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Biomedical subjects

L Carney

Publications and source records attributed to L Carney.

10 recordsLinked to original sources
PubMed2006

A colorectal cancer patient focus group develops an information package.

INTRODUCTION: In order to deliver high quality care and empower cancer patients in decision-making, good quality information and communication are essential. We describe the development of an information booklet. PATIENTS AND METHODS: A total of 22 colorectal cancer patients (12 male; median age, 72 years, range, 40-86 years) met on 3 occasions. Patients were asked to define their information needs and score them (1-4) according to importance. The information document was written. The second meeting involved feedback on the booklet. The modified booklet was reviewed/approved by the group before submission for local ethics committee approval prior to its distribution to other patients. RESULTS: All participants felt the project a good idea. Essential information included the surgeon's individual morbidity, mortality, survival, recurrence data and details of adjuvant therapies (score = 4). Also important were type of surgery, complications and postoperative recovery (score = 3). Simple anatomical drawings were also considered important. CONCLUSIONS: The booklet is now used to personalise information for all our patients and serves, in part, as a record of the key issues discussed during the consultation. The booklet has been evaluated in a randomised trial.

Adult↗
PubMed2004

Management of recurrent anastomotic stricture and iatrogenic stenosis by circular stapler.

Anastomotic stricture is an increasingly common clinical finding. It is thought to arise because of ischemia, disruption, or leakage at an anastomosis site. Its management can be difficult and strictures often are resistant to standard dilation therapy. Major corrective surgery is possible; however, it is technically challenging and not without risk. We have used a circular stapler to excise colorectal strictures, introducing the anvil of the stapler via a proximal stoma or colotomy, drawing the anvil through the stricture with a snare via a colonoscope and affixing it to the body of a circular staple gun and excising the stricture. We have with found this to be an effective treatment in appropriately selected patients.

Aged↗
PubMed2002

Laparoscopic inguinal hernia repair: a NICE operation.

Published evidence comparing laparoscopic and open herniorraphy is controversial. NICE recommends that open techniques are used for first time repairs and that TEP be considered for bilateral/recurrent repairs undertaken in specialist units. We report a consecutive series of 224 patients undergoing 268 TEP repairs between 1996 and 2001. Operating time, complications, return to normal activity/full time employment and recurrence were examined. The median operating time was 30 minutes. There was one conversion. Ninety four percent of patients drove on the third post-operative day. The median time to normal activity was 4 days (1-10 days). The median time to return to professional employment in 82 patients was 3 days (range 2-9 days). Four patients (1.7%) had self-limiting minor groin pain. There were 3 recurrences (1.4%) and none since altering the surgical technique to use a larger anchored mesh. We have demonstrated TEP to be an easily learnt, safe, effective technique with low morbidity, and with sufficient experience, takes no longer than an open repair. It can be performed at little increased cost and restores selected patients to an early return to full-time employment. We believe that the choice between open and laparoscopic repair is a subjective decision for patient and surgeon

Adult↗
PubMed2000

The accuracy and precision performance of four videokeratoscopes in measuring test surfaces.

In this study we evaluated the accuracy and precision of three placido-disk videokeratoscopes (the Keratron, Medmont and TMS) and one videokeratoscope that uses the raster-stereogrammetry technique (PAR-CTS) in elevation topography with six test surfaces. The test surfaces were a sphere, an asphere, a multicurve, and three bicurve surfaces. Each instrument performed well on certain test surfaces, but none of the instruments excelled on all of the surfaces. The results showed high accuracy of the Keratron and Medmont instruments in measuring the sphere, asphere, and multicurve surfaces, but not the bicurve surfaces. The precision of the Keratron and Medmont instruments were high. The TMS and PAR-CTS instruments showed poorer accuracy than the Keratron and Medmont instruments for the multicurve test surface but showed better performance for the bicurve surfaces. The PAR-CTS had the poorest performance in precision of the four instruments. The use of the Noryl spherical test surface instead of polymethyl methacrylate (PMMA) resulted in small differences in the accuracy performance of the placido-disk videokeratoscopes only.

Cornea↗
PubMed1998

Masking of irregular corneal topography with contact lenses.

PURPOSE: We examined the effectiveness of various types of contact lenses in masking irregular corneal topography using videokeratoscopy, residual aberrations, and measurement of visual acuity. METHODS: Thirteen subjects with differing degrees of keratoconus were recruited. Four types of soft lenses were used that varied in both thickness and water content, along with a rigid gas permeable (RGP) and a flexible gas permeable contact lens. RESULTS: RGP contact lenses provided the best visual acuity and the least residual aberrations. Flexible gas permeable lenses showed a reasonable masking of corneal distortion but did not provide the expected improvement in visual acuity. Soft contact lenses provided marginally better visual acuity than spectacle correction, but the level of residual aberrations was still high, even for relatively thick soft lenses (up to 0.2 mm). A significant correlation existed between the regularity of the front surface of the contact lenses on the eye and visual acuity in low illumination. CONCLUSIONS: Among the currently available contact lens materials, RGP lenses provide the best visual performance for subjects with keratoconus.

Adult↗