PubMed Health⌕ Search

Biomedical subjects

P M Hacking

Publications and source records attributed to P M Hacking.

16 recordsLinked to original sources
PubMed1990

Pressure measurements during automatic breast compression in mammography.

Breast compression during X-ray mammography results in improved image quality at a lower radiation dose to the patient, and, as a consequence, the Department of Health recommends that automatic breast compression devices are fitted to mammographic X-ray units. However, the degree of breast compression is not standardized and can vary depending on the size of the patient, the particular mammography X-ray unit and the conditions of its use. A pressure measuring system was used to determine accurately the pressure on the breast. This system takes the form of a fluid-filled neonatal cuff connected to a pressure transducer by a fluid line. The pressure measuring system was calibrated and tested, first without and then with the patients, to assess its practical feasibility. The elements of the pressure measuring system, the techniques involved in its calibration and its use on patients in the clinical environment are described here. The system has proved to be a quick and simple method of relating the pressure on the breast to the pressure reading of the mammography X-ray unit.

Automation↗
PubMed1990

Fibrinolytic therapy for infra-inguinal synthetic graft occlusions.

The results of infra-inguinal graft fibrinolysis are variable, and the true success rates are frequently disguised by the inclusion of patients receiving adjunctive surgery, such as surgical thrombectomy, anastomosis revision and graft extension. Follow-up is sparse. As part of a larger prospective study, we have offered fibrinolysis using streptokinase to 10 patients with occluded infra-inguinal synthetic grafts. In one patient the graft could not be entered with a catheter. The remaining nine patients received local low-dose intra-arterial streptokinase. Six patients experienced complete lysis and were discharged with functioning grafts. Significant stenoses were dilated by transluminal angioplasty. The median graft patency duration was 7 months. Two patients have since required above-knee amputations. Our results using transluminal angioplasty are comparable to those results where adjunctive surgery has been used to treat underlying anastomotic stenoses. Further research into graft anastomotic stenosis management is indicated.

Aged↗
PubMed1985

Comparison of venous digital subtraction angiography and aortography in patients with peripheral vascular disease of the lower limbs.

Twenty-eight patients referred for peripheral vascular imaging were investigated by both venous digital subtraction angiography and conventional aortography. A comparison of the two techniques revealed that, in the femoral region, venous digital subtraction angiography demonstrated all the abnormalities shown by aortography but missed three major and eight minor stenoses in the iliac region, due largely to bowel artefacts.

Angiography↗
PubMed1985

Renovascular hypertension: ten years' experience in a regional centre.

In a unit serving a population of three million, 60 hypertensive patients with renovascular disease were identified over a 10-year period. The presence of renovascular disease was usually suggested by intravenous urography (IVU), although this was falsely negative in 21 per cent of cases; isotope renography (IR) was normal in a similar proportion of patients (25 per cent). Eight patients were treated medically and 52 underwent surgical procedures; nephrectomy in 32, autotransplantation in 10, by pass graft in six and percutaneous transluminal angioplasty in four. Twenty-three per cent of patients were cured, 37 per cent improved and 40 per cent unchanged one year after surgery, but the response could not be accurately predicted. Clinical features were of some value in that those patients most likely to benefit from surgery were younger, had less severe hypertension of shorter duration, smoked less, had less severe retinopathy and less cardiomegaly. There was also a trend for those with better renal function and less electrocardiographic evidence of left ventricular hypertrophy to benefit from surgery. The IVU and IR did not predict response to surgery but arteriographic appearances of fibromuscular dysplasia indicated there should be a favourable response. The renal vein renin ratio, basal or stimulated, was of no prognostic value since approximately two-thirds of patients with ratios above or below the threshold value had some benefit from surgery. We conclude that the surgical treatment of renovascular hypertension is worthwhile but the number of patients suitable for surgery is small. Clinical features and the results of simple investigations provided the best guide to surgical outcome in our patients.

Adult↗
PubMed1979

Severe hypertension in primary aldosteronism and good response to surgery.

11 patients with primary aldosteronism have been encountered over 11 years and submitted to surgery in a provincial teaching hospital serving a population of 3 million. Contrary to classical teaching, the hypertension has usually been very severe. Precise identification of the site of the lesion preoperatively has been possible by the measurement of adrenal-vein aldosterone levels, and results of surgery have been excellent. The iodocholesterol adrenal scan also correctly identified the site of the adenoma in 5 out of 7 patients in which it was used. Adrenal venography was of little value except in siting catheters.

Adenoma↗
PubMed1979

The medical management of renal artery stenosis in transplant recipients.

The investigation, management and clinical course of 12 patients developing stenosis of the renal artery following transplantation are described. The possible aetiology of the three arteriographic patterns of stenosis is discussed. Surgical correction of graft arterial stenosis is difficult and may lead to graft loss, whereas the outcome with antihypertensive drug treatment with or without anticoagulants is good. Surgery should only be contemplated if medical treatment is failing or if renal function is deteriorating.

Anticoagulants↗
PubMed1977

A comparative study of double contrast and single contrast barium meals with endoscopic arbitration in the diagnosis of peptic ulcer.

The study compares the ability of a simple double contrast technique with our standard single contrast barium meal to diagnose peptic ulceration. Two hundred and six patients were randomly allocated to either examination. Endoscopy was used as the definitive diagnostic procedure. Deformity of the duodenal cap was more accurately detected by the double contrast technique (P less than 0.01). There was no significant difference in the detection rates for duodenal ulcer. False positive or false negative diagnoses of duodenal pathology were similar by both techniques. The incidence of gastric ulceration in the series was too low for statistical analysis.

Adult↗