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Biomedical subjects

D M Burge

Publications and source records attributed to D M Burge.

48 records · Page 3Linked to original sources
PubMed1989

Ventricular shunting for hydrocephalus following intraventricular haemorrhage.

31 patients underwent ventricular shunting (17 VA and 14 VP) for post-haemorrhagic hydrocephalus over 11 years. The mean gestational age was 31.8 +/- 4.17 (1 SD) weeks and birth weight 1.83 +/- 0.77 (1 SD) kg, with no differences between the VA and VP groups. Shunts inserted less than 5 weeks of age failed more frequently than those inserted after 5 weeks. There were 5 early (less than 30 days) blocks all in VP shunts (p = 0.023) but no difference in distal catheter blockage rate (p = 0.14). There were no early infections. In later follow-up, 35% of patients had block episodes and 22% infective episodes with no significant difference between the type of shunt used. Overall mortality was 6.5% and not related to shunt complications. Revisions were more frequent in VP shunts (0.9 revisions/shunt year) than VA shunts (0.6 revs/shunt year). Using life table analysis 60% of VP and 30% of VA shunts failed within 2 years of insertion.

Cerebral Hemorrhage↗
PubMed1987

Acute idiopathic scrotal oedema: incidence, manifestations and aetiology.

Twenty-four children with a total of 31 episodes of acute idiopathic scrotal oedema (AISO) were assessed during a 5 year period. AISO accounted for 30 per cent of all admissions with acute scrotal pathology in this period and was the final diagnosis in 69 per cent of cases in those presenting under the age of 10 years. Although presentation was with unilateral (48 per cent) or bilateral (52 per cent) AISO, considerable overlap between these two groups occurred. Five patients (21 per cent) had recurrent attacks. Fourteen boys (60 per cent) had a history of allergy or had allergic manifestations at presentation compared with an incidence of allergy of 28 per cent in 42 controls (P less than 0.05). AISO is the commonest cause of the 'acute scrotum' in boys under the age of 10 years and is probably allergic in origin.

Adolescent↗
PubMed1987

Noninvasive assessment of portosystemic shunting in extrahepatic portal hypertension in rats.

A simple reproducible animal model of extrahepatic portal hypertension (EHPHT) has been developed in weanling Wistar rats using a two-stage ligation of the portal vein. This model consistently produces substantial collaterals, both portosystemic (hepatofugal) and portoportal (hepatopetal). Using dynamic hepatic scintigraphy (DHS) with 99mTechnetium sulphurcolloid, hepatopetal collateral flow was measured as the mesenteric fraction (MF) of total hepatic blood flow and compared with measurement of hepatofugal collateral flow (portosystemic shunting) following intraportal injection of radiolabeled microspheres. Strong and significant correlation between the two assessments was found with reduction in MF denoting increased portosystemic shunting (PSS). The technique of DHS has been used successfully in adults to assess compromised portal venous flow and is a simple noninvasive test to aid diagnosis, assessment, and follow-up of children with EHPHT.

Animals↗
PubMed1987

Neonatal testicular torsion and infarction: aetiology and management.

Thirty neonates presented with signs of testicular ischaemia over a 20-year period. Eighteen children had primary exploration revealing extravaginal torsion (10), intravaginal torsion (3), infarction without torsion (2) and torsion of the appendix testis (1). The other two children had simple biopsy of necrotic testes. In two instances the testis was untwisted and retained but both subsequently atrophied. The remainder underwent orchiectomy. Twelve children did not have initial exploration and 11 of these had subsequent testicular atrophy. At contralateral testis fixation, performed in 17 cases, signs of contralateral involvement in the ischaemic process were found in seven, suggesting that the primary event in the condition is infarction, with torsion occurring secondarily.

Humans↗
PubMed1987

Congenital diaphragmatic hernia: the prognostic significance of the site of the stomach.

Congenital diaphragmatic hernia is associated with a significant mortality, despite intensive treatment. The degree of pulmonary vascular hypoplasia is the main factor affecting mortality. Various features have been considered to determine the prognosis in these infants. In this study a series of 50 consecutive cases of left-sided diaphragmatic hernia has been reviewed. The site of the stomach (abdominal or intrathoracic), demonstrated radiologically and confirmed at operation, has been related to the final outcome (survival or death). An abdominal site is associated with an excellent prognosis (6.2% mortality), while an intrathoracic site is associated with a 58.8% mortality.

England↗
PubMed1986

The conservative management of exomphalos major.

In 52 children with exomphalos treated over a 10 year period, the overall mortality was 31%. Death was almost invariably due to associated major congenital abnormalities. Treatment of minor exomphalos by primary closure incurred no additional mortality and minimal morbidity. Treatment of 25 children with exomphalos major by excharotics resulted in two deaths not attributable to other anomalies, one of which was a result of complications of this treatment regimen. Apart from infection, which was in general easy to control, the morbidity associated with this form of treatment was less than encountered in most reports of surgical closure.

Abnormalities, Multiple↗
PubMed1981

Intestinal haemorrhage in Turner's syndrome.

A 13-year-old girl with Turner's syndrome and bleeding from intestinal venous ectasia is reported. The various types of vascular anomaly of the bowel associated with Turner's syndrome are discussed. Awareness of these anomalies may help prevent unnecessary laparotomy in children with this syndrome.

Adolescent↗
PubMedDate not supplied

Prenatal diagnosis of laryngotracheoesophageal clefts.

Seven infants with laryngotracheoesophageal (LTE) clefts who had abnormal prenatal fetal sonographs were reviewed retrospectively to evaluate the antenatal scan characteristics, clinical features at presentation and associated malformations. The prenatal scans demonstrated polyhydramnios, lung cysts and an absent stomach in all. The mode of delivery was by emergency lower segment cesarean section for fetal distress, in all 7 babies. The mean gestational age at delivery was 36 weeks (range 33-38) and intrauterine growth retardation was seen in 4 neonates. A combination of endoscopy, surgery and autopsy confirmed LTE cleft type 4 in 5 patients, type 3 and type 2 in a patient each. Esophageal atresia and lower pouch tracheoesophageal fistula was present in all. Agastria was seen in 4 and microgastria in 3 children. Lung abnormalities were seen in all 7 infants and they included congenital lung cysts (4 patients), absent lung lobulation (3 patients), bronchogenic cysts (2 patients), cystic adenomatoid malformation (1 patient) and bronchoesophageal fistula (1 patient). The mortality was 86% and the sole survivor had a LTE cleft type 2 which was successfully repaired. The diagnosis of LTE cleft must be considered if a prenatal scan demonstrates the triad of: (1) polyhydramnios; (2) absent stomach, and (3) presence of lung cyst. This should lead to a detailed postnatal evaluation and early diagnosis of this uncommon anomaly resulting in early counseling and suitable management.

Abnormalities, Multiple↗
PubMedDate not supplied

Retrograde tunnel: a method for the fixation of long-term pediatric central venous catheters.

The fashioning of a subcutaneous tunnel has become an integral part of the placement of central venous catheters (CVC). Several methods have been described, but the long-term CVCs in pediatric practice pose special problems, particularly that of the patients continually testing the CVC's fixation. A polyurethane CVC is used that has not been previously described in pediatric usage and a retrograde tunneling technique has been developed which affords immediate and secure fixation.

Catheterization, Central Venous↗