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Biomedical subjects

C D Griffith

Publications and source records attributed to C D Griffith.

At least 37 records · Page 2Linked to original sources
PubMed1989

Transluminal iliac angioplasty with distal bypass surgery in patients with critical limb ischaemia.

Transluminal balloon angioplasty of the iliac artery was combined with a distal bypass graft procedure in 25 patients with critical ischaemia of the lower limb. Eleven patients had angioplasty in the operating theatre before a vascular graft and the remaining 14 patients had percutaneous transluminal angioplasty performed in the X-ray department before bypass surgery. The distal bypass grafts were 20 femoropopliteal and five femorofemoral grafts. Two patients died in the immediate postoperative period. Follow-up of patients ranged from 2 to 26 months with a graft patency of 63% at 12 months and 50% at 24 months but successful limb salvage rate of 75% at 12 and 24 months. Six patients required major amputations for failure of limb salvage. Transluminal iliac angioplasty is a valuable adjunct to distal bypass surgery by improving arterial inflow without the requirement for major aorto iliac surgery.

Actuarial Analysis↗
PubMed1989

Bipolar diathermy treatment of long saphenous vein varicosities.

A new technique of endoluminal diathermy of the long saphenous vein using a bipolar electrode is described. This is safer than conventional unipolar diathermy and histological examination of the diathermied veins shows similar appearances using unipolar and bipolar diathermy. Clinical assessment of both techniques yields similar results. Endoluminal bipolar diathermy is simple and relatively painless compared with conventional stripping of the long saphenous vein and can be recommended.

Electrocoagulation↗
PubMed1988

Limb salvage surgery in a district general hospital: factors affecting outcome.

In many patients with critical limb ischaemia, vascular reconstructive surgery is the only alternative to amputation to relieve severe rest pain or treat ischaemic ulcers and digital gangrene. Over a 4-year period, 402 patients with critical ischaemia of the lower limb were seen in the Derby Hospitals. One hundred and forty eight of these patients required primary amputation, 52 were treated with radiologically controlled angioplasty and in the remaining 208 patients, 218 surgical procedures for limb salvage were carried out. The overall operative mortality of patients undergoing limb salvage surgery was 9% with 72% of patients surviving 2 years or more. Postoperative mortality was greater in those patients over 70 years (16% vs 6% P less than 0.02). Patient survival at 2 years was reduced in patients over 70 years at the time of surgery (49% vs 83% P less than 0.001) and in those with 2 or more medical conditions (57% vs 71% P less than 0.001) present in the perioperative period. Overall limb salvage in surviving patients was 92% at 1 year and 91% at 2 years following surgery. Successful limb salvage at 2 years following femorodistal surgery alone was lower and related and to both infrapopliteal run off (2-3 vessels 87% vs 1 vessel 68% P less than 0.01) and the graft material used (vein 87%, Dardik 76%, Goretex 58%, P less than 0.01).

Adult↗
PubMed1987

The breast pain clinic: a rational approach to classification and treatment of breast pain.

Three hundred and fifty women complaining of breast pain symptoms of sufficient severity to interfere with their normal lifestyle were reviewed in a special breast pain clinic over a 5 year period. Seventy-two patients (21%) had spontaneous resolution of breast pain and they required reassurance only before discharge. Of the remaining 278 patients, accurate classification of breast pain syndromes was achieved in 89%, the commonest syndrome being cyclical breast pain which accounted for 54% of the women followed up. The remaining womens' breast pain was classified as trigger zone (14%), continuous (8%), Tietze's disease (5%), spinal root (4%), duct ectasia (4%) and psychological depression (2%). In the remaining 25 patients (9%) the breast pain could not be classified. The experience from this clinic is that a majority of women complaining of severe breast pain symptoms can be accurately classified and appropriate therapy instituted.

Breast↗
PubMed1986

Effect of halothane and nitrous oxide anaesthesia on natural killer lymphocytes from patients with benign and malignant breast disease.

