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J Gooding

Publications and source records attributed to J Gooding.

9 recordsLinked to original sources
PubMed2002

A 25-year study of emergency surgical admissions.

BACKGROUND: Numbers of emergencies are increasing, but no comprehensive data are available for emergency surgical admissions. This study documents the changes over 25 years in a district general hospital. METHODS: Details of all general surgical (including urological) emergency admissions were analysed for every fourth calendar year from 1974 to 1998. RESULTS: A total of 19,931 patients were admitted during the 7 years studied, rising from 2137 in 1974 to 3578 in 1994 (3377 in 1998). Mean age increased from 47.9 years to 52.6 years while mean length of stay fell from 9.5 days to 5.3 days. Hospital mortality decreased from 6.6% to 3.7%. When calculated per 100,000 population, the increase in admission rate was significant (P < 0.001) but bed requirements did not increase despite the increase in workload. Several diagnoses became significantly more frequent (ruptured aortic aneurysm, gallstones, constipation, cutaneous abscess, diverticular disease, gastroenteritis, non-specific abdominal pain, pilonidal sinus and urinary diagnoses). Appendicitis and non-malignant intestinal obstruction became significantly less common. CONCLUSIONS: This study has documented a progressive increase in surgical admissions. Despite increasing age of patients, lengths of stay and hospital mortality have decreased.

Age Distribution↗
PubMed1986

Plasma catecholamine levels during water immersion in man.

In ten normal subjects thermoneutral neck-out water immersion produced a highly significant natriuresis and diuresis mediated via an induced central hypervolaemia. During immersion suppression of plasma noradrenaline and adrenaline was observed but no change occurred in plasma dopamine levels. No correlation was found between the suppression of noradrenaline and the diuresis and natriuresis. The reduction in plasma noradrenaline observed may reflect a widespread diminution of sympatho-adrenal activity during water immersion. This reduction could be a consequence of the cardiovascular changes of immersion and may not be directly involved in the mechanism of the renal response.

Adult↗
PubMed1985

Hospital readmissions among the elderly.

This paper investigates the six-month hospital readmission rates among 444 patients 65 years of age or older admitted to a large metropolitan teaching hospital who had a primary discharge diagnosis of cerebrovascular disease, hip fracture, or congestive heart failure. Twenty-four percent were readmitted to the same institution one or more times during the six-month follow-up. Striking variability was observed in use of hospitals across these diagnostic groups. Patients with a primary diagnosis of congestive heart failure were at highest risk of hospital readmission (36%). Multiple readmissions among the congestive heart failure group were prevalent. These preliminary data suggest that hospital readmission among the aged is a complex multifaceted phenomena.

Aged↗
PubMed1985

The role of the polymorphonuclear leukocyte in hyperalgesia.

The results of recent studies of the mechanism of leukotriene B4-induced hyperalgesia suggest a dependence on polymorphonuclear leukocytes (PMNLs). In this study, we addressed the contribution of PMNLs to hyperalgesia evoked by the peptide chemotactic factors N-formyl-methionyl-leucyl-phenylalanine (fMLP) and the anaphylatoxin fragment of the fifth component of the complement pathway (C5a). Local injection of glycogen, which attracts but does not activate PMNLs, produced a marked shift to the left (toward lower concentrations) in the concentration dependence curve of fMLP-induced hyperalgesia. In addition, PMNL repletion by transfusion with syngeneic PMNLs reestablished fMLP-induced hyperalgesia in PMNL-depleted rats. Finally, supernatants from rat and human PMNLs, that had been stimulated with fMLP in vitro, produced hyperalgesia in PMNL-depleted rats. Preliminary characterization of the hyperalgesia-inducing activity released by stimulated PMNLs indicated that it is lipid in nature. The nonsteroidal anti-inflammatory indomethacin did not attenuate C5a and fMLP-induced hyperalgesia. Thus, the hyperalgesia produced by fMLP and C5a is similar to that produced by leukotriene B4 in that it is dependent on PMNLs and independent of the cyclo-oxygenation of arachidonic acid. Taken together, these data suggest that structurally diverse PMNL-chemotactic factors produce hyperalgesia by a novel mechanism, involving PMNL-derived factors.

Animals↗
PubMed1979

Triage in peace.

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Emergency Medical Services↗