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Biomedical subjects

G Duthie

Publications and source records attributed to G Duthie.

13 recordsLinked to original sources
PubMed2006

The relationship of obesity to the complications of diverticular disease.

OBJECTIVE: Diverticular disease is common in our community. Most patients remain asymptomatic and the development of diverticular complications is rare. A common clinical observation is that patients presenting with complications of diverticular disease are obese. The aim of this study was to examine the relationship of obesity to the complications of diverticular disease. METHODS: The study was based on a retrospective case note review conducted at the Flinders Medical Centre between 1/7/1998 and 30/6/2003. Patients were identified using ICD codes and their body mass index (BMI) calculated. Controls were taken randomly from the colonoscopy database at The Flinders Medical Centre. Patients were divided into four groups, those admitted with diverticular perforation or abscess, recurrent diverticulitis, a single episode of diverticulitis and a control group of patients with uncomplicated diverticulosis. The mean BMI for each group was calculated. Statistical analysis was performed by one way anova test with significance set at P < 0.05. RESULTS: Sixty-one patients were studied, including 16 patients with perforated diverticular disease, 11 randomly selected with recurrent diverticulitis, 16 patients with a single episode of diverticulitis and 18 controls. The control group had a significantly lower BMI than patients presenting with perforation (P = 0.001) or recurrent diverticulitis (P = 0.002). There was no significant difference between the control group and patients with a single episode of diverticulitis (P = 1.0). CONCLUSION: The study showed that patients with perforations and recurrent diverticulitis are significantly more obese than those who remain asymptomatic or have one episode. The aetiological relationship between obesity and diverticular complications remain unclear.

Aged↗
PubMed2000

Plant-derived phenolic antioxidants.

Antioxidant nutrients are important for limiting damaging oxidative reactions in cells, which may predispose to the development of major clinical conditions such as heart disease and cancer. There is great interest in the possibility that the antioxidant potential of plant-derived phenolic compounds, such as flavonoids, may reduce the risk of developing these conditions. Antioxidant effectiveness in vivo depends on the bioavailability of these compounds, which was assumed to be low. However, recent studies with improved methodology indicate that some plant phenolics appear in plasma and body tissues and, thus, may be important nutritional antioxidants. However, this cannot be established with certainty until their effects on biomarkers of oxidative stress are established.

Antioxidants↗
PubMed2000

Plant-derived phenolic antioxidants.

Antioxidant nutrients are important for limiting damaging oxidative reactions in cells, which may predispose to the development of major clinical conditions such as heart disease and cancer. There is great interest in the possibility that the antioxidant potential of plant-derived phenolic compounds, such as flavonoids, may reduce the risk of developing these conditions. Antioxidant effectiveness in vivo depends on the bioavailability of these compounds, which was assumed to be low. However, recent studies with improved methodology indicate that some plant phenolics appear in plasma and body tissues and, thus, may be important nutritional antioxidants. However, this cannot be established with certainty until their effects on biomarkers of oxidative stress are established.

Animals↗
PubMed1996

Vaginography--investigation of choice for clinically suspected vaginal fistulas.

PURPOSE: Vaginal fistulas are rare but can cause extremely distressing symptoms for patients and prove difficult to define anatomically. Barium studies have been reported as having a maximum sensitivity of only 34 percent for detection of vaginal fistulas. Vaginography is an alternative method for diagnosis and evaluation of suspected vaginal fistulas, which has been reported to have a sensitivity of 100 percent. We reviewed our total experience of vaginography to fully assess its capabilities. METHODS: Twenty-seven patients with clinically suspected vaginal fistulas were investigated with vaginography during a six-year period. Results of vaginograms were compared with final operative or clinical diagnosis and with results of other radiologic investigations. RESULTS: Vaginography successfully identified 19 of 24 fistulas, giving a sensitivity of 79 percent. In our series, barium enema was only able to identify 9 percent of fistulas arising from the colon. CONCLUSIONS: In this, the largest series of vaginograms, apparent reduction in sensitivity from the 100 percent quoted in earlier series to 79 percent probably represents a more accurate assessment of vaginography as a diagnostic investigation. Even allowing for this reduction, vaginography is still the most sensitive, economic, and informative investigation for identification and delineation of vaginal fistulas. We recommend that vaginography be the initial investigation of choice in patients with clinically suspected vaginal fistulas.

Adult↗
PubMed1991

Comparison of anterior sphincteroplasty and postanal repair in the treatment of idiopathic fecal incontinence.

Both postanal repair and anterior sphincteroplasty with levatorplasty have been advocated in the treatment of idiopathic fecal incontinence. To assess the functional results of these procedures, physiologic and radiologic measurements were carried out prospectively in 33 patients with idiopathic incontinence undergoing operative treatment, and 12 age- and sex-matched controls. Sixteen patients had anterior sphincteroplasty and levatorplasty and 17 had postanal repair. A satisfactory postoperative outcome was defined as perfect continence or incontinence of flatus only. Ten patients in the anterior sphincteroplasty group had satisfactory results (64 percent) and 10 in the postanal repair group (59 percent). Preoperatively, both groups had decreased resting and squeeze pressures, impaired and mucosal electrosensitivity, and marked pelvic descent vs. controls. Postoperatively, significant improvement in sphincter pressures and mucosal electrosensitivity was seen in both groups. No significant change in anorectal angle was demonstrated in the postanal repair group, whereas it was made significantly more obtuse in the anterior sphincteroplasty group. It is likely that the improved continence resulting from either of these two procedures is secondary to better anal sphincter muscle function and improved and sensation. It would appear that the anorectal angle is not crucial in maintaining continence.

