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Biomedical subjects

G G Youngson

Publications and source records attributed to G G Youngson.

At least 19 recordsLinked to original sources
PubMed1997

Theatre usage for emergency surgery--use or abuse?

A prospective study was performed to characterise the activity in the designated Emergency Operating Theatre of a fourteen hundred bed teaching hospital. The main conclusion was that a large group of non-emergency but non-elective patients undergo surgery in this facility. The study has shown that in this hospital, despite apparently adequate emergency facilities including a separate orthopaedic trauma theatre, additional theatre time equivalent to six designated theatre sessions would be required to optimise the management of these patients who are often elderly and require major surgery.

Adolescent↗
PubMed1997

Training initiative list scheme (TILS) for minimal access therapy: the MATTUS experience.

The objective of the MATTUS intercollegiate exercise was to set up and audit a training initiative list scheme (TILS) by which funds are awarded to Trust hospitals for operative sessions used specifically for the training of staff in minimal access therapy (MAT). A prospective centralized audit of TILS involving nine Trust hospitals in Scotland over a 12-month period (1 March 1995-end of February 1996) was carried out. These hospitals had contracted for 510 4-h training sessions (389 for minimal access surgery, 121 for allied interventional techniques) by MATTUS accredited consultant tutors. The scheme covered training in technical competence for Minimal Access Surgery (MAS), interventional flexible endoscopy and interventional radiology within Scottish Hospitals. The main outcome measures used in the audit were trainee completion rates, conversion rates, morbidity and mortality, assessment of training received by trainees and assessment of aptitude by the trainers. The results were as follows. Of 510 sessions, 482 (95%) were completed within the deadline. Of these, 463 sessions were audited (367 for MAS, 69 for flexible endoscopy and 27 for interventional radiology). During these sessions, 817 operations/procedures were performed (781 training and 36 developmental). A total of 544 operations were performed during 339 MAS training sessions and 237 radiological/flexible endoscopy procedures in 96 MAT training sessions. The trainee was the principal operator in 643 (82%) procedures and completed the task in 581 (74%) cases. Four per cent of the MAS operations (22/544) required conversion. Post-operative complications occurred in 42 out of 817 patients (5%). Four patients, all with advanced malignancy, died within 30 days of the procedure. Trainees graded 355 sessions as excellent, 109 good, two as average and one as unsatisfactory. The tutors graded their trainees' aptitude to perform the operation as excellent in 34%, good in 53%, average in 11% and poor in < 1%. The training initiative list scheme which allows unhurried training in MAT by consultant tutors using operating sessions that are extra to the service lists is operationally and educationally viable. Furthermore, it can be implemented within a pre-determined budget. The audit of TILS has also demonstrated that the immediate clinical outcome of patients is not compromised by this type of training.

Education, Medical, Graduate↗
PubMed1995

Acute abdominal pain in children: a 25 year comparison.

In the years 1967 and 1992, 649 children were admitted to the Royal Aberdeen Children's Hospital (RACH) as an emergency, with abdominal pain. The aims of this study were to estimate the change in the incidence of appendicitis and patterns of surgical admission between these years. Although the proportion of the childhood population requiring admission showed a small increase over the 25 year period, the pattern of admission changed significantly. While the overall incidence of appendicitis and the number of appendicectomies has fallen, a paradoxical increase is seen in those over 10 years of age. An increase in non-specific abdominal pain was seen which was similar in both sexes. Over the period of study, the risk of proceeding to surgery has fallen by 36%.

Abdominal Pain↗
PubMed1994

Acute pancreatitis in children: a 15-year review.

AIM: To review the aetiology, presentation, diagnosis, management, and sequelae of acute pancreatitis (AP) in children and to assess the relevance of prognostic criteria used to assess severity in adult AP. METHOD: A retrospective review (1978 through 1992) of childhood AP managed in three Scottish paediatric centres. RESULTS: Forty-nine cases of AP (34 male, 15 female) were reviewed (mean age, 7.1 years). The presenting features were abdominal pain and vomiting (80%), abdominal tenderness (73%), and parotid enlargement (22%); back pain was rare (8%). Ultrasound scan (US) findings were abnormal for 24 of 34 patients. Forty-one (82%) were managed conservatively. Six (12%) underwent early laparotomy; three (6%) underwent laparotomy after trauma. Five required subsequent definitive surgery. One patient died. Thirty-five (70%) suffered no sequelae, and five (10%) had further acute pancreatitis. Only half of the eight Imrie prognostic criteria had been recorded in these patients; only three were judged to have severe AP by the criteria. Other "clinically severe" cases were not identified. CONCLUSION: The most common causes of AP were mumps (39%) and trauma (14%); in 12, no cause was identified. US was the most useful imaging tool. The Imrie criteria were of doubtful value but warrant further prospective analysis and possible modification for children.

Acute Disease↗
PubMed1994

Intralobar bronchopulmonary sequestration: antenatal diagnosis.

A child with the antenatal diagnosis of pulmonary cystic adenomatoid malformation underwent thoracotomy and an intralobar bronchopulmonary sequestration was found. Histological examination of the resected specimen showed cystic adenomatoid malformation within the sequestered segment.

Child, Preschool↗
PubMed1991

Haemolytic uraemic syndrome in the defined population of northeast of Scotland.

Twenty seven cases of haemolytic-uraemic syndrome (HUS) were admitted to the Royal Aberdeen Children's Hospital between 1978 and 1989. All cases were from the defined childhood population of the Grampian region of Northeast of Scotland. Thirteen cases were admitted during the 2-year period 1987-1988 (Group 1). Of the 13 cases, 9 (Group 1 a) were admitted within the 11-month period between August 1987 and June 1988, and were from a small area (7 miles radius) within and around the City of Aberdeen. Their mean age was 7.1 years. Twelve cases of HUS were admitted between 1978 and 1986 and 2 cases were admitted in 1989 (total 14 cases; Group 2). Mean age was 3.0 years with no geographical clustering. The average annual incidence for group 2 was 1.25 per 100,000 children 0-16 years old.

Adolescent↗
PubMed1991

Management of the impalpable testis: long-term results of the preperitoneal approach.

During a 12-year period 396 operations for undescended testes were carried out by one surgeon. In 90 boys the testis was impalpable, and exploration was performed using a muscle-splitting preperitoneal approach. Testicular volume and location were prospectively recorded at 3 months and 1 year, 94% were intrascrotal at 1 year and 84% were judged to have grown. At late follow-up 6 to 16 years (mean, 11 years) after ochidopexy, 81% of testes were in the scrotum and 57% were of normal volume. The value and advantages of this operative approach and its place in the management strategy of the impalpable testis are discussed.

Child↗