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Biomedical subjects

R Waldron

Publications and source records attributed to R Waldron.

At least 37 records · Page 2Linked to original sources

Teicoplanin, its pharmacokinetics, blister and peritoneal fluid penetration.

The pharmacokinetics of a 440 mg iv dose of teicoplanin were studied in six male volunteers. The levels of the compound were measured microbiologically in serum, blister fluid and urine. The mean serum level 0-5 h after injection was 44.6 mg 1(-1), falling to 3.6 mg 1(-1) at 49 h. The serum elimination half-life of teicoplanin when fitted to a two-compartment model was 34.2 h; a three-compartment model gave a longer half-life. The apparent distribution half-life was 1.5 h. Penetration into cantharides induced blister fluid was moderately fast, the mean maximum concentration (14.8 mg 1(-1)) occurring at 2.7 h, the mean percentage penetration being 77.4%. Urinary recovery of the drug was 48.3% by 96 h. The drug penetrated rapidly into the non-inflammed peritoneal fluid of 34 patients undergoing elective surgery. The percentage penetration being 40% within the first hour, and 94.6% over the period of the study.

Adult↗

Technique and results of trans-scrotal operations for hydrocele and scrotal cysts.

Surgical procedures for scrotal hydroceles and cysts carry a significant morbidity rate from haematoma formation. Lord's transcrotal procedure involves minimal tissue dissection. The present series of 84 cases confirms Lord's original claims of a very low risk of haematoma with no recurrence. It is concluded that Lord's procedure is effective, simple, safe and economic.

Adult↗

Antiseptic vs. saline lavage in purulent and faecal peritonitis.

A prospective randomized trial compared antiseptic solutions and normal saline as a means of preventing morbidity and mortality from residual sepsis in patients with generalized peritonitis. Fifty-three patients, all given broad-spectrum antibiotics, were entered into the study. Twenty patients received a saline lavage, 19 lavage with chlorhexidine-gluconate and 14 a saline lavage with instillation of povidone-iodine. All deaths were due either to the severity of the presenting disease or co-existing complicating conditions. The incidence of postoperative pyrexia, wound infection and duration of hospital stay of the surviving patients were unaffected by lavage grouping.

Adolescent↗

Choledochal cysts--report of three cases and review.

Three cases of choledochal cyst are presented, with a review of previous publications. We re-emphasize the diagnostic dilemma involved and discuss current surgical management. A new complication is illustrated and an association with polycystic kidneys is reported. Choledochal cysts are uncommon, but correct management ensures a symptom-free future for the patient. Recent reports support cyst excision if technically feasible.

Adult↗

Effects of therapeutic amniocentesis on uterine and umbilical artery velocimetry in cases of severe symptomatic polyhydramnios.

The objective of this study was to determine the effects of removal of amniotic fluid in cases of symptomatic severe polyhydramnios on Doppler waveform indices of the uterine and umbilical arteries and flow velocities of the uterine arteries. Nine women underwent therapeutic amniocentesis during ten pregnancies for symptomatic polyhydramnios due to Beckwith-Wiedemann Syndrome (n = 1), esophageal atresia (n = 2), chorioangioma (n = 1), twin-twin transfusion syndrome (n = 3), a presumed autosomal recessive syndrome (n = 2), and an unbalanced double translocation (n = 1; partial dup 3q and partial del 9p syndrome). An average of 2.78 +/- 0.9 (range 1-4) 1 of fluid were removed at each procedure between the gestational ages of 18 and 34 weeks (mean of 28 weeks). The systolic/diastolic (S/D) ratio, pulsitility index (PI), and resistance index (RI) of the uterine and umbilical arteries were obtained before and after the procedure using color and pulsed Doppler. After angle correction, the peak systolic velocity (PSV) and mean velocity (MV) in centimeters/second (cm/s) of the uterine arteries were also determined. The presence or absence of a uterine artery waveform notch was determined. Dominant uterine arteries were defined as those with lower impedance indices or higher flow velocities. Statistical analysis was performed with the Wilcoxon signed-rank test. Significance was set at P < 0.05. There was a significant increase in the median value of the uterine artery MV (43.8 vs. 81.1 cm/s, P = 0.005) and PSV (74.2 vs. 125.5 cm/s, P = 0.007) after amniocentesis. The uterine S/D (3.0 vs. 1.84, P = 0.007), PI (1.12 vs. 0.68, P = 0.008), and RI (0.60 vs. 0.45, P = 0.005) impedance indices significantly decreased following amniocentesis. When uterine arteries were categorized as dominant vs. nondominant, there were greater improvements in impedance indices and flow velocities in the nondominant uterine arteries. There were three cases of unilateral and one case of bilateral early diastolic notches of the uterine artery waveforms which either resolved (n = 4) or improved (n = 1). There was no effect on the umbilical artery impedance indices. Therapeutic amniocentesis significantly improved uterine artery impedance indices and resulted in improved flow velocities, while there was no effect on umbilical artery waveform indices. The procedure resulted in the disappearance or improvement of the uterine waveform notch. Our findings suggest that in cases of severe polyhydramnios abnormal uterine artery velocimetry may not be due to lack of trophoblastic invasion of the spiral arteries but to increased intrauterine pressure secondary to polyhydramnios.

Amniocentesis↗

An audit of surgery for seventy-one primary parotid tumours.

Seventy-one consecutive patients who presented with lumps in the parotid gland over an eight year period (1981-1989) were analysed. Two-thirds of the patients presented with a history of swelling for over one year, while a quarter (24%) had a parotid mass for over five years at initial referral. The pathology of these masses was diverse, with pleomorphic adenoma being the commonest (64%). Superficial parotidectomy was the commonest procedure employed (50/71) with local excision being performed only in the initial part of our series (15/71). There were five cases of permanent facial palsy, four following radical resection for malignancy. Tumour recurrence rate was 2/15 (13%) in cases treated by local excision while none of the 50 patients treated by superficial parotidectomy had tumour recurrence at a mean follow-up of five years. Only three patients developed Frey's Syndrome. It is recommended that increased community awareness of early referral of a parotid mass is necessary, as surgical treatment in the form of superficial parotidectomy, which is the ideal procedure for such lumps, carries minimal morbidity when performed by a surgeon with a special interest in parotid surgery.

Adolescent↗