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Biomedical subjects

F T McDermott

Publications and source records attributed to F T McDermott.

At least 19 recordsLinked to original sources
PubMed1995

Bicyclist head injury prevention by helmets and mandatory wearing legislation in Victoria, Australia.

After a decade of promotion and education, legislation for mandatory helmet wearing by bicyclists in Victoria was introduced on 1 July 1990. The legislation was a world first. Comparison of 1710 bicyclist casualties wearing and not wearing helmets has demonstrated that wearing helmets certified to the Australian Standard reduces the head injury risk by at least 39% and lessens head injury severity. Simulated impact testing of helmets has shown that they provide protection in most impacts including collisions involving a motor vehicle. Legislation for mandatory helmet wearing in Victoria has led to increased wearing rates and marked reductions in bicyclist fatalities and head injuries. The Victorian experience gives substantial support to the introduction of legislation for mandatory helmet wearing by bicyclists.

Accidents, Traffic↗
PubMed1989

Obstructing carcinomas of the colon.

A series of 908 cases of colonic carcinoma has been analysed to elucidate reasons for the poor prognosis in obstructing colonic cancer. Complete obstruction was present in 148 cases (16.3 per cent), 280 cases (30.8 per cent) had partial obstruction and 480 (52.8 per cent) presented without obstruction. There were fewer Dukes' A tumours in those with complete obstruction (P less than 0.005) and greater numbers of advanced tumours (P less than 0.0005) compared with those without obstruction. This is reflected in a lower curative resection rate of 50.7 per cent in those with obstruction compared with 70.6 per cent in those without obstruction (P less than 0.001). However, after curative resection there was no significant difference in the distribution of tumour stage. Patients with complete obstruction showed a higher incidence of recurrence (P less than 0.01) after curative resection, consequent to an increased incidence of local recurrence (P less than 0.02). Five-year cancer-specific survival for the total series was decreased from 59.1 per cent in patients without obstruction to 31.8 per cent in those with complete obstruction (P less than 0.001). After curative resection there was also a significant reduction in survival (P less than 0.001). It is concluded that completely obstructing colonic cancers are more aggressive than other colonic cancers.

Adult↗
PubMed1988

The risks of suboptimal mammography.

This report emphasizes the importance of obtaining high-quality mammograms in patients with breast symptoms. An initial negative report in a 40-year-old woman with no palpable breast lump unfortunately was based upon inadequate films which, had they not been reviewed and repeat mammography been arranged, would have led to the patient being reassured mistakenly that no significant breast disease was present.

Adult↗
PubMed1987

Relative incidence of Crohn's disease and ulcerative colitis in six Melbourne hospitals.

Information on the relative incidence of Crohn's disease and ulcerative colitis was obtained by a prospective investigation at six Melbourne teaching hospitals. One hundred and eleven patients who presented with chronic inflammatory bowel diseases between 1980-1981 were admitted to the study. Forty (36%) patients were diagnosed as having Crohn's disease and 63 (57%) patients as having ulcerative colitis. The type of chronic inflammatory bowel disease could not be determined in eight (7%) patients. These findings suggest that the relative frequency of Crohn's disease and ulcerative colitis in Melbourne hospitals is within the range that is reported for northern Europe and the United States.

Adolescent↗
PubMed1987

Lung recurrence after curative surgery for colorectal cancer.

A total of 1578 patients were treated with potentially curative surgical resection for colon and rectal cancer by one surgeon from 1950 to 1982. Follow-up revealed that 117 (11.5 percent) of 1013 patients with rectal carcinoma eventually presented with clinical evidence of pulmonary recurrence, with or without evidence of spread elsewhere; the corresponding figures for the colon were 20 (3.5 percent) of 565 (P less than 0.001). An analysis of the times to recurrence revealed that half of the lung recurrences were clinically obvious within 32 months for rectal tumors and 34 months for colonic, compared to 22 and 21 months, respectively, for liver recurrences, excluding those with other distant metastases. The slower recurrence rate and the longer survival in patients with recurrences in the lung compared to the liver were statistically significant only for rectal primaries (P less than 0.02 and P = 0.001, respectively). Sixteen patients underwent surgery with curative intention for lung recurrences; four of these remain alive at two, six, 11, and 15 years, and one patient was free of recurrence when he died from other causes 15 months after surgery. The conditional probability survival rate for the 16 patients was 38 +/- 13 percent at five years after recurrence operation.

