Audit--how we carry it out.
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Biomedical subjects
Publications and source records attributed to R J Godwin.
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Fourteen cases of retained intravesical Foley balloon catheters occurred in the West Suffolk Hospital between 1988 and 1989. In all cases this was due to failure of the balloon to deflate. All cases were successfully managed with radiological techniques. The alternative methods described for retrieval of retained balloon catheters are reviewed, and two recommended methods are described in detail.
A case of large bowel obstruction complicated by a retained intracolonic Foley balloon catheter is reported, and the minimally invasive technique for removal is described.
In 35 legs being operated on for varicose veins a venogram showed that the part of the long saphenous vein below the knee does not undergo varicose dilatation. In 7 of the 9 examined postoperatively this segment remained patent after the vein above was stripped. Varicose veins resulting from saphenofemoral incompetence can be treated surgically by stripping the long saphenous vein only to the knee and yet still leave a non-varicose segment for future coronary artery bypass grafting.
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A non-invasive method for assessment of Björk-Shiley mitral and aortic heart valve movements has been developed. The Björk-Shiley tilting disc valve is described and its placement within the heart is explained. Twenty patients have been studied post-operatively with 23 valves, 10 mitral valves and 13 aortic valves, three patients having both. The method of assessment is described and consists of projecting the valve with its opaque disc marker in true profile and en face using the C arm screening system of a C.G.R. Angiorama coronary angiography unit. A cineradiograph is taken and the maximum opening angle of the valve is measured from the projected image directly or calculated from measurements taken from the image. Movement of the valve ring can also be assessed when paraprosthetic leak is suspected. The results of the study show that: (1) This method is simple, non-invasive, requires no preparation and is reproducible. (2) The valve discs open to a smaller angle than expected in most cases, and in only a few cases to 60 degrees or more. (3) It is valuable to record valve function post-operatively so that a comparison can be made later should valve malfunction be suspected. (4) In only one case was it found impossible to assess valve movement because of orientation of the valve within the patient.
Two patients formed urethral stones on hair growing within the urethra following urethroplasty, an uncommon complication of this operation. The technique of urethrography is important. A control exposure is essential at the start of any examination, and a post-micturition film can aid in better demonstration of stones.