The acquisition and maintenance of fire emergency skills: effects of rationale and behavioral practice.
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Biomedical subjects
Publications and source records attributed to H S Hillman.
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During a prospective six year study from 1972-1978 there were 894 admissions to a haematemesis and melaena unit. In 162 admissions bleeding was due to acute gastric ulceration, an incidence of 18%. The group comprised 157 patients, five patients being admitted on two occasions. There were 12 deaths (7%), seven after surgery and five in conservatively treated patients. A significant fall in incidence of admissions was noted in the final two year period of study. The reason for this is unknown as no other cause of haematemesis and melaena showed a similar fall in incidence. In addition over this two year period patients with acute ulceration followed a more benign course and required surgery less often.
A prospective study of patients with upper gastrointestinal bleeding admitted to a haematemesis and melaena unit has revealed an incidence of Mallory-Weiss tears of 8% (59 of 762 patients undergoing endoscopy). Prior vomiting was present in 60% and an associated upper gastrointestinal lesion in 44 percent. The majority of patients had a recent ingestion of alcohol and/or analgesics, whilst 34% had chronic heavy alcohol intake. Approximately 50% of patients required no blood transfusion, while 37% had over three units of blood. No patient in the group required surgical intervention, and one patient died because of general debility. This study suggests that the Mallory-Weiss tear accounts for a significant proportion of patients admitted with upper gastrointestinal bleeding, but that the mortality and morbidity are low.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.