to original sources
PubMed1992

Laparoscopic proctectomy for infiltrating endometriosis of the rectum.

Proctectomy for deep endometriosis of the rectal wall was performed without laparotomy. Although laparoscopic pelvic surgery and transperineal proctectomy with primary double-stapled anastomosis are established procedures in gynecological and gastrointestinal surgery, this is the first reported case in which these procedures are combined to mobilize the rectum and perform an extracorporeal transanal rectal resection and anastomosis.

Adult↗
PubMed1992

Laparoscopic treatment of infiltrative rectosigmoid colon and rectovaginal septum endometriosis by the technique of videolaparoscopy and the CO2 laser.

OBJECTIVE: To present the technique and results of videolaparoscopy and the CO2 laser as a treatment for deep, infiltrative endometriosis of the rectovaginal septum, uterosacral ligaments, pouch of Douglas and anterior wall of the rectosigmoid colon. DESIGN: Observational study with 1-5 year follow up. SETTING: Sub-specialty practice: Endometriosis clinic and centre for special pelvic surgery. SUBJECTS: 185 women, aged 25-41 years. All had pelvic endometriosis and were referred because of the failure of previous medical and/or surgical treatment. INTERVENTIONS: Vaporization and excision of endometriotic implants and nodules, ureterolysis, ureteric stents, laparoscopic anterior rectal wall resection and reanastomosis, presacral neurectomy, laparoscopic hysterectomy, salpingo-oophorectomy and appendicectomy using the CO2 laser. MAIN OUTCOME MEASURES: 174 patients were followed for 1-5 years after surgery by office visit questionnaire or telephone interview. Eleven were lost to follow-up. RESULTS: 175 patients were discharged within 24 h. Nine with bowel perforations and one with a partial bowel resection were discharged 2-4 days postoperatively. Two patients required ureteric stents, which were removed 6 weeks postoperatively without sequelae. 162 women reported moderate to complete pain relief (145 after one procedure, 13 after two and four after three). 12 reported persistent or worse pain following the surgery. Seven eventually underwent total hysterectomy, four had bowel resections and one had a salpingo-oophorectomy. Of 61 with infertility, 25 achieved pregnancy. Postoperative complications included shoulder pain, anterior abdominal wall ecchymosis, urine retention and dyschezia for one to two weeks. CONCLUSIONS: Our experience suggests that rectosigmoid colon and infiltrative rectovaginal septum endometriosis can be effectively treated via videolaparoscopy in the hands of experienced endoscopic gynaecologists.

Adult↗
PubMed1991

Laparoscopically assisted anterior rectal wall resection and reanastomosis for deeply infiltrating endometriosis.

A 28-year-old woman, presented with a history of long-standing, severe pelvic and bowel endometriosis. Pronounced cul-de-sac tenderness and nodularity were noted on pelvic examination. Videolaseroscopy was undertaken, the rectum was mobilized, and the tumor was prolapsed to the level of the anus. Anterior rectal wall resection and reanastomosis were performed; the colon was returned to the pelvis under direct visualization via laparoscope.

Adult↗
PubMed1990

Improving the adherence of urban women to mammography guidelines: strategies for radiologists.

Only 16% of women over 40 years of age are being screened regularly with mammography. To learn what radiologists and technologists can do to increase patient adherence to the screening guidelines of the American Cancer Society, especially by poor, urban women, the authors surveyed patients at a county facility immediately after mammography to document the patients' experiences with technologists and the procedure. Analysis of these data led to the conclusion that the radiologist should encourage an expanded role for the technologist as a breast health educator. By incorporating the use of a well-designed patient brochure, technologists can greatly enhance their effectiveness by decreasing the patient's anxiety and increasing her understanding of the procedure and of the importance of screening. Radiologists need to appreciate the potential of an expanded technologist's role for increasing future referrals.

Breast Neoplasms↗
PubMed1989

Mammographic screening in southern California: 2 1/2-year longitudinal survey of fees.

The American Cancer Society sponsored a community-wide low-cost mammographic screening project in March 1986. One of the major goals was to effect a decrease in mammographic screening fees. To evaluate the effectiveness of the project, a telephone survey of 58 facilities was conducted six times over 2 1/2 years, beginning January 1986 and at 6-month intervals thereafter. The number of facilities offering lower fees for screening than for consultative mammography increased from two with a mean fee of $50.00 in January 1986 to 16 with a mean fee of $68.71 in July 1988. The trend for differentiating screening and consultative examination fees occurred at both hospital- and office-based practices, but fees were significantly lower in the office-based practices. There was also a statistically significant increase in the number of facilities accepting self-referred patients between January 1986 (15.5% of facilities) and July 1988 (34.5%). At the time of the last survey, 60% of office-based practices were accepting self-referred patients.

California↗
PubMed1988

Immunization, practice records and the white paper.

The accuracy of all immunization records for a cohort of two to three year olds, registered with one general practice, was investigated. Information was obtained from practice notes, the practice computer, the district health authority records and the parents of those children whose records indicated they had outstanding immunizations. The combined results revealed a rate for completed immunization schedules of 72%, but the rate recorded by the district health authority was only 40%. All the records were defective because the systems for exchange of data were not functioning properly. The government's white paper on primary health care links practice income to performance, and immunization rate is one index of this. On the basis of the district health authority records, this practice would be wrongly penalized.

Child, Preschool↗