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Biomedical subjects

J W Squires

Publications and source records attributed to J W Squires.

10 recordsLinked to original sources
PubMed1985

Does the surgeon's annual case load make a difference in the quality of peripheral vascular surgery? A report of the mortality, morbidity, and long-term results of 101 procedures performed over 93 months.

The outcome of 101 peripheral vascular procedures performed during 93 months was reviewed to determine the quality of the results. Quality was defined as the following: series mortality rate, frequency and significance of complications, cumulative patency rate for bypass grafts, amputation rate, survival following abdominal aneurysm surgery, and neurologic events associated with carotid procedures. The series mortality rate was 4%; 44 procedures were free of complications; patency rates were not significantly different from published reports; the initial amputation rate was 7.4%; and only one out of ten patients was known to have died following aneurysm surgery. Neither of the two carotid procedures included neurologic complications. These data suggest that factors other than a surgeon's annual case load may influence the quality of the results and point out the need to further study this question in light of current admission criteria for the vascular surgery examination.

Adolescent↗
PubMed1982

Cause of wound complications in elderly patients with above-knee amputation.

Seventy-six above-knee amputations performed on elderly debilitated patients were reviewed. Fifty-one wounds healed without complications; 25 amputation wounds developed postoperative complications. The quality of the femoral pulse has a significant effect on wound healing after an above-knee amputation. Other significant conditions that appear to influence the frequency of wound complications are hypertension, a failed bypass procedure to the groin, and angiographic evidence of stenosis or occlusion of the common femoral or the profunda femoral artery. Multiple variable analysis suggests a beneficial effect of antibiotics in patients with a diminished or absent femoral pulse. Age, presence of cardiac disease, diabetes, associated diseases and the use of drains have no significant effect on the outcome. Before an above-knee amputation, patients with a diminished femoral pulse should undergo arteriography and perhaps reconstructive surgery. Primary hip disarticulation may be the initial procedure of choice in the presence of multiple risk factors.

Adult↗
PubMed1979

Heparin-induced spinal fractures.

A 27-year-old woman received heparin sodium for 152 days because of antepartum iliofemoral thrombophlebitis. At the end of this time, spinal osteoporosis and multiple vertebral fractures became clinically evident and were attributed to the prolonged administration of heparin. Previously reported cases of "heparin osteoporosis" were reviewed. The significance of the daily dose of heparin and the duration of therapy are reemphasized. This therapeutic complication and the management of antepartum iliofemoral thrombophlebitis are discussed. Prolonged administration of heparin in daily doses exceeding 10,000 units is potentially hazardous.

Adult↗
PubMed1976

The morbidity of vasectomy.

Elective bilateral vasectomy has become an established surgical procedure to achieve sterilization in the male. The ability to accomplish this by an ambulatory technique, with few side-effects, probably accounts for the widespread demand by the general public. However, a number of significant complications were encountered in a series of 250 patients who were carefully surveyed to determine the actual morbidity of this operation. In addition, five patients exhibited spontaneous regeneration of the severed vas deferens, one instance having been documented as occurring after the absence of spermatozoa from the ejaculate. These difficulties must be emphasized in preoperative discussions with patients seeking this method of contraception.

Adult↗
PubMedDate not supplied

The development and application of a surgical database.

Since 1971, the members of a department of surgery in a staff model HMO have maintained a surgical database using a microcomputer. The reasons for this effort are discussed with specific reference to the ethical requirements of such a database. The system design lends itself to any type of practice. Illustrative examples are given of the types of data easily obtained. The role this information plays in the practice of surgery is discussed. This approach is one way to address issues of clinical decision-making, quality control and research.

Computer Systems↗
PubMedDate not supplied

Axillo-femoral (PTFE) and infrainguinal revascularization (PTFE and umbilical vein). Vascular Registry of the New England Society for Vascular Surgery.

The Vascular Registry Committee of the New England Society for Vascular Surgery (NESVS) has prospectively evaluated prosthetic bypass grafts. A record of these operations and follow-up data were voluntarily submitted by members of the Society during the last 13 years. The 5-year primary patency rate for 103 axillo-femoral procedures was significantly greater for the bifemoral group (55%) than for the unifemoral group (14%). For infrainguinal reconstruction (402 cases), the 5-year primary patency rates were as follows: 57% (fem-pop AK PTFE claudication); 46% (fem-pop AK PTFE rest pain); 32% (fem-pop AK PTFE necrosis); 26% (fem-pop BK PTFE claudication); 17% (fem-pop BK PTFE rest pain); 21% (fem-pop BK PTFE necrosis); 69% (fem-pop AK umbilical vein); and 45% (fem-pop BK umbilical vein). None of the femoral tibial or peroneal prosthetic bypass grafts remained patent for 5 years. Umbilical vein bypasses may have had a higher patency than PTFE bypass; however, they did develop aneurysmal changes.

Aged↗