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Biomedical subjects

J Collin

Publications and source records attributed to J Collin.

At least 37 records · Page 2Linked to original sources
PubMed1989

How fast do very small abdominal aortic aneurysms grow?

Fifty patients with abdominal aortic aneurysms from 2.5 to 5.0 cm in anteroposterior diameter (median 3.1 cm, mean +/- S.E. 3.3 +/- 0.1 cm) were initially offered non-operative treatment. Two patients have subsequently undergone successful elective aneurysm resection because of increase in aneurysm size, and a third has died. The median annual growth rate of the aneurysm has been 0.22 cm and 77.8% increased in size between 6 monthly ultrasound examination. For aneurysms less than 4.0 cm the maximum 6 monthly increment in diameter was 0.7 cm. Even the smallest abdominal aortic aneurysms usually progressively increase in size and 6 monthly ultrasound remeasurement of aneurysm diameter is an essential component of non-operative management.

Aged↗
PubMed1989

Hemangiosarcoma of the rectum after chronic anorectal ulceration.

A 37-year-old man with a 30-year history of recurrent anorectal ulceration developed a hemangiosarcoma of the rectum. This diagnosis was made based on histology and immunocytochemistry. We believe this is the fifth reported case of hemangiosarcoma of the rectum and is another example of a rare granulation tissue sarcoma.

Adult↗
PubMed1989

Two year prospective analysis of the Oxford experience with surgical treatment of abdominal aortic aneurysm.

During the two years from 1 November 1985 to 31 October 1987, 177 patients were admitted to a hospital in Oxford with the diagnosis of abdominal aortic aneurysm (AAA). The aneurysm had ruptured in 88 patients, of whom 75 underwent emergent surgical treatment, yielding an operative mortality rate of 36 per cent. Of the 13 patients who did not have surgical treatment, two died before transfer to the operating room; in the other 11 patients, a deliberate decision was made not to undertake surgical treatment--in ten patients, the reason was an age of 85 years or more and in one patient, severe debilitating Parkinson's disease. Emergent operations were done upon another 15 patients--11 who had acute aneurysm and four in whom symptoms were not caused by an aneurysm. Emergent operations for ruptured or acute aneurysms represented 55 per cent of all operations for AAA. This high proportion and large number of emergent operations is in marked contrast with the experience of comparable specialist vascular surgical units in the United States. The 24-fold difference in mortality rates between surgical procedures performed electively and for ruptured aneurysm suggests that a considerable impact on over-all mortality could be achieved by a substantial increase in referral of patients

Acute Disease↗
PubMed1988

Oxford screening programme for abdominal aortic aneurysm in men aged 65 to 74 years.

824 men aged 65 to 74 were invited for ultrasound screening of the aorta and 426 (51.7%) attended. An abdominal aortic aneurysm was discovered in 23 (5.4%), and in 10 (2.3%) the aneurysm was 4.0 cm or more in diameter. 2 other patients had a common iliac artery aneurysm. The 36 men who had objective evidence of occlusive arterial disease of the lower limbs were twice as likely to be tobacco smokers and accounted for 5 (20%) of the aneurysms discovered. Extension of this screening programme to England and Wales could be expected to identify 52,500 men with an abdominal aortic aneurysm. If elective surgical replacement of the aneurysm were to be accepted by 60% of those with aneurysms 4 cm or more in diameter, 6000 unnecessary deaths from aortic aneurysm rupture could be prevented.

Aged↗
PubMed1988

Surgical care of patients over eighty: a predictable crisis at hand.

The number of people over the age of 80 in Britain will increase by around 30 per cent over the next 15 years. Little attention has been paid to the acute surgical services required to meet the surgical needs of this population. This study reviews 198 surgical admissions in 1 year of patients aged 80 years and over, of which 74.9 per cent were admitted as emergencies. The overall mortality was 10.1 per cent of all admissions and 41 per cent of admissions were accompanied by at least one serious complication. Eighty-eight patients underwent surgery with an operative mortality of 11.3 per cent. In only 63.5 per cent of cases could the patient be discharged directly home. By 2001, in Oxford, the proportion of acute surgical beds occupied by patients aged over 80 will increase to 9.2 per cent from the present 7.0 per cent. Unless additional resources are provided to meet this extra demand for acute surgical care of the old, elective surgery for younger patients will inevitably be curtailed.

Aged↗
PubMed1988

Dietary fibre and gastrointestinal disease.

This review examines the evidence linking dietary fibre to gastrointestinal disease. Fibre increases stool weight, decreases whole gut transit time and lowers colonic intraluminal pressure. While it may be of benefit in the treatment of constipation, the irritable bowel syndrome and diverticular disease, its role in the prevention or treatment of other gastrointestinal disease has yet to be established.

Dietary Fiber↗
PubMed1988

A community screening programme for abdominal aortic aneurysms.

Three-hundred and sixty-nine unselected men aged 65-79 years were invited for screening for abdominal aortic aneurysm. One hundred and forty-one men were examined and 4 aneurysms detected. 43.2% of men aged 65-74 attended for examination in response to a single unsolicited letter of explanation with the date of an appointment, but only 29.1% of those aged 75-79 years. It is suggested that community mortality from ruptured aortic aneurysm could be reduced by ultrasound screening of the aorta in men aged 65-74 years and early selective aneurysm surgery.

Aged↗
PubMed1988

Is abdominal wall tenderness a useful sign in the diagnosis of non-specific abdominal pain?

Pain arising from the abdominal wall has been implicated as a cause of non-specific abdominal pain (NSAP), and the presence of abdominal wall tenderness (AWT) has been proposed as an accurate diagnostic test for NSAP. One hundred and fifty eight patients admitted to hospital with abdominal pain were tested for the presence of positive AWT. In 53 patients the final diagnosis was appendicitis and positive AWT was found in five. Thirty eight patients were found to have a variety of other recognised pathological diagnoses, none of whom had a positive AWT. In 67 patients a diagnosis of NSAP was made in the absence of other pathological diagnosis, 19 of whom had positive AWT, which was significantly different from the other diagnostic groups. This study confirms the presence of AWT in up to 28% of patients with NSAP, and suggests that testing for AWT is of value in patients with abdominal pain, although a positive AWT is not as accurate a predictor of NSAP as previously reported.

Abdomen↗
PubMed1988

The epidemiology of abdominal aortic aneurysm.

Abdominal aortic aneurysm is common and aneurysm rupture accounts for 1.7% of all deaths in men aged 65-74 years. Most deaths are now preventable. Early diagnosis by routine ultrasound examination of the abdominal aorta in elderly men should permit elective aneurysm replacement before rupture in the majority of patients.

Aged↗