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Biomedical subjects

P Anseline

Publications and source records attributed to P Anseline.

10 recordsLinked to original sources

A preliminary exploration of the interactional skills of trainee surgeons.

BACKGROUND: The interactional skills of 21 surgical trainees were studied in the areas of breaking bad news to patients and preparing patients for potentially threatening medical procedures. When compared to the established guidelines for dealing with these issues, the trainees performed poorly. METHODS: Trainees were videotaped using clinical histories delivered by simulated patients in simulated consulting rooms. All videos were scored on standard rating scales where the criteria for rating the specific interactional skills were adopted from existing guidelines. RESULTS: The proportion of trainees who could meet the guidelines when breaking bad news was low. The proportion of trainees who met the guidelines were: closing the the consultation (0%), provided patient information about prognosis (43%) and treatment (38%) and when they gave support (10%). There were also low numbers of trainees who could meet the guidelines when they prepared patients for potentially threatening procedures. Ten per cent of trainees followed the guidelines when providing information, 25% could establish treatment goals, 35% could give a prognosis and 0% could deal appropriately with psychosocial issues or close the consultation appropriately. CONCLUSIONS: It is concluded that there is a need for further formal training in interactional skills as part of surgical training.

Clinical Competence↗

Colonic transit time assessed by 67 Ga-citrate in a case-series of patients with recto-sigmoid adenomas.

One plausible mechanism by which dietary factors may influence colorectal carcinogenesis is through their effect on intestinal transit time. This study examined colonic transit by means of oral 67Ga-citrate in a case-series of patients who had developed recto-sigmoid adenoma. Adenoma patients had a significantly shorter transit time than constipated patients (P = 0.01) and our results also suggest (but do not show conclusively) that colonic transit in adenoma patients is similar to that of normal controls. Although these findings require confirmation from a larger study, they raise the hypothesis that colonic transit times are not delayed in patients who harbour recto-sigmoid adenomas.

Adenoma↗

Multiplicity of fibronectin-binding alpha V integrin receptors in colorectal cancer.

Current data from in vitro and in vivo animal models indicate that fibronectin-binding integrin receptors expressed by colon cancer cells may regulate tumour growth. While individual members of the beta 1 subfamily of integrins have now been clearly identified in colorectal cancer, little information exists with respect to the alpha V subfamily. In the present study we show that alpha V can associate with multiple and different beta subunits capable of binding fibronectin in this tumour type. This is likely to have functional implications for growth and spread of colorectal cancer.

Antigens, CD↗

Colonic gall-stone ileus.

A case of obstruction of the colon by a solitary, large gall-stone is described. This rare event usually occurs in elderly females in whom there is frequently an underlying pathological condition at the site of obstruction in the colon. The calculus usually migrates via a cholecystocolic fistula. Diagnosis may be assisted by plain abdominal X-ray and contrast radiography. Immediate operative treatment should be tailored to the patient's general condition and the nature of the pathological changes.

Aged↗

Pancreatic heterotopia--a rare cause of bowel obstruction.

Pancreatic heterotopia is a developmental anomaly. When it produces complications, symptoms depend on the site of the lesion and may reflect the whole range of pathology affecting pancreatic tissue. In the ileum, pancreatic heterotopia is usually associated with a Meckel's diverticulum and may cause intestinal obstruction by intussusception. Isolated ileal pancreatic rests are rare and usually are discovered incidentally during surgery for other conditions. A case of a polypoid mass in the ileum containing aberrant pancreatic tissue that had been causing recurrent small bowel obstruction is described. Resection and primary anastomosis were curative.

Adult↗

Perforated peptic ulcer: an analysis of 246 cases.

An analysis of 246 cases of perforated peptic ulcer, treated at the Royal Newcastle Hospital from 1964 to 1974, is presented. The incidence has fallen considerably over that period. The rising proportion of women has reached a plateau. A perforated peptic ulcer in an Australian women is still just as likely to be located in the stomach as in the duodenum. In men, however, 84% of perforations are pyloroduodenal. A perforated gastric ulcer is closely associated with the use of salicylate preparations. The mortality rate has remained steady at 15% over the last 30 years. It is significantly higher in women. There is a highly significant relationship between the mortality and (a) the duration of perforation; and (b) the size of the perforation, particularly if it is located in the stomach.

Adult↗

Zinc-fume fever.

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Adult↗