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C D Collins

Publications and source records attributed to C D Collins.

18 recordsLinked to original sources
PubMed1992

Case report: pneumatosis intestinalis occurring in association with cryptosporidiosis and HIV infection.

We report a case of pneumatosis intestinalis (PI) occurring in association with cryptosporidiosis in a patient documented as being HIV-seropositive. Chest and abdominal radiographs taken 2 months previously were normal and the patient did not have any evidence of gastrointestinal infection at that time. The case was complicated by cyst rupture resulting in a pneumoretroperitoneum and pneumomediastinum. The association of pneumatosis and cryptosporidiosis has not been previously reported.

Adult↗
PubMed1991

Radical external beam radiotherapy for localised carcinoma of the prostate using a hypofractionation technique.

The survival of 232 patients with apparently localized carcinoma of the prostate is reported, who were treated between October 1964 and October 1984 by a radical course of external beam radiotherapy using a hypofractionation technique. Assessment was made in a retrospective analysis, noting influence of age, stage of disease at presentation, initial histology, dose of radiotherapy given and any subsequent treatment required, recorded up to October 1986. From this it will be seen that the development of a six fraction regime, given over a period of three weeks leads to comparable results to other reported series, whether assessed as a local response or by survival curves, and to the economical use of scarce resources, but even more important, is less wearing for patients than daily fractionation, with early and late morbidity being within acceptable limits.

Aged↗
PubMed1990

Caseload or workload?

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Diagnosis-Related Groups↗
PubMed1990

Caseload or workload? Scoring complexity of operative procedures as a means of analysing workload.

OBJECTIVE: To present a more realistic assessment of surgical workload than that provided by a case count. DESIGN: Prospective study of all the operative procedures performed in one year, classified according to the British United Provident Association's schedule of procedures and scored by the "intermediate equivalent" value (taking the recommended fee value of an intermediate operation as 1.0) compared with the number of operations performed. SETTING: General surgical unit of Taunton and Somerset Hospital, comparing four consultant surgeons and their teams. PATIENTS: Inpatients and day patients admitted under the care of general surgeons during 1989. MAIN OUTCOME MEASURE: Difference between the apparent workload represented by simple case counting (caseload) and the actual workload represented by calculation of the total "intermediate equivalent" value. RESULTS: The workload assessed in terms of intermediate equivalent values was greater than that suggested by case counting for complex operations (12% v 4%), operations at the district hospital (82% v 74%), and operations performed by consultants (53% v 35%) and was lower for minor operations (20% v 42%), operations at the community hospitals (18% v 26%), and operations performed by surgeons in training grades and clinical assistants (47% v 66%). CONCLUSIONS: The use of the intermediate equivalent values as an indicator of complexity allows a more realistic assessment of the operative workload than a simple case count of the number of different operations and is recommended for comparing workload in different hospitals and departments.

England↗
PubMed1990

Carcinoma of prostate treated by radical external beam radiotherapy using hypofractionation. Twenty-two years' experience (1962-1984).

The survival of 209 patients with apparently localized carcinoma of the prostate treated by radical external beam radiotherapy is reported, noting the influence of age, stage of the disease at presentation, initial histology, previous surgery, and dose of radiotherapy given. From this it is seen that the development of a six-fraction regimen given over a period of three weeks leads to excellent results whether assessed as a local response or by survival curves and to the economical use of scarce resources, but, even more important, is less wearing for patients than conventional daily fractionation and with no major early or late morbidity recorded up to October 1986.

Aged↗
PubMed1990

The role of discography in lumbar disc disease: a comparative study of magnetic resonance imaging and discography.

