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Biomedical subjects

K V Menon

Publications and source records attributed to K V Menon.

25 records · Page 2Linked to original sources
PubMed2000

Managing the complications of cirrhosis.

The 3 major and potentially fatal complications of cirrhosis of the liver result from portal hypertension and include variceal bleeding, ascites, and encephalopathy. The cause of other complications, eg, thyroid dysfunction and hepatopulmonary syndrome, is uncertain. Several recent advances have occurred in the treatment of varices. However, treatment of ascites is still primarily confined to achieving a negative sodium balance, and therapy for encephalopathy centers on the use of lactulose. Although effective therapy may be available for most complications of cirrhosis, a major complication indicates a poor long-term prognosis. Liver transplantation is the only effective long-term treatment of complications due to cirrhosis.

Adrenergic beta-Antagonists↗
PubMed2000

Emergency surgical admissions in patients aged more than 80 years: a study over four decades.

BACKGROUND: The proportion of older patients in the community is rising. The aim of this study was to determine the trend in emergency surgical admissions in patients over 80 years of age in 1997 compared with the previous three decades. PATIENTS AND METHODS: Data were obtained on all patients over 80 years of age admitted as general surgical emergencies in 1997 to the Royal Berkshire and Battle Hospitals, Reading, UK. Reasons for admission, management, mortality and duration of hospital stay were recorded and compared with results from 1966, 1976 and 1989. RESULTS: During 1997, 4807 patients over the age of 80 years were admitted as emergencies to all specialities. Of these, 447 (9.3%) were surgical. This compares with 122 in 1966, 248 in 1976 and 339 in 1989. Emergency surgical workload in patients over 80 years of age had increased from 6.2% in 1966 to 12% in 1997. A random sample of 261 patients was analysed. In-patient mortality was 13.8% in 1997 compared with 21.8% for 1976 and 22.4% for 1989. Median length of stay was 8 days (range, 0-41 days) for 1997 and 1989 compared with 14 days in 1976. Twenty-four patients either needed admission to other specialities or need not have been admitted as emergencies at all and were classified as inappropriate admissions to the general surgical ward. CONCLUSIONS: The trend of increased number of patients over the age of 80 years being admitted as emergencies to general surgery continues through four decades. There has been a decrease in mortality and length of stay since 1966, but no decrease in length of stay in 1997 compared with 1989. Avoiding inappropriate admissions would result in a significant improvement in bed utilisation for elective surgery and help to reduce waiting lists.

Aged↗
PubMed1999

Body mass index, height and cumulative menstrual cycles at the time of diagnosis are not risk factors for poor outcome in breast cancer.

Obesity, height and age at menarche have been shown to be risk factors for the development of primary breast cancer. However, their prognostic influence on breast cancer once it has presented is uncertain. The present study analysed 448 patients with primary breast cancer to determine whether or not body mass index (BMI), height and cumulative menstrual cycles at diagnosis are independent prognostic variables. The effects of all three variables on survival time and disease free interval were estimated. Of the 448 patients after a median follow up of 6 years, 190 (42%) developed recurrence and 162 (36%) had died. Body Mass Index and height could be calculated from available data in 403 patients and cumulative menstrual cycles in 388 patients. There was no evidence of an effect of BMI on survival time (P=0.99; hazard ratio=1.000; 95% Confidence Interval 0.968-1.034) or disease free interval (P=0.92; hazard ratio=1.002; 95% Confidence Interval 0.973-1.031). Similarly, height and cumulative menstrual years did not influence outcome in patients with primary breast cancer. However, nodal status and tumour size were both significant prognostic factors (P<0.001). The present study found no association between Body Mass Index, height and cumulative menstrual years and outcome in patients with primary breast cancer.

Journal Article↗
PubMed1999

Surgical patients with methicillin resistant staphylococcus aureus infection: an analysis of outcome using P-POSSUM.

The significance of MRSA infection in surgical patients was studied using the P-POSSUM scoring system. All surgical patients undergoing operation between 1/10/96 and 30/09/97 were prospectively scored using P-POSSUM. A subset of these patients with MRSA infection was analysed using P-POSSUM predicted mortality. Physiological and operative severity scores were compared with non-MRSA surgical patients and length of hospital stay with P-POSSUM matched non-MRSA controls. Thirty of the 1,132 patients were MRSA positive and of these five died, giving a P-POSSUM observed/expected deaths ratio of 1.7 (not significant; 95% CI -0.24 to 0.10). The P-POSSUM physiology score of 30 MRSA positive patients, compared with the non-MRSA group (n = 1102), was significantly more severe (20.9 v/s 17.4; 95% CI 1.09 to 5.95) as was the operative severity score (15.6 v/s 9.2; 95% CI 4.40 to 8.42). The length of stay for surviving MRSA positive patients was significantly longer than P-POSSUM matched controls. MRSA infection in surgical patients does not increase mortality. However, patients who contract MRSA infection are more debilitated and have undergone a greater surgical insult.

Adult↗
PubMed1998

Inferior vena caval filters: an overview of current use.

Inferior vena cava filters trap dislodged clot and decrease recurrent pulmonary embolism. The main indications are pulmonary embolism or extensive deep vein thrombosis when anticoagulants are contraindicated, and recurrent pulmonary embolism despite adequate anticoagulation. Newer filters trap clinically significant emboli while maintaining patency, making them safe and effective.

Contraindications↗
PubMed1991

Irreducible skin penetration of the ulnar head in Colles fracture--case report.

Three cases out of four of skin penetration by the ulnar head associated with Colles fractures were found to be irreducible. On exploration they had identical pathologic anatomy, viz, buttonholing of the ulnar head between the flexor carpi ulnaris, flexor digitorum profundus, pronator quadratus, and the flexor retinaculum. Incising the flexor retinaculum facilitated reduction.

Adult↗