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Biomedical subjects

R L Simpson

Publications and source records attributed to R L Simpson.

At least 199 records · Page 11Linked to original sources

A comparison of the effects of maternally administered meptazinol and pethidine on neonatal acid-base status.

A randomized double-blind study compared the effects of equi-analgesic doses of maternally administered meptazinol (1.5 mg/kg) and pethidine (1.5 mg/kg) on neonatal acid-base status. Heel-prick samples were taken for assessment of acid-base status at 10 and 60 min after delivery. Maternal antenatal history, details of labour and neonatal status at delivery were also recorded. Meptazinol produced less neonatal respiratory depression than pethidine: the mean 10 min acid-base data from 16 infants whose mothers received pethidine were indicative of a respiratory acidosis (pH 7.13, SD 0.08, PCO2, 9.11, SD 2.2 kPa; standard bicarbonate 22.3, SD 3.1 mmol/l). This was not evident in the mean acid-base data from 16 infants whose mothers received meptazinol (pH 7.23, SD 0.07; PCO2 6.83, SD 1.6 kPa; standard bicarbonate 20.9, SD 4.2 mmol/l). The mean pH and PCO2 in the two treatment groups were significantly different (P less than 0.002) at 10 min but not at 60 min after delivery.

Acid-Base Equilibrium↗

Reanimation of the long-standing partial facial paralysis.

Those unfortunate people who suffer from permanent partial facial paralysis have great difficulty finding surgeons who can offer corrective operations. Improving their function is a most delicate procedure. Great care must be exercised to avoid injuring nerves and muscles which are still operating, although in a greatly diminished state. The pathogenesis must be understood before attempting any corrective procedure. Adequate time must elapse from the moment of injury to surgical intervention, thus allowing for maximal nerve and muscle regeneration. This paper describes techniques that could improve facial movements. The most frequently used procedure is shortening of the levator and/or the zygomatic muscles that are partially atrophied. It must be understood that total reanimation is impossible as of this time.

Adolescent↗

Diagnostic, percutaneous peritoneal lavage in blunt abdominal trauma: rationale, technique and results.

The records of 90 consecutive adult patients, who presented after blunt abdominal trauma and who underwent diagnostic, percutaneous peritoneal lavage over a 3 year period, were reviewed. Lavage effluents were considered positive, negative or equivocal. An equivocal result was one where the tubing contained blood stained fluid, but it was still possible to see newsprint through the tubing. Fifty-one lavages were positive, 24 negative and 15 equivocal. All 51 patients with a positive effluent and three of the patients with an equivocal effluent had a laparotomy and in all but one case a significant injury was found. There were no false negative results. In a single patient the transverse colon was perforated during the insertion of the lavage catheter. Diagnostic, percutaneous peritoneal lavage is a simple, safe, rapidly performed, accurate technique designed to detect intraperitoneal blood and the results of this review suggest that it has a role to play in the decision-making process when assessing adult patients who have suffered blunt abdominal trauma.

Abdominal Injuries↗

Curative local excision of rectal adenocarcinoma.

The records of all 28 patients with rectal adenocarcinoma treated by potentially curative local excision by one surgeon (A.M.C.) between 1970 and 1984 were reviewed. Patient age, sex, tumour size, site, degree of differentiation and level of invasion are reported. The procedure was associated with no mortality and minimal morbidity. Twenty-two patients, followed for an average of 51 months, have either died of other causes or remain free of recurrent or disseminated malignancy. Six patients have required further surgery for local recurrence. Of these, one patient has had a repeat local excision while the remaining five patients have had an abdominoperineal excision of the rectum. All six patients, followed since the second operation for an average of 50 months, are free of further recurrent or disseminated disease. The results reported in this review suggest that in a selected group of patients with rectal adenocarcinoma curative local excision may offer a safe alternative to more radical forms of surgery.

Adenocarcinoma↗

Caustic burns from contact with wet cement.

Cement is a widely used mixture in construction. A corrosive alkali, calcium hydroxide, is liberated as water is added to the lime present in the cement mixture. Skin contact for prolonged periods produces deep chemical burns with thick eschar formation. Five cases of chemical burns to the lower extremities following contact with the cement mixture are presented. When full-thickness burns were present, long periods of hospitalization were necessary for eschar separation prior to skin grafting. Early excision of full-thickness caustic burns with immediate skin grafting diminished the length of hospitalization and returned the patient to work sooner.

Adult↗

Ileocaecal intussusception of a previously recognized Meckel's diverticulum.

A case is reported of an ileocaecal intussusception caused by a previously recognized Meckel's diverticulum. The case offers the opportunity to discuss the management of an asymptomatic Meckel's diverticulum found incidentally. The conclusion is reached that, in general, diverticulectomy is appropriate.

Adult↗

Adult intussusception in the tropics.

Thirty-two cases are reported of intussusception occurring in patients over the age of 12 years, diagnosed in Papua New Guinea in the 8 years from March 1973. Malignant disease was found in only 2 patients (6.3 per cent), and in 21 cases (65.5 per cent) no associated pathology was detectable. Benign inflammatory polypi were encountered in 7 patients (22 per cent). A high proportion of primary intussusceptions is characteristic of series reported from tropical countries. Many may be due to the abnormal motility associated with acute diarrhoeal illnesses. Due to the rarity of associated malignancy a policy of conservative operative management is justifiable in a tropical environment.

Adolescent↗