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Biomedical subjects

J A McCaul

Publications and source records attributed to J A McCaul.

16 recordsLinked to original sources
PubMed2006

The future of academic surgery--a consensus conference held at the Royal College of Surgeons of England, 2 September 2005.

A consensus conference organised by the Association of Surgeons of Great Britain and Ireland (ASGBI) and the Association of Surgeons of Training (ASIT) was held at the Royal College of Surgeons of England on 2 September 2005. All Specialist Advisory Committees and specialist associations were represented, except for orthopaedic surgery. The future of both academic surgery and training were discussed. We concluded that the European Working Time Directive, and Modernising Medical Careers are likely to have an adverse effect on future of research in oral and maxillofacial surgery. Most surgeons were concerned about the future of training and the development of surgery in general.

Academic Medical Centers↗
PubMed2005

Dyskeratosis congenita.

Dyskeratosis congenita is an inherited disorder that usually presents in males, consisting of the triad of leukoplakia of the mucous membranes, nail dystrophy and skin pigmentation. Whilst most cases are X-linked, autosomal dominant and recessive forms have been reported. The significance of the condition lies in premature mortality arising from either bone marrow failure or malignant change within the areas of leukoplakia. Various mucocutaneous and non-mucocutaneous manifestations have been reported. The syndrome arises from an inherited defect within the DKC1 gene that codes for the protein dyskerin in the X-linked recessive form of the disorder, whereas mutations in the RNA component of telomerase (TERC) result in the autosomal dominant form of the condition. The identification of a white patch within the mouth of a child in the absence of any other obvious cause should arouse suspicion of this rare condition. Greater understanding of the molecular biology surrounding this syndrome should lead to improvements in diagnosis, monitoring of disease progression and therapy.

Cell Cycle Proteins↗
PubMed2004

A new method for temporary maxillo-mandibular fixation.

We present a novel device which is an alternative to surgical wire for per operative maxillo-mandibular fixation prior to plate placement. It is easy to apply, causes minimal mucosal trauma and can be used in association with elastic chain.

Equipment Design↗
PubMed2002

Trainees' perceptions of UK maxillofacial training.

Training is a central component of the work of many units around the UK. Many changes to the way that junior doctors are trained have taken place over the past few years and maxillofacial surgery, of all the surgical specialities, has perhaps undergone the most far-reaching. A postal survey of 93 maxillofacial specialist registrars (SpRs) in all regions of the UK was carried out, of whom 81 (87%) responded. The aim was to seek their views on subjects directly related to the quality of, and access to, training. Information was gathered on age of trainees, entitlement to annual and study leave, certification for Advanced Trauma Life Support (ATLS) and office and research facilities.

Adult↗
PubMed2001

Transient hemi-diaphragmatic paralysis following neck surgery: report of a case and review of the literature.

Diaphragmatic paresis following trauma to the phrenic nerves is a rare complication after neck surgery. The resulting elevation of the ipsilateral hemi-diaphragm is diagnosed on post-operative chest radiography and may be confirmed by ultrasound or fluoroscopy. When unilateral, this may lead to respiratory, cardiac or gastrointestinal symptoms and atelectasis and pulmonary infiltrates on radiography. If nerve damage is bilateral a period of ventilation may be required.

Aged↗
PubMed2000

Aetiology of seroma formation in patients undergoing surgery for breast cancer.

Surgery for primary breast cancer and regional nodes often involves the use of suction drains post-operatively. It is believed that the fluid accumulating following axillary surgery is lymph from divided lymphatics or alternatively serum, although the composition of this fluid has never been studied in detail. Drain fluid following surgery for primary breast cancer was analysed for a number of haematological and biochemical parameters. Comparison of these values with plasma concentration produced a ratio that was compared with established lymph to plasma ratios. Haematological analysis indicates minimal contamination with blood. Comparison of drain fluid to plasma ratios with known lymph to plasma values for biochemical parameters showed that this fluid is compositionally different from lymph, but is similar to inflammatory exudate. Altering surgical technique to close dead space may avert the need for wound drainage, lead to reduced hospital stay and reduce the incidence of 'seroma' formation.

Journal Article↗
PubMed1999

Medical emergencies in general dental practice in Great Britain. Part 3: Perceptions of training and competence of GDPs in their management.

