PubMed Health⌕ Search

Biomedical subjects

C J Wright

Publications and source records attributed to C J Wright.

At least 37 records · Page 2Linked to original sources
PubMed1993

Hepatic injury from blunt trauma in children: follow-up evaluation with CT.

OBJECTIVE: Because CT is now used to assess the extent of abdominal injury after blunt trauma, children with hepatic injury often can be treated nonsurgically. We used a CT grading system to evaluate the frequency of complications and the time course of healing in children with hepatic injury from blunt abdominal trauma. MATERIALS AND METHODS: Forty-five children with CT or surgical evidence of hepatic injury after blunt abdominal trauma were followed up clinically and with serial CT scans. Hepatic injuries were graded as mild (< 25% of one lobe injured), moderate (25-50% of one lobe injured), or severe (> 50% of one lobe injured). Physical activities were limited until healing was verified with follow-up CT scans. RESULTS: All mild hepatic injuries (n = 12) appeared to have healed on follow-up CT studies 1 week to 11 months after the injury. Sixty-seven percent of moderate hepatic injuries (n = 19) showed complete healing on CT scans 1-3 months after injury, and 80% showed complete healing between 3.5 and 6 months. In all 14 children with severe hepatic injuries, residual lesions were seen on CT scans up to 8 months after injury. Residual lesions were seen in seven of 11 children with severe injuries who were reexamined 9-15 months after trauma. Despite this protracted course, no delayed hepatic complications occurred. No difference was seen between unenhanced and IV contrast-enhanced CT findings in 28 of 32 studies. IV contrast material improved the resolution of residual lesions in two cases, and two residual lesions were identified only on unenhanced CT scans. CONCLUSION: CT grading of acute hepatic injuries is useful for estimating the time course of healing. Although mild and moderate hepatic injuries heal relatively quickly, severe hepatic injuries take months to resolve. Follow-up CT scans to verify complete hepatic healing should be obtained 3 months after mild injuries, 3-6 months after moderate injuries, and 9 months after severe injuries.

Abdominal Injuries↗
PubMed1993

Gender differences in obesity-related cardiovascular disease risk factors among participants in a weight loss programme.

Obesity is associated with increased cardiovascular disease risk factors in some, but not all, individuals, and blood pressure responses to weight loss are also heterogeneous. The purposes of this study are: (i) to assess associations among cardiovascular disease risk factors in obese individuals and (ii) to determine clinical predictors of a hypotensive response to weight loss. The study was undertaken in 155 consecutive patients enrolled in a weight loss programme. Individuals entering the programme were predominantly women and differences were found between men and women who joined the programme. Before weight loss, obese men exhibited higher cardiovascular disease risk factors (body mass indices, waist-to-hip ratios, systolic and diastolic blood pressures, serum glucose, and lower HDL cholesterol) than did women. However, among women, but not men, cardiovascular disease risk factors clustered in individuals with higher waist-to-hip ratios. Furthermore, in contrast to men, a higher waist-to-hip ratio in women was associated with a reduction in systolic blood pressure in response to weight loss. While it is possible that selection bias may explain gender differences among programme participants, and smaller numbers of men available for study may obscure associations in men, our data document that even at high levels of obesity, waist-to-hip ratios are associated with hypertension and a clustering of cardiovascular disease risk factors in women. We conclude that body fat distribution, as reflected in waist-to-hip ratios, may be a more robust risk factor in female than in male obese patients and that this risk factor extends to those women with high levels of obesity.

Adult↗
PubMed1991

Safety-belt injuries in children with lap-belt ecchymosis: CT findings in 61 patients.

We have noted a complex of common injuries in children wearing lap-styled safety belts during vehicular accidents. Sixty-one children who were restrained passengers in motor vehicle crashes had linear ecchymosis across the abdomen and had CT for abdominal trauma. Thirteen children (21%) had a lumbar spine injury, and 14 children (23%) injured a hollow viscus (bowel, 12; bladder, two); five children (8%) had both spine and hollow viscus injuries. Abnormal findings on abdominal CT were recognized retrospectively in three of 13 children with lumbar spinal injury. Lateral radiographs of the spine showed lumbar spinal injury in all cases. Free intraperitoneal air was noted in on three (25%) of 12 children with bowel injury. In eight of those children, CT showed large, unexplained collections of peritoneal fluid. The presence of lap-belt ecchymosis should prompt a careful search for spine, bowel, and bladder injury. Recognition of the limitations of CT diagnosis of these injuries is important to reduce errors in interpretation.

Abdominal Injuries↗
PubMed1990

Vaginal probes.

Explore the source record for details and available documents.