The effect of halothane and nitrous oxide on the capacity of natural killer (NK) lymphocytes from female patients with benign and malignant breast disease to kill the tumour cell line K562, was studied in vitro. There was no depression of activity of NK lymphocytes when exposed to 2% halothane and 66% nitrous oxide either alone or in combination. However, NK lymphocyte activity was depressed at higher concentrations of halothane and the decrease in activity was significant (P less than 0.01) when 4% halothane was used. These findings suggest that exposure to clinically-used concentrations of halothane and nitrous oxide does not interfere with the NK lymphocyte response of the host.

Adult↗
PubMed1985

Long term parenteral nutrition in the management of severe Crohn's disease.

Twelve patients with active severe Crohn's disease, who failed to respond to medical treatment, received total parenteral nutrition (T.P.N.) via a Broviac long term feeding catheter for periods of 35-190 days prior to surgery. The 10 patients who were non-oedematous increased their mean weight by 3.3 Kg (p<0.01) and their mean plasma albumin by 5.80 g/l (p<0.025) after 28 days T.P.N. There were two episodes of catheter-related sepsis. Although the mean Crohn's disease activity index was significantly reduced from 364.50 (+/-91.51) to 236.75 (+/-121.29) (p<0.005) after 28 days T.P.N., all 12 patients were found to have active disease at operation. There was no post-operative mortality and the only major post-operative morbidity was a pelvic abscess following a panproctocolectomy. It is concluded that long term T.P.N. does not eliminate the need for surgery, but it may improve the nutritional status and reduce the post operative morbidity of malnourished patients with severe Crohn's disease.

Journal Article↗
PubMed1985

Treatment of oesophageal perforation by intubation.

The mortality following oesophageal perforation ranges from 25% to 100% depending on the delay in diagnosis and treatment. Although the treatment recommended for thoracic perforations is emergency thoracotomy and suture of the perforation, the avoidance of this approach in elderly patients is desirable. We therefore describe 6 cases of oesophageal perforation which were treated by insertion of a Celestin tube at laparotomy.

Aged↗
PubMed1984

Priapism--a complication of home parenteral nutrition?

A case of priapism in a patient receiving home parenteral nutrition is reported. To our knowledge this is the first such case to occur in a patient receiving home parenteral nutrition. The literature is reviewed and the possible aetiology discussed.

Journal Article↗
PubMed1984

The nature of enhanced natural killer lymphocyte cytotoxicity during anesthesia and surgery in patients with benign disease and cancer.

This study was instituted to determine the mechanism of enhanced natural killer (NK) lymphocyte activity during surgery. Natural cytotoxicity of whole blood to K562 target cells was assayed before anesthesia and during anesthesia and surgery in patients with benign and malignant gastrointestinal disease. Those patients with benign conditions and localized primary tumors showed enhanced NK lymphocyte cytotoxicity during surgery (p less than 0.025 and p less than 0.0025, respectively) but not patients with disseminated tumors. In patients with localized tumors, enhancement of NK lymphocyte cytotoxicity was an interferon-independent phenomenon but appeared to be related to a significant rise in the percentage of cells bearing the Leu 7 monoclonal antibody marker for NK cells (p less than 0.02). Exogenous leukocyte interferon caused further enhancement of NK cytotoxicity in patients with benign disease and some cancer patients. Enhancement of NK lymphocyte activity during surgery may be of significance in reducing tumor metastases by stimulation of natural cytotoxic mechanisms to circulating tumor emboli.

Adenocarcinoma↗
PubMed1984

A comparison of the 'Sheffield' Prognostic Index with forearm muscle dynamometry in patients from Sheffield undergoing major abdominal and urological surgery.

An increased awareness of the nutritional status of patients undergoing major elective surgery has lead to the finding that certain measurements of nutritional status either alone (dynamometry) or in combination (Prognostic Nutritional Index or the 'Sheffield' modified index) can identify patients at high risk from developing complications. This study presents a comparison of forearm muscle dynamometry versus the 'Sheffield' index in 70 patients undergoing major elective abdominal and urological surgery. Both tests successfully identified patients at risk of major post operative complications and death, but they failed to predict those patients who developed minor post operative complications. These data suggest that only major postoperative complications relate to the pre-operative nutritional status of patients undergoing major elective surgery. Identification of a patient as being at high risk of developing major postoperative complications by dynamometry or the 'Sheffield' index should alert the surgeon to the possible requirement for perioperative nutritional support.

Journal Article↗