PubMed Health⌕ Search

Biomedical subjects

J H MacLeod

Publications and source records attributed to J H MacLeod.

13 recordsLinked to original sources
PubMed1987

Management of anal incontinence by biofeedback.

One hundred thirteen patients with anal incontinence, in whom conventional sphincter exercises were ineffective, were treated by biofeedback, 89 in the office and 24 in the hospital rehabilitation department. Equipment consisted of an intraanal plug, containing two electrodes, connected to an electromyometer. In the last 16 cases, an Apple computer was added. With the plug in place and the electromyometer or computer screen in view, patients were instructed in sphincter contraction during an average of 3.34 1-h sessions. Follow-up was 6 mo to 5 yr, with no relapses. Sixty-three percent had either complete recovery of continence or at least a 90% decrease in the frequency of incontinence. When 13 cases of "keyhole deformity" were excluded, the success rate rose to 71%. This method is simple, inexpensive, and suitable for either office or hospital management of anal incontinence.

Biofeedback, Psychology↗
PubMed1983

Rational approach to treatment of hemorrhoids based on a theory of etiology.

In a series of 600 patients suffering from hemorrhoidal symptoms, 709 treatment procedures were performed. Only 7% of the patients required hemorrhoidectomy. In the remaining patients, symptoms were relieved by conservative therapy comprising sclerotherapy, band ligation, or cryotherapy of the internal hemorrhoids only. On the basis of this series, the following proposals are made: (1) the concept of hemorrhoidal destruction should be replaced by one of fibrosis, (2) only the internal hemorrhoids need be treated, (3) hemorrhoids need not be treated unless they produce symptoms and then only the symptoms need be treated, (4) only those far-advanced hemorrhoids in which there has been extensive fragmentation of the supportive connective tissue need be treated surgically, and (5) treatment may be chosen according to the stage of the hemorrhoids.

Adolescent↗
PubMed1983

Biofeedback in the management of partial anal incontinence.

Fifty patients with anal incontinence were treated by biofeedback as an office procedure. This took the form of an intra-anal plug, containing two ring electrodes and connected to an electromyometer. In four or less sessions, patients were instructed in sphincter contraction and extraneous muscle relaxation. All have been followed for at least one year, and in 74 per cent there has been satisfactory restoration of continence. The method was particularly successful in post-surgical (anal) patients, with the exception of those with "keyhole deformity" after anal fistulectomy. In nonsurgical patients, results were excellent in the idiopathic and postradiation groups, but were poor in patients with incontinence due to rectal prolapse or to neurogenic causes. The simplicity and portability of this method make it a valuable aid in the office management of anal incontinence.

Adult↗
PubMed1979

Biofeedback in the management of partial anal incontinence: a preliminary report.

This method of improving anal continence is recommended for patients with partial anal incontinence, in whom some functioning anal sphincter remains. It is particularly applicable for treating those patients who have sustained operative trauma, but is less helpful for those who have generalized sphincter weakness; however, any patient with some sphincter function may benefit. Emotionally unstable patients are less likely to benefit. Although the series was small, the results were considered sufficiently gratifying to justify a preliminary report.

Adult↗
PubMed1966

Estimation of blood loss in a small community hospital.

THREE METHODS OF BLOOD LOSS ESTIMATION WHICH ARE SIMPLE, ACCURATE AND CHEAP ARE: (1) weighing of sponges; (2) estimation of blood volume with Evans blue dye and (3) measurement of central venous pressure (CVP).Weighing of sponges is a valuable operating-room procedure although it has certain defects some of which are described. The Evans dye method is used chiefly in preoperative assessment when hypovolemia is suspected but serial estimations are feasible and can be performed in 45 minutes. Measurement of CVP, however, is the best single criterion of effective blood volume in relation to cardiac functional capacity and is the best guide to blood and fluid requirements. A simple "homemade" device for making serial CVP determinations, incorporating a manometer and a zero level, is described.These methods of blood loss estimation do not supersede the traditional methods of the clinical assessment of the surgical patient, but are valuable adjuncts to such assessment.

Blood Pressure Determination↗
PubMedDate not supplied

In defense of cryotherapy for hemorrhoids. A modified method.

The rationale of nonoperative hemorrhoid treatment, whether injection, ligation, or cryotherapy, consists of correction of prolapse and bleeding by the creation of submucosal fibrosis. Cryotherapy of hemorrhoids is most effective and has the least side effects when directed at the internal hemorrhoids only, at a high level, and in stages, each application being for a period of one minute only. A plan of treatment selection is presented, based on the stage of the hemorrhoids. The results of 528 treatment procedures are reported.

Adolescent↗