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Biomedical subjects

D B Hocken

Publications and source records attributed to D B Hocken.

9 recordsLinked to original sources
PubMed1990

Rectal examination in general practice.

OBJECTIVE: To investigate factors influencing a general practitioner's decision to do a rectal examination in patients with anorectal or urinary symptoms. DESIGN: Postal questionnaire survey. SETTING: General practices in inner London and Devon. SUBJECTS: 859 General practitioners, 609 (71%) of whom returned the questionnaire. MAIN OUTCOME MEASURES: Number of rectal examinations done each month; the indication score, derived from answers to a question asking whether the respondent would do a rectal examination for various symptoms; and the confidence score, which indicated the respondent's confidence in the diagnosis made on rectal examination. RESULTS: 279 General practitioners did five or fewer rectal examinations each month and 96 did more than 10 each month. Factors significantly associated with doing fewer rectal examinations were a small partnership and being a female general practitioner, and the expectation that the examination would be repeated. Lack of time in the surgery, and a waiting time of less than two weeks for an urgent outpatient appointment were also important. General practitioners were deterred from doing rectal examinations by reluctance of the patient (278), the expectation that the examination would be repeated (141), and lack of time (123) or a chaperone (39). Confidence in diagnosis was significantly associated with doing more rectal examinations, the perception of having been well taught to do a rectal examination at medical school, and being a male general practitioner. CONCLUSIONS: Factors other than clinical judgment influence the frequency of rectal examination in general practice. Rectal examination may become commoner with the trend towards larger group practices and if diagnostic confidence is increased and greater emphasis put on rectal examination in undergraduate and postgraduate teaching.

Attitude of Health Personnel↗
PubMed1987

Elastofibroma of the hand.

A 69-year-old man presented with a 20-year history of a slowly enlarging mass of the left index finger dating from a hammer injury. The mass was excised, and seen to have the characteristic histological appearance of an elastofibroma, a benign tumour-like growth usually found in the soft tissue of the back. Such a lesion has not previously been documented in the hand, which we consider surprising in view of the generally accepted traumatic aetiology of this entity and the susceptibility of the hand to injury.

Aged↗
PubMed1985

Streptococcus milleri as a cause of pleural empyema.

Review of an annual series of cases of empyema seen at a regional cardiothoracic unit showed that six out of 25 were due to Streptococcus milleri. The details of the cases are summarised. This organism is now an important cause of empyema, occurring much more commonly in men than in women; but since it is highly sensitive to penicillins permanent resolution can be achieved with antibiotic treatment combined with open or closed drainage.

Adolescent↗