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Biomedical subjects

A M Sutherland

Publications and source records attributed to A M Sutherland.

At least 19 recordsLinked to original sources
PubMed1998

Improving communication between hospital and primary care increases follow-up rates for asthmatic patients following casualty attendance.

Despite adequate access to primary care facilities, there is a group of patients who habitually present to hospital accident and emergency (A&E) departments when their asthma deteriorates. In Nottingham 50% of these patients are discharged from the A&E department without admission to hospital and are advised to inform and see their general practitioner (GP), but many fail to do so. We instituted a system of identifying all patients seen and discharged from our A&E department with asthma and informing their GPs and practice nurses within one working day of the event by fax. To determine whether any action had been taken following receipt of our fax, we contacted each general practice 1 month after the A&E attendance in 100 consecutive cases. Full data were available for 66 patients. Our faxes increased the notification of A&E attendances to GPs from 47 to 89%. This resulted in an increase in the number of follow-up appointments initiated by the practice, from 15 to 31. However, 29% of patients were not asked to attend for follow-up, in spite of the practice being aware of a recent A&E visit. Improving communication between hospital and general practice increases the rate of follow-up by GPs for patients with asthma who have been discharged from A&E. This has the potential to improve asthma management for this group of patients.

Asthma↗
PubMed1997

Gynaecological tuberculosis since 1951.

A study has been made of 711 patients with proved gynaecological tuberculosis investigated between 1 January 1951 and 31 December 1994. The main presenting symptoms in order of frequency were infertility, pelvic pain, excessive menstrual loss and amenorrhoea. The average age at first attendance was 31 years, only 16% of married women had been pregnant and palpable adnexal masses were found in 47%. Eight drug programmes were used, the best results being obtained with streptomycin, para-aminosalicyclic (PAS) acid and isoniazid or with rifampicin, ethambutol and isoniazid. Toxic drug reactions occurred in 114 patients, the drugs responsible in the majority being streptomycin and PAS. Where drug treatment failed, surgery under further drug cover was employed in 85 patients, with no deaths and no fistulae. After treatment, there were 95 pregnancies in 57 patients. In recent years there has been a rise in the incidence of tuberculosis in general in the Western world. Many factors play a part in this, by far the most important being the spread of AIDS.

Journal Article↗
PubMed1992

General practice and the provision of information and services for physically disabled people aged 16 to 65 years.

The study reported here was part of a larger survey investigating the nature and extent of disability in the Grampian region. Interviews with 212 people aged between 16 and 65 years who had a wide range of physical disabilities elicited perceptions of current and past service provision. Respondents expressed a strong need for information on disability services and reported difficulty in knowing whom to approach for this. General practitioners were the most commonly reported source of such information and low usage of the Department of Social Security, social work departments and voluntary organizations was identified. No significant relationship was found between degree of disability and frequency of consultation with a general practitioner. However, the more severe the disability the more likely it was that the general practitioner initiated contact rather than the patient. Although in general those interviewed were satisfied with medical information given regarding their diagnosis, they were more critical of information provided in relation to coping with the disorder, including that concerning benefits and services. The study confirmed the pivotal role of the general practitioner in the care of physically disabled people in the community aged between 16 and 65 years. The need to re-evaluate the role of the general practitioner in the provision of information and services is discussed.

Adolescent↗
PubMed1985

Gynaecological tuberculosis: analysis of a personal series of 710 cases.

A study has been made of 710 patients with proved gynaecological tuberculosis investigated between January 1, 1951 and March 31, 1985. The main presenting symptoms in order of frequency were infertility, pelvic pain, excessive menstrual loss and amenorrhoea. The average age was 31 years at first attendance, only 16% of married women had been pregnant and palpable adnexal masses were found in 47%. Seven drug programmes have been used, the best results being obtained with the current regimen employing rifampicin, ethambutol and isoniazid. Where drug treatment failed, surgery under further drug cover was successfully employed. Toxic drug reactions occurred in 114 patients.

Adolescent↗
PubMed1983

The changing pattern of tuberculosis of the female genital tract. A thirty year survey.

Between 1st January, 1951 and 31st December, 1980, 704 women with proven tuberculosis of the genital tract were investigated. The previous obstetrical history, age incidence, presenting symptoms, and pelvic findings have been reviewed in 10-year periods. The incidence of previous pregnancies rose in successive periods and the average age increased. The main differences in the presenting symptoms were a lessening in the frequency of amenorrhoea and vaginal discharge and an increase in postmenopausal bleeding. The incidence of palpable adnexal masses decreased in successive 10-year periods. Short drug courses were mainly employed in the earlier years and longer courses in the later years. The drugs used initially were streptomycin, PAS and isoniazid, ethambutol and rifampicin being introduced later. The incidence of surgical treatment following failure of drug therapy was much higher in those who had received short drug courses than in those who had received longer ones.

