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Biomedical subjects

L Bröte

Publications and source records attributed to L Bröte.

At least 19 recordsLinked to original sources
PubMed1993

Reduction mammoplasty: comparison of results of plastic and general surgeons.

OBJECTIVE: To compare the results in patients who had reduction mammoplasty in a department of plastic surgery with those of patients who had the same operation in a department of general surgery. DESIGN: Retrospective study of casenotes, and questionnaire. SETTING: Department of Plastic Surgery, University Hospital, Linköping, and Department of General Surgery, County Hospital, Motala. SUBJECTS: All 250 patients who had undergone reduction mammoplasty during the five year period 1980-84 (Linköping, n = 173; Motala, n = 77). MAIN OUTCOME MEASURES: Correlation between symptoms and expectations, and the patients' subjective assessment of the results. RESULTS: There was no difference between the rates of response to the questionnaire (149/173, 86%, from those operated on in the department of plastic surgery compared with 68/77, 88%, in the department of general surgery). Median stay in hospital was 6 days in both groups, and the number of days of sick leave was 29 and 33 days, respectively. The most common histological diagnosis was hyperplastic breast tissue with or without fibroadenosis (149/173, 86%, compared with 64/77, 83%) and there was one carcinoma, which was detected before operation. The main reason for the operation in both groups was the weight of the breasts, which caused shoulder or back pain; in nearly half this interfered with activities of daily living. Most patients had high expectations of the operation, and in over 80% these were fulfilled. CONCLUSION: We could find no reason why reduction mammoplasty should not be done by general surgeons, particularly in view of the long waiting lists, but there are some groups (for example, young women and patients either with exceptionally large breasts or who require only small reductions) who should still be treated by specialist plastic surgeons.

Adult↗
PubMed1983

Are the clinically important adrenal cysts hamartomas?

An adrenal cyst in a 36-year-old apparently healthy woman was diagnosed as a hamartoma with haemangiomatous structures and a large cyst, probably secondary to haemorrhage within the lesion. After reviewing the histological records of all the previously published cases of similar "haemorrhagic" non-inflammatory adrenal cysts, the aetiology of which has been considered unclear, we conclude that they too were probably hamartomas. We therefore propose that this type of adrenal cyst, the only of clinical importance, is aetiologically a hamartoma. These tumours often show super-imposed degenerative post-haemorrhagic changes.

Adrenal Gland Diseases↗
PubMed1981

Systemic prophylaxis in colorectal surgery a comparison between tinidazole and doxycycline.

43 patients were the subject of a comparative trial of the use of tinidazole (n = 22) and doxycycline (n = 21) in the prevention of surgical sepsis in elective colorectal surgery. The trial was open, prospective and randomized with prophylactic treatment instituted parenterally immediately before the operation. Topical ampicillin was supplemented in eight cases with fecal spillage. All patients underwent a standard preoperative mechanical preparation of the bowel. At the end of the trial period, there was one superficial aerobic abdominal wound infection and one deep anaerobic infection in the tinidazole group. Anastomotic dehiscence occurred in one patient treated with doxycycline. There were no significant differences in the results obtained with the two drugs and both regimens appear to be highly effective in the prevention of deep anaerobic postoperative sepsis in elective colorectal surgery.

Colon↗
PubMed1981

Postoperative wound infection after appendicectomy. Evaluation of infection risk with qualitative and quantitative incisional wound culture.

The predictive value for postoperative infection of incisional wound cultures obtained at wound closure was studied in two series of appendicectomies, comprising 404 patients studied with qualitative swab cultures, and 491 patients studied with quantitative velvet pad imprint cultures. 17% and 19%, respectively, of the patients in the two series yielded cultures positive with Gram-negative enterobacteria. The postoperative wound infection rate among contaminated cases was 36.1% and 26.9%, respectively, which was a significantly higher rate (p less than 0.001) as compared to operations yielding negative cultures. Using quantitative culture technique, 63% of all infections was shown to occur in the 15% of all patients whose culture yielded two or more colonies of enterobacteria. Of these high risk patients, those who were given antibiotics at operation had an infection rate of 25%, and those not given antibiotics had a rate of 48%. The remaining 85% of the patients had an infection rate of less than 5%.

