PubMed Health⌕ Search

Biomedical subjects

D Durrans

Publications and source records attributed to D Durrans.

15 recordsLinked to original sources
PubMed1993

Acute ischaemia of the lower limb: an unusual presenting feature of acute lymphoblastic leukaemia.

Malignant disease is often complicated by coagulation disorders presenting as abnormal clotting or bleeding, acute leukaemia being more often associated with the latter. Acute lymphoblastic leukaemia presenting with peripheral arterial thromboembolism, previously unreported in the literature, is presented. Aetiology, clinical features, and management of coagulation disturbances associated with malignancy are also reviewed.

Adult↗
PubMed1992

Role of topical lignocaine during carotid endarterectomy.

Forty carotid endarterectomies were undertaken in 34 patients. Operations were prospectively randomized to periarterial application of either 1 per cent lignocaine (n = 19) or normal saline (n = 21), and detailed measurements taken of intraoperative pulse rate and blood pressure. Patients receiving lignocaine demonstrated a lower pulse rate, and lower systolic and mean blood pressures than those receiving placebo, with significance in relation to clamp application and shunt removal (P < 0.05). It was particularly noticeable that patients receiving lignocaine demonstrated less intraoperative variation in pulse rate and blood pressure. Topical lignocaine stabilizes pulse rate and blood pressure during carotid endarterectomy.

Administration, Topical↗
PubMed1992

Endothelial cell seeding: a review.

The concept of endothelial cell seeding, designed to provide vascular grafts with a nonthrombogenic lining, has progressed from crude animal experiments during the past two decades to detailed in vitro functional studies using human cells. Although favorable results have been obtained in animal studies this has yet to be translated to humans, where current application of these techniques has been limited to a very few clinical trials. The history, current status and future directions are reviewed herein.

Animals↗
PubMed1991

Intragastric device for weight loss. Effect on energy intake in dogs.

It remains unclear whether or not intragastric devices promote weight loss. To elucidate if an intragastric balloon reduces energy intake by a placebo effect of inducing satiety, five free-feeding dogs had balloons inserted via a gastric cannula. Meal intake was assessed with the balloons inflated to 200 and 500 ml with saline and compared with intake during a control period when the animals maintained stable weight. Average energy intake during the control period was 0.3 MJ/kg/day. Inflation to 200 ml had no significant effect on intake (0.31 MJ/kg/day), whereas inflation to 500 ml significantly reduced energy intake to 0.14 MJ/kg/day (P less than 0.0001). An intragastric balloon does create aversion to feeding, presumably by producing satiety, but the effect is volume dependent.

Animals↗
PubMed1990

Microdochectomy for discharge from a single lactiferous duct.

Microdochectomy for persistent discharge from a single lactiferous duct was performed in 162 women. Invasive or in situ ductal carcinoma was diagnosed in 16 patients (10 per cent), none of whom had a palpable lump. The discharge was blood-stained in 14 of these women and in two it was clear. Mammography was performed in 15 of these 16 patients and was abnormal in only five. Three patients had atypical ductal hyperplasia, one of whom subsequently developed an invasive ductal carcinoma. Microdochectomy for persistent discharge from a single lactiferous duct is curative and gives a diagnosis of the cause. It remains the treatment of choice whether the discharge is blood-stained or clear.

Adolescent↗
PubMed1989

Bile acid malabsorption: a complication of conduit surgery.

We examined the possibility that use of a section of the terminal ileum for ileal conduit construction may impair bile acid absorption and cause choloretic diarrhoea. Nineteen normal subjects (mean age 41 years) and 16 patients with conduits (mean age 47 years) were investigated using the SeHCAT retention test. Conduit patients showed significant impairment of SeHCAT retention compared with normal subjects; 82% of patients had a retention below the lower limit of normal. The mean bowel frequency of patients during the test was 3 motions/day this being significantly different from their pre-operative bowel habit. It was concluded that the use of the terminal ileum in conduit construction may impair bile acid absorption, as measured by the SeHCAT retention test, and may cause an increase in bowel frequency.

Adult↗
PubMed1989

Comparison of weight loss with short term dietary and intragastric balloon treatment.

Treatment of 41 morbidly obese patients with a 3.34 mega joule diet has been compared with the same dietary regime together with an intragastric balloon. After eight weeks of closely supervised dietary regime a free floating silicone intragastric balloon with a capacity of 500 ml was inserted and the patient advised to adhere to the same diet for a further eight weeks. Thirty four patients completed the study. Forty eight per cent lost weight during the period compared with 97% during balloon treatment. The mean weight loss with diet alone was 1.9 (3) kg compared with 7.5 (4.1) kg with the balloon (p less than 0.001). Apart from postinsertion vomiting, which resolved by 72 hours, there were no gastric complications associated with the balloon. This study indicates that, in the short term at least, the intragastric balloon can improve on weight loss achieved by diet alone.

Adolescent↗
PubMed1985

The Angelchik anti-reflux prosthesis--some reservations.

A prospective study has been made of the use of the Angelchik prosthesis in the treatment of hiatus hernia and gastro-oesophageal reflux. Forty-one patients under the care of one surgeon were studied over a 3-year period. The operation is simple and safe to perform. Twelve patients suffered transient dysphagia which spontaneously resolved within 3 months. Satisfactory results were obtained thereafter in 80.9 per cent. Seven of the prostheses have been removed (17.1 per cent), all within 18 months of performing the operation. Dysphagia and recurrent symptoms were the main reasons for removal and in two of these stricturing was present pre-operatively. We feel the presence of an established stricture is a contraindication to the use of the device. We have, however, been impressed by its use as a second procedure when previous surgery has failed and when revisional surgery for recurrent hiatus hernia is difficult due to dense adhesion formation. While it is still early to assess the legacy that the use of this prosthesis might incur, we would recommend conservatism if not abandonment of its use until longer-term evaluation is available.

Adolescent↗
PubMed1985

Preoperative intraincisional cefamandole reduces wound infection and postoperative inpatient stay in upper abdominal surgery.

The use of preoperative intraincisional (POII) single dose antibiotic prophylaxis has the advantage of providing extremely high concentrations of antibiotic along all layers of the wound, whilst achieving adequate systemic concentrations throughout the operation. In a single blind controlled trial, 250 patients undergoing upper abdominal surgery were randomised to receive POII cefamandole (2g) or to act as control. There was one wound infection in the POII group compared with 18 in the control group (P less than 0.001). Hospital stay was reduced by an average of one day (P less than 0.02) in the antibiotic treated group.

Abdomen↗
PubMed1983

The pathology of meconium ileus equivalent.

A case of meconium ileus equivalent in a 25-year-old woman with cystic fibrosis is reported and the pathology of this condition is described. On gross examination the lumen of the terminal ileum was completely obstructed by a mass of inspissated faecal material with a putty-like consistency. The principal microscopic findings were plugging of the mucosal crypts with mucoid secretion, distention of goblet cells and the presence of a thick layer of mucus, admixed with faecal material, adherent to the mucosal surface. Mucin histochemistry demonstrated sulphomucin in the terminal ileum, although acidic mucins in the normal small intestine are almost exclusively non-sulphated.

Adult↗