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Biomedical subjects

M M Hares

Publications and source records attributed to M M Hares.

16 recordsLinked to original sources
PubMed1983

Prospective randomised comparison of photocoagulation and rubber band ligation in treatment of haemorrhoids.

Two hundred and sixty eight patients with haemorrhoids were allocated at random to treatment by either photocoagulation (group 1, n=141) or rubber band ligation (group 2, n=127) and followed up for one year. There was no significant difference in the symptomatic outcome of treatment between the two groups at one, four, or 12 months, irrespective of whether first or second degree haemorrhoids were treated. Side effects of treatment (bleeding or severe pain) were significantly more common after rubber band ligation (n=11) than after photocoagulation (n=2; p less than 0.01). Further outpatient treatment, however, was required significantly more often after photocoagulation (n=23) than rubber band ligation (n=6) (p greater than 0.02), and 19 patients (14 in group 1 and five in group 2; NS) subsequently had a haemorrhoidectomy. At one year 26 of 103 patients were dissatisfied after photocoagulation compared with 20 of 88 after rubber band ligation. Photocoagulation is a safe and comfortable treatment which gives long term results that are as good as those of rubber band ligation. Complications are more common after rubber band ligation, but further treatment is required more commonly after photocoagulation.

Adolescent↗
PubMed1983

Metronidazole need not be combined with an aminoglycoside when used for prophylaxis in elective colorectal surgery.

A prospective randomized controlled study has compared prophylactic intravenous metronidazole alone with the combination of metronidazole and gentamicin in 100 patients having elective colorectal surgery. There was no significant difference in mortality, infection, dehiscence or postoperative stay between the antibiotic groups. Postoperative sepsis was almost entirely due to aerobic organisms but was associated with minimal morbidity. A significantly higher rate of anastomotic dehiscence and postoperative infection was seen where the quality of bowel preparation was judged to be poor.

Abscess↗
PubMed1982

Clinical trials of the efficacy and duration of antibacterial cover for elective resection in inflammatory bowel disease.

A prospective double-blind placebo controlled trial was performed to test the values of 24-h cover with metronidazole and gentamicin in 57 patients requiring elective resections for inflammatory bowel disease (phase 1). The short term antimicrobial cover was not associated with a reduction in the incidence of postoperative sepsis. A further group of 30 patients who received metronidazole and gentamicin cover for 5 days (phase 2) was therefore studied and the results were compared with phase 1. There was a significant reduction in the incidence of sepsis in the patients receiving 5-day postoperative antibiotic cover compared with the placebo group.

Adult↗
PubMed1981

A randomized trial to compare rubber band ligation with phenol injection for treatment of haemorrhoids.

A prospective randomized trial has compared rubber band ligation with phenol injection in 82 patients with symptomatic haemorrhoids. The symptomatic results in all patients 12 months after treatment were indistinguishable, 64 per cent being improved after rubber band ligation, compared with 70 per cent after injection. Complications of treatment were recorded in 5 patients after rubber band ligation, 3 of whom required hospital admission compared with one minor complication after infection. However, repeated treatment was necessary in 13 patients after phenol injection compared with only 4 following rubber band ligation (P less than 0.05). Additional treatment was necessary in 6 patients from each group. Two-thirds of patients with third-degree piles required additional therapy. It is concluded that rubber band ligation and injection provide similar results, but rubber band ligation is more liable to complications with inexperienced operators.

Female↗
PubMed1981

A controlled trial to compare systemic and intra-incisional cefuroxime prophylaxis in high risk gastric surgery.

A prospective randomized controlled trial has compared single dose systemic cefuroxime (n = 27) or intra-incisional cefuroxime (n = 26) with a control group (n = 28) in 81 patients undergoing gastric resection, revision gastric surgery or operation for gastro-oesophageal malignancy. In the controls the incidence of sepsis was: 35 per cent wound infection, 29 per cent abscess, 21 per cent septicaemia. After intra-incisional cefuroxime the incidence was: 4 per cent wound sepsis, 19 per cent abscess and 4 per cent septicaemia. After systemic cefuroxime only 2 patients developed wound sepsis (7 per cent) with no cases of abscess or septicaemia. Excluded from this high risk group were 36 patients who had a vagotomy with or without drainage during the trial where antibiotics were not given, 4 of whom developed wound sepsis only (11 per cent). There was a poor correlation between the individual species isolated from the gastric aspirate and the organisms responsible for postoperative infection in the controls, but there was a good correlation between fasting gastric pH and the risk of sepsis in the controls.

Bacteria↗
PubMed1981

Influence of oral mannitol bowel preparation on colonic microflora and the risk of explosion during endoscopic diathermy.

Oral mannitol has been widely accepted as the bowel preparation of choice for colonoscopy and elective colorectal operation because it is well tolerated by patients. Recent concern has been expressed regarding the risk of explosion and sepsis using oral mannitol because it may provide a nutrient for certain gas-producing bacteria in the colon. Samples of colonic contents aspirated at operation were compared in patients prepared by oral mannitol, by whole bowel irrigation, mannitol preceded by 48 h of oral antibiotics (neomycin with metronidazole) and in patients who did not undergo any preparation. Significantly higher counts of gas-producing Escherichia coli were recovered from patients prepared with mannitol alone compared with whole bowel irrigation or mannitol preceded by oral antimicrobials. These data are consistent with the hypothesis that fermentation of mannitol by Escherichia coli is responsible for the production of potentially explosive gas mixtures after oral mannitol preparation and may also explain the increased incidence of sepsis when oral mannitol is used for bowel preparation.

Bacteria↗
PubMed1981

A randomised trial to investigate X-prep, oral mannitol and colonic washout for double-contrast barium enema.

Three methods of bowel preparation used prior to double contrast barium enemas were compared by a randomised trial in 60 patients. Evaluation was by radiological review and from a patient questionnaire. The preparations included X-Prep liquid with colonic washout, oral mannitol alone and oral mannitol with colonic washout. Adequacy of preparation as judged by faecal residue was significantly better after X-Prep than in either group receiving mannitol. The more severe purgation with mannitol did not result in better clearance of the large bowel and the addition of a colonic washout to mannitol did not reduce faecal residue. Side-effects and adverse comments were more common after mannitol. Diarrhoea was significantly less after X-Prep than after mannitol.

Anthraquinones↗
PubMed1981

A double-blind trial of half-strength Polybactrin Soluble GU bladder irrigation in cystoscopy.

In an attempt to reduce post-cystoscopy urinary tract infection half-strength Polybactrin Soluble GU solution was used as the bladder irrigating fluid. Although the infection rate was markedly reduced, this just failed to be significant. However, it is believed that with a better combination of antibiotics the incidence of post-cystoscopy urinary tract infection can be significantly reduced.

Aged↗
PubMedDate not supplied

An attempt to reduce the side effects of mannitol bowel preparation by intravenous infusion.

The authors compared two groups of patients receiving oral 5% mannitol for bowel preparation to see whether the volume of rectal effluent and quantity of bowel preparation could be maintained by a smaller oral mannitol intake supplemented by an intravenous infusion. Nineteen patients drank 2--3 1 5% mannitol, supplemented by an intravenous infusion of N/saline (intravenous Group) and 19 patients drank 4--5 1 5% mannitol (oral group). The volume of rectal effluent and the quality of bowel preparation was the same in both groups. The loss of sodium in the oral group was corrected by the intravenous infusion, but the infusion resulted in greater water retention. There was no reduction in the incidence of vomiting between the two groups.

Administration, Oral↗