Adult↗
PubMed1983

Immunodiagnosis of colorectal cancer: clinical evaluation of Tennessee antigen (Tenagen).

Blood samples from 172 consecutive patients undergoing complete colon investigations to exclude colorectal cancer (CC) were examined for levels of Tennessee antigen, i.e., Tenagen (Tg), and carcinoembryonic antigen. Patients included 48 with CC, 34 with adenomatous polyps, 14 with colitis, and 76 with no organic mucosal disease. All patients were investigated by the one clinical and histopathology department. Laboratory estimations were performed blindly. Although there were some statistically significant differences among average values, the degree of overlap among the groups of patients precludes the practical application of Tg in the diagnosis of CC.

Aged↗
PubMed1982

Postmenopausal tuberculosis of the female genital tract.

A study was made of women with postmenopausal tuberculosis of the genital tract investigated between January 1, 1951, and March 1, 1981. Twenty-six of 701 patients (3.7%) with proved gynecologic tuberculosis had postmenopausal infection. The age incidence of gynecologic tuberculosis has changed in recent years; the proportion of patients over 40 years of age is now much higher than in the past. Since January 1, 1976, a combination of rifampicin, ethambutol, and isoniazid has been employed in the treatment of this disease. Six new cases treated with this drug program are described. No patient showed evidence of recurrence at follow-up.

Adult↗
PubMed1980

Surgical treatment of tuberculosis of the female genital tract.

A study has been made of 91 women with proved tuberculosis of the genital tract treated by surgery between 1st January, 1951 and 15th October, 1979. In 77 the operation was performed during anti-tuberculosis drug therapy. In the remainder the diagnosis was made after operation and drug therapy was started as soon as possible thereafter. The indications for operation were paid (40 patients), pelvic masses (36 patients), recurrence of endometrial tuberculosis (10 patients), uterine bleeding (3 patients) and suspicion of endometrial neoplasia (2 patients). Total hysterectomy with removal of both tubes and ovaries was done in all patients except two, in whom pelvic clearance was not technically feasible. No patient developed a fistula and there were no deaths. All patients were well at follow-up.

Female↗
PubMed1979

Gynecological tuberculosis in the west of Scotland.

Between 1st January 1950 and 15th June 1978, 638 women with proved tuberculosis of the genital tract were investigated. 7 different drug programmes were used to treat 581 patients. Apart from the most recent regimens employing ethambutol and rifampicin, the best results were obtained with a combination of streptomycin, PAS and isoniazid for 18 mth or 2 yr. Today the treatment of choice is a combination of rifampicin, ethambutol and isoniazid for 1 yr. Surgery should be employed where drug treatment has failed. It is essential that women with tuberculosis of the pelvic organs should be followed up indefinitely after drug treatment.

Aminosalicylic Acid↗
PubMed1977

Twenty-five years experience of the drug treatment of tuberculosis of the female genital tract.

A study has been made of women with proved, tuberculosis of the genital tract who were treated with drugs between 1st January, 1951, and 1st July, 1976. Seven different drug programmes were employed and 566 women were treated. Apart from the last two schedules employing the newer antituberculosis drugs, which were too recent for a follow-up to be available, the best results were obtained with a combination of streptomycin, PAS and isoniazid for 18 months or two years. In this group, 87.7 per cent were regarded as cured after an average follow-up of six years and six months. Drug cover was employed in 79 patients in whom surgery was found to be necessary and the results were uniformly satisfactory. Toxic drug reactions occurred in 18.2 per cent of the patients treated.

Aminosalicylic Acid↗
PubMed1976

The treatment of tuberculosis of the female genital tract with streptomycin, PAS and isoniazid.

An analysis has been made of the results of treatment of 206 patients with tuberculosis of the female genital tract, using a combination of streptomycin, PAS and isoniazid for 18 months or two years. There was no follow-up in 21 cases. One hundred and sixty-six patients (90 per cent of those traced) were judged to be cured after an average period of six years from the end of treatment. In 19 cases (10 per cent) drug treatment failed and operation was employed. The results of surgical treatment under cover of a modified course of the same drug combination were satisfactory. There were no deaths and no major complications. Apart from the low incidence of successful pregnancy, the symptomatic results following drug treatment were generally good.

Adult↗