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Biomedical subjects

I R Gough

Publications and source records attributed to I R Gough.

At least 19 recordsLinked to original sources
PubMed1991

What value is given to quality of life assessment by health professionals considering response to palliative chemotherapy for advanced cancer?

A study was designed to obtain information on the importance of quality of life assessment (QL) during palliative chemotherapy. A questionnaire was answered by 542 health professionals (392 general practitioners, 20 specialist oncologists, and 130 oncology nurses). In both simulated patient situations and multiple-choice questions, all groups rated QL higher than other standard methods of assessment. General practitioners and oncologists appeared to weight the assessment criteria more equally than nurses who gave strong emphasis to QL. In the simulated patient situation, there was a small degree of interaction between QL and other assessment criteria. However, the analysis showed that QL was regarded as an independent variable and was considered to be the most important objective of palliative chemotherapy for advanced cancer.

Aged↗
PubMed1991

Metastatic carcinoid tumour: stability throughout pregnancy.

A patient with asymptomatic histologically proven extensive hepatic metastases of carcinoid tumour had no progression of disease for over 4 years without specific treatment. Throughout a normal pregnancy the hepatic metastases remained stable by clinical, computerized tomography and biochemical criteria.

Adult↗
PubMed1989

Surgery for thyroglossal cysts: Sistrunk's operation remains the standard.

Surgical techniques for thyroglossal cysts still vary considerably. In this review, one-third of patients treated by simple cyst excision had recurrence and this operation cannot be recommended. There should be consensus that excision of the mid-portion of the hyoid bone be performed routinely. However, variations have been described in the syprahyoid dissection. The present review indicated that the classic Sistrunk operation provided the lowest rate of recurrence and should remain the standard procedure.

Adolescent↗
PubMed1989

Aetiology of branchial cysts.

The aetiology of branchial cysts is unknown. It is possible that they arise by more than one mechanism. The major theories are that they originate either from the branchial apparatus or from lymphoid tissues. A retrospective review was conducted of 61 cases occurring over a recent 14-year period. Eighty-five percent were diagnosed after the age of 10 years, 80% occurred in the 'classical' position, 80% had a squamous epithelial lining and 87% had lymphoid tissue in the wall. The clinical and histological features strongly support the lymphoid aetiology theory for the majority of branchial cysts.

Adolescent↗
PubMed1989

Long-term follow-up of patients with benign thyroid fine-needle aspiration cytologic diagnoses.

Reliance on fine-needle aspiration (FNA) of the thyroid as the key determinant whether to observe only or proceed surgically is predicated on achieving a minimal false-negative error rate (the incidence of malignant disease in nodules diagnosed benign by means of FNA). To provide convincing data that malignant disease has not been overlooked requires extended follow-up on a large number of patients with cytologically benign lesions. The intent of our study was to assess the long-term accuracy of thyroid FNA-based diagnoses--particularly with respect to false-negative errors. From our total experience of more than 8000 patients, we reviewed the cases of 680 patients who underwent FNA in 1980, the first year we used it clinically. Follow-up information was obtained on 641 (94%) of the patients with a mean time since FNA of 6.1 years. Benign cytologic findings were reported on 439 (68%) of these patients, and only three (0.7%) had false-negative diagnoses. The false-positive rate was 0% for the 24 (4%) patients with positive aspirates. FNA is a safe, reliable, effective means of accurately discriminating benign from malignant thyroid lesions.

Biopsy, Needle↗
PubMed1988

Phaeochromocytoma.

Explore the source record for details and available documents.

3-Iodobenzylguanidine↗
PubMed1988

The value to the surgeon of parathyroid hormone assays in primary hyperparathyroidism.

The role of various parathyroid hormone (PTH) radio-immunoassays in the diagnosis of primary hyperparathyroidism (PHP) is controversial. A series of 204 patients with surgically proven PHP was studied. Serum total calcium, serum ionized calcium, amino (N)-terminal PTH and carboxyl(C)-terminal PTH were assessed in relation to the volume and weight of adenomatous or hyperplastic parathyroid tissue excised at operation. N-terminal PTH was elevated above the normal laboratory range in only 24% of patients and correlated relatively poorly with the volume of abnormal parathyroid tissue (r = 0.20, P = 0.05). C-terminal PTH was elevated above the normal range in 91% of patients and had a strong correlation with the volume of abnormal parathyroid tissue (r = 0.63, P less than 0.001). The correlation coefficients between C-terminal PTH and serum total calcium and serum ionized calcium were both 0.63 (P less than 0.001). In contrast, there was no correlation between N-terminal PTH and serum total calcium (r = -0.02), serum ionized calcium (r = -0.04) or C-terminal PTH (r = 0.09). A combination of hypercalcaemia and elevated C-terminal PTH can be regarded as strong diagnostic evidence of PHP. Furthermore, the level of C-terminal PTH can assist the surgeon by approximately predicting the amount of adenomatous or hyperplastic parathyroid tissue that may be expected at surgical exploration.

