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Biomedical subjects

G R McSwain

Publications and source records attributed to G R McSwain.

9 recordsLinked to original sources
PubMed1986

Cholecystectomy: clinical experience with a large series.

This large series of 1,035 consecutive operations with a primary diagnosis of inflammatory or calculus disease of the gallbladder included a large number of elderly patients with the greatest incidence in the seventh and eighth decades of life. Operation was performed after initial stabilization when acute illness presented and without prolonged delay of medical treatment. Cholecystectomy was almost always able to be performed successfully at the initial operation. This approach produced low rates of morbidity and mortality when compared with reports from large university centers and with reports advocating delayed operation for acute cholecystitis or planned cholecystostomy in elderly and high risk patients. Operative cholangiograms were rarely performed and rates of residual or retained common duct stones were low. Length of hospital stay was related to age and performance of a common duct exploration. Draining the subhepatic space routinely by way of a separate peritoneal stab incision and removing the drain within 48 hours produced a low rate of wound complications.

Acute Disease↗
PubMed1980

Evaluation of resuscitation from cardiopulmonary arrest by paramedics.

A series of 100 consecutive victims of cardiopulmonary arrest were evaluated for treatment in the field by paramedic teams and for the patients' subsequent course. Analysis of the data correlated success rates with specific factors, including response, treatment and transportation times, proximity to the emergency center, establishment of an intravenous line and administration of drugs, pulmonary aspiration of gastric contents, cardiopulmonary resuscitation by a bystander, cardiopulmonary arrest in the presence of the team, and other factors. Successful resuscitation was accomplished in 24% of cases, and 7% of the victims ultimately returned to their previous lifestyles. Therapeutic maneuvers which prolonged time at the scene worsened prognosis. These results were compared to recent reports from other institutions with specific reference to differences in technique regarding success rates. Although the basic policy of "rush the patient to the hospital" of past years has shifted to one of evaluation, emergency treatment and stabilization at the scene before transportation, the data suggest that specific guidelines consistent with the urgency of the situation are necessary to maximize the patient salvage rate.

Allied Health Personnel↗
PubMed1980

Granular cell myoblastoma.

The experience at this university between 1954 and 1978 included 96 granular cell myoblastomas in 67 patients. The unusual locations of the tumors were the breast, bronchus, vocal cord, stomach and rectus sheath. An extremely rare invasive squamous carcinoma developed from a lesion of the larynx with pseudoepitheliomatous hyperplasia of the overlying dpithelium. Two patients with malignant granular cell myoblastoma have been encountered.

Adolescent↗
PubMed1979

Meckel's diverticulum of the proximal jejunum.

There are no well-substantiated reports, to our knowledge of a Meckel's diverticulum arising outside the limits of the terminal ileum. We saw a diverticulum located in the proximal jejunum that fulfilled the anatomic and histologic criteria for the diagnosis of a Meckel's diverticulum. This was an incidental finding during the treatment of a sliding esophageal hiatus hernia and caused no apparent difficulty to the patient.

Gastroesophageal Reflux↗
PubMed1979

Antidiuretic hormone effect of vasopressin therapy for gastrointestinal hemorrhage.

Use of vasopressin injection (Pitressin) as an adjunct in the treatment of various types of gastrointestinal hemorrhage also produces an antidiuretic hormone effect of free water retention. This produces difficulties in fluid and electrolyte management and in the interpretation of changes in mental and hemodynamic status. This effect and its management are directly related to the total dose of the drug administered.

Gastrointestinal Hemorrhage↗