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Biomedical subjects

G Poole

Publications and source records attributed to G Poole.

At least 19 recordsLinked to original sources
PubMed2001

A simple technique of laparoscopic port closure allowing wound extension.

Reliable and safe access to the abdominal cavity and efficient removal of the resected gallbladder are essential to laparoscopic cholecystectomy. The unpredictable size of the cholecystectomy specimen can sometimes lead to frustration at the time of removal. A simple technique has been developed that allows for tissue extraction and easy fascial closure regardless of the size of the specimen. This is achieved by using a four bite "U-shaped" purse string at the time of Hasson insertion, with cephalad advancement of the proximal two bites. This allows for variable wound extension and secure closure, without the need for additional sutures.

Cholecystectomy↗
PubMed2001

Determination of polychlorinated dibenzo-p-dioxin and dibenzofuran congeners in air particulate and marine sediment standard reference materials (SRMs).

Due to the limited number of environmental matrix certified reference materials (CRMs) with assigned values for natural levels of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), an interlaboratory study was undertaken by the National Institute of Standards and Technology (NIST) and Environment Canada to establish reference concentration values for selected PCDD/Fs in two well-characterized NIST Standard Reference Materials (SRMs): SRM 1649a (Urban Dust) and SRM 1944 (New York/New Jersey Waterway Sediment). Results from 14 laboratories were used to provide reference values for the seventeen 2, 3, 7, 8-substituted PCDD/F congeners, the totals for individual tetra- through hepta-substituted PCDD/F homologues, and the total amount of tetra- through hepta-substituted PCDD/Fs. The mass fractions for the individual 2, 3, 7, 8-substituted congeners range from approximately 0.01 microg/kg to 7 microg/kg dry mass.

Air Pollutants, Occupational↗
PubMed2000

The use of temporary laparoscopic loop ileostomy in lumbosacral burns.

The technique of laparoscopic formation of loop ileostomies has been previously described for use in a variety of conditions. We present this as an option for faecal diversion in severe burns involving the back and buttock region and describe its use in two cases. Faecal diversion allows for easier wound care and nursing. Intra-abdominal assessment of these very sick patients can also be performed simultaneously. The technique is relatively simple, readily available and associated with minimal morbidity. Furthermore, this technique minimises interference with the abdominal wall as a donor site for skin grafts.

Adult↗
PubMed2000

Rectus abdominis muscle free flap harvest by laparoscopic sheath-sparing technique.

Previous reports of endoscopic rectus abdominis muscle harvest have described techniques that are hampered by the need for anterior rectus sheath division or mechanical devices to maintain the optical cavity. The authors report the first successful clinical case of a laparoscopic sheath-sparing rectus abdominis muscle harvest for free tissue transfer. It offers considerable advantages over the traditional open method and, with the help of an experienced laparoscopic surgeon, it should add little to operative time.

Aged↗
PubMed1999

Violence in America: a public health crisis--domestic violence.

Domestic violence is a major public health problem. It is important that physicians are aware of the extent and pervasiveness of this disease. It is important to identify potential victims of domestic violence when they are encountered in the hospital or office environment. A few, short, carefully asked questions can serve an important surveillance and diagnostic function. Once domestic violence is identified, a well thought out, sensitive, safe plan of action should be discussed with the victim. In this way, not only will the current event be well managed, but also the potential for mitigating further domestic violence events will be initiated. Through this document, EAST hopes to add its voice to that of other physician groups to serve as a catalyst for broad education on the subject of domestic violence as well as activating victim advocacy among physicians and others who come into contact with this problem in their patients.

Adolescent↗
PubMed1998

Claustrophobia and the magnetic resonance imaging procedure.