This study reviews prospectively a series of 29 patients who were examined by magnetic resonance imaging (MRI) and discography for degenerative disc disease. All had persistent low-back pain and non-diagnostic initial investigations, including plain films, myelography and/or computed tomography (CT). The imaging characteristics for degenerative disc disease correlated in 65 out of 73 intervertebral levels. All symptomatic discs were degenerate on both MRI and discography. Features of degenerative disc disease on MRI were assessed retrospectively, with a view to identifying the symptomatic level as defined by discography. MRI could not reliably detect this level, particularly in those with multi-level degenerative disc disease. Positive reproduction of symptoms at discography was the criteria used for surgery. All 12 patients in this group had posterior spinal fusion performed. Nine improved and three were unchanged. Of the ancillary features associated with disc degeneration, only a bulging annulus fibrosis proved to be of any value on MRI. Nonetheless, MRI should be used as the primary investigation in this patient group as it can lead to a marked reduction in the number of disc levels requiring injection.

Adult↗
PubMed1990

Model workload agreement for DGH general surgeon: discussion paper.

A guideline programme for a Consultant General Surgeon includes three operating lists, and two outpatient sessions per week. A General Surgical Consultant working with a 'standard' surgical team should expect to see approximately 1,000 new patients per year, and undertake an elective operative workload of 15 'hernia equivalent' procedures per week. A model workload such as this might assist surgical service planners to estimate the need for surgical staff in their Districts.

England↗
PubMed1989

Treatment of acromegaly by external irradiation.

Despite the place of hypophysectomy as the primary treatment in acromegaly, external radiotherapy maintains a role as a relatively slow but effective therapy for inadequately treated patients or those unsuitable for operation. Over the last 25 years our radiotherapy regimen has differed from the published series in that we give a larger dose per fraction, with fewer treatments. We have analysed the efficacy and side-effects of this regimen in 27 subjects with acromegaly. Growth hormone levels have fallen by, on average, 27% per year in the first five years, 83% of subjects achieving a basal growth hormone of less than 10 mU/l. The acute and chronic side-effects of irradiation are discussed, including the relevance of estimates of biological potency, for example the Time Dose Fraction (TDF). One patient suffered visual loss that was most likely to be secondary to the radiotherapy. We also report the histological appearances of the pituitary fossa in five subjects previously treated with radiotherapy.

Acromegaly↗
PubMed1975

The urodynamic assessment of adult enuresis.

Urodynamic analysis has revealed a high proportion of uninhibited bladder activity in adult enuresis. There was no associated neurological deficit to explain this abnormality. There was no correlation between the various diurnal symptoms and the presence of uninhibited bladder contractions. Enuresis was associated with obstructive uropathy in only 6 percent of cases. Some evidence has also been presented to support the concepts of ectopic sensory receptors and abnormal sphincter inhibition. A review of the problem of pathogenesis has suggested four main areas of possible abnormality: 1. A sensory lesion producing inadequate or delayed appreciation of bladder activity. 2. Cortical and subcortical dysfunction because of inadequate arousal or defective maturation of subconscious inhibition. 3. A congenital or acquired upper motor neurone lesion causing an uninhibited bladder. 4. A similar or related lesion causing an over-inhibited sphincter. These factors probably always occur in varying combinations. Because of the lack of association between symptoms, signs and objective measurements, there is a strong case for relating diagnosis, prognosis and treatment to urodynamic assessment.

Adolescent↗
PubMedDate not supplied

Percutaneous needle biopsy of lung nodules following failed bronchoscopic biopsy.

Though transthoracic needle biopsy (TNAB) is a well established method for obtaining pathologic diagnosis in lung masses, very often the procedure is only performed after a previous negative bronchoscopic biopsy (BB) attempt. In this study we analyzed the results of TNAB in 129 consecutive patients where one or more inconclusive BB had been performed. TNAB was diagnostic in 115 of 129 lesions (89%) and the yield was not significantly affected by size, cell type or tumour location. In 97 patients who underwent thoracotomy, cytologic specimens obtained by TNAB accurately reflected histologic tumour type in all cases. A false negative rate for malignancy on TNAB was 5%. Awaiting inconclusive BB results caused an average delay of three in-hospital days before TNAB. In those patients in whom a biopsy is warranted, TNAB is most useful as an initial diagnostic procedure in masses that are peripheral and in pleural based tumours, in mediastinal adenopathy associated with a lung mass and instead of a repeat, previously failed bronchoscopy.

Adenocarcinoma↗