Plasma Proteins in the Assessment of Haematemesis

Douglas, David (1949) Plasma Proteins in the Assessment of Haematemesis. PhD thesis, University of Glasgow.

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Of medical emergencies, none is more dramatic than severe upper alimentary haemorrhage and in none is more satisfaction to be gained from successful management and treatment. Yet few conditions call for more careful assessment or more discrimination in the application of the principles of therapy than massive haematemesis or haemorrhage which has persisted for days. Nor is the problem a small one and that it is one which is likely to become more frequent and more imperative in the future may be seen from a consideration of the changes which have been taking place in recent years in the nature of gastric and duodenal ulcer. Tidy (1) has shown, from analysis of the Registrar General's mortality figures, that there has been a rapid increase in the incidence of peptic ulcer and especially duodenal ulcer, in men over the age of 40 yrs. since 1920. The increase has been progressive, but would appear to be levelling off in recent years. In males over 40 yrs. the increase in gastric ulcer between 1921 and 1931 was almost 90% and in duodenal ulcer 100%. Of particular interest, is that in Scotland as opposed to the rest of the country, the increase in gastric ulcer continued right up to 1938. The same trend is reflected in the increase of perforations in (2) Glasgow reported by Illingworth, Scott and Jamieson. The peak in this case came in 1940. Figures published by Avery Jonesw for haematemesis over the period 1915 - 45 at the Central Middlesex Hospital are in agreement. The percentage of male admissions for haematemesis, who were over 40 yrs. of age, rose from 16% in 1915 to 50% in 1945. In view of these facts one would expect that the actual incidence of haematemesis and melaena would be on the increase and an examination of the number of admissions over the past 14 yrs. to a medical unit in the Glasgow Royal Infirmary does bear this out. Considering only the cases of chronic ulcer of both sexes, and grouping the figures into 3 yr. periods in order to obtain numbers large enough to be significant, the following chart may be prepared.

Item Type: Thesis (PhD)
Qualification Level: Doctoral
Keywords: Medicine
Date of Award: 1949
Depositing User: Enlighten Team
Unique ID: glathesis:1949-79780
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 31 Mar 2020 09:09
Last Modified: 31 Mar 2020 09:09

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