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Biomedical subjects

L K Bickerstaff

Publications and source records attributed to L K Bickerstaff.

9 recordsLinked to original sources
PubMed1988

Pain insensitivity in schizophrenic patients. A surgical dilemma.

Some schizophrenic patients have decreased pain perception while others have decreased pain expression. These factors frequently lead to difficulties in the diagnosis of acute intra-abdominal surgical emergencies. Increasingly large numbers of schizophrenic patients are being cared for in the community. It is therefore imperative that surgeons be acutely aware of the diagnostic dilemmas presented by this group of patients so that misdiagnosis is avoided and appropriate surgical therapy is instituted in a timely manner.

Abdomen, Acute↗
PubMed1984

Changing incidence of abdominal aortic aneurysms: a population-based study.

The apparent incidence of abdominal aortic aneurysms among Rochester, Minnesota residents increased seven-fold between 1951 and 1980, while the incidence of thoracic aortic aneurysms declined somewhat. Rates for abdominal aneurysms rose with age and were greater among men. The overall incidence in 1971-1980 was 36.5 per 100,000 person-years. While all clinical classes of abdominal aortic aneurysms became more frequent, the greatest rise in incidence was for small, asymptomatic, and uncomplicated aneurysms which suggested an important role for more complete case ascertainment in recent years. The secular trend in abdominal aortic aneurysm incidence seems to be different from that observed for stroke or for coronary heart disease in the same community.

Adult↗
PubMed1984

Abdominal aortic aneurysms: the changing natural history.

The records of all patients with abdominal aortic aneurysms (AAAs) in a Midwest city with a stable population over a 30-year period were reviewed. There were 296 patients (196 men and 100 women) for an incidence of 21.1 aneurysms/100,000 person-years. The median age at diagnosis was 69 years for men and 78 years for women. Seventy-eight percent of patients were asymptomatic at the time of diagnosis; their aneurysms were incidental findings. Rupture occurred in 60 patients (20.3%). Thirty-six patients (12.2%) had rupture of the aneurysm as the presenting complication. For previously diagnosed aneurysms that subsequently ruptured, the average period from diagnosis to rupture was 48.7 months. Rupture occurred in only two aneurysms smaller than 5 cm. The overall mortality rate from rupture was 15.5%. Evaluation of data (including autopsy reports) by decade revealed an absolute increase in the incidence of AAAs in the population under study. More aneurysms of all sizes occurred from 1971 to 1980 than in the previous two decades combined. Although ultrasound examination has increased the detection of small aneurysms, the incidence of aneurysms 7 cm or larger at the time of diagnosis has also increased; the frequency of rupture was greatest in the last decade. To compare the data of the population-based study with the statistics for patients seen in a referral practice, the records of 616 patients from a referral population were also reviewed. In the referral population the ratio of men to women was 5:1, and the age at diagnosis was lower for both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

Abdominal aortic aneurysm repair combined with a second surgical procedure--morbidity and mortality.

Some patients who undergo repair of an abdominal aortic aneurysm require a concomitant procedure. This study compares the morbidity and mortality rates of patients who undergo combined procedures with those who undergo aneurysmorrhaphy alone. Five hundred sixty-three elective aneurysmorrhaphies were performed in the years 1971, 1976, and 1980. Three hundred thirty-five individuals underwent aneurysm repair alone (group I), while 115 underwent at least one additional vascular procedure (group II), and 113 underwent one or more nonvascular procedures (group III) concomitant with aneurysmorrhaphy. Mortality rates for the three groups were 2.6%, 3.5%, and 6.0%. Morbidity rates were 12.8%, 26.1%, and 18.5%. The differences in rates do not achieve statistical significance, but causes of death and complications varied slightly in each group. Deaths in group I were largely due to myocardial infarction, while deaths in groups II and III were largely due to complications of operation or underlying disease. Patients who required concomitant renal artery revascularizations had the greatest number of serious complications in group II. Patients with concomitant cholecystectomy appeared to have an increase in serious complications, but concomitant herniorrhaphy or lumber sympathectomy appeared to be free of any additional morbidity.

Aged↗
PubMed1982

Thoracic aortic aneurysms: a population-based study.

Thoracic aortic aneurysms were detected in 72 residents (44 women and 28 men) in a stable midwestern community over a 30-year period, for an age- and sex-adjusted incidence of 5.9 new aneurysms per 100,000 person-years. The incidence was equal in both sexes and decreased slightly over the 30 years. Ages ranged from 47 to 93 years (median 65 years for men and 77 years for women). The ascending aorta was involved in 37 patients, the aortic arch in 8, and the descending aorta in 27. Pathologic examination was performed in 51 patients. The cause was aortic dissection in 27 patients (53%), atherosclerosis in 15 (29%), aortitis in 4 (8%), cystic medial necrosis in 3 (6%), and syphilis in 2 (4%). All autopsied patients had pathologic evidence of significant hypertension. Eleven patients (25%) had concomitant abdominal aortic aneurysms. Rupture occurred in 53 patients (74%) and 50 died. Thirty-seven of these patients had no prior diagnosis of aneurysm. The median interval between diagnosis and rupture in the 16 remaining patients was 2 years (range 1 month to 16 years). Ninety-five percent of aortic dissections ruptured and 51% of nondissecting aneurysms ruptured. The actuarial 5-year survival for all 72 patients was 13%; for patients with aortic dissection, 7% and for patients without dissection, 19.2%.

Actuarial Analysis↗