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Biomedical subjects

M Harman

Publications and source records attributed to M Harman.

11 recordsLinked to original sources
PubMed1988

Routine preoperative ultrasonography and cesarean section.

This prospective investigation was undertaken to determine whether routine ultrasound visualization of the gravid uterus shortly before cesarean section would provide useful information in determining the site for uterine incision. Complete data were gathered on 124 pregnancies using a portable real-time ultrasound machine. Determination of the placenta and umbilical cord locations, fetal presentation, and amniotic fluid volume were reliable. Compared with a matched group without ultrasonic visualization, the eventual site for uterine incision and morbidity to the mother and fetus were not significantly different. Although routine visualization of the intrauterine contents before surgery is not necessary, worthwhile information may be gained in select cases to confirm a previously suspected noncephalically presenting fetus or a low anterior placenta.

Cesarean Section↗
PubMed1986

Prospective testing of a scoring system designed to improve case selection for upper gastrointestinal investigation.

A recently described scoring system designed to assess the individual risk of finding serious pathology in patients referred for upper gastrointestinal investigation has been prospectively tested in 1279 patients undergoing first-time endoscopy and 321 patients undergoing radiologic examination. The scoring system has been confirmed to give a reasonable prediction of the likelihood of finding serious pathology in two hospitals with differing endoscopic practice, and also to be applicable to patients attending for radiology. The system works best at defining a low-risk group (score less than 412, 26% of total) in which the incidence of serious pathology was 3%. All cases of malignancy (n = 55) occurred in patients scoring greater than 464 (50% of total). A simple table is described that allows for the easy calculation of score at a glance without the use of a computer. We believe that this scoring system, which can be implemented in seconds, is the simplest yet described and that it could prove to be a useful educational aid.

Age Factors↗
PubMed1985

An investigation into the validity of the present classification of inflammatory bowel disease.

To assess the validity of the present subdivision of patients with inflammatory bowel disease into those with Crohn's disease of the small bowel or of the colon and those with ulcerative colitis, 252 patients with inflammatory bowel disease have been studied by questionnaire and case note review. One hundred and seventy-two variables concerning the nature and frequency of symptoms in remission and relapse, the incidence of complications and results of investigation have been analysed by computer. As expected, there were many highly significant variables between patients with ulcerative colitis and those with Crohn's disease of the small bowel. The latter showed evidence of a more severe disease course with more complications. There were similar, although less marked, differences between patients with Crohn's disease of the colon and those with Crohn's disease of the small bowel. There were very few differences in disease course between patients with Crohn's disease of the colon and those with ulcerative colitis. The results suggest that while separate classification of patients with Crohn's disease of the small bowel is justified on clinical grounds, the present separation of patients with disease confined to the colon into groups labelled ulcerative colitis or Crohn's disease of the colon is not. Alternative methods of classification should therefore be investigated.

Colitis, Ulcerative↗
PubMed1983

Scoring system to improve cost effectiveness of open access endoscopy.

The introduction of an open access general practitioner endoscopy service may result in many unnecessary examinations being performed. In an attempt to prevent this, 235 patients attending for endoscopy were interviewed and the results analysed to determine which factors best discriminated between those with major disease (ulcers, cancers, oesophageal strictures; n = 48) and those without (n = 187). The six characteristics which best discriminated between the two groups were increasing age, history of vomiting, male sex, smoking, and a past history of peptic ulcer or hiatus hernia. With the use of these six features a scoring system was devised, designed to give an indication of the likelihood of finding such disease in an individual patient. This was assessed prospectively in a further 356 patients. The results showed that by utilising this scoring system it would be possible to reduce the number of examinations performed by 30% yet still detect 98% of serious disease. If confirmed in further prospective studies, this scoring system (or a modification) could more accurately assess individual priority for endoscopy and enable optimum use to be made of limited resources.

Age Factors↗
PubMed1983

Symptoms of irritable bowel syndrome in ulcerative colitis in remission.

The prevalence of symptoms suggestive of a motility disturbance similar to the irritable bowel syndrome was investigated in 98 patients with ulcerative colitis in remission, and a similar number of age- and sex-matched healthy controls. Thirty-three per cent of patients compared with 7% of controls fulfilled the criteria for such a syndrome (p<0.01). Contrary to expectations these symptoms were not confined to patients with distal disease. Other symptoms such as constipation were also very common in the colitic group (31%).

Abdomen↗
PubMed1983

Factors preceding relapse of ulcerative colitis.

The effect of intercurrent diarrhoea on relapse of ulcerative colitis was investigated. Diarrhoea resulting from travel abroad, gastroenteritis or antibiotic usage resulted in an approximately 50% relapse rate. With regard to colonoscopy and barium enema, only the latter was followed by relapse and this may reflect differences in the preparation for the procedure.

Anti-Bacterial Agents↗
PubMedDate not supplied

Labour relations.

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Delivery, Obstetric↗