Gallbladder changes in the critically ill patient.
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Biomedical subjects
Publications and source records attributed to R Barry.
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Over a period of six years, 265 femoropopliteal and infrapopliteal bypasses were performed in 243 patients with infrainguinal arterial occlusive disease. The cumulative patency rate for all grafts was 70.9 per cent at one year, 59.3 per cent at three years and 48.5 per cent at five years. Femoropopliteal bypasses showed a significantly better patency rate than femoral infrapopliteal grafts and autogenous vein grafts had a significantly higher patency rate than human umbilical vein grafts. No demonstrable difference in patency rates was shown in patients with and without diabetes. Synchronous proximal and distal revascularization for limb salvage in properly selected patients with multisegmental disease achieved a cumulative patency rate of 100 per cent at two years with no operative deaths. Therefore, this procedure is recommended, but individualization of treatment rather than routine synchronous repair is urged.
The usefulness of fluorescein dilaurate as an indicator of pancreatic exocrine failure has been assessed in 70 patients and normal volunteers. The test consisted of a comparison of urinary fluorescein excretion after ingestion of fluorescein dilaurate with that after ingestion of unesterified fluorescein. The test was easy to perform and acceptable to the patients. The sensitivity of the test was 95%. There was a false-positive rate of 11% in a group of patients who had steatorrhoea which was non-pancreatic in origin. The test can be a useful screening test for the exclusion of pancreatic exocrine failure as a cause of steatorrhoea and can be conducted in outpatients.
A disposable skin stapler (Proximate; Ethicon) was compared with conventional nylon sutures in respect of time taken for wound closure, cosmetic result and ease of application and removal. It was found that a time saving of 80% is possible with the stapling device, and that the cosmetic result with staples is as good as if not better than that with nylon sutures. A certain amount of experience and practice facilitates the use of the stapler.
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OBJECTIVE: To determine the prevalence and awareness of HTA in Guinean rural populations with respect to age and gender. DESIGN AND SETTING: Cross-sectional survey in rural Guinea: Köpèrè-Döfili (400 inhabitants) and Töbölön (900 inhabitants). PARTICIPANTS: 188 subjects (81 in Köpèrè-Döfili and 107 in Töbölön), 15 years and older were visited in their homes between November 2000 and April 2001. METHODS: The blood pressures were measured with an electronic tensiometer "Philips HF305". Awareness of HTA and risk factors were determined by interviews. HTA was defined as mean SBP/DBP = 140/90 mmHg. RESULTS: Overall, 69% (56/81) in Köpèrè-Döfili and 27% (29/107) in Töbölön were hypertensive. Among these, only 2 (Köpèrè) and 6 patients (Töbölön) were aware of their condition. HTA was strongly gender dependent in Köpèrè where 98% (44/45) of the males were concerned. In Köpèrè-Döfili, the combined systolo-diastolic hypertension (SDH) was predominant (80%; 45/56) and was associated to the male gender (80%; 36/45). In the hypertensive population of Töbölön, the isolated PAD (DH) was mainly associated with the female group (47%, 8/17). The grade III HTA (PAS/PAD > or = 180/110 mmHg) concerned both gender (41%, 18/44 for males; 42%, 5/12 for females) in Köpèrè-Döfili and mainly the female group in Töbölön (29%, 5/17). Smoking was the most frequently associated risk factor in the studied population of Köpèrè-Döfili (70%) and Töbölön (45%). The smokers were predominantly female in Köpèrè-Döfili (89%, 32/36) or male in Töbölön (51%, 24/47). Among the smokers, the hypertensive individuals were 96% (24/25) of the males and 38% (12/32) of the females in Köpèrè, 29% (7/24) of the males and 38% (9/24) of the females in Töbölön. CONCLUSION: Hypertension is highly prevalent in two Guinean rural localities where less than 5% of the studied population were aware of their conditions, suggesting the nationwide demand for preventing and controlling HTA in Guinea.
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