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Biomedical subjects

K Bloor

Publications and source records attributed to K Bloor.

At least 37 records · Page 2Linked to original sources
PubMed1994

The costs of managing severe cancer pain and potential savings from transdermal administration.

The economic evaluation of any new or existing therapy should include a comprehensive appraisal of costs. When evaluating pharmaceutical interventions, it is inappropriate to identify the purchase price alone. Other relevant costs include the costs of time of doctors, nurses and other personnel in administering and monitoring the effects of the therapy, and the costs of treating any side-effects. This study estimates direct National Health Service (NHS) costs in the U.K. of current medical practice in managing severe cancer pain, using a review of the published literature and constructing a cost analysis for four 'typical' patients. Costs are estimated for patients with severe cancer pain in a hospital and an ambulatory setting, with oral and subcutaneous routes of drug administration. The study includes costs of drugs, supplies, equipment and personnel time. The results demonstrate the importance of personnel time costs, and potential cost savings which could result from the use of transdermally administered opioid analgesics.

Administration, Cutaneous↗
PubMed1989

An introduction to the practice, prevalence and chemical toxicology of volatile substance abuse.

1. Volatile substance abuse is largely a teenage practice; it is estimated that in the UK 3.5-10% of young people have at least experimented and that 0.5-1% are current users. 2. The products abused are many and varied but only about 20 chemical compounds, notably toluene, chlorinated solvents such as 1,1,1-trichloroethane, fuel gases such as butane and aerosol propellants, are commonly encountered. 3. The acute hazard varies with the compound, product and mode of abuse. Mortality in the UK is now about 100 per year, from all social classes, 90% of whom are male. 4. Chronic toxicity is difficult to assess, partly because of the diversity of products abused. However it is clear that some long-term abusers suffer permanent damage to the central nervous system, heart, liver and kidney. 5. Toxicological analysis may be relied upon for confirmation of diagnosis, providing attention is paid to the kinetics of excretion and stability in the sample. 6. Responses include codes of practice for the sale of products and educational strategies; legislation has also been enacted. There is little evidence that any of these measures have made a significant impact on the problem.

Adhesives↗
PubMed1983

Autologous blood collection in abdominal vascular surgery. Assessment of a low pressure blood salvage system with particular reference to the preservation of cellular elements, triglyceride, complement and bacterial content in the collected blood.

A simple, low pressure, blood scavenging system has been assessed in major abdominal vascular operations. The aim of this study was to assess the quality of blood obtained with this device and its suitability for reinfusion. Three areas of special interest, which have not been reported so far, are the fate of plasma complement, the load of fat aspirated after tissue dissection and the degree of bacterial contamination in the scavenged blood. The development of autologous blood scavenging systems is reviewed. The features which most affect the quality of scavenged blood are identified and their importance discussed by comparison with our experience. Key features of our system were: simplicity of the apparatus, controlled low-pressure aspiration, the use of systemic heparin and the avoidance of mechanical pumps. The blood obtained was of excellent quality with good preservation of cellular elements, platelets and fibrinogen. Plasma total haemolytic complement, C3 and C4 fractions were preserved in normal, though slightly reduced, quantities. Lipid (triglyceride) content was minimally increased after filtration. Bacterial contamination was present in all cases, but at a very low level provided that aspiration was limited to the peritoneal cavity. This low-level of contamination is not thought to be of great significance; its origin and importance are discussed.

Abdomen↗
PubMed1980

Popliteal aneurysm: sinister harbinger of sudden catastrophe.

A series of twenty-eight aneurysms of the popliteal artery is reviewed. The cases were collected from the records of two large hospitals each with a unit with a special interest in vascular surgery. They are uncommon--only 1 popliteal aneurysm to every 17 aneurysms of the abdominal aorta--but one-third of our patients had both types of aneurysm present. The majority of patients had symptoms and 7 lost a leg as a direct result of thrombosis or rupture. The results of treatment were best when saphenous vein was used to replace an uncomplicated aneurysm and, since the behaviour of aneurysms is unpredictable, we conclude that this is the treatment of choice.

Adolescent↗
PubMed1977

The thoracic outlet syndrome.

Thirty-one patients with thoracic outlet syndrome have been studied in detail in the neurological and vascular clinics at this hospital. The patients were classified on the basis of their presenting symptoms into four groups--predominantly vascular, neurological, combined vascular and neurological, and pain and paraesthesiae alone. The majority of patients had radiological abnormalities and all had structural lesions in the superior thoracic aperture seen at operation. All operations were carried out through a standard supraclavicular approach, enabling the compressive structures to be visualized. This would not have been the case had the commoner trans-axillary approach for first rib resection been followed and in fact none of the operations included removal of the first rib. The results of operation were evident in our patients with a marked relief in their vascular symptoms, their pain and paraesthesiae and a slight but definite improvement in muscle bulk and power.

Adolescent↗
PubMed1975

Complete disappearance of popliteal arterial thromboses in 2 patients.

Two young male patients with complete spontaneous resolution of popliteal thrombosis are described. The thromboses had been present for roughly 3 1/2 and 4 months. Such resolution has not been previously reported. The cause of the lesions is unexplained. It is suggested, should such a lesion be encountered, that the correct treatment is exploration to exclude adventitial cysts and popliteal entrapment, and simple evacuation of clot and anticoagulation.

Adolescent↗
PubMed1972

Elective splenorenal anastomosis.

Thirty-six patients underwent splenorenal anastomosis for haemorrhage from oesophageal varices. Twenty-nine patients were cirrhotics and seven had extrahepatic blocks or congenital hepatic fibrosis. The patients have been followed from 16 years to 6 months. The operative mortality was 11%. Recurrent haemorrhage occurred in two patients (6%) and neurological manifestations in 38% of the patients at risk. It is concluded that splenorenal anastomosis is associated with a high degree of shunt patency.

Adolescent↗
PubMed1970

The association between aneurysm of the abdominal aorta and peptic ulceration.

In a survey of 7,044 necropsies there were 99 cases of aneurysm of the abdominal aorta and 523 cases of peptic ulceration. The incidence of peptic ulceration in the general necropsy population was 7.2% whilst in cases with aneurysm it was 22.6%. There was a significant increase in duodenal ulceration in males with abdominal aortic aneurysms. The possible causes for this increased incidence are discussed.

Adolescent↗