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Biomedical subjects

M Irving

Publications and source records attributed to M Irving.

At least 127 records · Page 7Linked to original sources
PubMed1981

The benefits of central vein feeding and long term access to the circulation.

Although parenteral nutrition can be safely administered by peripheral vein for long periods most workers find it a difficult technique primarily because of phlebitis induced by the nutrient solutions. Additionally the need for immobilisation of an arm for at least part of the day restricts the patient's mobility. On the other hand, nutrition through a catheter inserted into a large vein, with its tip positioned in the superior vena cava, allows the infusion of large volumes of nutrients with only minimal risk of phlebitis. If the catheter is inserted through the subclavian or jugular veins there is no need to immobilise a limb and, using portable systems the patient can remain mobile, even whilst infusion is occurring. It is the development of these latter techniques that has led to Home Parenteral Nutrition being a feasible treatment. The hazards associated with central vein nutrition can be minimised by skillful insertion of the catheters and meticulous maintenance thereafter.

Catheterization↗
PubMed1979

Seat-belts.

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Legislation as Topic↗
PubMed1979

A safe and effective disposable low pressure suction drain.

The physical and microbiological properties of a new disposable suction drainage system have been investigated under clinical and laboratory conditions. The system appears to have overcome the disadvantages associated with previous disposable and reusable low pressure suction drainage systems for use after surgical operation in that this system effectively prevents reflex and retrograde contamination.

Bacteria↗
PubMed1979

The heat produced by frog muscle in a series of contractions with shortening.

1. Heat production has been measured in muscles undergoing rapid shortening 1 sec after the start of stimulation in a 2 sec tetanus. In a series of three such tetani where the periods of shortening were separated by 5 sec the shortening heats in the second and third tetani were 111 (+/- 4)% and 116 (+/- 6)% respectively of that in the first tetanus (mean +/- S.E. of mean, nine experiments). 2. When a similar series was carried out after an interval of 3 min the shortening heat in the first tetanus of the second series was 127 (+/- 3)% of that in the first tetanus of the first series (mean +/- S.E. of mean, three experiments). 3. The results are not in agreement with those of Dickinson & Woledge (1974). The discrepancy is explained by an artifact which, with certain arrangements of the apparatus, affects the measurements of shortening heat in a series of contractions. We have measured this artifact by two independent methods; the shortening heat values quoted above have been corrected accordingly. 4. The increase in the shortening heat in repeated contractions is not a specific consequence of previous shortening; an increase of the same magnitude is observed following isometric tetani. 5. During the time when the muscle is shortening, the total rate of heat production, which is initially high, falls to a steady value. This value is not significantly different in the three tetani of the series.

Animals↗
PubMed1977

Ulcerative colitis.

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Colitis, Ulcerative↗
PubMed1977

Protection of the skin around intestinal fistulas.

The use of two recently introduced skin protective preparations in the treatment of perifistular skin inflammation is described. Karaya gum in paste form (karaya paste) and a compressed wafer of gelatin, pectin and methyl cellulose (Stomahesive) were used, alone or in combination; with drainable collecting appliances. The method protects the inflamed skin from fistula discharge and allows healing to proceed beneath the dressing. A technique to improve the adhesion of the appliance, in spite of large fluid losses, is outlined. Healing of skin excoriation was obtained in nearly all cases. Complete control of leakage was achieved in a group of patients with a high output fistula.

Administration, Topical↗
PubMed1977

Local and surgical management of enterocutaneous fistulas.

Intensive nutritional treatment is now recognized as the single most important factor in achieving closure of enterocutaneous fistulas, replacing attempts at early surgical closure. Operation in the early stages of management should be confined to the drainage of abscesses, the defunctioning of diseases or disrupted bowel and the formation of feeding enterostomies. In those few cases where spontaneous closure of the fistula does not occur, definitive surgical operation can be carried out when malnutrition has been corrected. The combination of nutritional treatment, skin protection and judicious surgery can reduce the mortality to below 10 per cent.

Abscess↗
PubMed1976

Intensive investigation in management of Hodgkin's disease.

Ninety-eight patients with clinically localised Hodgkin's disease underwent laparotomy and splenectomy to determine the extent of microscopic spread. In 68 patients the procedure was carried out for untreated disease apparently confined above the diaphragm. Abdominal disease cannot be confidently excluded on the basis of non-invasive investigation at presentation. Clinical assessment of splenic disease was unreliable unless gross splenomegaly was present. Pedal lymphography was accurate in assessing para-aortic and iliac disease but of no value in assessing other intra-abdominal lymph node involvement, including that of the mesenteric lymph node. Trephine bone marrow biopsy findings were normal in all patients before surgery, and only one patient was found to have diseased bone marrow by Stryker-saw biopsy at operation. Liver disease was identified at operation in nine patients, some of whom were asymptomatic with clinically undetectable splenic and nodal disease. Detailed clinical staging failed to detect disease in one-third of patients who underwent laparotomy. These studies show that if radiotherapy is to remain the treatment of choice for disease truly localised to lymph nodes a detailed staging procedure, including laparotomy and splenectomy, remains essential. The value of this potentially curative treatment is considerably diminished in the patient who has been inadequately staged.

Hodgkin Disease↗
PubMed1976

Surgical audit: one year's experience in a teaching hospital.

For 12 months the surgical staff at Hope Hospital have operated a form of audit. The monitored information included work load, methods of treatment, complications, misdiagnoses, and deaths. The method described is suitable for any district general or teaching hospital provided adequate secretarial help is available. In addition to helping to maintain standards, an audit of this type has a positive educational role.

England↗
PubMed1976

Major disasters: hospital admission procedures.

Triage in the accident and emergency department and the admission of all patients needing further care to one ward can form the basis of the successful hospital management of the victims of a major disaster.

Blast Injuries↗
PubMed1975

The role of surgery in the management of Hodgkin's disease.

The marked improvement in the prognosis of patients with Hodgkin's disease has resulted from advances in radiotherapy and chemotherapy. Success with these treatments depends upon accurate knowledge of the extent of the disease. Clinical assessment of the presence of abdominal disease is unreliable. Exploratory laparotomy with splenectomy, multiple lymph node biopsy and liver biopsy will reveal that preoperative assessment of the extent of the disease is inaccurate in 30 per cent of cases. The information obtained prevents relapses from undiagnosed abdominal disease and ensures that inappropriate radiotherapeutic treatment is not given to patients with disseminated disease.

Abdomen↗