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Biomedical subjects

P A Sykes

Publications and source records attributed to P A Sykes.

At least 19 recordsLinked to original sources
PubMed1999

Evidence for tissue-specific forms of glutaminyl cyclase.

Glutaminyl cyclase (QC) is responsible for the presence of pyroglutamyl residues in many neuroendocrine peptides. An examination of the bovine tissue distribution of QC immunoreactivity, enzyme activity, and mRNA confirmed that QC was abundant in brain and pituitary by all three measures. However, enzymatic activity was considerably more widespread than either immunoreactivity or mRNA, suggesting multiple enzyme forms. Partially purified QC from bovine spleen differed significantly from the known bovine pituitary QC in physical and catalytic properties. We propose that this form of glutaminyl cyclase plays a role in the posttranslational processing of constitutively secreted pGlu-containing proteins.

Aminoacyltransferases↗
PubMed1991

Risk factors and operative mortality in surgery for colorectal cancer.

The operative mortality rate after surgery for colorectal carcinoma remains significant. A series of 578 patients has been studied prospectively. The features which most significantly affect operative mortality are the age of the patient, a history of loss of weight, limited preoperative patient mobility and the presence of intestinal obstruction with perforation of the bowel. By identifying high-risk groups of patients, attention may be focused on particular patients at risk, in order to reduce operative mortality.

Activities of Daily Living↗
PubMed1991

Surgery in a district general hospital.

All operations performed in all surgical specialties in a district general hospital over a 4-week period were monitored. Although most elective operations were performed or supervised by trained staff, the service, particularly emergency care, was heavily dependent on incompletely trained doctors. Consultants, who operated on 41% of elective cases, were more likely to perform major operations. Supervision of junior surgeons for elective surgery was considered satisfactory. Thirty-one per cent of all major cases were performed by doctors in training, usually under supervision. However, 86% of all emergency operations were performed by trainee surgeons without consultant supervision. A consultant anaesthetist or clinical assistant attended all elective operating lists and either supervised or gave the anaesthetic. However, anaesthetists in training were not usually supervised for emergency cases outside normal working hours. It is worrying that one-third of all procedures were undertaken by surgeons who had been on duty for periods in excess of 24 h.

Consultants↗
PubMed1990

Ingrowing toenails: studies of segmental chemical ablation.

Recent studies have suggested that segmental ablation is the treatment of choice for patients with ingrowing toenails and that the success rate is 96%. This procedure has been common practice among chiropodists for 20 years, usually using phenol in the United Kingdom, and sodium hydroxide in the United States. However, there has been little critical evaluation of the relative merits of the two chemicals, of the period of chemical application, or of the duration of post-operative pain and healing time. We therefore embarked upon a number of controlled prospective studies to examine these questions. A prospective study of 422 procedures for patients with ingrowing toenails (onychocryptosis) shows that good results are achieved by segmental chemical ablation performed by chiropodists in 91% of cases. The average period of post-operative pain is 3.6 days. Similar results are obtained using either 80% phenol or 10% sodium hydroxide. We believe that segmental chemical ablation by a chiropodist is the treatment of choice for the typical patient with an ingrowing toe nail.

Cautery↗
PubMed1988

Who undertakes the consultations in the outpatient department?

In a study of all 4275 outpatient consultations over one month in a district general hospital it was found that the clinics in surgical specialties had the largest numbers of patients. In general surgery less than half of new patients and only one third of all patients attending the clinic were seen by a consultant. (Nine months later about a third of all new patients had still not seen a consultant in the clinic.) In the medical clinics just over a quarter of patients were seen by doctors who had less than six months' experience in their present specialty after registration. Overall, doctors had been on continuous duty for at least 24 hours before a third of consultations. Doctors in training had actually worked during the previous night before attending a quarter of the clinics. Much of the large volume of work is performed by tired, incompletely trained doctors. It is suggested that a greater proportion of the work should be performed by fully trained staff. The workload might be reduced by modifying the pattern of the consultation.

England↗
PubMed1988

Operative mortality rate and surgery for colorectal cancer.

Different authors use different definitions of operative mortality rate when reporting results of their operations. Four definitions used in current literature were applied to our own series of 578 patients with colorectal carcinoma. The operative mortality rate was found to vary from 7.3 per cent to 12.2 per cent, depending on the definition used. 'Death within 30 days of the last operation' was the definition which best reflected true operative deaths. We urge that this definition of operative mortality rate be adopted as a standard for all operations.

Cause of Death↗
PubMed1988

Ceftriaxone versus povidone iodine in preventing wound infections following biliary surgery.

The effect of either prophylactic antibiotic or wound antiseptic on bile bacteriology, wound and other postoperative sepsis has been studied in a controlled prospective randomised trial of 243 patients undergoing biliary surgery at a district general hospital. Wound infection rates were significantly less in patients given intravenous ceftriaxone (1%) at induction of anaesthesia when compared to povidone iodine sprayed into the wound at the completion of surgery (9%) (P = 0.02). In all but one patient infected wounds grew organisms identical to those cultured from the bile. There were also fewer chest and urinary infections in the ceftriaxone group but this was not statistically significant.

Administration, Topical↗
PubMed1987

Emergency abdominal re-exploration in a district general hospital.

A series of 3600 consecutive patients undergoing laparotomy was studied prospectively. Fifty six patients required a total of 64 urgent re-explorations of the abdomen during the period of hospitalisation after the first operation. The re-exploration rate was 1.7%. Re-laparotomy was most often necessary in the elderly and following gastroduodenal or intestinal operations. The indication for re-operation must in part reflect the nature of surgical practice but in this general surgical unit the most common complications requiring re-laparotomy were sepsis, small bowel obstruction and wound dehiscence. Biliary operations were relatively uncomplicated. Mortality rose with age. Diagnosis depends upon the ability to distinguish the clinical symptoms and signs of developing complication from the clinical features inevitable following abdominal surgery. We believe that the decision to re-operate and the second operation should normally be undertaken by experienced surgical staff.

Abdomen, Acute↗