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Biomedical subjects

D C Gough

Publications and source records attributed to D C Gough.

15 recordsLinked to original sources
PubMed1992

Continent cutaneous diversions in children: experience with the Mitrofanoff procedure.

Continent cutaneous diversions with a urinary reservoir emptied by clean intermittent self-catheterisation (CISC) using a non-refluxing conduit--the Mitrofanoff principle--were carried out in 10 children. Their age range was 3.9 to 17.1 years (average 12.2). The underlying diagnoses were ectopia vesicae (7), myelodysplasia (2) and a cervical cord injury secondary to birth trauma (1). The indications were incontinence secondary to poor bladder neck resistance in 8 children and an inaccessible urethral orifice in 2. The catheterising conduits used were the appendix in 9 and a vascularised gastric tube in 1. Eight children are bone-dry with CISC. Another child needed a reoperation following dehiscence of her bladder neck closure. The other child has an intact bladder neck and urethra and occasionally leaks overnight. Mitrofanoff diversions are a reliable means of continence with CISC. This means of urinary diversion can be permanent or temporary in children who cannot or will not catheterise urethrally. Elective appendicectomy in children with potential urinary incontinence or complicated urogenital anomalies is not recommended.

Adolescent↗
PubMed1991

Long-term follow-up of children with testicular tumours: surgical issues.

Testicular tumours are rare in childhood. The clinical, pathological and follow-up details of 48 children are presented. The combined approach of surgery, chemotherapy and radiotherapy is confirmed as being extremely effective. Transcrotal orchiectomy is not an appropriate surgical procedure. Testicular biopsy is detrimental to prognosis.

Child, Preschool↗
PubMed1990

Circumcision--which dressing?

Three methods of circumcision dressing were compared in a prospective trial. The results showed that dressings containing tincture of benzoin adversely affected wound healing in children. Dressing the wound with greasy tulle gave better results; the addition of soframycin did not produce better results than those achieved with ordinary paraffin tulle.

Anti-Bacterial Agents↗
PubMed1990

Long-term follow-up of children with renal carcinoma.

Renal carcinoma is a rare tumour in children. The clinical, histological and follow-up details of 6 patients are presented. Haematuria is confirmed as an important indicator of renal pathology. Long-term follow-up suggests that chemotherapy and radiotherapy have little effect on the prognosis in advanced disease.

Adolescent↗
PubMed1990

Colonic atresia: current results of treatment.

Eleven cases of colonic atresia presenting in a 13-year period are described. The incidence of this condition is estimated at 1 per 66,000 live births in the north-west of England. A higher incidence of involvement of the transverse colon has been noted in comparison with previously reported cases. Survival was unaffected by the type of surgical procedure, with both primary anastomosis after resection or staged reconstruction after initial colostomy giving excellent results. No deaths occurred in the ten patients subjected to surgical treatment.

Anastomosis, Surgical↗
PubMed1989

Wilms' tumour: trials and tribulation.

Surgery, radiotherapy and chemotherapy are currently the basis of multimodal treatment of Wilms' tumor. Surgery plays the central role in the management of this tumour and will cure 25% of patients if employed alone. Surgical mortality has been reduced to 1.5% at major centres and the most dangerous intra-operative complication is a venacaval tumour embolising into the pulmonary artery. Patients found to be initially inoperable who then have local and systemic therapy, followed by successful secondary surgery, have a reduced survival rate. Definite statements on bilateral tumours are difficult to make. The most fundamental determinants of survival are the histological characteristics of the tumour and the stage of the disease at presentation. Just as the quality of surgery has improved, so have radiotherapy techniques been refined. However, radiotherapy has been replaced by chemotherapy in many instances. The advent of chemotherapy has added to clinical success with a further improvement of survival figures by 25%. Chemotherapy is most effective in controlling micrometastases. However, it must be remembered that the treatment is toxic and needs skillful handling and modification.

Child↗
PubMed1989

Neonatal urological ultrasound: diagnostic inaccuracies and pitfalls.

Ninety one patients with urinary tract abnormalities diagnosed before birth were reviewed. Diagnoses based on prenatal and postnatal ultrasound scans alone were compared with the final diagnoses after full urological investigations, with operative or necropsy confirmation in 79 cases. The results confirmed that ultrasound examination before birth usually detects nonspecific abnormalities and although scanning after birth is more accurate it is not absolutely reliable. A diagnosis of "multicystic kidney' made on ultrasound scan alone is especially prone to error. Such mistakes can be avoided if full urological investigation is undertaken in every case.

Diagnosis, Differential↗
PubMed1988

Abdominoscrotal hydrocele in infancy.

Abdominoscrotal hydrocele is the primary cause of a lower abdominal cystic tumour in association with an inguinoscrotal hydrocele in infancy. Treatment is surgical, with excision of all elements of the hydrocele sac through an inguinal skin crease incision. We discuss the aetiological theories in the light of our surgical experience in three cases and we report the first bilateral case.

Abdomen↗
PubMed1987

Vascular access for acute haemodialysis.

Vascular access for acute haemodialysis was required on 29 occasions in 26 children over a six year period. Comparison was made of the forms of vascular access employed, these being the Scribner shunt, the Hickman line, and percutaneous polyvinylchloride cannulae. The Hickman catheter was used to provide vascular access in 17 patients (mean age 8.8 years (range 2.5-16 years) and mean weight 25.5 kg (range 7.7-60 kg)) and allowed adequate haemodialysis to occur. Only one catheter had to be removed because of infection, and no other serious complications were encountered. These results show the superiority of the Hickman catheter as vascular access for acute haemodialysis in children.

Adolescent↗
PubMed1979

Giant exomphalos--conservative or operative treatment?

The rate of survival for infants with intact giant exomphatos has much improved during the last 20 years; this is partly due to better respiratory and nutritional support. The use of a staged operative closure using a sialon prosthesis has been advocated for 12 years, but our data do not show this to be superior to nonoperative management.

Ethanol↗
PubMed1978

The use of bulk evacuant in patients with haemorrhoids.

Fifty-three patients with symptomatic haemorrhoids have been studied in a double-blind cross-over trial of a bulk forming agent (ispaghula husk) against a placebo. Although only 11 per cent of patients ocmplained of constipation, a significant benefit in symptoms and improved bowel habit was demonstrated.

Cellulose↗