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Biomedical subjects

D D Mulholland

Publications and source records attributed to D D Mulholland.

5 recordsLinked to original sources
PubMed1981

Does bacteremia follow upper gastrointestinal endoscopy?

To determine the risk of bacteremia, 53 patients had blood collected for culture before and five, ten and 15 minutes following fiberoptic endoscopy of the upper digestive tract. One patient had transient bacteremia with Acinetobacter Sp. five minutes after endoscopy. Combining our study with four others, 447 patients have been evaluated of which 6% had bacteremia after upper gastrointestinal endoscopy. Biopsy or other endoscopic operation does not increase the likelihood of bacteremia. We recommend careful attention to instrument and accessory cleaning and prophylactic antibiotics (probably penicillin or oxacillin alone suffices) only for patients with prosthetic heart valves.

Acinetobacter Infections↗
PubMed1980

Proctosigmoidoscopic examinations by gastroenterology assistants.

Four gastroenterology assistants learned proctosigmoidoscopy by each performing 200 examinations with a physician. The assistants then examined a total of 7557 patients independently. The quality of their examination was assessed by reexamination of about every 10th patient by a physician. The data from all examinations were processed for computer tabulation and periodically reviewed. The patients accepted the examination by the gastroenterology assistant in all but three instances. The time spent by the patient for proctosigmoidoscopy, including preparation and examination, averaged 47 minutes before the assistant program and was reduced to an average of 34 minutes by the gastroenterology assistants. Ten patients had polyps (all smaller than 0.4 cm in diameter) undetected by the gastroenterology assistant but discovered by the physician. All 31 cancers and all of 371 polyps 0.5 cm or larger were discovered by the assistants. We conclude that a satisfactory proctosigmoidoscopy examination can be performed by a properly trained gastroenterology assistant, that it will conserve the physician's time, and that it reduces the waiting time of patients.

Gastroenterology↗
PubMed1976

Does bacteremia follow colonoscopy?

In order to determine the risk of bacteremia from colonoscopy, we cultured blood specimens from 40 patients the day before laxative and enema preparation; right after such preparation; and 15 min, 1 hr, and 4 hr after colonscopy. Bacteremia was not induced by either the vigorous preparation or the colonscopy which, in 27 patients, included polypectomy, biopsy, and/or fulgurations. On the basis of our data, we conclude that the risk of bacteremia following colonoscopy is small, and we doubt the need of antibiotic prophylaxis for those with susceptible hearts.

Colon↗