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Biomedical subjects

R MacMillan

Publications and source records attributed to R MacMillan.

29 records · Page 2Linked to original sources
PubMed1985

A study of stab wounds.

A study was made of patients with stab wounds who attended the Accident and Emergency Department of Glasgow Royal Infirmary during 1978 and 1983. There were 318 patients. The majority, 304 (96%), were males. A total of 87 (27%) were teenagers. The most common sites of the wounds were the chest (143 patients) and the abdomen (113 patients). The features of the patients and their wounds are compared with those of a previous study carried out at the same hospital in the early 1960s (Batey & MacBain, 1967). The post-mortem reports of 25 fatal stab injury cases occurring in Glasgow between 1971 and 1978 are also reviewed. Some aspects of diagnosis, management and prevention of stab wounds are discussed.

Abdominal Injuries↗
PubMed1983

Urethrotomy under direct vision: the primary treatment for urethral stricture.

Urethrotomy by direct visualization is highly successful in managing urethral strictures. The authors treated 55 patients by this method between 1978 and 1982. Thirty-four had undergone multiple dilatations previously and their unanimous agreement that visual urethrotomy was less painful and accompanied by fewer complications prompted the authors to use the latter method as the primary treatment in 21 patients, on an outpatient basis. The success rate in these 55 patients was 75%. The failure rate was 7%. The remainder were improved but had recurrent strictures, though less frequently than before visual urethrotomy. Because the procedure can be done on an outpatient basis, with a high success rate and minimal morbidity, the authors conclude that urethrotomy under direct vision should be the standard primary procedure for managing all urethral strictures.

Adolescent↗
PubMed1981

Epidemiology of head injury.

To find the incidence of the various types of head injury that occur in the community separate yearly rates (per 10(5) population in Scotland) for deaths, admissions to hospital, and attendance at accident and emergency departments were estimated and compared (when possible) with rates in England and Wales and the United States. Hospital admissions provide the best data for comparing incidences in different geographical areas and rates of attendance at accident and emergency departments the most reliable guide to incidences in the community. Admission rates, however, vary with local facilities and policies, and these also determine the proportion of patients referred to regional neurosurgical units. Such epidemiological data must be sought both for planning health care for head injury and for monitoring the effectiveness of services.

Adolescent↗
PubMed1981

Head injuries at an inner city accident and emergency department.

A prospective study was carried out of 784 adults (aged 13 years and over) with recent head injuries who attended the Accident and Emergency Department of the Glasgow Royal Infirmary during an 11-week period (April-June 1978). One-third were caused by assault and only one-tenth by road traffic accidents. Half the patients had recently ingested alcohol, one-quarter of all patients had at least a brief period of post-traumatic amnesia (PTA). The overall admission rate was 28 per cent. Radiography of the skull was performed in 65 per cent and a fracture seen in 5 per cent of these. One-quarter of the patients had at least one unsatisfactory radiograph. Two patients whose fractures were initially missed on radiography were not admitted. Seven of the 24 patients with fractures had no clinical evidence of brain damage (no PTA, no impaired conscious level, no focal neurological signs or symptoms), but all had wounds of the scalp. One-third of all patients did not have radiography of the skull performed, nor were they admitted to hospital, yet one-quarter of these had some evidence of brain damage.

Adolescent↗
PubMed1979

Head injuries in three Scottish neurosurgical units. Scottish head injury management study.

The organisation of care for patients with head injuries in Scotland was investigated by studying retrospectively 785 patients admitted in 1974 and 1975 to neurosurgical units in Glasgow, Aberdeen, and Dundee. The reasons for the injuries and the patients' clinical conditions were similar in each unit. The referral practices at the hospitals containing the units were compared and found to be different from that of the unit in Edinburgh. It is concluded that patients in the Glasgow, Aberdeen, and Dundee units, which operate a similar policy for head-injured patients, are in general similar. Transferring to a neurosurgical unit only selected patients rather than all patients with head injuries is safe practice only if policies are agreed with primary surgeons and patients can be transferred without delay.

Adolescent↗
PubMed1978

Head injuries in accident and emergency departments at Scottish hospitals.

The features of 3500 patients with head injury who attended accident and emergency departments in Scotland during 1974 are described. These represented 10 per cent of all attenders at these departments. Recent alcohol consumption was noted in 25 per cent of adult males; this was commonest amongst those who were victims of assault or pedestrians involved in traffic accidents. Forty-one per cent of patients had scalp wounds; 58 per cent had radiographs of the skull taken and of these 2.7 per cent had fractures of the skull. Although 20 per cent of patients had altered consciousness at some time, only 5 per cent showed any evidence of impaired consciousness when seen at hospital. Twenty-three per cent of those attending were admitted to hospital. Criteria which are important when assessing whether a head-injured patient should be admitted to hospital are listed.

Accidents↗