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Biomedical subjects

J M Fitzpatrick

Publications and source records attributed to J M Fitzpatrick.

At least 73 records · Page 4Linked to original sources
PubMed1987

Patients' delay in the presentation of testis cancer in Ireland.

A study of 217 cases of testis cancer in Ireland revealed a longer duration of symptoms (median 2.8 months, mean 10 months) than elsewhere: 32% of patients waited at least 6 months before seeking medical advice. Delay was associated with metastases (P = 0.001), diminished prospects of cure (P = 0.001) and increased mortality (P = 0.002) but not with marker status or complexity of treatment required. Eleven per cent did not notice a detectable swelling and 25% waited at least 3 months after such a discovery. These facts and the incidence of maldescent (12%, with more than two-thirds untreated) highlight the need for better health education in this area.

Attitude to Health↗
PubMed1987

Surgical approach to inferior vena caval extension of renal carcinoma.

Between 1979 and 1985, 10 patients were treated for renal carcinoma with extension into the inferior vena cava but without evidence of disseminated disease. Two of these had tumour thrombus extension up to the level of the hepatic veins and in four the extension was above the level of the diaphragm, two of which entered the atrium. Thrombus was removed en bloc at radical nephrectomy. Six patients are still alive, with a mean survival of 22 months. There was no correlation between the level of tumour thrombus and perinephric extension or indeed any correlation between tumour thrombus level and overall survival. It is suggested that tumour thrombus in the inferior vena cava, in the absence of metastatic disease, should be managed by radical surgery.

Adult↗
PubMed1987

The canine kidney in haemorrhagic shock: effect of verapamil.

Recent evidence suggests that verapamil administration reduces myocardial and small intestinal damage in canine haemorrhagic shock, and verapamil has also been shown to reduce renal dysfunction in clamp models in post-ischaemic renal failure. The effects of high-dose verapamil and hypovolaemia on renal haemodynamics and function in a canine haemorrhagic shock model were studied. Anaesthetized mongrel dogs were divided into three groups. Animals of group I (n = 5) were not subjected to shock but given a 90-min verapamil infusion (2.28 micrograms/kg); animals of group II (n = 5) were subjected to shock (mean blood pressure 40 mm Hg) for 2 h and given a 90-min 0.9% saline infusion, and animals of group III (n = 7) were both subjected to a 2-hour shock and given verapamil. The electrocardiograph was monitored, and general haemodynamic parameters were measured before shock (period 1), at the end of shock (period 2), after reinfusion of shed blood (period 3) and 1 h after shock (period 4). Total renal and cortical zonal blood flow was estimated by radioactively labelled microsphere injection during each period. Creatinine and osmolar clearance were estimated before and after shock. Verapamil administration caused heart block in groups I and III which lowered heart rate and blood pressure and exacerbated the haemodynamic effects of shock in group III. Despite this, no measurable difference in renal function was recorded between groups II and III. Total renal blood flow fell during shock, and this was exacerbated in animals given verapamil, suggesting a cumulative deleterious effect of shock and verapamil in renal blood flow.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1987

Prostate cancer.

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Humans↗
PubMed1986

Bladder carcinoma in patients 40 years old or less.

A total of 50 patients 40 years old or less presented with transitional cell carcinoma of the bladder between 1967 and 1982: 24 were 15 to 30 years old (group 1) and 26 were 31 to 40 years old (group 2). Of the patients 2 (8 per cent) in group 1 and 14 (54 per cent) in group 2 had recurrences. Invasion did not occur in group 1 but it did occur in 3 patients in group 2. Almost two-thirds of each group smoked roughly 20 cigarettes per day. It would appear that bladder carcinoma in patients 30 years old or less has a favorable prognosis but it still should be followed carefully. Disease occurring when the patient is 31 to 40 years old has a much worse prognosis and is no different from that affecting the older age groups.

Adolescent↗
PubMed1986

Superficial bladder tumors (stage pTa, grades 1 and 2): the importance of recurrence pattern following initial resection.

We treated 414 new patients with stage pTa, grades 1 and 2 bladder tumors by transurethral resection between 1970 and 1982. All of the patients with grade 3 or previous upper tract tumors, or who had been treated at some stage with intravesical chemotherapy were excluded. Followup for 5 or more years was available in 188 of the patients. There was a low increase in T stage (6 per cent). Of the patients followed for 5 or more years 46 per cent remained free of tumor. Only 16 per cent of the patients had multiple tumors at presentation and 20 per cent had tumors of 10 gm. or more. These factors were associated with a worse prognosis. Patients free of tumor at 3 months had an 80 per cent chance of having no further recurrences and this rate remained the same up to 2 years from the start of the disease. Patients with a recurrence at 3 months were much less likely to remain free of tumor, and had a higher chance of recurrence at every future visit.

