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T G Parks

Publications and source records attributed to T G Parks.

At least 37 records · Page 2Linked to original sources
PubMed1991

Surgical training posts in Northern Ireland: assessment by surgeons in training.

Northern Ireland has one of the largest surgical training programmes in the United Kingdom. The surgical trainees' assessment of the quality of training provided has been collated prospectively since 1983, and provides a useful insight into the strengths and weaknesses of the programme, as well as the training value of individual posts. The overall quality of clinical training in surgery was considered to be well above average, but some registrars felt that supervision of operative surgery could be improved. Clinical research was considered to be of average quality in the teaching hospitals but below average in district general hospitals. In the current climate of restriction of the number of training posts in general surgery, the views of the trainees should not be neglected in assessing which posts are best suited for training.

Education, Medical, Continuing↗
PubMed1990

The investigation of anorectal dysfunction in the solitary rectal ulcer syndrome.

To investigate anorectal function in solitary rectal ulcer syndrome 22 patients were studied by means of balloon expulsion, intestinal transit time, barium enema and evacuation proctography. Half of the patients tested had difficulty in expelling a water filled balloon. Delay in intestinal transit was noted in only three patients. Barium enema was of little benefit in diagnosing the condition. Evacuation proctography was the investigation of choice in that it showed at least one abnormality of pelvic floor function in all of the patients and can help select patients for surgery.

Adult↗
PubMed1990

Smooth muscle tumours of the alimentary tract.

Neoplasms arising from smooth muscle of the gastrointestinal (GI) tract are uncommon, comprising only 1% of gastrointestinal tumours. A total of 51 cases of smooth muscle tumour of the GI tract were analysed; 44 leiomyomas and 7 leiomyosarcomas. Lesions occurred in all areas from the oesophagus to the rectum, the stomach being the commonest site. Thirty-six patients had clinical features referable to the tumour. The tumour was detected during investigation or management of an unrelated disease process in 15 patients. The clinical presentation varied depending on tumour location, but abdominal pain and GI bleeding were the commonest presenting symptoms. The lesion was demonstrated preoperatively, mainly by endoscopy and barium studies, in 27 patients. Surgical excision was the treatment of choice, where possible. There was no recurrence in the leiomyoma group but four patients died in the leiomyosarcoma group. Although rare, smooth muscle tumours should be considered in situations where clinical presentation and investigations are not suggestive of any common GI disorder. The preoperative assessment and diagnosis is difficult because of the variability in clinical features and their inaccessibility to routine GI investigation. It is recommended that, where possible, the lesion, whether symptomatic or discovered incidentally, should be excised completely to achieve a cure and prevent future complications.

Adult↗
PubMed1990

Crohn's disease in Northern Ireland--a retrospective study of 440 cases.

The incidence of Crohn's disease in the community is thought to be changing, with conflicting evidence for increases, decreases or steady state situations being described. A retrospective study, using strict criteria for diagnosis, for a 16 year period in Northern Ireland demonstrated an increasing incidence of Crohn's disease, with a distribution in the population similar to that described in previous studies.

Adolescent↗
PubMed1990

Wound sepsis in 10,000 surgical patients.

A twelve year prospective wound audit was undertaken in an academic surgical unit. Data from 10,000 operations were analysed. Overall, wound infection rates decreased during this time. Infection rates in contaminated wounds in particular fell from 19.2% to 4.7%. This decrease in wound infection may be related in part to a change in the antibiotic prophylactic regimen and in part to the institution of the wound sepsis audit which provided regular information on the unit infection rates. This audit permitted early detection of adverse trends, and may have had a direct influence on surgical techniques.

Cephalosporins↗
PubMed1989

Clinical features in patients with excessive perineal descent.

We have found excessive perineal descent to be associated with a variety of anorectal problems and have reviewed the clinical features in 29 patients who were noted to have excessive perineal descent as measured by perineometer. The condition mostly occurs in women and is usually associated with straining at stool, rectal bleeding, mucus discharge, perineal or abdominal pain and urinary incontinence.

Adult↗
PubMed1988

A prospective randomized trial to compare triple dose mezlocillin with triple dose cefuroxime plus metronidazole as prophylaxis in colorectal surgery.

The results of a prospective randomized clinical trial to compare three dose regimens of mezlocillin with cefuroxime plus metronidazole for prophylaxis in emergency and elective colorectal surgery are reported. Severe wound infection occurred in five patients (10%) receiving mezlocillin and in four patients (7%) receiving cefuroxime and metronidazole. There were two episodes of septicaemia, each in the mezlocillin group. The total number of surgically related infections was less with cefuroxime plus metronidazole (n = 10) compared with mezlocillin (n = 17), but this was not statistically significant (P greater than 0.1).

Adult↗
PubMed1988

Some clinical aspects of Crohn's disease in Northern Ireland: an aid to earlier diagnosis?

A retrospective epidemiological study of Crohn's disease in Northern Ireland between 1966 and 1981 has been carried out. Using strict diagnostic criteria 440 cases were identified and aspects of the clinical presentation of the disease at initial diagnosis were examined. This paper describes the clinical pattern of the major symptoms of the disease and highlights the delay in diagnosis. One-third of cases (32.7%) were not diagnosed until more than a year after the onset of symptoms and 7.5% of cases were not diagnosed for more than five years. Colicky abdominal pain, one of the classical diagnostic symptoms of Crohn's disease was not present at initial diagnosis in 28.6% of cases nor were altered bowel habits found in 24.5% of cases. Only 17.7% of cases had an abdominal mass, just over half had an elevated erythrocyte sedimentation rate or lowered haemoglobin level and only 39.8% had rectal bleeding.Increased awareness by general practitioners of the delay in diagnosis of Crohn's disease may lead to earlier investigation and diagnosis of the condition which in this community occurs with an incidence of 2.34 new cases per 100 000 of the population per year.

Adolescent↗
PubMed1986

The presentation and management of presacral tumours.

Twenty cases of presacral tumours are presented, nine males and eleven females being affected. Malignancy occurred in 50 per cent of adults and was commoner in men than in women. Diagnosis depends on a careful rectal examination. Computerized axial tomography is the single most useful investigation; however, should it not be available, plain X-rays and ultrasonography give considerable information. For lesions less than 10 cm in size a local parasacral approach is often feasible but for larger lesions an abdominal approach or combined approach should be considered.

Adolescent↗
PubMed1986

Does cholecystectomy predispose to colorectal cancer? A case control study.

A case-control study of 598 patients with colorectal cancer (296 men, 302 women) admitted from January 1974 to October 1983 was undertaken. Patients were matched for age and sex, with controls admitted for unrelated conditions. All information was obtained from the hospital records. In men, there was no evidence of an increased risk of colonic cancer after cholecystectomy relative to men without cholecystectomy. There was some evidence of an increased risk in women (relative risk = 1.7; 95 percent confidence interval, 1.0 to 3.1) and this was highest when the tumor was in the right colon (P less than 0.005). This study confirms previous observations that cholecystectomy leads to an increased risk of right-sided colonic tumors in women but not in men. The apparent difference between the sexes may be explained by the low rate of cholecystectomy in the men examined.

Cholecystectomy↗