Biomedical subjects

H Cockburn

Publications and source records attributed to H Cockburn.

3 recordsLinked to original sources

PubMed2000

Retrospective study on red cell usage in primary total knee replacement surgery.

BACKGROUND AND OBJECTIVES: There is wide variation in the use of red cell transfusions for the same clinical indication. The purpose of the study was to comment on preoperative and discharge haemoglobin (Hb) levels and perioperative blood loss, and to project the Hb level if transfusions were not administered. MATERIALS AND METHODS: The case notes of 187 patients who underwent primary total knee replacement were reviewed retrospectively. RESULTS: More than 90% of the transfusions were given in the immediate postoperative period as a matter of routine and a significant number of transfusions appeared to be unnecessary. CONCLUSION: For surgical procedures involving moderate blood loss, transfusions should not be given as a routine and the decision to transfuse should take into consideration the clinical state of the patient, blood loss and pre- and postoperative Hb levels.

Aged↗

PubMed1998

Current practice in neonatal exchange transfusions: a retrospective audit based at one transfusion centre.

As a result of the widespread use of phototherapy, the need for neonatal exchange transfusion has declined markedly over the last 25 years. However, in spite of this, we have discovered a marked disparity in the number of requests for units of blood suitable for exchange transfusion made by neonatal units of similar size. A retrospective audit was therefore performed to establish current practice. A questionnaire was sent to consultant neonatologists and an audit trail of all units of blood issued from our Transfusion Centre for exchange transfusion over an 18-month period was followed. A significant finding was the large amount of overordering of blood by neonatologists, resulting in units produced expensively to high specification being given to other patients. Only 42% of the blood issued for exchange transfusions was actually used for that purpose. Also, published guidelines are not being adhered to, particularly with respect to the specification of the blood products being used. Better communication between neonatologists, hospital haematologists and transfusion medicine specialists would help to ensure that infants requiring exchange transfusion are given the best product and that valuable resources are not wasted.

Blood Transfusion↗

PubMed1993

Reliability of histological diagnosis including grading in gliomas biopsied by image-guided stereotactic technique.

We report clinical and pathological data of 419 image-guided stereotactic biopsies. In the present series the diagnostic yield, estimated by comparing the original histological diagnoses with follow-up data, was found to be approximately 94% in gliomas. As it has been suggested that malignancy of astrocytic gliomas may be considerably underestimated in the small tissue samples obtained by stereotactic biopsy, we have reviewed 160 adult, diffuse supratentorial astrocytic tumours, correlating the original Kernohan tumour grades with survival. In this grading system, although there was generally a good correlation between histological grade and survival probability (P < 0.0001), no distinction could be made between the grade 3 (anaplastic astrocytoma) and grade 4 (glioblastoma) groups. Tumour grades obtained by applying the criteria of the more recent Daumas-Duport grading system were also determined and correlated with survival. These latter tumour grades not only correlated well with survival (P < 0.0001), but also enabled us to identify a group of patients with intermediate grade malignancy (grade 3, anaplastic astrocytoma), surviving longer than those with grade 4 tumours. Image-guided stereotactic biopsy is a useful means of providing tissue samples for histological diagnosis of brain neoplasms, including gliomas. Histological grading of adult, diffuse supratentorial astrocytic gliomas diagnosed by this technique is possible and should be carried out using an appropriate grading system.

Adolescent↗