Colonic Neoplasms↗
PubMed1986

Repetition strain injury: a review of current understanding.

"Repetition strain injury" (RSI) is a controversial condition and has become a major occupational health problem in Australia. It seems to be a disorder that is consequent to the introduction of new technology without due concern for human performance. The introduction of mechanized and partly automated processes apparently has made physical workloads lighter but has resulted in an increased regularity of physical movement with workloads that frequently are concentrated locally. Mechanization and automation have also produced an increased rate of work. A combination of several factors, each of which in itself is seemingly tolerable, may lead to this occupational hazard. Physical, psychological and ergonomic aspects may contribute to the condition but there are no useful diagnostic investigations. The pathology is unknown. Management of the condition requires carefully supervised treatment of the patient and his or her environment. The prevention of RSI necessitates improved organizational and ergonomic control in the work environment. Fundamental research into its causes, natural history and pathophysiology is essential for the development of scientifically based preventive strategies and patient therapy.

Arm Injuries↗
PubMed1986

Changing survival prospects in rectal carcinoma. A series of 1,306 patients managed by one surgeon.

Cancer-specific survival prospects for rectal carcinoma in a series of 1306 patients managed from 1950 to 1979 by one surgeon worsened from 1970 to 1979. The prognosis was worse for all patients treated operatively from 1970 to 1979 compared with 1960 to 1969 (P less than 0.03). After potentially curative resection, survival was worse from 1970 to 1979 compared with 1950 to 1959 (P less than 0.02) and 1960 to 1969 (P less than 0.01), respectively; the corresponding five-year survivals were 72.5 percent, 72.3 percent, and 61.5 percent. The curative resection rate for the three decades was similar (66 to 70 percent). An increase in the incidence of Dukes' Stage C tumors from 23.3 percent to 32.3 percent (P less than 0.01) explains, at least partly, the decreased survival. The worsened survival prospects were not accounted for by changes in referral pattern, tumor site, or in the proportion of sphincter-saving resections performed. The worsening was paradoxically paralleled by earlier symptomatic presentation (P less than 0.001). Analyses of other Australian data are required to test the hypothesis that the worsened survival prospects are consequent to altered tumor biologic aggressiveness, possibly related to differences in the causal factors operating over the 30-year study period.

Adult↗
PubMed1986

Alcohol on wheels.

Alcohol misuse remains the single most important contributing factor to road accident deaths and injuries in Australia. The results of compulsory blood alcohol tests on road casualties have shown that probationary licensed drivers have a threefold increased risk of road accident injury compared to fully licensed drivers and are additionally over-represented in alcohol-related crashes. These findings led the Victorian Road Trauma Committee to campaign for a zero blood alcohol limit for learner and probationary drivers and motorcyclists. In May 1984, zero blood alcohol legislation was enacted in Victoria. The present legislation applies to learner and first year probationary licence holders. For the first time we have evidence of a moderate reduction in alcohol-related road trauma in Victoria. Between 1977 and 1983 there has been a significant reduction in the proportion of driver casualties admitted to hospital with illegal blood alcohol concentrations and in the number of driver fatalities with blood alcohol concentrations in excess of 0.15 g%. An evaluation of the following recommended drink driver countermeasures is presented: improved driver education, increased penalties, re-education--rehabilitation programmes for convicted drink drivers, interlock devices and an increase in the legal drinking age.

Accidents, Traffic↗
PubMed1986

The outcome of patients with ulcerative colitis managed by subtotal colectomy.