We examined fear induced by the magnetic resonance imaging (MRI) procedure in 80 adult patients who were undergoing the procedure for the first time. Participants completed self-report measures of claustrophobia, anxiety sensitivity, thoughts about the scan, and pain. Participants were assessed pre- and postscan, and at 1-month follow-up. Twenty-five percent of the participants experienced moderate to severe anxiety during the MRI scan. Prescan scores on the Claustrophobia Questionnaire (CLQ: Rachman and Taylor, 1993) significantly predicted participants' distress during the scan: pain and anxeity sensitivity did not. Furthermore, CLQ scores discriminated between participants who reported panic during the scan and participants who did not report panic. A brief screening instrument consisting of six items from the 29-item CLQ is suggested. This brief screening instrument administered prior to the scan may help identify in advance those people who are most likely to experience claustrophobic fear and, in particular, those who panic during the MRI procedure.

Adult↗
PubMed1997

Haemolytic disease of the fetus and newborn due to anti-Fy(a) and the potential clinical value of Duffy genotyping in pregnancies at risk.

Haemolytic disease of the newborn (HDN) caused by anti-Fy(a) is uncommon and usually mild. Current guidelines recommend that pregnant women with anti-Fy(a) are monitored less rigorously than those with anti-D, -c or -K. However, in a review of our recent experience of 68 pregnancies where anti-Fy(a) was detected, three were identified where the fetus was severely anaemic; in two cases the fetus received intrauterine transfusions. Our data suggest that pregnancies in which anti-Fy(a) is detected at significant titres (> 64) should be closely monitored in a similar way to pregnancies where other 'significant' antibodies are present. Moreover, in the presence of high or rising antibody titres, if the father is heterozygous and functional assays suggest the antibody is active, then fetal genotyping should be offered to help plan the future management of that pregnancy.

Blood Group Incompatibility↗
PubMed1997

Laparoscopic common bile duct exploration after failed endoscopic stone extraction.

BACKGROUND AND STUDY AIMS: Despite the documented success rate and safety of laparoscopic ductal stone extraction, the majority of patients are treated with preoperative endoscopic stone extraction followed by laparoscopic cholecystectomy. When this fails, conventional open cholecystectomy and common bile duct exploration are performed. We report here a series of patients who were treated laparoscopically after failed attempts at endoscopic stone extraction. PATIENTS AND METHODS: Nineteen patients (12 women and seven men, aged 41-96 years) were treated laparoscopically. Four had undergone previous cholecystectomy. ERCP had been attempted in all patients, was unsuccessful in three patients, and had been interpreted as normal in two. Endoscopic stone extraction had been attempted in 14 patients. The mean follow-up period was 23 months, range 1-54 months. RESULTS: Ductal calculi were confirmed in 18 patients with successful and complete laparoscopic ductal clearance in 15 (83%), two of whom underwent an additional laparoscopic choledochoduodenostomy due to a large stone load and a grossly dilated common bile duct. Conversion to open surgery was required in three cases (17%). Ductal clearance at a single operation was achieved in all 18 patients. There were no postoperative deaths, but two patients developed postoperative complications (11% morbidity), one requiring laparotomy. The median postoperative hospital stay was five days, range 4-41 days. Recurrence of calculi was encountered in one patient. CONCLUSIONS: Laparoscopic ductal stone clearance after failed endoscopic stone extraction is successful in the majority of patients, and should be attempted prior to recourse to open surgery, provided the necessary laparoscopic biliary expertise is available.

Adult↗
PubMed1994

Elderly clients' perceptions of caring of a home-care nurse.

This descriptive multiple case study examined elderly home-care clients' perceptions of caring behaviours of the nurse within the context of the nursing relationship. Five clients were nursed over a 2-5 month period, during which time data were collected. Client perceptions of nurse caring behaviours were collected through one semi-structured interview at the termination of the nursing relationship. Results from this study support the perception of nurse attributes as caring, consistent with previous research. Moreover, the results suggest that these nurse attributes form the basis of caring in nursing interventions. A model of caring is proposed. Implications for nursing practice and future research are addressed.

Activities of Daily Living↗
PubMed1994

Hydrops fetalis caused by a blood group antibody usually undetected in routine screening.

