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Biomedical subjects

I McConachie

Publications and source records attributed to I McConachie.

At least 19 recordsLinked to original sources
PubMed2001

The significance of psammoma bodies on cervical cytology smears.

OBJECTIVE: The association between psammoma bodies on cervical smear (PBCS) and the presence of gynecological malignancy has been documented previously. The aim of this study was to determine the incidence of malignancy where psammoma bodies were detected on smear, to identify features that may be predictive of associated malignancy, and to make recommendations about management. METHODS: The databases of two large private pathology laboratories were accessed to obtain details of all patients reported to have PBCS between April 1992 and May 2000. A retrospective review was then undertaken to determine if any patients were found to have gynecological malignancies. The appearances of the background cells on the cervical smear and details of clinical management were recorded and evaluated. RESULTS: Twenty-two patients were found to have PBCS. Five patients were found to have a gynecological malignancy. These five patients were significantly older than the remaining patients. When these results were combined with all cases reported in the world literature, it became apparent that patients with coexisting malignancy were statistically significantly older than those not found to have malignancy (P < 0.0001). The cytological appearance of cells on the background smear was highly predictive of the presence or absence of malignancy. CONCLUSIONS: There is an association between PBCS and genital tract malignancy. This association is much stronger for postmenopausal women. The background cytology is highly predictive of the presence of associated malignancy. There is a strong argument that all women with psammoma bodies on cervical smear should undergo smear review, pelvic ultrasonography, hysteroscopy and biopsy, and laparoscopy to exclude the presence of a gynecological malignancy. For younger reproductive-aged women, a negative workup is reassuring.

Adult↗
PubMed2001

Evaluation of a new percutaneous dilatational tracheostomy set apparatus.

Percutaneous tracheostomy is a well established technique used primarily to assist weaning from mechanical ventilation on many intensive care units. We report our experiences of a total of 36 procedures performed with the new Blue Rhino Percutaneous Tracheostomy Introducer Set developed by Ciaglia. The technique was successful in all cases and was simpler and quicker to perform than with the earlier Ciaglia percutaneous tracheostomy set. Difficulties were encountered when using Shiley tracheostomy tubes. Significant complications included one posterior wall tear and one tracheal cartilage ring fracture.

Adult↗
PubMed1994

Peri-operative effect of major gastrointestinal surgery on serum magnesium.

This study investigates the changes in serum magnesium levels after major gastrointestinal surgery and evaluates if Plasma-Lyte 148 used as maintenance fluid influences these changes in the peri-operative period. Thirty patients presenting for procedures ranging from anterior rectal resection to thoraco-abdominal cardio-oesophagectomy were randomly allocated into two groups, one of which received compound sodium lactate solution as the maintenance crystalloid during the intra- and postoperative period, and the other Plasma-Lyte 148, a magnesium-containing crystalloid solution. Serum magnesium levels were measured pre-operatively, in the immediate recovery period and 24 h postoperatively. The results showed a statistically significant (p < 0.05) reduction in the magnesium levels in both groups. The reduction was less marked in the Plasma-Lyte group but this did not achieve statistical significance (p > 0.05) compared with the compound sodium lactate group.

Acetates↗
PubMed1991

Vasovagal asystole during spinal anaesthesia.

A patient in whom vasovagal asystole was induced by the performance of a spinal anaesthetic in the upright position is described. This illustrates the importance of routine monitoring of the electrocardiograph during regional anaesthesia. The risk of vasovagal syncope may be increased by the use of the sitting position and by the omission of anxiolytic premedication.

Adult↗
PubMed1989

Effect of anaesthesia on the QT interval.

A prolonged electrocardiographic QT interval may be harmful during general anaesthesia. It may be prudent, therefore, to select anaesthetic agents which have the least effect on the QT interval. In a controlled study, propofol has been shown to have less effect on the QT interval than thiopentone (P less than 0.05). Our data suggest also that any effects which may be caused by enflurane and isoflurane are masked by the effects of the induction agent.

Anesthesia, General↗
PubMed1988

Thiamine status after major trauma.

A prospective study of thiamine status in patients with severe injuries (injury severity scores greater than 12) showed that they all developed signs of severe thiamine deficiency on the basis of transketolase activity, the standard biochemical test for thiamine deficiency. This occurred within the first week after their injuries despite routine enteral or parenteral feeding including vitamin supplements. This may be due to increased requirements secondary to increased metabolic activity or increased cellular losses. An increased awareness of thiamine requirements and metabolism is essential to avoid the appearance of deficiency syndromes.

Adult↗
PubMed1988

Ilioinguinal nerve blockade for analgesia after caesarean section.

Bilateral ilioinguinal nerve blockade was performed, using 0.5% plain bupivacaine 10 ml to each side, in 13 patients having elective Caesarean section under general anaesthesia. Pain scores and requirement for postoperative analgesia were compared with 13 patients in a control group. Pain scores were less in the block patients at all times during the first day after operation, with the exception of 12 h. There was an increased time from the patient's recovery from anaesthesia to the first injection of opioid in the block group. In the control group, patients required more analgesia in the first 24 h after surgery compared with patients having ilioinguinal nerve blockade. There were no observed adverse effects following nerve blocks.

Anesthesia, General↗
PubMed1987

Value of pre-operative carotid sinus massage.

The usefulness of carotid sinus massage in pre-operative assessment is discussed with case examples. The technique and risks of carotid sinus massage are described. Carotid sinus massage is of particular value in the demonstration of sino-atrial and atrioventricular node disease in the absence of definitive abnormalities on the routine resting electrocardiogram, and in the identification of patients who show a hypersensitive response to vagal stimulation. These patients should be identified prior to procedures that involve marked vagal activity, since prolonged sinus arrest may occur.

Aged↗
PubMed1986

Pacemaker assessment for junior doctors.

Recent experience at the Merseyside Regional Pacemaker Centre has emphasized that many junior doctors are unfamiliar with numerous important facts regarding permanent pacemakers. It is important to detect quickly a fault in a permanent pacemaker if, for example, a patient presents with recurrent dizziness, blackouts or a cerebrovascular accident.

Anesthesia↗