Appendectomy↗
PubMed1980

Effects of a plastic wound drape on contamination with enterobacteria and on infection after appendicectomy.

The preventive effects of a plastic wound drape (Vi-drape) on wound contamination and subsequent infection was investigated in 289 appendicectomies randomized into treatment and control groups. Samples for quantitative culture of enterobacteria using a simple technique were obtained from the drape, the wound under the drape and from the wounds of patients being operated without the drape. The drape reduced the number of wound bacteria by an average of 94% or 1.2 logarithms. The overall rate of postoperative wound infection was 7.6% in the treatment group and 9.1% in the control group (N.S). Evidence is presented that the drape might prevent infection in patients with contaminated operations.

Anti-Bacterial Agents↗
PubMed1979

Peroperative estimation of the size of the thyroid remnant.

A new method for estimation of the size of the remaining tissue after thyroid resection is described. The method has been tested on cadavers and during lobectomy in a series of patients. It is shown that intraoperative quantification of the thyroid remnant can be performed mostly with +/- 0.5 g for an individual thyroid lobe with a coefficient of variation of +/- 7.6%. In patients with toxic nodular goiter and calcifications, however, the error might be larger due to the varying homogeneity of the thyroid tissue. In 73 patients with negative antibody titers operated on for hyperthyroidism it was shown that the size of the thyroid remnant was negatively correlated to the delta TSH, determined 6 weeks after the operation.

Cadaver↗
PubMed1978

Parathyroid localization in patients with previous neck surgery.

The results of parathyroid arteriography and venous parathyroid hormone assay were evaluated in thirteen patients reexplored for persistent or recurrent hyperparathyroidism. The operative findings in these patients were ten adenomas and eight hyperplastic parathyroid glands. Angiography disclosed eight of the adenomas and failed to visualize one. Only two of the hyperplastic glands were disclosed by angiography. By venous sampling the correct side was predicted in seven out of eight cases of unilateral lesions--in one case of an adenoma no hormonal maximum was found. In two cases of bilateral lesions a maximum was found on one side only, while in three cases of unilateral two-lesions the maximum was correct in two cases and contralateral in one. We conclude that a combination of angiography and venous sampling gave localization or lateralisation in 12/13 patients with previous neck surgery for hyperparathyroidism and found the methods to be complementary to each other and prefer both done in these cases.

Adenoma↗
PubMed1977

Effects of ampicillin on intracellular levels of adenosine triphosphate in bacterial cultures related to antibiotic susceptibility.

Short time effects of ampicillin on viability and levels of intracellular ATP were studied in bacterial cultures and a close relationship between intracellular ATP levels and viability was demonstrated. The connection between the effects observed and MIC values is discussed. The possibility of using the phenomenon for rapid antibioitc susceptibility testing was studied in clinical isolates incubated for 2 hours followed by luciferase assay of intracellular ATP. A positive correlation was demonstrated between ampicillin-induced decreases in intracellular ATP and inhibitory zone diameters, as measured by the agar diffusion technique.

Adenosine Triphosphate↗
PubMed1977

A 14-month study of severe non-wound infectious complications in general surgery.

A retrospective study of serious non-wound infectious complications in general surgery during at 14-month period is reported. A prospective study on wound infections in available from the same institution and period. Septicemia, intraabdominal and intrathoracal abscesses and rare cases of osteomyelitis occurred in 1.3% of all treated patients, whereas postoperative wound infection developed in 7.5% of primarily non-infected patients. Mortality was significantly higher among patients with serious infections than in all patients nursed during the same period. Severe postoperative infectious complications was in fact the third most common cause of death and accounted for 14% of the mortality of the clinic. This rate rises to close to 50% when death from incurable disease is excluded. Septicemia carried a significantly higher mortality rate than intraabdominal abscesses. The risk of a serious infection developing was significantly higher in operations on the small or large intestine than after appendectomies or biliary operations. Gram negative bacteria dominated, especially in cases with a fatal outcome. Contributing factors such as malignancy, preoperative infection or macroscopic peroperative wound soiling, were more common in patients where a serious infectious complication developed postoperatively.

Abscess↗