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Biomedical subjects

M Smith

Publications and source records attributed to M Smith.

1,654 records · Page 92Linked to original sources
PubMedDate not supplied

[Abdominal localization of invasive thymomas. Contribution of tomodensitometry].

Routine abdominal and thoracic computed tomography examinations in 20 patients with invasive lympho-epithelial thymomas demonstrated the frequency of abdominal localizations (9 cases), particularly in renal (7 cases) and adrenal (3 cases) tissues. The mode of extension and course during treatment of these tumors are discussed, and the different diagnostic procedures, particularly ultrasonography, are compared.

Abdominal Neoplasms↗
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Footsteps in the snow.

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Community Health Nursing↗
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Impact of a collaborative immunisation programme in an inner city practice.

OBJECTIVES: To describe the impact of a collaborative immunisation programme, between an inner city practice and the Eastern Health Board (EHB). DESIGN: An observational study using a computer database formed from practice and EHB records. SETTING: One Dublin inner city practice with three partners located in an area with a deprived socio-economic profile. SUBJECTS: All patients in the practice aged more than six months and less than five years identified both from practice registers and opportunistically during study period. RESULTS: 342 children, older than six months and less than five years were identified at start and 464 (a 36% increase) by end of the programme. Uptake changed for DPT from 30% before, to 57% after the programme (p < 0.0005), for DT from 15% to 13%, for Hib from 7% to 50% (p < 0.0005) and for MMR (over 15 months) from 53% to 75% (p < 0.0005). Uptake of the DPT, Hib and MMR was 35% among GMS eligible, 51% among GMS ineligible (p < 0.005). CONCLUSION: A collaborative immunisation programme significantly improved practice uptake rates. These improved rates still do not attain declared national targets. To achieve these targets, radical overhaul of the immunisation service is required.

Cooperative Behavior↗
PubMedDate not supplied

Are older people satisfied with discharge information?

In this article we report the views of older discharged patients who have had a stroke or have fractured the neck of their femur on the information they were given about their condition and treatment while in hospital. Structured face-to-face interviews carried out 10 days after discharge contained some open-ended questions. Responses to a question on information were coded according to whether they were indicative of satisfaction. These responses were also analysed qualitatively to identify themes: 41% reported satisfaction with information and 40% dissatisfaction. The responses of the remaining 19% could not be coded either way. Views indicative of dissatisfaction were more likely to be expressed by subjects with the poorest outcomes and those who had experienced most ward moves. All staff should be vigilant in ensuring that information is always clearly conveyed to the most frail patients.

Aged↗
PubMedDate not supplied

Pancreatic fistula after pancreaticoduodenectomy: a comparison between patients with periampullary tumors and chronic pancreatitis.

BACKGROUND/AIMS: Whether the frequency of anastomotic leak after pancreaticoduodenectomy for benign diseases is greater than for malignant conditions and whether fistula development is associated with surgical mortality remains controversial. The purpose of this study is to compare the incidence of anastomotic leak in patients operated on for chronic pancreatitis and periampullary tumors. METHODOLOGY: The authors retrospectively reviewed the charts of 67 patients (46 males, 21 females, mean age 47 years) submitted to pancreaticoduodenectomy for chronic pancreatitis and periampullary tumors between 1990 and 1996. RESULTS: In 44 patients with periampullary cancers, pancreatic fistula developed in 13 (29%) cases, and in 6 (26%) of the 23 patients with chronic pancreatitis (p>0.05). Of the 19 patients who developed this complication, 5 (26.3%) died, and in the remaining 48 cases, there was only one (2.1%) death (p<0.05). CONCLUSION: The frequency of pancreatic fistula after pancreaticoduodenectomy in patients with periampullary tumors and chronic pancreatitis is not different, but the presence of a fistula is strongly involved in postoperative mortality.

Adolescent↗
PubMedDate not supplied

Hemimegalencephaly and focal megalencephaly in tuberous sclerosis complex.

We describe two children with complex cortical malformations as well as the typical intracranial manifestations of tuberous sclerosis complex. One child had hemimegalencephaly and the other had extensive focal megalencephaly. These cases are discussed in terms of the current concepts of cortical malformations.

Cerebral Cortex↗
PubMedDate not supplied

Comparison of outpatient laparoscopic cholecystectomy in a private nonteaching hospital versus a private teaching community hospital.

The development of laparoscopic cholecystectomy has allowed the introduction of outpatient surgery for biliary tract disease. However, there appears to be a wide variation of the interpretation of "outpatient surgery," ranging from discharge the same day to keeping patients for overnight observation. We prospectively reviewed the last 50 chole-cystectomies performed at Spartanburg Regional Medical Center, a private teaching institution, and Upstate Carolina Medical Center, a private nonteaching hospital. All cholecystectomies were performed by board certified surgeons or surgical residents under the supervision of board certified surgeons. Spartanburg Regional Medical Center's standard was 23-hour observation with 9 patients (18%) being discharged home the day of surgery. Upstate Carolina Medical Center's standard was discharge home (usually 4-8 hours after completion of the procedure) with 39 patients (78%) discharged the same day. No patient discharged the same day presented back with any significant complication. Comorbid disease, biliary pancreatitis, ascending cholangitis, gangrenous gallbladder, extreme age and living conditions and conversion to open were factors considered for admission. Intra-operative difficulty such as oozing, excessive adhesiolysis, postoperative nausea, vomiting or pain control were also indications for overnight admissions. The extra 15 to 19 hours for routine observation did not change any treatment for any of the 41 patients and resulted in additional cost to the hospital of approximately $15,000. We conclude that same day, outpatient laparoscopic cholecystectomy can be done safely with discharge home 4 to 8 hours postoperative without significant morbidity in selective patients.

Adolescent↗