Follow-Up Studies↗
PubMed1986

The sapphire crystal infrared photocoagulator and polyglactin (Vicryl) mesh: two new alternatives to the suturing of radial nephrotomies.

The sapphire crystal infrared photocoagulator and polyglactin (Vicryl) mesh, two new methods for closure of radial nephrotomies, were assessed in 16 dogs. Six radial nephrotomies were carried out in each dog; in 10 the nephrotomies were sealed by the infrared photocoagulator and in six they were left open, but the kidney was covered with a polyglactin mesh. Functional and morphological studies were performed using creatinine clearance, microfil casting, corrosion cast angiography and histology. There was no significant loss of function or loss of renal tissue. Both methods were shown to be safe and effective in the closure of radial nephrotomies.

Animals↗
PubMed1986

Recent trends in mortality due to testicular cancer in Ireland: a comparison with England and Wales.

In the period 1961-84, the number of deaths in Ireland due to the testis cancer rose by 64%. This was due both to significant male population expansion (25.3%) and to an increased mortality rate. In the 25-34 years age group, one of the groups at highest risk, the mortality rate rose by 123%. In contrast, in England and Wales, although the male population has risen by 8.5% since 1961, the number of deaths has decreased by 17%. This is due to falling mortality rates, for example an 18% decrease in those aged 25-34 years. The highest rate of all occurred in those Irish over 75 years old. The changing Irish trends appear to lag behind those in England and Wales by some decades, and this raises important aetiological considerations.

Adolescent↗
PubMed1986

Testis cancer.

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Humans↗
PubMed1985

Percutaneous nephrolithotripsy: a functional and morphological study.

Percutaneous removal of renal calculi requires a nephrostomy track, irrigation and lithotripsy. The purpose of this study is to investigate the effects of these procedures on renal function and anatomy. Renal access was obtained through a small left subcostal incision and a 22 Ch nephrostomy track was formed by fine parenchymal puncture and serial dilation in 15 dogs. Three liters of glycine solution were perfused through these tracks. In a further 16 dogs, human calculi were placed transparenchymally in the renal pelvis and disintegrated under vision through the Wolf nephroscope using an ultrasonic probe in 8 and electrohydraulic probe in 8. Assessments were made in all animals at 48 hours or 6 weeks by creatinine clearance, microfil casts, contrast radiography and ex-situ conventional and digital subtraction angiography. There was no significant urinary leakage or bleeding from the nephrostomy track at 48 hours. There was a small track hematoma and at 6 weeks a surface dimple and fine linear parenchymal scar. There was no ureteric or pelvic damage. Microfil casts showed small track defects at 48 hours resolving to a fine scar at 6 weeks. All angiograms were normal. Some IVU's displayed minor track defects at 48 hours but all were normal at 6 weeks. Corrosion casts and subtraction angiography demonstrated no significant vascular defects. Creatinine clearance showed no significant difference between experimental and control sides. Occasionally, intra pelvic scatter of fine calculus fragments was seen at 48 hours but none was detectable at 6 weeks. Transparenchymal nephrostomy, irrigation and nephrolithotripsy caused initial minor anatomical defects that rapidly resolved and were not associated with any loss of renal function.

Animals↗
PubMed1985

Bladder neck contracture following prostatectomy.

In an 11-year period, 49 patients developed bladder neck contracture after prostatectomy--an incidence of 0.86%. This complication was found to be more common after resection of small fibrous hyperplastic prostates. The best results for treatment of the contracture were obtained after bladder neck incision, which gave a 9% incidence of recurrence; after transurethral resection of the bladder neck contracture the recurrence rate was 46%, and after bladder neck dilatation it rose to 100%.

Aged↗
PubMed1985

Percutaneous coagulum nephrolithotripsy: a new approach.

Intrarenal scatter of stone fragments during percutaneous nephrolithotripsy is a complication which may predispose to post-operative pain and further stone formation. The use of a coagulum to prevent such a complication has proved difficult when introduced percutaneously. This experimental study describes a new gelatine (Lithogel) which is introduced through the nephroscope to coat the renal calculus; it allows easy disintegration of the calculus within the gel, is safe to use and effectively prevents the scatter of fragments into inaccessible calices.

Animals↗
PubMed1985

Simple aid to ureteroscopy.

Initial experience with the rigid ureteroscope showed that despite ureteral dilation and guide wire followers, introduction of the ureteroscope can be difficult due to bladder mucosa catching on the instrument. A simple, cheap disposable device using a modified ureteric catheter is presented that overcomes this problem.

Catheterization↗