Adolescent↗
PubMed1988

A study of diagnostic accuracy in suspected acute appendicitis.

A prospective study was conducted of 276 patients with suspected acute appendicitis. Two hundred and eighteen patients had operations and 165 had acute appendicitis. Data from a previous retrospective study were used to develop an eight-item statistical program for a pocket calculator and this was made available to half the surgical registrars as an additional aid to clinical decision making. The other registrars involved in the study used only their clinical skills. There was no difference in diagnostic accuracy or frequency of operations or complications between patients managed by the two groups. Forty items of clinical data on each patient were collected prospectively. These were subsequently analysed on a computer program for the diagnosis of the acute abdomen which was developed in the United Kingdom. The accuracy of diagnosis of the clinicians was superior to the accuracy of the computer diagnosis.

Acute Disease↗
PubMed1988

Papillary thyroid carcinoma in children and adults: long-term follow-up of 1039 patients conservatively treated at one institution during three decades.

Fifty-eight children (18 boys, 40 girls) less than 17 years of age, undergoing initial surgery because of papillary thyroid carcinoma (PTC) at Mayo Clinic from 1946 through 1975 and followed up for a median time of 27.6 years were compared with 981 adults (323 men, 658 women) treated during the same period and followed up for a median period of 19.5 years. At initial evaluation, mean tumor size (+/- SD) was greater in children (3.1 +/- 1.7 cm) than in adults (2.1 +/- 1.7 cm) (p less than 0.001); tumor DNA content was nondiploid in 10% of 39 children and in 25% of 110 adults (p = 0.047). Neck node metastases at diagnosis were detected in more children (89.7%) than adults (34.7%) (p less than 0.0001), but extrathyroidal invasion was not significantly more frequent in children (24.1%) than adults (15.8%) (p = 0.095). Distant metastases at diagnosis were detected in more children (6.9%) than adults (2.1%) (p = 0.022). Postoperatively, neck node metastases recurred more frequently in children (30%) than in adults (7%) (p less than 0.001), but local neck recurrences were not significantly more frequent in children (12%) than in adults (5%) (p = 0.083). Postoperative distant metastases occurred with similar frequency in children (6%) and adults (5%) (p = 0.98). Survival (all causes of death) for both adults and children up to 30 years after the initial surgery was no different from expected survival rates. Only adults aged more than 40 years had a significantly higher mortality from PTC than did children (p less than 0.0001). Fourteen percent of children had died of PTC by 15 years after diagnosis of distant metastases, whereas 68% of similarly affected adults were dead at 15 years (p = 0.014). PTC was more often metastatic to neck nodes and lungs before initial surgery and more often recurrent in neck lymph nodes postoperatively. However, PTC tended to be less fatal in children, and this may be related to the infrequency of nondiploid DNA content in the childhood PTC tumors.

Adolescent↗
PubMed1988

Local recurrence in papillary thyroid carcinoma: is extent of surgical resection important?

From a multivariate analysis of more than 20,600 patient-years' experience with papillary thyroid carcinoma (PTC), we devised a prognostic scoring system based on patient age, tumor grade, extent, and size (AGES). This scoring system was used as an adjustment variable for analyzing the role of different types of surgical treatment in the development of local recurrence (LR) in 963 PTC patients who underwent unilateral (15%), bilateral subtotal/near-total (69%), or total thyroidectomies (16%) from 1946 through 1975 at the Mayo Clinic. In 866 patients with AGES scores of 3.99 or less, the risk of LR developing at 10, 20, and 30 years was 7%, 14%, and 14% after unilateral resection and 1.5%, 2%, and 4% after bilateral resection (p less than 0.001). In 97 patients with AGES scores of 4 or more, the comparable rates were 26%, 45%, and 59% after unilateral resection and 13%, 20%, and 20% after bilateral resection (p less than 0.001). In neither the low- nor the high-risk group was there a significant difference in the frequency of LR comparing total thyroidectomy with bilateral subtotal/near-total thyroidectomy. At 30 years after diagnosis of LR, mortality from PTC was 48%; the risk of cancer death with an LR located outside the thyroid remnant was much greater than with a remnant recurrence alone. In this series of 52 patients, followed up for as many as 41 years, no patient with tumor recurrence limited to the thyroid remnant died of thyroid cancer.

Adolescent↗
PubMed1987

Intestinal pseudo-obstruction in pheochromocytoma.

Intestinal pseudo-obstruction is a rare complication of pheochromocytoma. We describe a 39 year old man with a large right adrenal pheochromocytoma and extremely high catecholamine levels, who developed pseudo-obstruction which responded promptly to intravenous phentolamine infusions. This case supports the concept that this complication is attributable to high circulating levels of catecholamines, acting by direct and indirect inhibition of gastrointestinal motility.

Adrenal Gland Neoplasms↗
PubMed1986

A brief history of eponyms in endocrinology.

Many of the disorders of the endocrine glands are known by the names of the person credited with their description. The origins of commonly used eponyms and the original descriptions are reviewed.

Endocrine System Diseases↗