PubMed Health⌕ Search

Biomedical subjects

R W Beart

Publications and source records attributed to R W Beart.

14 recordsLinked to original sources
PubMed1979

The continent ileostomy: a viable alternative.

The continent ileostomy is one of the alternative techniques in managing patients who require a proctocolectomy. Although previously plagued with up to 30% revisions, the continent ileostomy appears to contribute significantly to the social and psychologic well-being of these patients. Our experience suggests that improved surgical techniques make this procedure a safe and favorable alternative to the traditional Brooke ileostomy.

Adolescent↗
PubMed1979

The surgical treatment of incapacitating constipation associated with idiopathic megacolon.

Results of the surgical treatment of idiopathic megacolon with incapacitating constipation in 23 patients are reviewed. The Swenson endorectal pull-through procedure, although it gave satisfactory results, was associated with high morbidity and resulted in the only death in this series. Anterior resection gave good results in six of eight patients. This procedure should give good results when the dilatation as seen on barium enema studies is confined to the rectosigmoid. However, for patients who have more extensive dilatation of the colon, extensive left hemicolectomy or total abdominal colectomy should be strongly considered, for these procedures have been associated with uniformly good results and little morbidity. There is little to recommend bilateral lumbar sympathectomy.

Adolescent↗
PubMed1978

Accessory splenectomy in management of recurrent idiopathic thrombocytopenic purpura.

Residual splenic tissue can occasionally be responsible for recurrent idiopathic thrombocytopenic purpura after splenectomy. Although this is an uncommon phenomenon, we have identified six such patients at the Mayo Clinic in the last 40 years, and a review of the literature revealed nine others. Only 4 of the 15 patients with sufficient follow-up were significantly improved after splenectomy, 1 requiring less medication to control his thrombocytopenia. The presence of residual splenic material is suggested by the absence of Howell-Jolly bodies in the peripheral smear and confirmed by technetium-99m scanning. Accessory splenectomy should be considered as an adjunct to the control of idiopathic thrombocytopenic purpura in previously splenectomized patients but with the realization that remission or improvement in the clinical course may occur in only about one-half of such patients.

Adolescent↗
PubMed1978

Fatal disseminated intravascular coagulation after peritoneovenous shunt for intractable ascites.

Peritoneovenous shunt for intractable ascites was complicated by disseminated intravascular coagulation, which resulted in the death of the patient. Attention is called to this potentially serious complication. The cause of disseminated intravascular coagulation occurring after peritoneovenous shunt is uncertain. Patients at risk for this complication need to be identified if this shunt is being considered.

Ascites↗
PubMed1978

Intestinal stomas: managing the "unmentionable".

Learning to live with an intestinal stoma is a difficult adjustment for elderly patients. Thoughtful, sensitive preoperative counseling and postoperative education in caring for the stoma are essential, and both are often the responsibility of the primary care physician. Irrigation is the preferred method of colostomy management, and with proper instruction, most patients can learn the technique. The physician and nurse should work in concert to teach patients how to control bowel movements, prevent odor, and maintain the integrity of the stoma and the skin. Elderly patients are able to accept a stoma much more readily if they can manage it easily.

Age Factors↗
PubMed1976

Hepatic transplantation, 1975.

This report reviews experience with 97 patients given liver transplants. We regard out survival statistics as unsatisfactory, but fell they should encourage further work since 22 patients have survived at least one year with a maximum survival of 5 13 YEARS. The Achilles' heel of liver transplantation os bile duct reconstruction. We presently rely upon Roux-en-Y reconstruction, or alternatively, duct-to-duct anastomosis with a T-tube stent. The prime indication for liver replacement is non-neoplastic liver disease, but a favourable malignancy for treatment may prove to be small intrahepatic duct cell carcinomas.

Adolescent↗
PubMed1976

Past experience and future studies with antilymphocyte globulin in recipients of kidney homografts.

We remain convinced that antilymphocyte globulin (ALG) is a potent immunosuppressive agent in humans. For that reason, we have used it in essentially every case of renal transplantation since May of 1966; now, however, we are about to embark on a controlled clinical trial of ALG in kidney transplantation and await with tremendous interest the results of other such trials from other centres around the world.

Antilymphocyte Serum↗
PubMed1976

Use of a U tube in the treatment of biliary disease.

This surgical technique has permitted re-entry into the intrahepatic and extrahepatic biliary tree for the purpose of dilatation and the manual propulsion of debris through a ductal anastomosis. The method undoubtedly has other applications in the treatment of complicated biliary duct problems.

Aged↗