A case of isoimmunisation in pregnancy caused by antibodies to the Kpa red blood cell antigen is described. The preceding pregnancy had resulted in fetal hydrops for which no cause was found as the antibody screening cells used to investigate the fetal hydrops were Kpa negative. This case emphasises the importance of serological screening at a reference laboratory for low frequency red cell antigens before a diagnosis of non-immune hydrops is made.

Adult↗
PubMed1989

Reducing sleep disruptions in young children: evaluation of therapist-guided and written information approaches: a brief report.

Regular night waking of young children is one of the most common problems encountered by parents. This study compared a standardized night waking programme that involved organized bedtime routines, procedures for settling the child and for the handling of crying, calling out and getting out of bed, with a group which received written information only and a waiting list control group. The children receiving the standard programme and those receiving written information only showed significant improvement over children in the waiting list group. This result supports the use of written parent instructions with or without therapist support.

Behavior Therapy↗
PubMed1971

Potentially serious side effects of high-dose twice-weekly rifampicin.

Daily rifampicin in a single dose of 600 mg, combined with other drugs, usually streptomycin and isoniazid, was given to 49 patients for three months. It was planned to continue for another 15 months with twice-weekly rifampicin 1,200 mg plus isoniazid 900 mg, but the high incidence of side effects led to cessation of the intermittent regimen when only two patients had completed 18 months.Though there was no serious problem with daily treatment 11 patients (22%) were unable to continue rifampicin on the intermittent regimen. In 8 (16%) a pyrexial syndrome occurred. In one of these patients there was also temporary renal failure, and in another precipitous thrombocytopenia led to epistaxis and bleeding into the tongue and lips. Symptomless thrombocytopenia developed in two other patients, making three cases (6%) of thrombocytopenia in all.In 16 (33%) of the 49 patients antibodies to rifampicin were detected in the blood. Side effects occurred in 9 (56%) of these, including the three developing thrombocytopenia, but in only 2 (6%) of the 33 patients with no antibodies detected. This association of toxic reactions with antibodies is highly significant (P<0.001).

Acute Kidney Injury↗
PubMed1970

Endocrine and metabolic disordes in bronchial carcinoma.

In an unselected series of 185 patients with histologically confirmed bronchial carcinoma 16 had endocrine disturbances attributable to the tumour (excluding pulmonary osteoarthropathy). Of these, 11 patients had hypercalcaemia; three inappropriate secretion of antidiuretic hormone; one Cushing's disease; three hypertrophic osteoarthropathy; and one gynaecomastia. Cushing's disease and inappropriate antidiuresis are specifically associated with oat-cell tumours, and hypercalcaemia occurs most frequently with squamous carcinoma. A negative correlation exists between gynaecomastia and osteoarthropathy on the one hand and oat-cell carcinoma on the other.

Adenocarcinoma↗
PubMed1969

Intermittent chemotherapy for tuberculosis in an urban community.

A regimen designed for effective foolproof antituberculosis treatment, acceptable on a routine basis, was applied to all patients newly diagnosed at the Chest Clinic, Hammersmith Hospital, in 1963, 1964, and 1965. During the first three months of treatment patients received daily (six days a week) streptomycin 0.75 g. plus isoniazid 300 mg. plus sodium para-aminosalicylate (P.A.S.) 12 g. The P.A.S. was usually stopped when bacterial sensitivity reports made this possible. For a further 15 months streptomycin 1 g. plus isoniazid 600 mg. was given on three alternate days each week to complete a total of 18 months' treatment.Of the total of 140 patients (66% sputum-positive) 112 (80%) completed the planned 18 months with intermittent streptomycin plus isoniazid and a further eight completed treatment on alternative regimens (a total of 85%). The equivalent figures for one year are 88% and 94%. Excellent clinical and radiological results, together with sputum conversion, were achieved in 138 of the 140 patients (99%). Only two patients were lost from surveillance, because of failure to co-operate, before quiescence was obtained.It is concluded that the total efficiency of supervised intermittent treatment is greater than that of unsupervised daily regimens. Since 100% arrest of tuberculosis is possible with co-operative patients, less should not be accepted in developed countries.

Adolescent↗