Adult↗
PubMed1990

Ambulatory anorectal physiology in patients following restorative proctocolectomy for ulcerative colitis: comparison with normal controls.

The purpose of this study was to determine the manometric activity of ileoanal W pouch reservoirs following restorative proctocolectomy for ulcerative colitis and to compare the results with normal controls. Thirty-one studies were carried out; there were 15 controls (median age 52 years (range 29-80 years), 10 men, 5 women) and 16 pouch patients (median age 40 years (range 28-52 years), 13 men, 3 women). Mid-anal sphincter pressure and 'rectal' pressure were measured with a microtransducer catheter. The signals were digitalized and recorded in a portable electronic memory for later computer display and analysis. The system allowed the study of patients with minimal constraints while fully ambulant. The frequency of sampling (rectal pressure greater than or equal to sphincter pressure), sensation of flatus present and flatus being passed were 7(1-41), 3(1-7) and 1(0-3.5) per hour in the normal controls and 0(0-3), 0(0-1) and 0(0-1) respectively per hour in the pouch patients (P less than 0.001). Compared with the highly dynamic nature of the anorectum in normal subjects the patients with a pouch had very little activity. The sensation of pouch filling and the desire to defaecate were noted on 12 occasions and in six were associated with a rise in pouch pressure greater than 20 mmHg. One patient had nocturnal soiling and this was the only patient in whom frequent pouch contractions were noted. The results suggest that ileoanal pouch motility is usually quiescent and that incontinence in this group may be related to increased pouch activity.

Adult↗
PubMed1990

Aortic aneurysms--who should do them?

All patients undergoing abdominal aortic aneurysm repairs in a district general hospital between 1 January 1983 and 31 December 1987 were reviewed. Of the 76 cases, 53 were planned and 23 were ruptured aneurysms. The male:female ratio was 4.4:1, and the age range was 47-84 years (mean 67.6 +/- 6.97 years). Half underwent an ultrasound scan, showing a maximum diameter range of 3-12 cm. Fifty-seven (75%) had tube grafts, and 19 (25%) bifurcation grafts. The 30-day mortality was 3.7% for planned cases, and 26% for ruptured cases. The principal operator in 55 (72.5%) cases was a consultant; consultant anaesthetists were involved in 61.3% cases. We conclude that aneurysm surgery can safely be performed in a district general hospital by a general surgeon with an interest in vascular surgery.

Aged↗
PubMed1989

Anterior sphincter plication and levatorplasty in the treatment of faecal incontinence.

The surgical treatment of faecal incontinence has been traditionally divided into sphincteroplasty for sphincter disruption and postanal repair for idiopathic cases. However, many studies have failed to show a correlation between outcome and change in the anorectal angle. This study was carried out to determine the effectiveness of anterior sphincteroplasty and levatorplasty in the treatment of faecal incontinence, regardless of aetiology. Thirty consecutive patients underwent surgery, 14 with traumatic sphincter injuries and 16 with idiopathic faecal incontinence. A satisfactory clinical result was obtained in ten (71 per cent) patients in the traumatic group and in ten (62 per cent) in the idiopathic group. This was associated with a significant increase in maximum voluntary contraction pressure in the traumatic group and in those patients who had a good result in the idiopathic group (traumatic: preoperative median 80 cmH2O (range 50-115 cmH2O) versus postoperative 115 cmH2O (75-290 cmH2O), P less than 0.005; idiopathic: preoperative 105 cmH2O (45-190 cmH2O) versus postoperative 120 cmH2O (45-230 cmH2O), P less than 0.05; Wilcoxon paired signed ranks test). There was also significant improvement in anal sensation in the upper anal canal in both groups (traumatic: preoperative mean 17 mA versus postoperative 11 mA, P less than 0.05; idiopathic: preoperative 24 mA versus postoperative 9 mA, P less than 0.02). The anorectal angle increased in the idiopathic group at rest (preoperative median 105 degrees (range 86-152 degrees) versus postoperative 118 degrees (95-180 degrees), P less than 0.05). In conclusion, the type of approach (anterior or posterior) and the anorectal angle are irrelevant to the outcome of surgery for idiopathic faecal incontinence. Success appears to be related more to improved sphincter pressure and anal sensation.

Adult↗
PubMed1984

Meshed adhesive tape for the treatment of crushed fingers in children.

Over 300 children a year are treated at the Royal Aberdeen Children's Hospital for crushed finger tips. We estimate that 5.8% of children, under 13 years of age, suffer this injury, mainly in domestic (72.5%) or car doors (12%). The treatment of partial avulsions of pulp with nail dislocation is described.

Adhesives↗