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Biomedical subjects

A L Golding

Publications and source records attributed to A L Golding.

13 recordsLinked to original sources
PubMed1989

Mortality from diabetes mellitus in Jamaica.

Mortality data for 8,799 Jamaican diabetics who died between 1970 and 1979 were collected by reviewing the death certificates of all jamaicans that were recorded for that period. Diabetes was found to account for 6.5% of all deaths; 62% of these deaths occurred among females; and diabetics were found to die earlier than nondiabetics. There was also underreporting of diabetes in the official Registrar General's statistics, in that about a third of the descendents who had diabetes recorded on their death certificates were not coded as having died of diabetes, because the disease was not recorded as the underlying cause of death. Vascular disease was a prime cause of death among these diabetics.

Adult↗
PubMed1981

No-needle dialysis (NND): experience with the new carbon transcutaneous hemodialysis (HD) access device (CTAD).

A new carbon transcutaneous access device (CTAD) for hemodialysis id described the precludes the need for needle puncture. The device consists of a vitreous carbon access port attached to a PTFE graft. A disposable connector provides for movement of blood from the device into and out of the dialyzer. Twenty-one of the devices have been implanted in 18 patients. Overall 9 month patency rate is 64.3%, comparing favorably with conventional PTFE grafts. The incidence of infection (1 per .05 patient months) and thrombosis (28.6% at 9 months) similarly compare favorably with other forms of vascular access. The CTAD provides a unique opportunity by permitting hemodialysis without the pain or risk of needle punctures.

Arteriovenous Shunt, Surgical↗
PubMed1976

Lower extremity ischemia after femoral arteriovenous bovine shunts.

Use of bovine carotid artery grafts for femoral arteriovenous fistulas is now an accepted method of circulatory access for patients who require chronic hemodialysis. A serious but infrequently mentioned complication of this technique is lower extremity ischemia secondary to an arterial steal phenomenon. Three cases of this syndrome are presented and specific recommendations made for preoperative and intraoperative evaluation in order to avoid this complication. A possible surgical technique for correction of this syndrome is also discussed.

Adult↗
PubMed1976

High-output congestive failure from femoral arteriovenous shunts for vascular access.

Femoral arteriovenous bovine shunts (FAVBS) represent an accepted method of vascular access for patients requiring chronic hemodialysis. The authors present 4 patients who required corrective surgery for high-putput congestive heart failure (HOCHF) secondary to high flow rates through the shunt. In order to avoid this serious complication, intraoperative graft flow rates should not exceed 900 cc/min. HOCHF secondary to FAVBS may be refractory to conservative therapy and require either banding of the shunt or its removal.

Adult↗
PubMed1976

Hemodynamic consequences of femoral arteriovenous bovine shunts.

Seventeen patients with femoral arteriovenous bovine shunts (FAVBS) were evaluated to delineate the cardiovascular consequences of the procedure. The resting cardiac index (CI), as estimated by echocardiography, was increased in 8 patients (47%). Twelve of the 17 patients (71%) had more than a 20% reduction in CI after 5 minutes of shunt occlusion. In 6 of these, the CI returned to normal from an abnormally high value. As a group, the decrease in CI was significant (P = 0.001). This was accomplished mainly by a significant decrease in stroke volume (P less than or equal to 0.004). Signs and symptoms of congestive heart failure developed in 10 of the 17 patients during the year following FAVBS. Because of the marginal cardiac reverse in patients with renal failure and the significant increase in cardiac index resulting from FAVBS, alternative forms of vascular access should be used whenever possible.

Adolescent↗
PubMed1975

Temporary external shunt bypass in the traumatically amputated upper extremity.

The technique of temporary external shunt bypass offers early perfusion of a traumatically amputated extremity, thus decreasing the total anoxic time, permitting bony fixation after perfusion is established, and allowing arterial revascularization with good venous outflow and minimal blood loss. This technique may increase the survival of these severely damaged limbs.

Amputation, Traumatic↗
PubMed1970

Quinton-Scribner cannulas for hemodialysis. Review of four years' experience.

Data on a study group of 52 maintenance hemodialysis patients cannulated with Quinton-Scribner cannula in a four-year period were analyzed. The average period of dialysis was 11.8 months with either a pumped coil or a pumpless Kiil artificial kidney system. One hundred and forty-five cannulations were performed. The mean arterial cannula survival was 7.8 months and the mean venous cannula survival was 7.2 months. The exceptional longevity of cannula survival occurred despite the high incidence of atherosclerotic changes at operation and the advanced mean age (47 years) of the patients. The cannula longevity may be partially related to the technique used and to meticulous surgical care given the patient before and after cannulation. Complications from cannulation included two deaths, one from septic pulmonary embolism of Staphylococcus origin, and one from acute Pseudomonas endocarditis. A total of 36 infections of cannulas were recognized, the majority being due to Staphylococcus aureus, but 28 percent being secondary to Gram-negative bacteria.

Acute Kidney Injury↗