PubMed Health⌕ Search

Biomedical subjects

D Pounder

Publications and source records attributed to D Pounder.

At least 19 recordsLinked to original sources
PubMed2000

Cryosurgery for chronic injuries of the cutaneous nerve in the upper limb. Analysis of a new open technique.

We have treated six patients with chronic pain following nerve injury using a cryosurgical probe. All had a significant return of hand function and improvement of pain during a mean follow-up of 13.5 months. Open visualisation of the injured nervous tissue is essential for patients undergoing this technique. Four patients regained normal sensation in the dermatome of the previously injured nerve.

Adult↗
PubMed1999

Percutaneous cervical cordotomy for the control of pain in patients with pleural mesothelioma.

BACKGROUND: Severe chest pain is common in mesothelioma. Percutaneous cervical cordotomy, which interrupts the spinothalamic tract at the C1/C2 level causing contralateral loss of pain sensation, is particularly appropriate in mesothelioma as the tumour is unilateral and systemic analgesia may be ineffective and is limited by harmful side effects. METHOD: A retrospective review was performed to determine the effectiveness and complication rate of this procedure. RESULTS: Fifty two patients were using opioids prior to cordotomy. The median daily dose of morphine before and after cordotomy was 100 mg (range 0-1000 mg) and 20 mg (range 0-520 mg), respectively (p < 0.001). Forty three patients (83%) had a reduction in pain such that their dose of opioid could be at least halved. Twenty patients (38%) were able to stop completely. Recurrence of pain requiring an increase in opioid medication was recorded in 18 patients at a median time of nine weeks (range 0.7-26 weeks). Four patients developed mild weakness, two had troublesome dysaesthesia. The median time from cordotomy to death was 13 weeks (range 0.3-52 weeks). Six early deaths within two weeks of cordotomy occurred early in the series and reflect postoperative chest infection and poor selection as the patients were in the terminal stages of mesothelioma. CONCLUSIONS: Percutaneous cervical cordotomy is successful in treating pain from mesothelioma. There was a low complication rate in this series. Referral to a unit experienced in cordotomy is recommended as soon as pain from chest wall invasion is suspected.

Adult↗
PubMed1989

Pericervical intrafallopian bupivacaine instillation to reduce postoperative pain after laparoscopic tubal sterilisation.

In a double-blind comparative study of 46 women undergoing laparoscopic tubal sterilization under general anesthesia using Falope ring bands, the group of women (study group, n=22) having 0.5% bupivacaine instilled paracervically had less pain than women given normal saline (control group, n=24) at 1 and 2 hours. The trial group also required narcotic analgesia significantly less often (6/22 vs 19.24) than the control group. The reduction in postoperative pain afforded by this method of administration of bupivacaine allows day case laparoscopic sterilization to be performed with greater confidence.

Anesthesia↗
PubMed1988

Prognostic factors in colorectal carcinoma of young adults.

To determine why the prognosis for colorectal cancer in young adults is poor, survival and prognostic factors in patients under 40 years of age were compared with those in patients between 40 and 50 years of age. In a 10-year period, 122 patients less than 50 years of age (88 between 40 and 50 years) presented at the Victoria General Hospital in Halifax, NS, with colorectal cancer. Their charts were retrospectively reviewed. Follow-up was obtained for all patients. Of the 34 patients younger than 40 years, 71% (24) were men compared with 38% (33) of older patients. Symptoms, their duration and the location of primary tumours were similar in the two groups. Patients younger than 40 years presented with advanced lesions (Dukes' stages C and D) in 67% of cases compared with 52% of the older group. Mucinous tumours were twice as common in patients less than 40 years old (p = 0.036) and actuarial survival rates were lower at all stages for the same group. The authors conclude that the poorer prognosis in patients less than 40 years of age is not due to late symptom reporting or delay in diagnosis, but to more aggressive disease.

Adult↗
PubMed1980

Legionnaires' disease in South Australia. Four case reports.

Four severe cases of Legionnaires' disease are described. In addition to multilobar pneumonia with respiratory failure, involvement of the central nervous, cardiovascular, renal, hepatic and coagulation systems had occurred. Adult respiratory distress syndrome complicated respiratory management. Early development of acute renal failure was associated with a poor prognosis. Erythromycin was the most commonly used antibiotic. Review of stored pathological material from patients who died from unidentified pneumonias enabled confirmation of the existence of Legionnaires' disease in Australia in 1974.

Adult↗