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Biomedical subjects

I A Goulbourne

Publications and source records attributed to I A Goulbourne.

12 recordsLinked to original sources
PubMed1990

Long-term results after Nissen fundoplication: a 5-15-year review.

In a study of 154 consecutive patients who had a Nissen fundoplication performed by 12 surgeons over a 10-year period, 117 (76%) were available for review of symptoms 5-15 years after the procedure. Heartburn, the most common presenting symptom, was abolished in 85.5% and epigastric pain in 84.6% of patients. Fifteen patients (12.8%) considered the operation a failure because of dysphagia (17%), bloating (17%), pain (13%), heartburn (13%) or diarrhoea (6%). Comparison of possible risk factors between successes and failures showed no difference between these two groups in terms of age, sex, rank of surgeon, smoking, or accompanying crural repair. Prior response to H2-receptor antagonists did not influence outcome. Nissen fundoplication is successful in some 85% of patients over a period of 5-15 years after operation.

Adolescent↗
PubMed1987

111In-platelet and 125I-fibrinogen deposition in the lungs in experimental acute pancreatitis.

An experimental model of acute pancreatitis in rats has been used to study intrapulmonary 125I-fibrinogen and 111In-platelet deposition. Pancreatitis caused a significant increase in wet lung weight compared to normal, and this could be abolished by heparin or aspirin pretreatment. 125I-fibrinogen was deposited in the lungs of animals to a significantly greater degree than in controls (P less than 0.01). 125I-fibrinogen deposition was reduced to control levels by pretreatment with aspirin or heparin (P less than 0.05). The uptake of radiolabeled platelets was greater in pancreatitis than in controls (P less than 0.001). Pancreatitis appears to be responsible for platelet entrapment in the lungs. Platelet uptake was reduced by heparin treatment but unaffected by aspirin therapy.

Acute Disease↗
PubMed1986

Bacteriology of the closed duodenal loop model of acute pancreatitis and ultrastructural changes induced in the lungs.

Injection of infected human bile into a closed duodenal loop in the rat consistently produces lethal pancreatitis with severe pulmonary damage. Lung abnormalities, resembling the human adult respiratory distress syndrome (ARDS) are frequently seen in this model and are usually ascribed to the pancreatitis. Similar pulmonary problems are seen in the human form of acute pancreatitis. Recently, it has been suggested, that the lung changes in the experimental animal are more likely to be due to bacteremia than to the pancreatitis. The aim of this study was to determine whether bacteremia occurred in this model, and if so, to determine whether bacteremia alone, in the absence of pancreatitis could produce this lung damage. A group of rats underwent induction of acute pancreatitis by a closed duodenal loop method and were compared to two groups comprising a closed small bowel loop bile infusion preparation, isolated from the pancreas, and a control group of rats undergoing a "sham" gastrotomy. Both pancreatitis and closed small bowel groups of animals were found to be bacteremic when sacrificed at 6 hr. The lungs from the animals with pancreatitis were significantly heavier than those in the other groups and scanning electron micrographs of the lungs in pancreatitis showed gross abnormalities, with marked increases in the alveolar wall thickness. The lungs in the closed small bowel loop preparation were indistinguishable from a control sham gastrotomy group of non-bacteremic rats. These results indicate that although the closed duodenal loop model of pancreatitis produces bacteremia, pancreatitis is necessary for development of pulmonary abnormalities.

Animals↗
PubMed1985

The value of an erect abdominal radiograph in the diagnosis of intestinal obstruction.

The value of an erect abdominal radiograph in the diagnosis of acute intestinal obstruction has been studied. Four observers independently assessed 100 supine abdominal films and then reassessed them in combination with an erect film. The addition of the erect film did not significantly increase the accuracy of diagnosis of obstruction or help in the correct identification of its level. The presence or absence of gas in the rectum was of no diagnostic value.

Humans↗
PubMed1984

Computer aided diagnosis in acute testicular pain.

Over an 11-year period in Edinburgh, 495 patients with a proven diagnosis of testicular torsion or acute epididymo-orchitis were admitted to hospital. The final diagnosis in 227 was epididymitis, in 236 torsion of the testis and in 32 torsion of a testicular appendage. The immediate salvage rate from torsion of the testis was 67 per cent. To try to improve diagnostic accuracy in these three conditions, a computer program was constructed using a data base derived from the literature. On retrospective analysis of the 495 patients, the program achieved a 92.3 per cent accuracy in differentiating torsion from epididymitis. If the computer's diagnosis had been followed it would have reduced the exploration rate in epididymitis from 18 to 1.8 per cent. It would further have increased the diagnostic accuracy of a junior doctor to that of a senior colleague, but the number of torsions 'missed' by the computer and senior doctor would have been similar. The technique is inexpensive, rapid, immediately available, non-invasive and easy to use. It is suggested that such a program will increase diagnostic accuracy in acute testicular pain and, hopefully, the salvage rate from torsion of the testis.

Acute Disease↗
PubMed1980

Day-bed units.

Explore the source record for details and available documents.

Ambulatory Surgical Procedures↗
PubMed1979

Operations for hernia and varicose veins in a day-bed unit.

Over eight years (1970-8) 1055 patients underwent operations for hernia or "major" varicose veins in a day-bed unit. Here, 608 were discharged home on the day of operation, 262 were transferred to a convalescent hospital for 48 hours, and 161 were retained in the acute ward as part of a controlled trial. Special emphasis was placed on selection and preadmission screening. Failure of planning was uncommon in that only 2.5% were detained in hospital and 1% had to be readmitted. About one-quarter of the patients had complications but these were generally trivial and were satisfactorily treated by the community nursing sisters or general practitioners, or both. Analysis of the total operations for hernia or varicose veins in the unit over the past 19 years shows that, whereas formerly all patients with these conditions were admitted to the main surgical ward, nowadays almost all are managed either by day care or in a five-day ward.

Adult↗