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Biomedical subjects

B Pritchard

Publications and source records attributed to B Pritchard.

6 recordsLinked to original sources

An unusual transcapitate fracture of the wrist.

A patient sustained a crush-type hyperextension injury to his wrist, and presented to the emergency department (ED) with wrist pain, swelling, and paresthesias along the median and superficial radial nerve distributions. His initial radiographic study was interpreted as showing a radial styloid fracture. The next day, he returned for a scheduled revisit with continued wrist pain and swelling. He also had loss of two-point discrimination in the median nerve distribution and loss of thumb opposition. Repeat radiographs were interpreted as showing not only a radial styloid fracture, but also a fracture of the capitate with the proximal fragment rotated 180 degrees in the sagittal plane. The patient was admitted for surgery, and did well, with good return of function. The unusual position of the capitate fracture obscured the common signs of fracture recognition and thus went unnoticed on the patient's initial ED visit. However, in light of the patient's disproportionate symptoms with seemingly negative diagnostic study results, appropriate follow-up care was given, and definitive treatment was appropriately rendered.

Adult↗

Transthoracic defibrillation using sequential and simultaneous dual shock pathways: experimental studies.

Dual pathway sequential DC shocks reduce energy requirements for internal defibrillation. Our purpose was to determine if dual pathway shocks similarly reduce energy requirements or improve shock success in transthoracic (external) defibrillation. We studied 39 closed-chest anesthetized mongrel dogs. The dual pathways used were left chest to right chest and left chest to posterior. In eight dogs we also assessed dual shock pathways oriented orthogonally, left lower chest to right upper chest and left upper chest to right lower chest. Four different dual pathway groups were studied: group 1: simultaneous shocks, sinusoidal waveform; group 2: sequential shocks, sinusoidal waveform, 100-msec shock separation, orthogonal shock pathways; group 3: sequential shocks, sinusoidal waveform, 100 msec shock separation; and group 4: sequential shocks, rectangular waveform (sequential shocks: 2 pulses, 2.5 msec each, 0.1-msec separation; single shock: 1 pulse, 5 msec). Shocks were given at 50 (J) joules, 100 J and 150 J and curves of energy versus success compared for dual pathway shocks versus single shocks. We found that the highest mean success rates (96 +/- SD 9%) were achieved by simultaneous sinusoidal waveform dual pathway shocks at 100 J; this was identical to results achieved by the single pathway sinusoidal waveform comparison shocks at 100 J. Sequential dual pathway sinusoidal shocks separated by 100 msec achieved a mean success rate of 79 +/- 31% at 150 J; the comparison single pathway mean success rate was similar: 81 +/- 22% at 150 J. Thus, dual pathway sequential or simultaneous transthoracic shocks did not demonstrate clear superiority over single pathway shocks.

Animals↗

Umbilical inflammatory conditions: case report and differential diagnosis.

Umbilical inflammatory conditions may result from a variety of congenital and acquired abnormalities, some of which may be life threatening. An understanding of the developmental anatomy of the umbilicus provides a basis for formulating an approach to both evaluation and treatment of these conditions. A case report is presented.

Diagnosis, Differential↗

Introducing the pressure support surfaces from Kaymed.

The range of support surfaces available is quite varied. It is important that both the purchaser and the users are satisfied with the quality, comfort and the pressure-reducing properties of the mattress. The mattress needs to be versatile, in that it can be used both in a patient's home or in a hospital or nursing home and also on profiling beds. The Kaymed range of mattresses offers increased comfort with low interface pressures for patients up to and including high risk. This product focus examines the Kaymed mattress and looks at the design and results of tests performed on the visco-elastic foam used in the manufacturing of the mattresses.

Beds↗