A total of 1,494 patients with a diagnosis of ulcerative colitis were managed by one surgeon between 1950 and 1981. Subtotal colectomy was performed upon 286 patients of whom 82 had a primary and 65 a secondary ileorectal anastomosis. There was no significant difference in the postoperative mortalities between patients treated by subtotal colectomy (8.7 per cent) and a group of 71 patients treated by proctocolectomy (9.9 per cent). The postoperative mortality after primary and secondary ileorectal anastomosis was 6.9 and 1.5 per cent, respectively. Rectal excision because of disease activity was required in 109 patients after subtotal colectomy (13 after primary and nine after secondary ileorectal anastomosis) with a postoperative mortality of 0.5 per cent. The probability of rectal excision was 21 per cent at 12.6 years after primary anastomosis and 19 per cent at 16.2 years after secondary ileorectal anastomosis. Carcinoma of the rectum has developed in 11 (3.8 per cent) of the patients after subtotal colectomy. The probability of having carcinoma of the rectum develop was 17.1 per cent at 27 years after primary anastomosis and 20.0 per cent at 24 years after secondary ileorectal anastomoiss, the time beyond which no disease has yet been diagnosed in either group. The disease was advanced in stage and of high histologic grade with a median cancer specific survival time of 14 months.

Adult↗
PubMed1985

Head injury predominance: pedal-cyclists vs motor-cyclists.

A study of the pattern of head injuries in pedal- and motor-cyclist casualties treated at four teaching hospitals in Melbourne was undertaken to determine whether significant differences occurred between the two groups. The injuries were coded according to the 1980 revision of the Abbreviated Injury Scale of the American Association for Automotive Medicine and the data subjected to statistical analysis. Although motor-cyclist casualties sustained more severe injuries to the body, the results show that pedal-cyclist casualties sustained more frequent and severe head injuries. It is considered that the differences are due, at least in part, to a far lower use of protective helmets among pedal-cyclists. Education to increase community awareness of this safety measure followed by legislation for the compulsory wearing of approved safety helmets is urged.

Accidents, Traffic↗
PubMed1985

Accuracy of blood alcohol estimations obtained with a breath alcohol analyser in a casualty department.

The accuracy and reliability of a rapid blood alcohol estimation by means of a breath alcohol analyser has been evaluated under casualty department conditions in a series of 646 road-crash victims managed at the Dandenong and District Hospital. A higher correlation (r = 0.91) was found between the breath alcohol analyser readings in 633 casualties and those obtained by blood analysis in the police laboratory. In 13 unconscious casualties in whom a nasal breath test was performed, the correlation was lower (r = 0.76). In six casualties, the breath alcohol analyser readings showed lower alcohol concentrations than the legal limit of 0.05 g/100 mL (10.9 mmol/L), but blood analysis detected an illegal concentration. Further evaluation of the accuracy of the breath alcohol analyser in other casualty departments is necessary before it can be recommended as a screening device in States which have legislated for compulsory blood alcohol tests in adult road casualties.

Accidents, Traffic↗
PubMed1985

Driver education.

Explore the source record for details and available documents.

Accidents, Traffic↗
PubMed1985

Mortality from bleeding peptic ulcer. Alfred Hospital, Melbourne, 1976-1980.

Of 682 patients (755 admissions) who were admitted to hospital with bleeding peptic ulcers or erosive gastritis-duodenitis during a five-year period, 92 died (12% of admissions). In 70% of admissions to hospital, the patients were aged 50 years or older. The overall mortality rates were 13% in patients with bleeding gastric ulcers; 12% in those with duodenal ulcers; and 11% in those with gastritis-duodenitis. Fourteen per cent of patients with bleeding gastric ulcers, 21% of those with duodenal ulcers, and 4% of those with erosive gastritis-duodenitis had undergone surgery. Ten of 92 deaths (11%) occurred after the operation; of these, only one patient who died was aged less than 50 years. The postoperative mortality rates were 8% in patients with bleeding gastric ulcers, and 12% in those with duodenal ulcers; there were no deaths after operation for gastritis-duodenitis. Whereas the 13% overall mortality rate in patients with bleeding gastric ulcers closely resembled that found in other series, the 12% overall mortality rate in patients with bleeding duodenal ulcers was about twice that reported in recent British and Australian series.

Adult↗