Animals↗
PubMed1989

A multicentre trial in spontaneously breathing patients. A comparison of recovery following alfentanil or enflurane.

Recovery from anesthesia and the effect of premedication, induction agent and the individual anesthetist on the measure of recovery was assessed in 707 patients scheduled to undergo short surgical procedures. Patients were randomly allocated to receive either alfentanil or enflurane as a supplement to an induction agent, nitrous oxide/oxygen anesthetic technique with or without premedication. Patients who received alfentanil had a faster immediate recovery than those who received enflurane (p less than 0.001). Total anesthetic time was shorter in the alfentanil group (p = 0.02). For 36 of 37 anesthetists recovery was faster in the alfentanil group compared to the enflurane group. Choice of premedication and induction agent had a significant effect on recovery, thiopentone or lorazepam prolonged recovery time in each group. Although the alfentanil group had a higher incidence of apnoea, movement and vomiting (p less than 0.001), the enflurane group had a higher incidence of coughing (p less than 0.001) and shivering (p = 0.004). Overall the anesthetists assessed the alfentanil technique as excellent or good in more patients than the enflurane technique.

Adjuvants, Anesthesia↗
PubMed1986

Breast cancer screening: a different look at the evidence.

The data on screening for breast cancer were studied to extract information on rates of biopsy recommendation, detection of benign disease, and mortality. Relative and absolute mortality rates for breast cancer and other causes were calculated. Approximately 5% of women screened have a suspicious result and are referred for further assessment. The reduction in breast cancer mortality rates attributed to screening procedures ranges from 0.049% to 0.144% of the screened population, demonstrating that up to 2041 women must be screened for each woman who will benefit. If women subjected to operation for benign disease are considered to be harmed by the screening program, then the harm/benefit ratio ranges up to 62:1. It is suggested that enough information on the question of cost/harm/benefit is already available to make the decision that mass screening for breast cancer should be abandoned and that the procedure should be reserved for those women with high-risk factors.

American Cancer Society↗
PubMed1985

Cancer of the colon and rectum: 30-year follow-up study.

This study reviews the course of all patients registered at the Saskatoon Cancer Clinic between 1949 and 1951, with histologically proven cancer of the colon or rectum. The data were abstracted, coded and analysed by life-table methods. Follow-up was complete to death or to 1982. There were 403 patients (58.3% were men). Cancer of the rectum accounted for 51% of the total, the sigmoid colon 22% and the cecum 10%. The primary tumour was resected by abdominoperineal resection, hemicolectomy or segmental colectomy in 63% of the patients; colostomy alone was performed in 21%. The overall survival was 31% at 5 years, 24% at 10 years, 15% at 20 years and 7% at 30 years from diagnosis. Many of the deaths in this relatively elderly group of patients were due to causes other than the cancer. Considering cancer-related causes of death only in patients with resectable lesions, the cumulative probability of survival at 5, 10, 20 and 30 years was 63% +/- 4%, 54% +/- 4%, 48% +/- 4% and 47% +/- 6%, respectively (probability +/- 1 standard error), for those without lymphadenopathy, and 14% +/- 3%, 12% +/- 2%, 10% +/- 2% and 9% +/- 3%, respectively, for those with involved nodes. Death from the cancer was rare after 10 years while deaths from competing causes continued to occur, at a near constant rate, for 30 years. The data suggest that the cancer was eradicated in one third of all patients, and in one half of patients in subgroups with no lymphadenopathy or with shallow primary lesions.

Actuarial Analysis↗
PubMed1984

The room search.

Explore the source record for details and available documents.

Health Facilities↗
PubMed1983

Effect of femoral profundaplasty on blood flow.

The effect of femoral profundaplasty on blood flow in the lower limb was examined. In 15 patients with signs and symptoms of femoropopliteal artery occlusion, the following measurements were made before and after profundaplasty with vein-patch graft: ankle pressure index, muscle blood flow at rest and with maximal exercise (xenon clearance technique), and blood flow in the calf and in the great toe (venous occlusion plethysmography). No significant change was found in resting muscle blood flow, or in the results of calf or toe plethysmography. Muscle blood flow was significantly (p less than 0.01) increased 1 minute after maximal ischemic exercise (6.3 +/- 2.0 ml/100 g X min-1 before operation and 10.4 +/- 3.9 after) and the time to reach peak muscle blood flow after tourniquet release was significantly reduced (p less than 0.01) after operation, from 149 +/- 52 to 102 +/- 46 seconds. Ankle pressure index was unchanged by profundaplasty (0.63 +/- 0.17). All of the six patients with claudication were subjectively improved, and in seven of the nine patients with foot ischemia the limb was saved. The changes in blood flow help to explain the clinical improvement noted after profundaplasty.

Aged↗