OBJECTIVES: To ascertain the training received in management of medical emergencies recalled by general dental practitioners (GDPs), as undergraduates and since graduation, to examine how well prepared they felt to manage such events and how their readiness might be improved. DESIGN: Postal questionnaire survey of a random sample of GDPs in Great Britain. SUBJECTS: 1500 GDPs, 1000 in England & Wales and 500 in Scotland. RESULTS: There was a 74% response. Among respondents, 75% had received training as undergraduates in the management of medical emergencies, 95% had subsequently received training. The proportion considering themselves 'well' or 'fairly well' prepared to manage emergencies rose from 30% at graduation to 80% currently. The 20% who felt themselves 'not very well' or 'not at all' prepared were less likely to possess the drugs and equipment to manage an emergency. Nevertheless, a need for further training was expressed by 96%: only 3% felt no need. CONCLUSIONS: Virtually all GDPs (99.2%), had received training in the management of medical emergencies at some time, principally since graduation. The 20% who feel inadequately prepared are less likely to possess the necessary drugs and equipment. There is a perceived need for further training among the majority of respondents.

Attitude of Health Personnel↗
PubMed1999

Medical emergencies in general dental practice in Great Britain. Part 2: Drugs and equipment possessed by GDPs and used in the management of emergencies.

OBJECTIVE: To ascertain the emergency drugs and equipment possessed by general dental practitioners (GDPs), the treatment provided and drugs used in management of the medical emergency events they reported. DESIGN: Postal questionnaire survey of a random sample of GDPs in Great Britain. SUBJECTS: 1500 GDPs, 1000 in England & Wales and 500 in Scotland. RESULTS: There was a 74% response. An aspirator, an airway, oxygen, adrenaline and an injectable steroid were possessed by about 90% of respondents; glucose, glyceryl trinitrate and a salbutamol inhaler by about 80%. Glucose was used in management of nearly one in ten of the events reported, an inhaler, glyceryl trinitrate and oxygen were the next most commonly used. Cardiopulmonary resuscitation (CPR) was carried out in management of 1.1-1.4% of events not associated with general anaesthesia (GA) and in 4.7-16% of events associated with GA, an average of once in 250 years of practice. CONCLUSIONS: Most respondents possessed drugs and equipment necessary to manage a medical emergency. Half the drugs recommended by the 'Poswillo report' to be available in every dental practice were not used in more than 8000 years of practice.

Adrenergic Agonists↗
PubMed1999

Medical emergencies in general dental practice in Great Britain. Part 1: Their prevalence over a 10-year period.

OBJECTIVE: To assess the prevalence, nature and outcome of medical emergencies experienced by general dental practitioners (GDPs) over a 10-year period. DESIGN: Postal questionnaire survey of a random sample of GDPs in Great Britain. SUBJECTS: 1500 GDPs, 1000 in England & Wales and 500 in Scotland. RESULTS: There was a 74% response. Emergency events were reported by 70.2%: the number reported by a single individual ranged from none to 33. The most commonly experienced events, including those associated with general anaesthesia, were (as a percentage of the total) for England & Wales and Scotland, respectively: fits and seizures (31.0%, 36.3%); swallowed foreign bodies (15.7%, 18.1%); attacks of asthma (13.8%, 11.1%); chest pain associated with angina pectoris (10.1%, 11.0%) and diabetic events (10.6%, 9.0%): none of these resulted in any serious sequelae. More events were reported in Scotland. Overall, there were 20 deaths resulting from medical emergencies reported in the survey, 4 affecting passers-by and none associated with general anaesthesia. 8849 years of practice experience were represented (by 94% of respondents), from which an estimate of the frequency of events was made. CONCLUSIONS: An emergency event was reported, on average, for every 4.5 practice years in England & Wales and 3.6 years in Scotland and death associated with general dental practice, on average, once in 758 and 464 years, respectively.

Cause of Death↗
PubMed1994

Multiple oral mucoceles treated with gamma-linolenic acid: report of a case.

Multiple mucoceles are an extremely rare condition in the oral cavity. We report a case which responded entirely to systemic gamma-linolenic acid but which recurred several months following discontinuation of therapy. Spontaneous resolution of the condition seems unlikely and it would appear that gamma-linolenic acid could have an effect on minor salivary gland composition and/or viscosity and may be worth prescribing on a trial basis prior to surgical treatment of this rare condition.

Aged↗