Thirty-one-year review of medical education.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to H G Bingham.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A four-year update is reported on the Eugene Tubbs Burn Intensive Care Unit at the University of Florida Shands Hospital. Flame (68%) and scald (18%) burns have remained fairly constant over the period. There were 123 inpatients and 356 outpatient visits this past year with an infection rate of 21%. Seventeen patients were age 50 or older and the average body surface area involved of the 9% mortality group was 57.4%. The advantage of a burn team working in a specially designed unit is emphasized.
Explore the source record for details and available documents.
Management of the burned patient requires great skill and understanding of the burn wound. Knowledge of the wound has increased rapidly over the past few years and management of patients has progressively changed. The resuscitation formulae are widely recognized and "burn shock" rarely occurs in the acute phase. More often the patient receives excessive amounts of fluid due to over-estimation of the body surface involved.
The patient described in this article is a 45-year-old woman who developed an infiltrating ductal carcinoma in her left breast next to a Silastic mammary implant that had been used for augmentation some 13 years previously. She underwent a modified radical mastectomy and removal of the silicone prosthesis with an axillary lymph node dissection. Twenty-six axillary lymph nodes were negative for metastatic disease. The 165-gram silicone gel prosthesis was surrounded by a thin fibrous capsule with an attached 1-cm carcinoma that did not invade the fibrous capsule. It appeared that the capsule presented a barrier to the invading ductal carcinoma. The fibrous capsule surrounding the Silastic implant may have altered the spread of the breast cancer without being related to its genesis.
The purpose of this article is to call attention to an unusual syndrome that may lead to a major loss of soft tissue, limb, and life. The application of principles learned from trauma and burn care may substantially reduce the morbidity and mortality, which in the past have been associated with purpura fulminans.
Twenty-seven burned patients who had facial burns, hoarseness, or evidence of carbonaceous sputum or had been in a smoke-filled enclosed space underwent fiberoptic bronchoscopy at the time of admission. Airway severity was indexed (grades 1-5, grade 5 being the most severe). Fifteen nonsurvivors had a bronchoscopic index of 3.2 +/- 1.6 and 12 survivors an index of 3.4 +/- 1.2 (p greater than 0.05). No patient died of respiratory complications. Bronchoscopic index correlated poorly with the level of positive end expiratory pressure required to maintain oxygenation in any patient (r = 0.50). Likewise, bronchoscopic index did not correlate with duration of intubation in any survivor (r = 0.33). Immediate bronchoscopy after burn injury neither indicates the level of respiratory support that will be required nor predicts its duration.
Explore the source record for details and available documents.
At present, adjuvant chemotherapy exerts no significant impact on long-term survival and only occasionally provides brief palliation in head and neck cancer. The major contribution of chemotherapy has been in the preoperative period, when therapy for advanced squamous cell carcinoma may render some patients candidates for curative operations or radiotherapy. This article discusses the use of single-agent chemotherapy, combination chemotherapy, and combination irradiation and surgery as well as the advantages of adjuvant chemosurgery.
We report a series of 10 congenital hemangiomas which have been followed by serial examinations with the Doppler apparatus, to determine persistence of and increase in A--V fistulae, or a decrease in same. We believe the data on the A--V fistulae correlate inversely with the likelihood of spontaneous regression and involution.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The Doppler ultrasonic flowmeter has been used as an aid in locating blood vessels that supply axial flaps in several different clinical situations. It has also been of value in microvascular surgery in which axial vessels of island flaps can be located and continuous patency monitored after their transfer and anastomosis.
Explore the source record for details and available documents.
Various problems, involving money, space, personnel, and their relationship to the hospital administration, can be associated with the establishment of a Burn Unit. However, these problems can be overcome. During the creation of a Burn Unit, consultation regarding the design features of the unit is particularly important.