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Biomedical subjects

J Payne-James

Publications and source records attributed to J Payne-James.

26 records · Page 2Linked to original sources
PubMed1988

A trial of mezlocillin versus cefuroxime with or without metronidazole for the prevention of wound sepsis after biliary and gastrointestinal surgery.

A randomized controlled trial was undertaken to compare the role of mezlocillin, as the sole prophylactic agent, with a combination of cefuroxime and metronidazole in patients undergoing biliary and gastrointestinal surgery. No difference in wound infection rates was seen in patients following appendicectomy, biliary or gastro-oesophageal surgery. A significantly higher wound infection rate was seen in patients undergoing colorectal surgery who received mezlocillin alone (30.2%) compared with those receiving cefuroxime and metronidazole (11.5%): this rate was similar to that of historical placebo controls in other units. The wound infections seen in patients receiving mezlocillin alone were polymicrobial involving organisms of faecal origin, including non-sporing anaerobes which were predominantly sensitive to mezlocillin. Infections due to Staphylococcus aureus, resistant to mezlocillin, were more frequent in patients receiving mezlocillin and usually secondary in nature. We conclude that mezlocillin may be an effective sole prophylactic agent in appendicectomy but not in colorectal surgery; the possible reasons for failure to adequately prevent infection, following colorectal surgery, are discussed.

Biliary Tract Diseases↗
PubMed1988

Enteral nutrition: background, indications and management.

Enteral nutrition is only part of the wider field of clinical nutrition in which great advances in both theory and practice have been made over the last decade. We have attempted to summarize what we consider to be the advances that have most relevance to the clinical practice of enteral nutrition. This chapter reviews our present understanding of the processes of digestion and absorption of protein, carbohydrate and fats, and examines how this theoretical understanding can be applied to patients in the clinical situation. A broad classification of the different enteral diets is undertaken, and the reasons for the development of particular diets are discussed. The clinical value of these diets is assessed. The wide variety of indications for enteral (as opposed to parenteral) nutrition are discussed and the specific benefits of enteral nutrition for the patient are highlighted. Techniques of administration of enteral nutrition are reviewed in detail, and the methods by which enteral nutrition should be monitored are outlined. Finally, complications of enteral nutrition are summarized and advice given on how to prevent or treat them.

Dietary Carbohydrates↗
PubMedDate not supplied

Enteral nutrition: accessing patients.

This review highlights important points in regard to use of the enteral route to provide nutrition support to nutritionally compromised patients. Enteral nutrition has become technologically advanced medical therapy in the last 15 yr, and as clinical nutrition continues to develop, further advances will be made. With the range of access routes and delivery systems available, appropriate nutrition can be provided in a safe, effective manner.

Duodenostomy↗
PubMedDate not supplied

Partial malrotation associated with pseudo-obstruction of the small bowel.

Intestinal pseudo-obstruction is defined as a syndrome in which there are signs and symptoms of intestinal obstruction without an actual obstructing lesion. In many cases it is associated with other disease entities but may be idiopathic. We report a case associated with partial malrotation of the gut which has not been described in the literature before.

Adolescent↗