Biomedical subjects

W M Rambo

Publications and source records attributed to W M Rambo.

At least 19 recordsLinked to original sources

PubMed1991

Endometriosis mimics general surgical disease.

Endometriosis is rarely encountered by the general surgeon but may on occasion mimic general surgical disease. Although usually diagnosed easily because of cyclic symptoms and typical physical findings, six atypical cases are presented. These cases were diagnosed as appendicitis (2), subcutaneous mass (2), pelvic wall malignancy, and lower gastrointestinal hemorrhage. Diagnosis was ultimately made by laparotomy or excisional biopsy in five cases and by fine needle aspiration in one. Resection of the lesion, if feasible, is often curative. If resection is not feasible, therapy depends on the severity of the symptoms, and the patient's desire for fertility. Recognition of the typical appearance of an endometrioma may avoid mistaking it for cancer.

Abdominal Neoplasms↗

PubMed1989

The educational value of community preceptorships in surgery.

Increasing class size provided the impetus to send students on the core surgery course at the Medical University of South Carolina College of Medicine into the community hospitals with members of the clinical faculty. Each student was assigned to a surgeon and accompanied this preceptor on rounds, in the operating room, and in the office. To determine whether the students' learning was affected by being outside the university, the authors looked at the experience from 1977 to 1986 with 683 surgery students who took community preceptorships and 696 surgery students who took only university-based rotations. The two groups were compared in regard to age, sex, basic science grade-point average, class rank at the end of the first two years in medical school, ward evaluations, grades on departmental final examinations, and National Board of Medical Examiners "mini-examination" scores and Part II surgery scores. No differences were found. Choices of specialty for the first postgraduate year and evaluations of program directors were reviewed for 1982, 1985, and 1986, and were similar for all three years. The preceptorship program has been popular with students, who stated that they valued the one-to-one relationship with surgeons who liked to teach. The program has relieved pressure on the university hospital system and provided a good learning experience for students.

Educational Measurement↗

PubMed1986

Elective cholecystectomy for the patient with sickle cell disease and asymptomatic cholelithiasis.

Experience with elective cholecystectomy in ten patients with sickle cell disease and one patient with sickle-thalassemia from 1977-1984 was reviewed. In contrast to an earlier review from our institution, the current series had a low morbidity. This improvement is attributed to careful perioperative care, especially preoperative transfusion, hydration, and oxygenation. Because of the increasing longevity of sickle cell patients, because of the incidence of eventual significant complications of even asymptomatic cholelithiasis, and in order to simplify medical management by eliminating the diagnostic confusion between acute cholecystitis and sickle cell hepatobiliary crisis, the authors believe that elective cholecystectomy is to be recommended for the sickle cell patient with asymptomatic gall stones.

Adolescent↗

PubMed1979

Treatment of cholelithiasis in patients with sickle cell anemia.

The incidence of cholelithiasis and surgical risk of cholecystectomy in patients with sickle cell anemia is reviewed. Records of all patients with sickle cell disease currently attending the Medical University of South Carolina Hematology Clinic were reviewed. An oral cholecystogram has been part of the initial evaluation for the past year. The records of 16 patients having cholecystectomy from 1968 to 1977 were reviewed with regard to diagnostic studies, preoperative preparation, morbidity, and mortality. When the status of the gallbladder is known, the incidence of cholelithiasis is 67%. The morbidity of elective cholecystectomy was high (37%); there was one death. Cholecystectomy is not recommended for the discovery of asymptomatic gallstones because of the relatively poor surgical risk and short life expectancy of these patients.

Adolescent↗

PubMed1977

Management of massive lower gastrointestinal bleeding.

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Adult↗

PubMed1975

Serum prognostic indicators in experimental Bacteroides peritonitis.

Serum lysozyme and hemolytic complement (CH100) levels were measured in dogs with experimental Bacteroides peritonitis. The CH100 levels showed little change in surviving animals. Nonsurvivors showed a moderate decrease in complement levels shortly after contamination. Both surviving and nonsurviving animals showed a slight initial decrease in lysozyme levels shortly after contamination. In surviving dogs this was followed by an increase to normal levels. In nonsurvivors, levels continued to increase, reaching a threefold magnification just prior to death. As a result of antibiotic therapy, CH100 levels exhibited no major changes; however, dogs deprived of antibiotic showed noticeable and persistent increases in lysozyme levels while treated animals showed only a mild elevation in lysozyme levels. The changes in the level of serum lysozyme may be a good indicator of antibiotic efficacy and approaching death from Bacteroides peritonitis.

Animals↗

PubMed1974