Biomedical subjects

F G Quigley

Publications and source records attributed to F G Quigley.

9 recordsLinked to original sources

PubMed1995

Vascular surgery.

Recent developments in vascular surgery have occurred in many areas. The topics of intimal hyperplasia and reperfusion injury are the subject of much current research and possible methods of treatment are at an early stage of development. Advances in perioperative care have contributed to a reduction in mortality and morbidity. Endovascular techniques are being employed widely but the indications for their use are not yet agreed. The laboratory assessment of patients has been enhanced by the availability of duplex ultrasound scanning. The indications for carotid endarterectomy are becoming less controversial and a more aggressive approach is being taken in patients with abdominal aortic aneurysm. In patients with chronic lower limb ischaemia, long bypass grafts to the level of the ankle are being performed more frequently. The use of temporary shunts in patients with major arterial injuries appears to improve the results of treatment.

Humans↗

PubMed1995

Transmetatarsal amputation for advanced forefoot tissue loss in elderly patients.

Transmetatarsal amputation is considered a useful procedure because it is more likely to preserve mobility than a major amputation. In this retrospective review of 33 consecutive transmetatarsal amputations for advanced tissue loss of the forefoot, a high revision rate to major amputation (18/33) was offset by a significantly greater chance of preserving independent mobility in patients whose heel was preserved (P = 0.01). There was no difference in the non-invasive test results, smoking or diabetes history, or in the age of those who healed or those who did not. Factors that may contribute to improved wound healing rates in the future include refinements in the use of non-invasive tests, improved wound care, and advances in techniques of revascularization.

Aged↗

PubMed1994

Duplex ultrasonography of recurrent varicose veins.

Varicose veins are a common clinical finding with a high recurrence rate following treatment with either surgery or sclerotherapy. Patterns of incompetence in 100 limbs with recurrent varicose veins were determined using duplex ultrasonography. Saphenofemoral or recurrent groin tributary incompetence was present in 44 limbs, an incompetent long saphenous remnant in 20, saphenopopliteal incompetence in 28, perforator incompetence in 35 and deep venous incompetence in 22. No significant incompetence was detected in 15 limbs. The findings suggest an important role for deep venous incompetence in recurrent veins and show that a re-exploration of the groin is unnecessary in over half of limbs with recurrent veins.

Humans↗

PubMed1992

Duplex ultrasound mapping of sites of deep to superficial incompetence in primary varicose veins.

Most patients undergoing treatment for primary varicose veins have only a clinical assessment or examination with a continuous wave Doppler. In this study duplex ultrasound was used to determine the site of deep to superficial reflux in 137 limbs of 96 patients presenting with primary varicose veins. The incidence of saphenopopliteal (22%) and perforator (28%) incompetence was higher than that in previous studies based on clinical examination. Only five limbs had deep venous incompetence at the popliteal level and three of these limbs had lipodermatosclerosis or ulceration. The saphenopopliteal junction was either absent or more than 10 cm from the knee joint in 13% of limbs. The information obtained from duplex scanning of patients with primary varicose veins facilitates surgical management and may lead to a lower recurrence rate.

Femoral Vein↗

PubMed1991

A comparison of Doppler ankle pressures and skin perfusion pressure in subjects with and without diabetes.

Doppler ankle pressure measurements may be misleading in some patients because medial calcification has made the arteries of the leg incompressible. This problem is especially common in diabetics. Medical calcification that is not severe enough to make an artery clinically incompressible may cause an increased stiffness of the arterial wall that will limit the accuracy of Doppler ankle pressure measurements. A comparison of skin perfusion pressure, using an isotope technique, and Doppler ankle pressures was made in 226 subjects, diabetic and non-diabetic. Patients with incompressible arteries were excluded from the study. The slopes of the regression lines relating skin perfusion pressure to Doppler ankle pressure in diabetic and non-diabetic subjects were significantly different (P = 0.03). This result was consistent with the hypothesis that diabetic subjects have arteries that are less compressible than normal arteries and may make Doppler ankle pressure measurements in diabetic subjects misleading over the whole range of pressures recorded.

Ankle↗

PubMed1991

Transcutaneous oxygen tension measurements in the assessment of limb ischaemia.

The measurement of transcutaneous oxygen tension (TcPO2) has been adapted for the assessment of the blood supply of the lower limb. This study was undertaken to determine the most useful means of expressing TcPO2 measurements. We studied 176 patients with peripheral vascular disease and/or diabetes and 34 normal volunteers. Approximately++ half of the patients studied had ulceration or gangrene of the foot. A comparison of three methods of expressing TcPO2 measurement for predicting presence of ulceration was made using ROCA analysis. The absolute value of TcPO2 on the dorsum of the foot was the best predictor of the presence of ulceration or gangrene. An absolute value of TcPO2 of 30 mmHg on the dorsum of the foot had a sensitivity of 42% and specificity of 91%. The sensitivity of the test was as good in diabetic patients as in non-diabetic patients.

Blood Gas Monitoring, Transcutaneous↗

PubMed1989

Transcutaneous oxygen potentials in venous disease.

Abnormal levels of transcutaneous tissue oxygen tension (TcPO2) have been reported in venous disease but the most appropriate application of the technique to the study of venous disease is not clear. Patients with mild (superficial varicosities) and severe venous disease (ulcers and/or skin changes) and normal controls were studied. Four variables derived by measurement of TcPO2 were used for comparison between groups. The peak postischaemic response was reduced markedly in patients with severe venous disease and may be the most appropriate way of applying TcPO2 measurements to investigation of venous disease. The findings support the theory that a diffusion block to oxygen exists in severe venous disease.

Blood Gas Monitoring, Transcutaneous↗

PubMed1988

Monitoring of heparin in vascular surgery.

In patients heparinized for surgery on the infrarenal aorta, the degree of anticoagulation by heparin of stasis blood (taken from below the aortic clamp) was compared with that obtained in circulating blood taken from a forearm artery. A measurement of activated partial thromboplastin time (APTT) was made on a venous blood sample taken from each patient before 5000 units of heparin was administered intravenously. Further measurements of APTT from static blood and from circulating arterial blood were made at 3, 15, 30, and 60 minutes after heparinization. Samples taken below the aortic clamp showed measurements of APTT lower than those from circulating arterial blood at 15, 30, and 60 minutes (p less than 0.05 paired Wilcoxon rank sum test). Current methods for administering and monitoring heparin may not provide an adequate degree of anticoagulation in static blood during vascular surgery. The consequences, if any, of inadequate anticoagulation in vascular surgery need further study.

Aged↗

PubMed1988

Duodenal obstruction as the presenting symptom of aortic aneurysm.

Two patients with duodenal obstruction as the presenting symptom of an abdominal aortic aneurysm are reported. The increasing frequency of aortic aneurysm in an ageing population may make this rare cause of duodenal obstruction more common. Vomiting, abdominal pain, and weight loss are the common presenting, symptoms. This report includes only the third successful aortic replacement in these patients. Upper gastrointestinal examination with contrast and endoscopy and computerized tomography scan of the abdomen are considered the most relevant investigations.

Aged↗