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Biomedical subjects

C M Backhouse

Publications and source records attributed to C M Backhouse.

9 recordsLinked to original sources
PubMed1991

Oxerutins in the prevention of recurrence in chronic venous ulceration: randomized controlled trial.

The value of oxerutins [O-(beta-hydroxyethyl)-rutosides] in the prevention of venous ulcer recurrence was investigated in a double-blind randomized controlled trial of 138 patients with recently healed chronic venous ulcers. Oxerutins in the form of Paroven 500 mg twice daily or identical placebo were given, and all patients were provided with elastic compression stockings. At follow-up 3 months later, patients were assessed for re-ulceration and for tablet and stocking compliance. Oxerutins (n = 69) and placebo (n = 69) groups were well matched for age, sex, duration of previous ulceration and deep vein thrombosis. Cumulative re-ulceration by life-table analysis at 12 and 18 months was 22 and 32 per cent respectively for placebo, and 23 and 34 per cent respectively for oxerutins (P = 0.93). Recurrence was more frequent in patients who complied with both tablets and stockings, suggesting that compliance was influenced by continued symptoms (P = 0.006). This trial failed to demonstrate that oxerutins influenced ulcer recurrence.

Anticoagulants↗
PubMed1988

Sustained compression and healing of chronic venous ulcers.

STUDY OBJECTIVE: Comparison of four layer bandage system with traditional adhesive plaster bandaging in terms of (a) compression achieved and (b) healing of venous ulcers. DESIGN: Part of larger randomised trial of five different dressings. SETTING: Outpatient venous ulcer clinic in university hospital. PATIENTS: (a) Pressure exerted by both bandage systems was measured in the same 20 patients. (b) Healing with the four layer bandage was assessed in 148 legs in 126 consecutive patients (mean age 71 (SE 2); range 30-96) with chronic venous ulcers that had resisted treatment with traditional bandaging for a mean of 27.2 (SE 8) months. INTERVENTIONS: (a) Four layer bandage system or traditional adhesive plaster bandaging for pressure studies; (b) four layer bandaging applied weekly for studies of healing. END POINTS: (a) Comparison of pressures achieved at the ankle for up to one week; (b) complete healing within 12 weeks. MEASUREMENTS AND MAIN RESULTS: (a) Four layer bandage produced higher initial pressures at the ankle of 42.5 (SE 1) mm Hg compared with 29.8 (1.8) for the adhesive plaster (p less than 0.001; 95% confidence interval 18.5 to 6.9). Pressure was maintained for one week with the four layer bandage but fell to 10.4 (3.5) mm Hg at 24 hours with adhesive plaster bandaging. (b) After weekly bandaging with the four layer bandage 110 of 48 venous ulcers had healed completely within 12 (mean 6.3 (0.4)) weeks. CONCLUSION: Sustained compression of over 40 mm Hg achieved with a multilayer bandage results in rapid healing of chronic venous ulcers that have failed to heal in many months of compression at lower pressures with more conventional bandages.

Ankle↗
PubMed1988

Comparison of absorbable materials for surgical haemostasis.

The haemostatic effect of two new materials has been compared with surgical gauze and oxidized cellulose using a standardized liver laceration in New Zealand White rabbits. Following excision of a 3 cm2 disc of tissue from the liver, 42 rabbits were randomized to the use of gauze swabs (n = 6), oxidized cellulose (Surgicel) (n = 12), porcine collagen (Medistat) (n = 12) or calcium alginate (Kaltostat) (n = 12) to control the resulting haemorrhage. Blood loss and time to haemostasis were accurately recorded. The absorbable materials were left in situ and animals killed between 2 weeks and 6 months later to examine speed of absorption and resulting adhesions. Calcium alginate stopped bleeding in less than 3 min in all animals compared with a mean (+/- s.e.m.) of 5.7 +/- 0.75 min for porcine collagen, 12.5 +/- 0.9 min for oxidized cellulose and greater than 15 min with gauze (P less than 0.001). Oxidized cellulose and calcium alginate reabsorbed within 3 months leaving a fibrous scar, but a vigorous foreign body reaction was seen with porcine collagen which caused intestinal obstruction in 5 out of 12 animals within 3 months.

