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Biomedical subjects

P Dykes

Publications and source records attributed to P Dykes.

9 recordsLinked to original sources
PubMed1986

A randomized controlled trial of variceal compression as an adjunct to endoscopic variceal sclerosis.

Endoscopic variceal sclerosis is effective at eradicating oesophageal varices and prolonging survival, but early rebleeding before varices have been obliterated remains a problem. A randomized controlled trial was therefore conducted to determine whether more rapid variceal obliteration and hence a lower morbidity and mortality in the first month could be achieved by compressing the varices after the first injection of sclerosant. Forty patients bleeding from previously untreated varices were studied. There was no demonstrable benefit from post-sclerosis variceal compression in terms of early death from rebleeding (compression, 3 of 19; no compression, 3 of 21 in the first month), total number of patients rebleeding (compression, 5 of 19; no compression, 6 of 21 in the first month), or speed of variceal obliteration (percentage of variceal columns obliterated at 1 month: compression, 13%; no compression, 26%). This study shows that post-sclerosis variceal compression by means of the Williams overtube and Sengstaken tamponade does not improve the efficacy of endoscopic variceal sclerosis.

Clinical Trials as Topic↗
PubMed1976

Effect of gestational length on albumin content of meconium.

During a screening programme for the detection of CF using the meconium albumin technique, the overall false-positive rate was found to be approximately 1%. When the gestational age of the infants was taken into account the false-positive rate was found to be significantly higher in preterm (8%) as compared to term infants (0.55%). This was due largely but not solely to the presence of occult blood. Possible explanations for these findings are discussed and attention drawn to the limitation of meconium albumin content as a screening technique for CF in preterm infants.

Albumins↗
PubMed1976

A study of the factors influencing mortality rates from gastrointestinal haemorrhage.

A prospective study is reported of 300 consecutive patients admitted to the General Hospital, Birmingham, because of acute gastrointestinal haemorrhage. The characteristics of the group have been outlined and the causes of death examined. It is shown that in patients diagnosed as having peptic ulcer or erosions, the major causes of death were thrombotic vascular disease and surgical complications. Current policies in the management of gastrointestinal bleeding are examined in this light, and it is concluded that gastric resection should be avoided wherever possible, and that procedures should be considered which might reduce intravascular clotting. The advisability of immediate surgery is also questioned and a case made for consideration of a policy of more prolonged resuscitation. A detailed analysis of mortality rates is included from reported European series, with particular reference to the increasing proportion of older patients. Taking this into consideration, it is argued that mortality rates are continuing to improve, and that early diagnosis must be an important contributory factor. It is also pointed out that not only are nearly half the patients in present studies over the age of sixty, but also the risk of developing such a haemorrhage is much greater in the older sections of the community. Gastrointestinal bleeding is more of a geriatric than an adolescent problem.

Adolescent↗