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Biomedical subjects

W H Thomson

Publications and source records attributed to W H Thomson.

At least 19 recordsLinked to original sources
PubMed1998

Tube caecostomy to protect rectal anastomoses.

BACKGROUND: Low rectal anastomoses are associated with a substantial risk of anastomotic leakage. Tube caecostomy offers a potentially simple method of anastomotic protection. METHODS: Some 226 patients undergoing restorative rectal resection with on-table colonic lavage and tube caecostomy over an 11-year period were reviewed. Endpoints selected included clinical anastomotic leakage, requirement for a subsequent formal stoma and complications of tube caecostomy. RESULTS: Overall, clinical anastomotic leakage occurred in 25 patients with a caecostomy (11.1 per cent). All leaks were noted among patients in whom caecostomy protection had been used after low anterior resection, giving a leak rate of 14.9 per cent (25 of 168) for this group of whom 17 (10.1 per cent) required reoperation and a formal stoma, and five (3.0 per cent) died. Complications of caecostomy or prolonged drainage after tube removal occurred in ten (4.4 per cent) and 15 (6.6 per cent) patients respectively. There were two cases of life-threatening invasive infection. CONCLUSION: Tube caecostomy provides inadequate protection of rectal anastomoses; complications are common and may be life threatening.

Anastomosis, Surgical↗
PubMed1995

Radiation protection issues associated with nuclear medicine out-patients.

This paper reviews the published data relating to the radiation hazards associated with nuclear medicine outpatients. It is discussed both in the context of the current UK advice as well as potential guidelines following the recommendations in ICRP 60. For diagnostic studies there is little need for restrictions. The main exceptions are for a prolonged journey home by public transport with high levels of 99Tcm and for the situation of an outpatient given 111In who has to look after a fretful infant. The main problem occurs following the administration of 131I therapy for thyrotoxicosis. The principal hazards are associated with external exposure; radiation doses from ingestion due to contamination are small. Restrictions should only be necessary for administered activities greater than 400 MBq (e.g. public transport, return to work, sleeping with partner). With such restrictions it is considered that 131I therapy for thyrotoxicosis can continue to be given on an outpatient basis.

Adult↗
PubMed1994

Closing the audit loop: a patient satisfaction survey.

A patient satisfaction survey was carried out in a nuclear medicine department of a large acute hospital. Surveys were initially carried out by interview and postal techniques, with approximately 100 responders in each category. The responses to each question were not significantly different for the two types of survey, although overall there was a significantly larger number of dissatisfied responses in the postal survey (22%) compared with the interview study (12%). The postal survey was repeated after 1 year, thus completing the audit loop. A significant reduction in dissatisfied responses has occurred in those areas which had been addressed following the criticisms revealed by the first survey.

Hospital-Patient Relations↗
PubMed1993

Where do we stand with the International Commission on Radiological Protection Report 60?

We have examined the implications of ICRP60 for nuclear medicine. Radiation doses to staff are currently low and reduction of the dose limits will have little impact. However, the proposed figures for the fetus may have implications for pregnant women where the workloads are high. With nursing staff on the ward, laboratory staff or indeed departmental porters there seems little problem. Radiation dose to the fingers is, however, a key factor, and ensuring that no further restrictions are placed on the proposed dose limits is important. The concept of constraints is becoming clearer but will need further thought, particularly with regard to exposure of the general public. The previous basis for declaring controlled and supervised areas has been abandoned, and the situation is now less clear. A most important area of debate will be the patient who is a controlled area, and great care will have to be taken to ensure that the number of patients in this category is not increased so that many more patients need to be kept in hospital. Exposure of the general public is also an issue and expanding the concept of medical exposure to include carers is an important development. This should prevent a number of unnecessary restrictions and adds weight to the point that two waiting rooms are not justified in nuclear medicine departments. ICRP recommendations will soon be incorporated into the legislation of member states and it is import for everyone to ensure that drafts are read carefully and that national proposals are not too restrictive.

Europe↗