Absorption↗
PubMed1988

Mammary duct ectasia and pituitary adenomas.

Mammary duct ectasia developed in three postmenopausal patients who had had pituitary chromophobe adenomas. The first patient had bilateral duct ectasia that developed 8 and 11 years after hypophysectomy. The second patient, who also had bilateral ectasia, had a prolactin-producing pituitary adenoma for which bromocriptine was prescribed. The ectasia developed in one breast before commencing bromocriptine therapy, and in the other breast 2 years later. The third patient also had a prolactin-producing pituitary adenoma. Unilateral duct ectasia developed while bromocriptine was taken. The ectasia in all patients was very marked and affected all excised ducts. Cholesterol granulomas were sometimes very extensive. These cases suggest a relationship between certain hypothalamic/pituitary disorders, possibly related to prolactin secretion and the development of mammary duct ectasia in postmenopausal patients.

Adenoma, Chromophobe↗
PubMed1987

Microscopic split-skin grafts: a new technique for 30-fold expansion.

Split skin was diced into 200 microns squares for use as a graft for large granulating wounds in pigs. "Diced" skin expanded 26-fold to give healing rates virtually identical with those obtainable with meshed split skin, despite a ten-fold difference in the area of donor skin used. The technique has been successfully applied in five patients with venous ulcers and seems to be a simple alternative to tissue culture for grafting extensive wounds.

Animals↗
PubMed1987

Carcinoma of the breast in women aged 35 or less.

Breast cancer in young women is an unusual problem which has acquired a poor prognostic reputation in the eyes of many clinicians. We have reviewed all 59 patients with malignant disease of the breast aged 35 years or less managed in the Breast Unit at Charing Cross Hospital between 1974 and 1984. After exclusion of 5 patients (2 with lymphomas, 1 with fibrosarcoma, and 2 with inadequate available data), 54 patients were available for analysis. More than 3 months delay from first symptoms to presentation was seen in 45 per cent and 36 per cent were considered 'late' at initial clinical staging (T3-4, N2-3 or M1). Nevertheless, a 5-year survival of 66 per cent was seen among the 29 patients with sufficient length of follow-up. Distribution among the main histological types was very similar to that found in a consecutive series of 264 breast cancers of all age groups in our unit. We conclude that breast carcinomas in young patients do not significantly differ in type or behaviour from other age groups and that with treatment similar to other premenopausal patients, a prognosis comparable to older patients can be expected.

Adult↗
PubMed1987

Controlled trial of occlusive dressings in healing chronic venous ulcers.

Fifty-six patients with chronic venous ulcers present for a mean of 2.4 years were randomized to either a new occlusive hydrocolloid dressing (Granuflex, Squibb Surgicare) or a porous non-adherent dressing (N A, Johnson and Johnson). In all patients, dressings were applied beneath a standard graduated compression bandage. There was no difference between the two groups, with complete healing in 21 out of 28 (75 per cent) of occlusive dressing patients and 22 out of 28 (78 per cent) with N A dressings by 12 weeks. Careful graduated compression bandaging achieves healing even in the majority of so-called resistant chronic venous ulcers; there was no additional benefit from applying occlusive dressings which tend to be expensive.

Adult↗
PubMed1987

Particulate contaminants of intravenous medications and infusions.

Particulate contamination in small volume parenteral medications has been studied and compared with that found in a selection of large volume infusions. Particle counts in 39 commonly used small volume medications and 7 large volume infusions were performed by an automated light blockage method (HIAC) or by optical microscopy. Based on these results and a random survey of drug therapy of intensive care patients, it is concluded that the contribution of intravenous medications to the total particle load received by such patients is likely to be many times greater than from infusion fluids. Until firm evidence regarding the harmful systemic effects of drug particles is available and the manufacturing regulations adjusted appropriately, final in-line filtration of infusions immediately proximal to the intravenous cannula should be considered when drugs are being given intravenously.

Drug Contamination↗