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J C Penfold

Publications and source records attributed to J C Penfold.

18 recordsLinked to original sources
PubMed1991

A comparison between single and double dose intravenous Timentin for the prophylaxis of wound infection in elective colorectal surgery.

A prospective, randomized, single-blind, controlled clinical trial was undertaken to determine whether two doses of systemic Timentin provided superior prophylaxis against postoperative sepsis in elective colorectal surgery compared with a single dose of the same antibiotic. Timentin, a combination of ticarcillin and clavulanic acid was administered intravenously (3.1 g) at the commencement of operation to all patients, and this was repeated after 2 hours in those patients randomized to receive a second dose. The wound infection rate was 11 percent in the 143 patients completing follow-up and receiving a single dose, and 13 percent in the 128 patients receiving two doses of Timentin (P greater than 0.05). The rates of postoperative septicemia 3 vs. 4 percent and intra-abdominal abscess 5 vs. 8 percent were similar. Multivariate analysis of the factors likely to affect postoperative would infection rate demonstrated an association with the type of hospital, public or private, wound infection rate 16 and 6 percent, respectively (P less than 0.01), and the surgeon group defined by the number of patients contributed greater than 25 or less than 25, wound infection rate 6 and 18 percent, respectively (P less than 0.05). We concluded that a single dose of intravenous Timentin was as effective as two doses for prophylaxis against surgical infection and that the surgeon group and the hospital in which the operation took place were statistically significant predictors of postoperative wound infection.

Clavulanic Acids↗
PubMed1989

Impact of a hospital-based register on the management of familial adenomatous polyposis.

Colorectal cancer in familial adenomatous polyposis is a preventable disease in at-risk relatives of patients with primary cases. Until the recent establishment of a register in Western Australia, there has been no registration of pedigrees or central organization of surveillance in Australia. In the present study, the experience of 20 such families who were associated with The Royal Melbourne Hospital was documented, with an analysis of the reasons for any failure of management. The impact of a hospital-based register on the management of the disease was studied. In each family, results were categorized according to whether "at-risk" relatives had been diagnosed at surveillance examinations, and whether the Hospital register were involved. Before involvement with the register, 24 family members presented with symptomatic polyposis after the first affected case had been diagnosed. Eighteen of these had colorectal cancer at diagnosis, and 16 subjects now are dead. Identifiable reasons for the failure of surveillance were family communication failure (two cases), family denial (two cases), failure of the hospital clinic (two cases) and a failure to cover extended branches of families who were living locally (nine cases), interstate (four cases) or overseas (three cases). In contrast, only two (6%) of 33 affected cases that were identified at a planned surveillance endoscopy had colorectal cancer at diagnosis. Without the active surveillance of at-risk family members, lethal delays in diagnosis are likely to occur. Most reasons for failure potentially are correctable by a dedicated registry that is responsible for notifying clinicians and patients about the timing of surveillance procedures.

Adenomatous Polyposis Coli↗
PubMed1975

The results of diagnostic colonoscopy in the management of unexplained bleeding from the rectum.

A consecutive series of 71 colonoscopies performed for unexplained bleeding per rectum is reported. All patients had had previous barium enema examinations reported as normal. In 26 colonoscopies lesions were detected; there were 12 cancers and 11 polyps. Twenty-five of these lesions were in the left colon. These findings illustrate the value of colonoscopy in supplementing the available radiological findings. The sighting of blood at sigmoidoscopy was associated with a lesion found on colonoscopy in most instances, whereas the presence of occult blood was associated with a lesion in very few. Colonoscopy should be considered prior to laparotomy in every case of unexplained blood in the stools.

Adenocarcinoma↗
PubMed1975

Large-bowel polypectomy via the colonoscope: experience with 80 polyps.

The experience of two colonoscopy units in managing 88 patients referred with 114 suspected colonic polyps are presented. Almost a quarter of the suspected polyps were artefacts, while some actual polyps were not visualized at the initial colonoscopy. All but 10 of the confirmed polyps were successfully snared. Morbidity was low. Five of the polyps were malignant. The technical aspect of snaring and of setting up colonoscopy units are discussed. It is considered that colonoscopic polypectomy is the optimum management of colonic polyps.

Adult↗