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Biomedical subjects

M J Hollands

Publications and source records attributed to M J Hollands.

27 records · Page 2Linked to original sources
PubMed1984

The use of an instillation test to define alkaline reflux gastritis.

Alkaline reflux gastritis following gastric surgery is an ill-defined syndrome characterised by epigastric pain, bile vomiting and weight loss. Endoscopy and gastric histology do not confirm the diagnosis. It appears that duodenal contents refluxing into the stomach are the cause of this entity. In an effort to quantify this attempts have been made to quantitate the reflux. Techniques include measuring bile acids in fasting gastric aspirates and, more recently, Tc HIDA scanning. Tolin et al showed a good correlation between the enterogastric reflux index and patients with symptoms of alkaline reflux gastritis. Recent work has suggested that HIDA reflux is difficult to quantitate. Recently Meshkinpour et al induced the symptoms of alkaline reflux gastritis by infusing endogenous duodenal juice onto the gastric mucosa. This paper confirms those findings and uses the technique to improve patient selection for Roux-en-Y diversion.

Duodenogastric Reflux↗
PubMed1983

Primary hyperparathyroidism unmasked by donor nephrectomy.

A patient who was normocalcaemic before donation of a kidney to her son developed hypercalcaemia in the immediate postoperative period, which was subsequently found to be due to a parathyroid adenoma. It is assumed that the hypercalcaemia was unmasked by the reduction in glomerular filtration rate following the nephrectomy.

Adenoma↗
PubMed1983

Oral cholecystographic findings and the incidence of wound infection after cholecystectomy.

Six hundred and sixty-one patients undergoing cholecystectomy were reviewed, and the over-all incidence of postoperative wound infection was found to be 18.6 per cent. Of the 274 patients who underwent cholecystography preoperatively, 150 were found to have functioning nonobstructed stone filled gallbladders. There were 12 postoperative wound infections in this group, 8 per cent. One hundred and twenty-four patients had nonfunctioning and obstructed gallbladders, 31 of whom, 25 per cent, had wound infections develop. The finding of an obstructed gallbladder upon oral cholecystography was associated with a high incidence of wound infection. This group should be considered for prophylactic antibiotics.

Adolescent↗
PubMed1981

Penetration of a prophylactic antibiotic into peritoneal fluid.

The ability of an antibiotic, given for prophylaxis, to enter the peritoneal fluid was measured in 40 patients having abdominal operations. Cefuroxime, the antibiotic studied, attained a satisfactory level (4 mg/1) in the peritoneal fluid of 34 of the 40 patients (85 per cent). There was no difference between emergency and elective operations, suggesting that peritoneal inflammation does not enhance the penetration of cefuroxime into peritoneal fluid.

Adolescent↗
PubMedDate not supplied

Hepatic incidentaloma: a modern problem.

As clinical skills give way to increased reliance on organ imaging, a new clinical problem is identified--the hepatic "incidentaloma." This may be defined as an unexpected solid filling defect in the liver of a well patient. Thirty-six such lesions have been seen in one practice over a period of 36 months. Twenty-nine (81%) were benign: 24 (67%) nonneoplastic conditions 5 (14%) benign tumors. The remaining 7 (19%) were malignant: 5 secondary tumors and 2 primary tumors. Patients with physical signs of liver mass or enlargement were more likely to harbor malignancies. An elevated serum alkaline phosphatase (SAP) was suggestive of malignancy. Hepatic hemangioma was the most common single diagnosis (20 patients, 56%). We propose a regimen of investigation which should allow diagnosis to be reached in about one-half of these patients without admission to the hospital. The rest will need at least a short hospital admission for angiography and fine-needle aspiration biopsy.

Adult↗
PubMedDate not supplied

The role of hepatic resection in the management of blunt liver trauma.

Forty-two (14%) of 306 patients with liver injuries presenting to Westmead Hospital over a 10-year period required hepatic resection as their definitive treatment. Two types of resection were performed: Resectional debridement utilized the plane of injury as the line of resection while anatomical resection utilized anatomical planes. Resectional debridement was used in 35 patients. In 29, the major technical problem was bleeding and 21 of these patients had associated hepatic vein injuries. In 5, the major problem was devitalized parenchyma, and, in 1, it was an intrahepatic bile duct injury. Anatomical resection was performed in 7 patients: 3 with bleeding, 2 with devitalized parenchyma, and 2 with intrahepatic bile duct injuries. Overall, 15 patients died (36%). The most common cause of death was bleeding in 9 of the 15 patients. Survivors spent a median of 32 days in hospital (range: 11-162 days) and sustained a median of 2 complications (range: 0-6). The most common complications were respiratory infection and/or failure, coagulopathy, and sepsis. Resection successfully addressed bleeding, devitalized parenchyma, and intrahepatic bile duct injuries with an acceptable mortality in critically ill patients who would otherwise have died.

Adult↗