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Biomedical subjects

J B Bourke

Publications and source records attributed to J B Bourke.

At least 19 recordsLinked to original sources
PubMed1990

Adenocarcinoma of the stomach following radical radiotherapy for testicular cancer.

Two male patients who underwent curative surgery and adjuvant radiotherapy (with further chemotherapy in one) for testicular cancer developed adenocarcinoma of the stomach 5 and 19 years after treatment. The stomach is included in the field of radiotherapy used to treat the para-aortic lymph nodes and this may lead to dysplastic changes in the stomach mucosa which can lead to frank malignancy. Early endoscopy should be offered to patients with dyspeptic symptoms after adjuvant radiotherapy for testicular cancer.

Adenocarcinoma↗
PubMed1990

[Incidence and geographical distribution of acute pancreatitis in Nottingham 1969 to 1983].

During the fifteen year period 1969-1983, 493 patients with primary acute pancreatitis were admitted to Nottingham hospitals. The incidence of this disease increased from 75.1 per million per year for 1969-1976 admissions to 116.9 per million per year for 1977-1983 admissions. For both cohorts there were large statistically significant variations in the distribution of pancreatitis within the study area. The spatial distribution for both cohorts revealed that the highest incidence rates clustered in an area east of the city centre which is supplied by particularly "hard" water. The chemical composition of the domestic water supply may play a role in the manifestation of acute pancreatitis.

Acute Disease↗
PubMed1979

Splenectomy for undiagnosed splenomegaly.

During the 9-year period 1968-76 116 splenectomies were performed at the General Hospital, Nottingham. Of these, 13 (11 per cent) were undertaken for unexplained splenomegaly. In 6 patients a diagnosis was established by the operative procedure (2 with sarcoidosis, 2 splenic cysts, 1 Gaucher's disease and 1 haemangiosarcoma). Histological examination of the excised spleens in the remaining 7 patients showed no specific features. Two of these patients benefited considerably from removal of very large spleens. Another patient died from lymphosarcoma which was diagnosed 21 months after splenectomy. In the remaining 4 patients with mild to moderate splenomegaly, there were no real diagnostic or therapeutic advantages. It is concluded that splenectomy should always be considered in patients with unexplained moderate or gross splenomegaly but it may not be helpful in the patient whose spleen is only midly enlarged.

Adolescent↗
PubMed1979

Variations in the incidence and the spatial distribution of patients with primary acute pancreatitis in Nottingham 1969-76.

During the eight year period 1969-76, 214 patients with primary acute pancreatitis were admitted to Nottingham hospitals from the Nottingham defined population area (the City of Nottingham and the four adjacent urban districts, which had a population of 469,720 in 1971). There was considerable variation in both the incidence and distribution of the disease within the study area and the crude average incidence rates ranged between 31.8 and 388.7 per million. Six of the eight wards with rates in excess of 200 per million were contiguous with similar wards; together these formed a U-shaped area extending from the city centre to the eastern boundary of the study area. These findings could not be accounted for by the age structure of the population or its social class structure. Although the Nottingham defined population area is relatively small (147 km2 or 57 sq. miles), it is subdivided into distinct and fixed domestic water supply areas. The distribution of patients among the six water supply areas showed that the Burton Joyce supply area, which is a particularly 'hard' water, contained significantly more patients than could have occurred by chance (P less than 0.002). This investigation of some social and geographical factors suggests that the chemical composition of the domestic water supply may affect the distribution of this disease within this particular urban area. This concentration of patients in the Burton Joyce water supply area suggests that some, as yet unidentified, property of the water supply may be an aetiological factor.

Acute Disease↗
PubMed1978

Drug-associated primary acute pancreatitis.

Drug histories were taken from 100 patients in their first attack of acute pancreatitis, and each was matched with a control subject of the same sex who was admitted to hospital as an emergency with acute abdominal pain, whose serum-amylase was within the normal range, and whose age was within three years of the pancreatitis patient's. The major differences between the patient groups was in the use of cardiovascular agents, and this was primarily due to a statistically significant excess of diuretic takers among the pancreatitis patients. There was an associated excess of intake of digoxin and antihypertensive and anti-anginal agents, but neither difference was statistically significant. Other categories of drugs showed no substantial differences. The difference between the pancreatitic patients and controls is almost entirely accounted for by takers of cyclopenthiazide with potassium chloride and of frusemide, especially the former. Further clinical and experimental evidence is required before the role of diuretics and/or potassium chloride in causing acute pancreatitis can be determined.

Acute Disease↗
PubMed1978

The clinical and economic effects of early return to work after elective inguinal hernia repair.

Since 1 January 1976 male patients of four consultant surgeons undergoing elective repair of a unilateral inguinal hernia have been included in a trial to see if 'early' return to work or normal activity is associated with an increased recurrence rate and also to investigate any economic consequences. To date 295 patients have been entered into the trial and the first 150 have been reviewed at 1 year. There was a complete follow-up at 1 year. There was 1 recurrence (0.7 per cent) at 1 year, and this had occurred by the time the patient came to the clinic to be included in the trial. Patients supervised by their general practitioner were off work for 78.5 days, while those advised to return to work early were off work for 52.1 days. This difference of 25.4 days is significant at the 0.1 per cent level. Loss of earnings while off work was reported by 36.7 per cent of patients, and the average sum lost was 19.86 per week. Thus, patients lost 72.06 on average. If patients went back to work at 52 days instead of at 78 days, the benefit to the economy would be of the order of 7 m., and this 'early' return to work is not associated with an increase in the recurrence rate at 1 year.

Convalescence↗
PubMed1976

A comparison between suction and corrugated drainage after simple mastectomy: a report of a controlled trial.

A randomized prospective trial of closed suction wound drainage compared with corrugated wound drainage after simple mastectomy for early breast cancer (lesion confined to the breast and without skin ulceration) is reported. Fifty-one patients were admitted to the study and there was no difference between the two groups with respect to local complications such as ifection, skin necrosis and collection under flaps and wound healing. Dressings require to be performed significantly less frequently with suction as opposed to corrugated drainage and suction drains were removed significantly sooner than corrugated drains. It is concluded that closed suction wound drainage should be used after simple mastectomy.

Bandages↗
PubMed1975

Variation in annual incidence of primary acute pancreatitis in Nottingham, 1969-74.

A review of the 202 patients admitted to Nottingham hospitals with primary acute pancreatitis during the six years 1969-74 has been undertaken. The City of Nottingham and the four adjacent former urban districts had a population of 469 720 in 1971, and an attempt was made to obtain details of all patients from within this defined population area. 134 of the 202 patients came from this area. The annual incidence varied by 4-fold throughout the six years of the survey from a peak incidence of 83-0 per million population in 1974 to a low incidence of 21-2 per million in 1970. There was no detectable pattern behind this variation and consideration of the individual figures did not suggest that any particular predisposing factor accounted for the variation. Spatial variation analysis is now being undertaken to see if population and environmental subgroups can be identified.

Acute Disease↗
PubMed1975

Peritoneal nesothelioma.

Two patients with primary peritoneal mesothelioma are reported. They had abdominal symptoms, no symptoms referable to the respiratory system and normal chest X-rays. There was no clinical evidence of impaired respiratory function. One of the patients had a history of brief asbestos exposure over 20 years before diagnosis. The procedure for obtaining compensation is outlined and the protean uses of, and hence possible exposure to, asbestos are noted. In screening programmes consideration should be given to both pulmonary and abdominal symptoms. Laparoscopy may have a part to play in earlier diagnosis of peritoneal mesothelioma.

Aged↗